Validation of a Causal Model of Agitation Among Institutionalized Residents With Dementia in Taiwan

Chen, Yiheng; Lin, Li‐Chan; Chen, Kuen‐Bao; Liu, Yucheng

doi:10.1002/nur.21573

Cited by 6 publications

(18 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…That is, enhanced ADL performance indirectly mitigates agitated behaviours by improving cognitive function and reducing depression. This result is similar to the findings reported by Chen, Lin, Chen, and Liu (), in which ADL could indirectly improve agitation by improving depression.…”

Section: Discussionsupporting

confidence: 92%

Modelling factors of urinary incontinence in institutional older adults with dementia

Chen

Hsu

2019

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and Objectives This study applied structural equation modelling to explore the relationships among agitated behaviours, depression, cognitive function and activities of daily living, as well as associations between these factors and urinary incontinence). Background A high prevalence of urinary incontinence is found among institutional older adults with dementia. People with urinary incontinence suffer from increased financial burden and social isolation and experience reduced quality of life. Design Cross‐sectional correlational research. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Methods In total, 226 older adults with dementia were recruited through convenience sampling at 15 long‐term care facilities in southern Taiwan. The urinary incontinence frequency, agitated behaviours, depression, cognitive function and activities of daily living were evaluated using bladder records, the Cohen‐Mansfield Agitation Inventory, the Cornell Scale for Depression in Dementia, the Mini‐Mental State Examination and the Barthel Index, respectively. Results Activities of daily living performance was found to be significantly associated with urinary incontinence; however, age, cognitive function, depression and agitated behaviours were not significantly related to urinary incontinence. Age did not have effects on any of the variables tested in this model, whereas activities of daily living performance was significantly associated with cognitive function and depression. Results further showed that cognitive function and depression were mediators between activities of daily living and agitated behaviours. Conclusion Enhanced activities of daily living independency directly reduced urinary incontinence, improved cognitive function, decreased degrees of depression and indirectly reduced agitated behaviours. Relevance to clinical practice The findings could serve as a valuable reference for long‐term care facilities in providing effective urinary incontinence care and prevention to older adults with dementia.

show abstract

Section: Discussionsupporting

confidence: 92%

Modelling factors of urinary incontinence in institutional older adults with dementia

Chen

Hsu

2019

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…This can be supported by Miu and Chan (2014) who found that 15% of the patients who had pain also had the presence of depression compared to 8.4% of the patients without pain. Furthermore Chen et al (2014) found a direct association between depression and agitation, and pain was identified to affect agitation via depression. This suggests that pain, depression and agitation could be connected and this would need to be considered when assessing patients, also that further research needs to be undertaken to see the links between depression and pain and agitation.…”

Section: Pain and Behaviourmentioning

confidence: 96%

“…Three of the papers (Miu and Chan 2014;Chen et al 2014;Husebo et al 2014) looked at whether pain was associated with depression and agitation, and discovered an association between pain agitation and depression. Husebo et al (2014) considered if pain treatment affected mood in patients with dementia.…”

Section: Pain and Behaviourmentioning

confidence: 99%

“…Ahn and Horgas (2013) and Ahn et al (2015) took their data from the MDS where various aspects of agitation are assessed, including verbal aggression, physical aggression, socially inappropriate, resisting care, restlessness and repetitive physical movement. Chen et al (2014), Husebo et al (2014) and Habiger et al (2016) used the validated Cohen-Mansfield Agitation Inventory (CMAI) that contains observations of 29 agitated behaviours over a week. Miu and Chan (2014) however did not use a tool for behaviour, however observations identified whether behaviours such as, verbal disruption, physical aggression and wandering were present or not.…”

Section: Assessment Toolsmentioning

confidence: 99%

See 1 more Smart Citation

Pain and agitation in dementia: a review of the literature

Richardson

Board

2018

Nursing and Residential Care

View full text Add to dashboard Cite

-Between 30-60% of residents of nursing homes with late stage dementia suffer with pain daily and this is thought to be due to the inability to communicate their needs. The purpose of this literature review is to analyse research to identify if there are links between pain and agitation. Three themes emerged when analysing the papers in relation to links with pain and agitation: -behavioural change that could be associated with pain, undertreating of pain and pain assessment tools. Drawing upon the findings it can be suggested that pain could be a factor that is associated with agitated behaviour, however, there needs to be further research that determines cause and effect.

show abstract

“…The use of SEM (and other related causal analysis approaches) is rapidly expanding in epidemiology [ 9 , 16 ]. Emerging areas particularly include occupational exposure assessment [ 17 ], multiple determinants of single disease exposures [ 18 , 19 ], behavioral studies linked to disease [ 20 ], environmental determinants of disease [ 21 ], and non-transmissible diseases [ 22 ]. The application of SEM to study co-infection remains rare [ 23 – 25 ], but can be used to examine relationships among measured variables (pathogens) without requiring a priori knowledge of pathogen exposure order.…”

Section: Introductionmentioning

confidence: 99%

Closing the gap on causal processes of infection risk from cross-sectional data: structural equation models to understand infection and co-infection

et al. 2015

View full text Add to dashboard Cite

BackgroundEpidemiological studies of disease exposure risk are frequently based on observational, cross-sectional data, and use statistical approaches as crucial tools for formalising causal processes and making predictions of exposure risks. However, an acknowledged limitation of traditional models is that the inferred relationships are correlational, cannot easily distinguish direct from indirect determinants of disease risk, and are often considerable simplifications of complex interrelationships. This may be particularly important when attempting to infer causality in patterns of co-infection through pathogen-facilitation.MethodsWe describe analyses of cross-sectional data using structural equation models (SEMs), a contemporary advancement on traditional regression approaches, based on our study system of feline gammaherpesvirus (FcaGHV1) in domestic cats.ResultsSEMs strongly supported a latent (host phenotype) variable associated with FcaGHV1 exposure and co-infection risk, suggesting these individuals are simply more likely to become infected with multiple pathogens. However, indications of pathogen-covariance (potential facilitation) were also variably detected: potentially among FcaGHV1, Bartonella spp and Mycoplasma spp.ConclusionsOur models suggest multiple exposures are primarily driven by host phenotypic traits, such as aggressive male phenotypes, and secondarily by pathogen-pathogen interactions. The results of this study demonstrate the application of SEMs to understanding epidemiological processes using observational data, and could be used more widely as a complementary tool to understand complex cross-sectional information in a wide variety of disciplines.

show abstract

Validation of a Causal Model of Agitation Among Institutionalized Residents With Dementia in Taiwan

Cited by 6 publications

References 55 publications

Modelling factors of urinary incontinence in institutional older adults with dementia

Modelling factors of urinary incontinence in institutional older adults with dementia

Pain and agitation in dementia: a review of the literature

Closing the gap on causal processes of infection risk from cross-sectional data: structural equation models to understand infection and co-infection

Contact Info

Product

Resources

About