Factors associated with aggressive behavior among nursing home residents with dementia.
Factors associated with aggressive behavior among nursing home residents with dementia.
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与痴呆症疗养院居民的攻击行为相关的因素。
DOI：
10.1093/geront/48.6.721
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发表时间：
2008
期刊：
影响因子：
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通讯作者：
Beck,Cornelia
中科院分区：
文献类型：
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作者：
Whall,AnnL;Colling,KathleenB;Kolanowski,Ann;Kim,HyoJeong;SonHong,Gwi-Ryung;DeCicco,Barry;Ronis,DavidL;Richards,KathyC;Algase,Donna;Beck,Cornelia
目的：在试图更彻底地描述侵略性行为在养老院居民痴呆症，我们检查了背景和近端因素的指导下，需求驱动的痴呆症，妥协的behaviormodel.Design和方法：我们采用了多变量横断面调查，重复测量;参与者居住在9个随机选择的养老院在四个中西部县。最小数据集（由护理人员进行验证）确定了参与者。我们使用了107名参与者（51%有攻击行为史）的不成比例的概率样本来确保可变性。录像护理活动包括四个直接护理（淋浴，用餐，穿衣和脱衣）和两个非直接护理（下午和晚上两个随机选择的20分钟时间段）。大多数参与者（75%）接受了三次淋浴，共282录像baths.Results：因为淋浴是唯一的护理事件显着相关的攻击行为（F= 6.9，p <0.001），只有这些数据。多水平统计模型确定了背景因素（性别，精神状态评分和终身不愉快史）和近端因素（夜间睡眠量）作为淋浴期间攻击行为的重要预测因素（p<0.05）。我们发现，在洗澡时，攻击性行为和消极的主体情感（r= 0.27）之间存在显著相关性，攻击性行为和终身宜人性水平（r=-0.192）之间存在显著相关性。我们还发现了显着的相关性之间的精神状态和教育的量（r=.212），负性照顾者的影响和负性参与者的影响（r=.321）。影响：我们确定了三个背景和一个近端因素为显着的危险因素，在痴呆症的攻击行为。数据不仅确定了那些在护理过程中最有攻击性行为风险的人，而且还确定了与攻击性行为最相关的护理事件。这些数据共同为痴呆症患者的康复以及痴呆症攻击行为干预研究的设计提供了信息。
Purpose:In an attempt to more thoroughly describe aggressive behavior in nursing home residents with dementia, we examined background and proximal factors as guided by the Need-Driven Dementia-Compromised Behavior model.Design and Methods:We used a multivariate cross-sectional survey with repeated measures; participants resided in nine randomly selected nursing homes within four midwestern counties. The Minimum Data Set (with verification by caregivers) identified participants. We used a disproportionate probability sample of 107 participants (51% with a history of aggressive behavior) to ensure variability. Videotaped care events included four of direct care (shower baths, meals, dressing, and undressing) and two of nondirect care (two randomly selected 20-minute time periods in the afternoon and evening). The majority of participants (75%) received three shower baths, for a total of 282 videotaped baths.Results:Because the shower bath was the only care event significantly related to aggressive behavior (F= 6.9,p<.001), only those data are presented. Multilevel statistical modeling identified background factors (gender, mental status score, and lifelong history of less agreeableness) and a proximal factor (amount of nighttime sleep) as significant predictors (p<.05) of aggressive behavior during the shower bath. We found significant correlations between aggressive behavior and negative subject affect (r=.27) during the bath, and aggressive behavior and lifetime agreeableness level (r= −.192). We also found significant correlations between mental status and the amount of education (r=.212), and between negative caregiver affect and negative participant affect (r=.321).Implications:We identified three background and one proximal factor as significant risk factors for aggressive behavior in dementia. Data identify not only those persons most at risk for aggressive behavior during care, but also the care event most associated with aggressive behavior. Together these data inform both caregiving for persons with dementia as well as the design of intervention studies for aggressive behavior in dementia.