Overview and inter-rater reliability of an incident-based rating scale for aggressive behaviour following traumatic brain injury: The Overt Aggression Scale-Modified for Neurorehabilitation-Extended (OAS-MNR-E).
OBJECTIVE
The presentation and evaluation of the Overt Aggression Scale-Modified for Neurorehabilitation-Extended (OAS-MNR-E).


METHODS
Inter-rater reliability study using data collection procedures mirroring clinical practice.


METHODS
Fifteen clinical staff representing five different disciplines received a 30-minute orientation to the study and a 30-minute overview of the OAS-MNR-E. There were 34 patients who engaged in a rateable behaviour and were observed by two raters. There were 199 observed aggressive behaviours during the 6-week study period.


RESULTS
All sub-scales of the OAS-MNR-E had high percentage agreement (>92%) and the kappa statistic was uniformly excellent (>0.77). Multiple ratings within a sub-scale resulted in lower reliabilities. Incidents with multiple interventions were of longer duration. Interventions were on average more intrusive when used in combination than when used singly.


CONCLUSIONS
The OAS-MNR-E can be easily incorporated into facility routines and is reliable. The rating tool reported here can provide data that assists in programme design, evaluation and treatment planning.
Giles
Gordon Muir
GM
Idylwood Care Center, Samuel Merritt College, Oakland, CA 94609, USA. ggiles@samuelmerritt.edu
Mohr
James D
JD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation*; D008875:Middle Aged; D015588:Observer Variation; D011594:Psychometrics; D015203:Reproducibility of Results