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Agitation in Demented Patients in an Acute Care Hospital: Prevalence, Disruptiveness, and Staff Burden

Published online by Cambridge University Press:  10 January 2005

Rosa Sourial
Affiliation:
Departments of Nursing and Quality Management, St. Mary's Hospital, Montreal, Canada
Jane McCusker
Affiliation:
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital, Montreal, Canada Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
Martin Cole
Affiliation:
Department of Psychiatry, St. Mary's Hospital, Montreal, Canada Department of Psychiatry, McGill University, Montreal, Canada
Michal Abrahamowicz
Affiliation:
Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada Division of Clinical Epidemiology, Montreal General Hospital, Montreal, Canada.

Abstract

Background/literature review: The prevalence of agitated behaviors in different populations with dementia is between 24% and 98%. Although agitated behaviors are potentially disruptive, little research attention has been focused on the effects of these behaviors upon nursing staff. The objectives of this study of demented patients in long-term-care beds at an acute care community hospital were to determine the frequency and disruptiveness of agitated behaviors; to investigate the associations of patient characteristics and interventions with the level of agitation; and to explore the burden of these agitated behaviors on nursing staff. Method: The study sample comprised 56 demented patients in the long-term-care unit during the study period. Twenty-seven staff who cared for these patients during three shifts over a 2-week period were interviewed to rate the frequency and disruptiveness of agitated behaviors using the Cohen-Mansfield Agitation Inventory, and the burden of care using a modified version of the Zarit Burden Interview. Data on patient characteristics and interventions extracted from the hospital chart included scores on the Barthel Index and Mini-Mental State Examination, the use of psychotropic medication, and the use of physical restraints. Results: Ninety-five percent of the patients with dementia were reported to have at least one agitated behavior; 75% had at least one moderately disruptive behavior. A small group of six patients (11%) had 17 or more disruptive behaviors. The frequency of most behaviors did not vary significantly by shift. Length of stay on long-term care, Barthel Index score, and the use of psychotropic medications were significantly associated with the number of agitated behaviors. The number of behaviors, their mean frequency, and their mean disruptiveness were all significantly correlated with staff burden. Discussion: The prevalence of agitated behaviors in patients with dementia in long-term-care beds at an acute care hospital is similar to that reported in long-term-care facilities. These behaviors are associated with staff burden.

Type
Articles
Copyright
© 2001 International Psychogeriatric Association

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