title: The Initial Development of a Checklist for Assessing Thirst in Patients With Advanced Dementia.
abstract: BACKGROUND
  Patients with advanced dementia (PwAD) often have difficulty expressing their needs verbally because of cognitive impairments. PwAD thus often communicate these needs through behaviors and psychological symptoms. Understanding the behavioral characteristics of certain needs is critical for caregivers and clinicians when caring for PwAD.
  
  
  OBJECTIVE
  The purpose of this study was to develop a checklist that may be used to assess the thirst status of PwAD.
  
  
  METHODS
  A mixed method design was used. The checklist was developed using qualitative interviews and surveys. The initial items were developed through interviews with 10 professional nurses who were caring for PwAD. Four experts in dementia assessed the content validity of these items. PwAD caregivers from eight facilities were then invited to complete the checklist based on their current PwAD patient care experience. Data obtained in this study were analyzed with regard to content validity, interrater reliability, internal consistency, and exploratory factor analysis.
  
  
  RESULTS
  The content validity of the initial 18 items was .96, interrater reliability was -.33 to 1, and internal consistency reliability was .52. Exploratory factor analysis identified seven checklist items, including repetitive movements, squirming, restlessness or anxiety, persistent or unreasonable demands, pacing back and forth, repeating a sentence or question without purpose, and slow reaction. The factor loadings of these seven items accounted for 49.3% of the total variance. The reassessed internal consistency reliability was .66.
  
  
  CONCLUSIONS
  Caregivers may use this checklist as an aid to identify the thirst or fluid needs of PwAD who are unable to communicate their needs effectively.
authors.affiliation: 1MS, RN, Doctoral Candidate, Institute of Allied Health Science, College of Medicine, National Cheng Kung University and Assistant Professor, Department of nursing, Chang Jung Christian University 2PhD, RN, Associate Professor, Department of Nursing, College of Medicine, National Cheng Kung University 3PhD, RN, Professor, Department of Nursing and Institute of Allied Health Science, College of Medicine, National Cheng Kung University.
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Yang
authors.forename: Chi-Jane
authors.initials: CJ
authors.lastname: Wang
authors.forename: Jing-Jy
authors.initials: JJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057189:Checklist; D003704:Dementia / Q000150:complications* / Q000451:nursing*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011568:Psychiatric Nursing / Q000592:standards*; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000592:standards*; D013894:Thirst / Q000502:physiology*