Research Brief

Failure to Identify Behavioral Symptoms of People with Dementia and the Need for Follow-Up Physical Assessment

Christine R. Kovach, PhD, RN, FAAN; Brent R. Logan, PhD; Laura L. Joosse, PhD, RN; Patricia E. Noonan, MSN, GCNS, BC

  • Research in Gerontological Nursing
  • April 2012 - Volume 5 · Issue 2: 89-93
  • DOI: 10.3928/19404921-20110503-01
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Abstract

This descriptively designed study examined the sensitivity and specificity of staff nurses’ identification of behavior change in nursing home residents with dementia. Behavior changes and whether further physical assessment was indicated were described and compared with judgments made by one expert advanced practice nurse. The convenience sample included 155 residents and 38 staff nurses from 11 nursing homes. Verbal symptoms and body part cues were the most prevalent behaviors, regardless of the assessor. Sensitivity, or probability of identifying a real behavior change, was generally low for the staff nurses, ranging from 35% to 65% for the different types of behaviors, while specificity was high at more than 95%. Additional assessment was believed to be needed for 51% of residents by the staff nurse and for 73% of residents by the expert. This study found that staff nurses are under-identifying behavior changes and the need for additional physical assessment.

AUTHORS

Dr. Kovach is Professor and Methods Director, Self-Management Science Center, and Dr. Joosse is Assistant Professor, College of Nursing, University of Wisconsin-Milwaukee, Dr. Logan is Associate Professor, Medical College of Wisconsin, and Ms. Noonan is Gerontological Clinical Nurse Specialist, Columbia St. Mary’s, Milwaukee, Wisconsin.

The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity. This study was funded by the U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Nursing Research grants 5R01NR07765 and 1P20NR010674. Dr. Kovach was not involved in the peer review or decision-making process for this manuscript.

Address correspondence to Christine R. Kovach, PhD, RN, FAAN, Professor and Methods Director, Self-Management Science Center, University of Wisconsin-Milwaukee, Cunningham Hall, 1921 East Hartford Avenue, Milwaukee, WI 53201-0413; e-mail: ckovach@uwm.edu.

Received: December 15, 2009
Accepted: January 5, 2011
Posted: May 18, 2011

doi: 10.3928/19404921-20110503-01

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