A brief agitation rating scale (BARS) for nursing home elderly

Area of Science:

• Geriatric Medicine
• Psychiatry
• Nursing Research

Background:

• Agitation is a common and challenging behavior in elderly nursing home residents.
• Accurate and efficient assessment tools are crucial for effective management of agitation.
• The Cohen-Mansfield Agitation Inventory (CMAI) is a comprehensive measure but can be lengthy.

Purpose of the Study:

• To evaluate the effectiveness of a new Brief Agitation Rating Scale (BARS).
• To determine if BARS, derived from the CMAI, offers a reliable and valid alternative for assessing agitation.
• To assess the presence and severity of agitated behaviors in elderly residents.

Main Methods:

• A 10-item Brief Agitation Rating Scale (BARS) was developed from the CMAI.
• The study involved 232 nursing home residents and 40 nursing staff at the Lieberman Geriatric Health Centre.
• Reliability and validity were tested using observational ratings, item-to-total correlations, and comparisons with BEHAVE-AD and BSSAD scales.

Main Results:

• BARS demonstrated good internal consistency reliability across all shifts (.74-.82), comparable to the full CMAI (.86-.91).
• BARS scores showed very high correlations with CMAI total scores (r = .94-.95), explaining approximately 90% of the variance.
• Concurrent validity was supported by significant correlations with established agitation assessment scales (BEHAVE-AD, BSSD).

Conclusions:

• The Brief Agitation Rating Scale (BARS) is a brief, reliable, and valid instrument for assessing agitation in elderly nursing home residents.
• BARS effectively captures the presence and severity of physically aggressive, physically non-aggressive, and verbally agitated behaviors.
• This scale offers a practical tool for routine clinical assessment and management of agitation in geriatric care settings.