Assessing disruptive behavior in older adults: the Disruptive Behavior Scale

The present study developed and tested an instrument to assess the severity of disruptive behavior in geropsychiatric patients. A qualitative analysis of existing instruments and literature was used to develop the 45 items of the Disruptive Behavior Scale (DBS). Disruptive behaviors were weighted using a Q-sort performed by experts in geropsychiatric nursing. Weighted scores were used to predict perceived patient disruptiveness. Nurses providing care served as data collectors. They completed the DBS for each shift across a one-week period for each of the older adults, indicating the frequency of occurrence of each of the 45 behaviors for each hour. Weighting improved the ability to predict perceived patient disruptiveness over other schemes to score disruptive behavior. The DBS provides a measure of patient disruptiveness that takes into account the frequency and impact of individual behaviors. Some items of the DBS were found to be more reliable than others.