Regular ArticlesThe Pittsburgh Agitation Scale: A User‐Friendly Instrument for Rating Agitation in Dementia Patients
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METHODS
The reliability and validity of the PAS were assessed in two separate environments: an acute-care psychogeriatric unit and a chronic-care nursing facility.
Acute Care Geropsychiatry Unit
Reliability: The intraclass correlation for the four nurses using the PAS during their work on the inpatient unit was +0.82 for the PAS Total Score. For the individual items of Aberrant Vocalizations, Motor Agitation, Aggressiveness, and Resisting Care, the intraclass correlations were +0.64, +0.54, +0.63, and +0.88, respectively. Figure 1 illustrates the distribution of total PAS scores recorded for the reliability studies in both the inpatient and nursing home settings.
Validity: Interventions
DISCUSSION
The PAS has been shown to be reliable when used by clinical staff on an acute care geriatric psychiatry unit as well as by trained research staff in a nursing home. The difference in the intraclass correlations between these two settings reflects the intensity of clinical responsibility on the inpatient service, where each observer is assigned to care for 8 to 10 patients, compared to the intensive observation performed by the research technicians in the nursing home. Also, it is important to
PAS Instructions
The Pittsburgh Agitation Scale allows an observer to describe the severity of agitation in four specific behavioral dimensions: Aberrant Vocalizations, Motor Agitation, Aggressiveness, and Resisting Care. The observer uses behavioral anchors to assign the highest possible score within each behavior group. The higher score reflects more agitation.
The behavior dimensions of “aberrant vocalizations” and “motor agitation” are assessed by intensity (loudness or rapidity of movement), disruptiveness
References (16)
- et al.
A new scale for assessing behavioral agitation in dementia
Psychiatry Res
(1992) - et al.
Troublesome and disruptive behaviors in dementia: relationships to diagnosis and disease severity
J Am Geriatr Soc
(1988) Caregiving strain and the desire to institutionalize family members with Alzheimer's disease: possible predictors and model development
Research on Aging
(1985)- et al.
A meta-analysis of controlled trials of neuroleptic treatment in dementia
J Am Geriatr Soc
(1990) - et al.
Non-neuroleptic medications in the management of agitation in Alzheimer's disease and other dementia: a selective review
International Journal of Geriatric Psychiatry
(1991) - et al.
NOSIE-30: a treatment-sensitive ward behavior scale
Psychol Rep
(1966) - et al.
Behavioral symptoms in Alzheimer's disease: phenomenology and treatment
J Clin Psychiatry
(1987) The Sandoz Clinical Assessment-Geriatric (SCAG) Scale: a general-purpose psychogeriatric rating scale
Gerontology
(1983)
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