Revising the Resistiveness to Care Scale.

Area of Science:

• Gerontology
• Nursing
• Psychometrics

Background:

• Dementia often leads to resistance to care, complicating essential health practices like oral hygiene.
• Quantifying this care-resistant behavior is crucial for developing effective interventions.

Purpose of the Study:

• To describe the modification and validation of the Resistiveness to Care Scale for Dementia of the Alzheimer's Type.
• To assess the reliability and clinical validity of the revised scale (RTC-r) in persons with dementia.

Main Methods:

• The original scale was revised and pilot tested.
• The revised instrument (RTC-r) was administered in 7 facilities with 83 residents.
• Systematic training ensured inter-rater reliability for mouth care observations.

Main Results:

• Inter-rater reliability for the RTC-r ranged from 0.87 to 1.0 across 2,328 observations.
• Clinical validity was confirmed in pilot and interventional studies.
• The scale demonstrated strong reliability in measuring resistance to care.

Conclusions:

• The revised Resistiveness to Care Scale for Dementia of the Alzheimer's Type (RTC-r) is a valid and reliable instrument.
• The RTC-r accurately measures care-resistant behaviors in individuals with dementia.