Reliability and Validity of the Resistiveness to Care Scale Among Cognitively Impaired Older Adults.
Elizabeth Galik, Barbara Resnick, Erin Vigne and 2 others
PMID 27776986WHAT IT FOUND
Most nursing home residents with moderate to severe dementia showed no resistiveness to care during a five-minute observation.
Saying no was the most common behavior. The scale worked, but many low scores could not be separated.
Key findings
01186 residents (72%) showed no resistiveness to care, and saying no to care was the most common behavior (43 residents, 16%).
02The scale's reliability was acceptable (0.84), and all items fit the model.
03More cognitive impairment, more functional dependence, and more agitation were associated with more resistiveness to care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All nine nursing homes were in a single state and were similar in size, so the results may not apply to other settings. The frequency of resistiveness to care behaviors was low, and 210 residents were too low for the scale to differentiate. Residents most likely to show resistiveness to care may not have agreed to participate, which could bias the sample. Each resident was observed for only five minutes, so behaviors during other care episodes may have been missed. Function was reported by a proxy, so it may reflect what staff did for the resident rather than what the resident could do. The study tested a measurement scale, and it did not test whether using the scale changes care or reduces adverse outcomes.
Declared interests
The authors reported no conflicts of interest. The paper is listed as supported by N.I.H. extramural research.
The easy way to misread this
Do not conclude that a low score means a resident has no resistiveness to care. In this study, 186 residents (72%) had no evidence of resistiveness to care during a five-minute observation, and 210 residents were so low that the scale could not differentiate them.