Factors Associated With Aggressive Behavior Among Nursing Home Residents With Dementia

被引:53
作者
Whall, Ann L. [1 ,2 ]
Colling, Kathleen B. [1 ]
Kolanowski, Ann [3 ]
Kim, Hyo Jeong [4 ]
Hong, Gwi-Ryung Son [5 ]
DeCicco, Barry [6 ]
Ronis, David L. [1 ,7 ]
Richards, Kathy C. [8 ]
Algase, Donna [1 ]
Beck, Cornelia [9 ]
机构
[1] Univ Michigan, Sch Nursing, Ann Arbor, MI 48109 USA
[2] Oakland Univ, Sch Nursing, Rochester, MI 48063 USA
[3] Penn State Univ, Sch Nursing, University Pk, PA 16802 USA
[4] Ewha Womans Univ, Coll Nursing Sci, Seoul, South Korea
[5] Hanyang Univ, Coll Med, Seoul 133791, South Korea
[6] Univ Michigan, Hosp & Hlth Ctr, Ann Arbor, MI 48109 USA
[7] US Dept Vet Affairs, Ann Arbor, MI USA
[8] Univ Penn, Polisher Res Inst, Philadelphia, PA 19104 USA
[9] Univ Arkansas, Med Sci Coll Med, Fayetteville, AR 72701 USA
关键词
Aggression in dementia; Need-Driven Dementia-Compromised Behavior (NDB) model of; dementia care; Nursing home care;
D O I
10.1093/geront/48.6.721
中图分类号
R4 [临床医学]; R592 [老年病学];
学科分类号
1002 ; 100203 ; 100602 ;
摘要
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 non-direct 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 care-giver 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.
引用
收藏
页码:721 / 731
页数:11
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