title: Validation of a causal model of agitation among institutionalized residents with dementia in Taiwan.
abstract: The aim of this study was to test a causal model of the predictors of agitation among 405 nursing home residents in Taiwan with varying degrees of cognitive impairment. Chart review and behavioral observations were used to assess residents' physical and psychosocial condition. The final version of the model had a good fit. Cognitive function and depression had direct effects on agitation, and pain and functional ability had indirect effects on agitation via depression. Additionally, cognitive function and pain influenced functional ability directly, which in turn influenced depression and ultimately influenced agitation. The results suggest that effective management of agitation in demented residents requires identifying the needs underlying the behavior rather than directly treating the behavior itself.
authors.affiliation: School of Nursing, Mackay Medical College, New Taipei, Taiwan, ROC.
authors.forename: Yi-Heng
authors.initials: YH
authors.lastname: Chen
authors.forename: Li-Chan
authors.initials: LC
authors.lastname: Lin
authors.forename: Kuen-Bao
authors.initials: KB
authors.lastname: Chen
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Liu
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003704:Dementia / Q000453:epidemiology* / Q000451:nursing*; D003866:Depressive Disorder / Q000453:epidemiology; D019468:Disease Management; D005260:Female; D015577:Geriatric Assessment; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D008297:Male; D016294:Models, Nursing; D015233:Models, Statistical; D009735:Nursing Homes / Q000706:statistics & numerical data; D010146:Pain / Q000453:epidemiology; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000453:epidemiology* / Q000517:prevention & control*; D013624:Taiwan / Q000453:epidemiology
keywords: agitation; causal modeling; cognitive function; dementia; depression; pain; path analysis; structural equation modeling