Rudman D, Alverno L, Mattson D E
Department of Medicine, Medical College of Wisconsin, Milwaukee 53295.
Hosp Community Psychiatry. 1993 Jun;44(6):571-5. doi: 10.1176/ps.44.6.571.
To investigate an apparent difference in the prevalence of physically aggressive behavior in two Veterans Affairs (VA) nursing homes, the authors compared ratings by nurses of residents' assaultive behaviors at the beginning and end of two six-month periods in 1987 and 1991.
The prevalence of assaultive behavior in each of three diagnostic subgroups (neurologic, psychiatric, and medical) at nursing homes A and B was determined using standardized biannual ratings of patients' behavior. Chi square analysis was used to compare prevalence rates and to compare the proportions of nonaggressive patients who were rated as aggressive at the end of each six-month period.
Nursing homes A and B were significantly different in the proportions of patients in the three subgroups; facility A had a greater percentage of neurologic and psychiatric patients, and facility B had a greater percentage of medical patients. Both in 1987 and in 1991, the prevalence of assaultive behavior in nursing home A in all three diagnostic subgroups was higher than that in nursing home B, usually by a statistically significant margin. A significantly higher proportion of nursing home A residents in each subgroup who were rated as nonaggressive at the beginning of the two periods were rated as aggressive at the end of each period.
Further studies are needed to learn whether the substantial difference in assaultive behavior resulted from intrinsic characteristics of the facilities' populations or from the qualities of their environments.
为调查两家退伍军人事务部（VA）疗养院中身体攻击性行为发生率的明显差异，作者比较了护士对1987年和1991年两个六个月期间开始和结束时居民攻击性行为的评分。
使用患者行为的标准化半年评分来确定疗养院A和B中三个诊断亚组（神经科、精神科和内科）中攻击性行为的发生率。采用卡方分析来比较发生率，并比较在每个六个月期间结束时被评为有攻击性的非攻击性患者的比例。
疗养院A和B在三个亚组患者的比例上有显著差异；机构A中神经科和精神科患者的比例更高，机构B中内科患者的比例更高。在1987年和1991年，疗养院A中所有三个诊断亚组的攻击性行为发生率均高于疗养院B，通常在统计学上有显著差异。在两个时期开始时被评为非攻击性的每个亚组中，疗养院A的居民在每个时期结束时被评为有攻击性的比例显著更高。
需要进一步研究以了解攻击性行为的显著差异是由设施人群的内在特征还是其环境质量导致的。
