Zuidema Sytse U, de Jonghe Jos F M, Verhey Frans R J, Koopmans Raymond T C M
Department of Nursing Home Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Dement Geriatr Cogn Disord. 2007;23(1):35-41. doi: 10.1159/000096681. Epub 2006 Oct 31.
BACKGROUND/AIMS: To establish the construct validity of the Dutch version of the Cohen-Mansfield Agitation Inventory (CMAI-D) in institutionalized patients with dementia.
The CMAI-D was administered to a large sample of 1,437 patients with moderate to severe dementia, receiving nursing home or outreaching nursing home care. Exploratory factor analysis was used to examine the behavioral dimensions underlying CMAI-D observations.
A restricted 3-factor solution showed 3 factors, i.e. physical aggression, physically nonaggressive behavior and verbally agitated behavior, with prevalences of 62, 67 and 62%, respectively. An unrestricted factor solution revealed 3 additional behavioral dimensions: hiding/hoarding, vocal agitation and a factor of miscellaneous items (i.e. repetitious mannerisms, spitting), which occurred in 30, 28 and 35% of the patients, respectively.
The 3-factor solution of physical aggression, physically nonaggressive behavior and verbally agitated behavior corroborates earlier findings in other patient samples and therefore establishes the construct validity in institutionalized patients with severe dementia. The robustness of these findings across different care settings suggests that agitated behaviors have a common basis. In addition, unrestricted factor analysis showed 3 other important independent behavioral symptoms in dementia, but they are in fact too small to be used as a subscale. These findings might add to the taxonomy of agitation and aggression in dementia.
背景/目的：在患有痴呆症的机构化患者中建立荷兰版科恩-曼斯菲尔德激越量表（CMAI-D）的结构效度。
对1437名中重度痴呆患者的大样本进行CMAI-D评估，这些患者接受养老院或院外护理服务。采用探索性因素分析来检验CMAI-D观察结果背后的行为维度。
一个受限的三因素解决方案显示出三个因素，即身体攻击、非身体攻击行为和言语激越行为，其发生率分别为62%、67%和62%。一个不受限的因素解决方案揭示了另外三个行为维度：隐藏/囤积、声音激越和一个杂项因素（即重复的习惯动作、吐痰），分别出现在30%、28%和35%的患者中。
身体攻击、非身体攻击行为和言语激越行为的三因素解决方案证实了在其他患者样本中的早期发现，因此确立了在患有重度痴呆的机构化患者中的结构效度。这些发现在不同护理环境中的稳健性表明激越行为有一个共同的基础。此外，不受限的因素分析显示痴呆症中还有其他三个重要的独立行为症状，但实际上它们太小而不能用作子量表。这些发现可能会丰富痴呆症激越和攻击行为的分类学。
