A New Behavioral Assessment Scale for Geriatric Out‐ and In‐Patients: the NOSGER (Nurses' Observation Scale for Geriatric Patients)

Abstract

Although a great number of psychometric tests and rating scales for the assessment of psychogeriatric patients is available, there is still an urgent need, in research and practice, for a clinical rating instrument that meets the following main requirements: (1) applicable to institutionalized and community patients and covering a wide range of behavioral pathology; (2) acceptable and easy to use for professionals and lay persons alike; (3) covering a wide range of behavior relevant to daily functioning but independent of sex or social status of the individual assessed. The NOSGER contains 30 items of behavior, each rated on a 5-point scale according to frequency of occurrence. Item scores are summarized into 6 Dimension scores (memory, instrumental activities of daily life, self-care, mood, social behavior, and disturbing behavior) which are clinically relevant in dementia, depression, and other psychiatric disorders of old age. Validation studies with a preliminary version of the NOSGER indicated good acceptance of the scale, high inter-rater and test-retest reliability, and high correlations of all NOSGER Dimension scores with results of a variety of established assessment instruments. The NOSGER is currently being used in a number of European and North American centers and should turn out to be a useful instrument for longitudinal studies in psychogeriatrics.

A systematic review of the relationship between behavioral and psychological symptoms (BPSD) and caregiver well-being

“…Two studies consistently had the highest mean distress rating across each of the behavior domains: Balieiro et al (2010) and Tan et al (2005). Both of these studies were clinic-based, higher distress ratings would be expected as those experiencing more BPSD might be more likely to attend a clinic, as, indeed, were the majority of studies included in the meta-analysis.…”

“…Both of these studies were clinic-based, higher distress ratings would be expected as those experiencing more BPSD might be more likely to attend a clinic, as, indeed, were the majority of studies included in the meta-analysis. It may be possible that dementia severity is an explanation, since participants in the studies with the highest distress scores (Tan et al, 2005;Balieiro et al, 2010) had moderate and severe dementia respectively, whereas Baiyewu et al (2003), who consistently reported the lowest distress scores across each of the behavior domains, included participants with mild dementia. However, both Aarsland et al (2007) and de Vugt et al (2006) reported lower mean distress scores in comparison with the other included studies, and they both included participants with moderate dementia.…”

“…Using the BEHAVE-AD (Reisberg et al, 1982) and the NOSGER (Spiegel et al, 1991) mood, social behaviors, and disturbing behaviors were found to have a significant moderate association with burden but no significant correlations with depression in caregivers. Chiu et al (2014) noted that all of the behaviors on the NPI significantly predicted sleep disturbance in caregivers other than anxiety and aberrant motor behavior.…”

“…BPSD are described as a major source of distress for the caregiver (Craig et al, 2005;Tan et al, 2005;Bandeira et al, 2007) and are composed of wide-ranging symptoms such as agitation, aggression, calling out repeatedly, sleep disturbance, wandering, and apathy. The majority of past research which has investigated the empirical relationship between BPSD and poor caregiver outcomes has used summative BPSD scores; therefore, it remains unclear as to whether specific individual symptoms impact caregivers differentially (Mohamed et al, 2010;Rocca et al, 2010).…”

Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations

“…These are the Neuropsychiatric Inventory (NPI), 236 Brief Psychiatric Rating Scale (BPRS), 229 Alzheimer's Disease Assessment Scale-Non Cognitive scale (ADAS-Noncog), 174 CERAD's Behavioural Rating Scale for Dementia, 231 the Revised Memory and Behaviour Problems Checklist, 247 Dysfunctional Behaviour Rating Instrument, 234 Behavioural Pathology in Alzheimer's Disease (BEHAVE-AD), 450 Nurses' Observation Scale for Geriatric Patients 243 and Plutchik Geriatric Rating Scale. 246 …”