title: Aggressive Behaviour Risk Assessment Tool for newly admitted residents of long-term care homes.
abstract: OBJECTIVE
  The aim of this study was to revise the 10-item Aggressive Behaviour Risk Assessment Tool for predicting aggressive events among residents newly admitted to long-term care homes.
  
  
  BACKGROUND
  The original tool had acceptable sensitivity and specificity for identifying potentially aggressive patients in acute care medical-surgical units, but its usefulness in long-term care homes is unknown.
  
  
  METHODS
  A retrospective cohort study design was used.
  
  
  METHODS
  All residents admitted to 25 long-term care homes in western Canada were assessed for the risk of aggression using the original tool within 24 hours of admission from January 2014 - December 2014 (n = 724). Incident reports of aggressive events occurring within 30 days of admission were collected. Multiple logistic regression and receiver operating characteristics analyses were performed.
  
  
  RESULTS
  Fifty-three residents of 724 exhibited aggressive behaviours. The demographic variable of age less than 85 years was found to be a positive predictor of aggressive events in multivariate logistic regression model and was added to the tool. The revised six-item Aggressive Behaviour Risk Assessment Tool for Long-Term Care consists of one new item, age less than 85 years and five items from the original tool: History of physical aggression, physically aggressive/threatening, anxiety, confusion/cognitive impairment and threatening to leave. The receiver operating characteristics of the revised tool with weighted scoring showed a good discriminant ability with satisfactory sensitivity and specificity at the recommended cut-off score of 4.
  
  
  CONCLUSIONS
  The revised six-item tool may be useful in identifying potentially aggressive residents newly admitted to long-term care homes.
authors.affiliation: St. David's School of Nursing, Texas State University, Round Rock, Texas, USA.
authors.forename: Son Chae
authors.identifier: http://orcid.org/0000-0001-8709-3948
authors.initials: SC
authors.lastname: Kim
authors.affiliation: Extendicare (Canada) Inc., Unit 227, Calgary, Alberta, Canada.
authors.forename: Lori
authors.initials: L
authors.lastname: Young
authors.affiliation: Extendicare (Canada) Inc., Unit 227, Calgary, Alberta, Canada.
authors.forename: Brigette
authors.initials: B
authors.lastname: Berry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes / Q000458:organization & administration*; D010343:Patient Admission; D018570:Risk Assessment
keywords: Aggression; instrument development; long-term care; nursing homes; older people; sensitivity; specificity