Disruptive behavior in elderly nursing home residents: a survey of nursing staff.

A significant number of nursing home residents exhibit behavior disturbances that are disruptive to the living and working environment in the nursing home. The most common disruptive behaviors cited by licensed nursing personnel included hitting/slapping, verbally aggressive remarks, screaming, pacing, wandering, and repetitive verbal requests. Self-injurious behavior, property destruction, and hiding things were not mentioned. Many of the nursing strategies listed by nursing staff as being used to alleviate disruptive behaviors are traditional care activities, eg, talking to and counseling patients, touching, or altering care. However, chemical and physical restraints were also frequently listed.

Agitated behavior in the cognitively impaired elderly.

The study of agitation is of interest to caregivers because of potential nursing interventions that could be implemented to prevent or alleviate these behaviors. To ensure an effective plan of care for agitated patients, it is essential that the assessment be based on an objective measurement of the observed agitated behavior. Reliability and validity of the three instruments used to measure agitation were supported; however, none were considered an ideal tool for use with this population because frequently observed behaviors fell into the nonspecific "other" category. Agitated behaviors were highly variable among the subjects in this study; thus, no predictable pattern of occurrence could be established.

Hyperparathyroidism: the overlooked disorder.

Hyperparathyroidism often goes undiagnosed because the early symptoms are very subtle and, if they are noticed, are attributed to old age, depression, or anxiety. The serum calcium level is crucial to the diagnosis. Some of the symptoms of the disorder suggest anxiety or depression, but the overall cluster does not fit DSM-III R or nursing diagnosis criteria. Because hyperparathyroidism requires surgical intervention, nurses can offer assistance by providing emotional support and recommending strategies that will help elderly persons maintain function until the treatment is completed.

Tardive dyskinetic movements over time.

Tardive dyskinetic (TD) movements have been noted to fluctuate in intensity throughout the hours of the day. There have been very few descriptive studies of this fluctuation; the resulting lack of knowledge has made treatment and monitoring procedures for TD problematic. This study sought to describe TD symptom variations across the hours of the day and between days and to relate these variations to control factors. This small study (eight subjects) identified several potentially important variations which need to be further examined in larger studies.

On robust partial discriminant analysis as a decision-making tool with clinical and analytical chemical data.

Classification is one of the fundamental goals of science and is basic to the diagnosis of disease. Unfortunately, classifying objects (e.g., patients) on the basis of clinical and/or laboratory experimental observations into various groups can be difficult when the groups overlap or contain outlying points. Recently, Broffitt, Randles, and co-workers proposed a procedure, robust partial discriminant analysis (RPDA) for dealing with such problems, but testing of the procedure was limited to Monte Carlo simulation. In this study, RPDA was applied to real data, in order to compare its effectiveness with ordinary discriminant analysis, as well as to determine if RPDA was a suitable procedure to use to classify chemical compounds on the basis of experimental observations and as a tool in the diagnosis of disease (in particular, multiple sclerosis and thyrotoxicosis), with data based on experimental and clinical observations. The resulting RPDA classifications were an improvement over those obtained from ordinary discriminant analysis.