The MDS Challenging Behavior Profile for long-term care

Area of Science:

• Gerontology
• Psychiatry
• Nursing Home Care

Background:

• Challenging behaviors are prevalent in nursing home residents.
• Existing assessment tools may lack comprehensive coverage or specific application within the Minimum Data Set (MDS) framework.

Purpose of the Study:

• To construct a reliable and valid challenging behavior scale using items from the MDS.
• To evaluate the psychometric properties of the developed scale.

Main Methods:

• Exploratory factor analyses were conducted on a sample of 656 nursing home residents.
• A 16-item Behavior Profile with four subscales was identified.
• Internal consistency, inter-rater reliability, and validity against the Behavior Rating Scale for Psychogeriatric Inpatients (GIP) were assessed on a separate dataset of 227 residents.

Main Results:

• The 16-item scale demonstrated good internal consistency for its subscales (alpha range: 0.69-0.80 in the first sample, 0.54-0.78 in the second).
• Inter-rater reliability for items was 0.53 (kappa) and for the overall scale was 0.75 (ICC).
• The scale measures conflict, withdrawn, agitation, and attention-seeking behaviors.

Conclusions:

• The MDS Challenging Behavior Profile is a potentially valuable addition to existing MDS clinical scales.
• Further research is necessary to confirm its reliability, validity, and clinical utility.