MCI patients encounter stress-inducing practical, social and psychological difficulties. Based on the current preliminary findings, the key themes for an MCI support-group programme should include the provision of information about the syndrome's causes, course, concomitant symptoms, attributions, social consequences, and available treatments. The impact of receiving an MCI label warrants further investigation.

Background. To assess a patient's cognitive functioning is an important issue because nurses tailor their nursing interventions to the patient's cognitive abilities. Although some observation scales exist concerning one or more cognitive domains, so far, no scale has been available which assesses cognitive functioning in a comprehensive way. Objectives. To develop an observation scale with an accepted level of content validity and which assesses elderly patients' cognitive functioning in a comprehensive way. Methods. Delphi technique, a multidisciplinary panel developed the scale by consensus through four Delphi rounds (>70% agreement). The International Classification of Functioning/ICF was used as theoretical framework. Results. After the first two Delphi rounds, the panel reached consensus about 8 cognitive domains and 17 sub domains. After two other rounds, 39 items were selected, divided over 8 domains and 17 sub domains. Discussion. The Nurses' Observation Scale Cognitive Abilities (NOSCA) was successfully designed. The content validity of the scale is high because the scale sufficiently represents the concept of cognitive functioning: the experts reached a consensus of 70% or higher on all domains and items included; and no domains or items were lacking. As a next step, the psychometric qualities of the NOSCA will have to be tested.

This is the first study that investigated why geriatric nurses make daily observations of their patients' cognitive functioning. In addition, we explored their understanding of the concept of cognitive functioning. Based on the fact that the content of an assessment is determined by its aim, the objectives to perform daily observations have to be clear and stated explicitly. To observe patients in an unambiguous way, it will be necessarily to develop a validated observation scale.

the bathtub, and 572 were in a state of cardiopulmonary arrest, only four of whom were resuscitated. The mortality was higher in women than in men (58% vs 49%, Po.01), although incidence was higher in men than in women (14 vs 9 per 100,000, Po.001). Fatal cases were older than nonfatal ones (77 vs 65, Po .001) and were found more often in colder months than in warmer months (January, 60%, October, 46%, Po.02).The total number of deaths during bathing in Japan for 1999 to 2000 was estimated by adjusting the present result to the stratified national age distribution and using annual data obtained from the Tokyo Metropolitan Medical Examiner's Office, where 22.3% (2,264/10,132) of all unnatural deaths in Tokyo were autopsied (Figure 1). 3 The annual number of deaths during bathing in Japan is estimated to be 14,134. This figure is almost identical to the estimation based on the total number of drowning deaths in Japan (3,205) 1 and the average proportion of drowning deaths to total deaths during bathing between 1990 and 1999 in Tokyo (22%) 4 (3,205/0.22 5 14,568). Because three fourths of the victims were estimated to be aged 65 and older and the number exceeds the total deaths due to traffic accidents, death during bathing is a sociocultural challenge for the aged Japanese society.

Results indicate that an observation scale of memory function may have value for providing information about the underlying memory impairment. The results of nurses' observations may be used in triage contributing to the diagnostic process by selecting patients requiring further neuropsychological assessment.