Using the Nursing Home Behaviour Problem Scale in an Australian residential care setting

Objective: To report on the validity of the Nursing Home Behaviour Problem Scale (NHBPS) in an Australian residential care setting. Method: Cluster randomised controlled trial. As part of this, questionnaires were administered to residential care staff concerning participating residents. The study was carried out in 20 residential care facilities (10 hostels, 10 nursing homes) in metropolitan Adelaide, South Australia. Staff closely associated with the resident's care completed 694 questionnaires. Internal consistency of the scale was examined along with exploratory and confirmatory factor analysis to determine the validity of the NHBPS in the Australian setting. Results: Analyses indicated that four of the 29 questions should be excluded from the Australian version of the NHBPS. Factor analysis demonstrated five factors accounting for 25 of the questions, grouped around behaviours of uncooperative, inappropriate, attention seeking, unsafe, and agitation. Conclusions: There is a need for patient-specific outcome measures, particularly measuring difficult behaviours, for use in residential care settings. Despite the similarities in the prevalence of disturbed behaviours, we were unable to reproduce the six factors reported in the original validation of the instrument, possibly due to differences between the USA and Australia. The results indicate the number of questions should be reduced to 25 in the Australian version of the NHBPS.Maria Crotty, Julie Halbert, Lynne C. Giles, Robert Birks, Kylie Lange and Craig H. Whitehea