title: Patterns of agitated behaviour during acute brain injury rehabilitation.
abstract: OBJECTIVE
  To monitor daily shift-by-shift changes in agitated behaviour during adult brain injury rehabilitation.
  
  
  METHODS
  A prospective, descriptive study.
  
  
  METHODS
  Eight participants were monitored daily for up to 28 days. The Agitated Behaviour Scale (ABS) evaluated behaviour during three nursing shifts (morning, afternoon, night). Severity of agitation, peak intensity and concomitant behaviours were calculated. Shift differences and patterns of behavioural changes were analysed.
  
  
  RESULTS
  Four hundred and seven recordings were taken with the ABS. All participants demonstrated multiple agitated behaviours (between 3-13 concomitant behaviours per person); the most common behaviours were representative of the ABS Disinhibition sub-scale. Weekly peak intensity ranged from 14-55 on the ABS. Mean ABS scores were highest during the afternoon shift and lowest at night. Improved cognition was associated with resolving agitated behaviour; while persistent agitated behaviour was associated with low levels of cognition. Minimal agitated behaviour was observed in participants who emerged from post-traumatic amnesia.
  
  
  CONCLUSIONS
  Agitated behaviour during acute brain injury rehabilitation has a complex clinical presentation. High levels of agitation observed during the afternoon shift may be associated with low levels of structured activities available at that time, higher levels of environmental stimuli during visiting times and increased cognitive fatigue. Lower cognitive ability was related to consistently higher levels of agitated behaviour and vice-versa.
authors: Brain Injury Rehabilitation Service, Westmead Hospital, Wentworthville, NSW, Australia. melissan@biru.wsahs.nsw.gov.au
authors: Melissa T
authors: MT
authors: Nott
authors: Christine
authors: C
authors: Chapparo
authors: Robert
authors: R
authors: Heard
authors: Ian J
authors: IJ
authors: Baguley
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000503:physiopathology / Q000523:psychology*; D012720:Severity of Illness Index; D016896:Treatment Outcome