Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-26T20:39:31.909Z Has data issue: false hasContentIssue false
  • English
  • Français

Construct validity and internal consistency of the neuropsychiatric inventory – nursing home (NPI-NH) in German nursing homes

Published online by Cambridge University Press:  07 January 2016

Sven Reuther ,
Martin N. Dichter ,
Sabine Bartholomeyczik ,
Johanna Nordheim  and
Margareta Halek
Sven Reuther*
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Stockumer Str. 12, 58453 Witten, Germany School of Nursing Science, Witten/Herdecke University, Stockumer Str. 12, 58453 Witten, Germany
Martin N. Dichter
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Stockumer Str. 12, 58453 Witten, Germany School of Nursing Science, Witten/Herdecke University, Stockumer Str. 12, 58453 Witten, Germany
Sabine Bartholomeyczik
Affiliation:
School of Nursing Science, Witten/Herdecke University, Stockumer Str. 12, 58453 Witten, Germany
Johanna Nordheim
Affiliation:
Institute of Medical Sociology and Rehabilitation Science, Charité-Universitaetsmedizin Berlin, Luisenstr. 13, 10117 Berlin, Germany
Margareta Halek
Affiliation:
German Center for Neurodegenerative Diseases (DZNE), Stockumer Str. 12, 58453 Witten, Germany School of Nursing Science, Witten/Herdecke University, Stockumer Str. 12, 58453 Witten, Germany
*
Correspondence should be addressed to: Sven Reuther, German Center for Neurodegenerative Diseases (DZNE), Stockumer Str. 12, 58453 Witten, Germany. Phone: +49 2302 926-231; Fax: +49 2302 926-239. Email: Sven.Reuther@dzne.de.
Get access

Abstract

Background:

The Neuropsychiatric Inventory (NPI) is one of the most popular and frequently used instruments for assessing so-called challenging behavior in individuals with dementia in research practice. However, no information is available regarding the factor structure of the German version of the Neuropsychiatric Inventory – Nursing Home (NPI-NH). The aim of this study was to evaluate the factor structure (an aspect of construct validity) and internal consistency of the NPI-NH for two different stages of dementia severity in a large German nursing home population.

Methods:

A total of 784 residents with dementia from 40 nursing homes in three studies was included in a secondary data analysis. Principal component analysis (PCA) using an orthogonal rotational procedure (with varimax rotation) was used to evaluate the factor structure of the NPI. Cronbach's α was used to assess the stability of the scale.

Results:

The factors agitation & restless behavior, psychosis, and mood were identified (with factor loading > 0.4 explaining 50% of the variance). The factors showed a moderate internal consistency of 0.55 and 0.68 (Cronbach's α).

Conclusions:

The results show the acceptable factor structure of the NPI for a German population in nursing homes and confirm the results of studies from other countries. The three identified factors appear to be robust over the various stages of dementia severity. The results also support the hypothesis that the NPI-NH can be subdivided into multiple domains.

Keywords

neuropsychiatric behaviordementiavalidityinstrumentpsychometric propertiesnursing homes
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 6 , June 2016 , pp. 1017 - 1027
Copyright
Copyright © International Psychogeriatric Association 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aalten, P. et al. (2003). Behavioral problems in dementia: a factor analysis of the neuropsychiatric inventory. Dementia and Geriatric Cognitive Disorders, 15, 99–105.CrossRefGoogle ScholarPubMed
Amaratunga, D., Cabrera, J. and Shkedy, Z. (2014). Exploration and Analysis of DNA Microarray and Other High-Dimensional Data. Hoboken, NJ: John Wiley & Sons.CrossRefGoogle Scholar
Canevelli, M. et al. (2013). Behavioral and psychological subsyndromes in Alzheimer's disease using the neuropsychiatric inventory. International Journal of Geriatric Psychiatry, 28, 795–803.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Dichter, M., Bartholomeyczik, S., Nordheim, J., Achterberg, W. and Halek, M. (2011). Validity, reliability, and feasibility of a quality of life questionnaire for people with dementia. Zeitschrift für Gerontologie und Geriatrie, 44, 405–410.CrossRefGoogle ScholarPubMed
Dichter, M. N. et al. (2013). Scalability and internal consistency of the German version of the dementia-specific quality of life instrument QUALIDEM in nursing homes - a secondary data analysis. Health and Quality of Life Outcomes, 11, 91.CrossRefGoogle ScholarPubMed
Fischer, T., Kuhlmey, A., Sibbel, R. and Nordheim, J. (2008). Die deutsche fassung der «Serial Trial Intervention»(STI-D) Entwicklung und Testung eines pflegerischen Ansatzes zur Reduktion von herausforderndem Verhalten bei Menschen mit Demenz. Zeitschrift für Gerontopsychologie & Psychiatrie, 21, 199–203.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Gaugler, J. E., Yu, F., Krichbaum, K. and Wyman, J. F. (2009). Predictors of nursing home admission for persons with dementia. Medical Care, 47, 191–198.CrossRefGoogle ScholarPubMed
Lai, C. K. (2014). The merits and problems of neuropsychiatric inventory as an assessment tool in people with dementia and other neurological disorders. Clinical Interventions in Aging, 9, 1051–1061.CrossRefGoogle ScholarPubMed
Lange, R. T., Hopp, G. A. and Kang, N. (2004). Psychometric properties and factor structure of the neuropsychiatric inventory nursing home version in an elderly neuropsychiatric population. International journal of Geriatric Psychiatry, 19, 440–448.CrossRefGoogle Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Lyketsos, C. G. et al. (2011). Neuropsychiatric symptoms in Alzheimer's disease. Alzheimers & Dementia, 7, 532–539.CrossRefGoogle ScholarPubMed
Mapi Research Trust (2006). Neuropsychiatric inventory: nursing home version (Swiss German version) [Neuropsychiatrisches Inventar: Version Pflegeheim (Swiss German version of the NPI-NH]. Lyon.Google Scholar
Mokkink, L. B. et al. (2010). The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. Journal of Clinical Epidemiology, 63, 737–745.CrossRefGoogle ScholarPubMed
Moniz-Cook, E., Vernooij-Dassen, M., Woods, B. and Orrell, M. (2011). Psychosocial interventions in dementia care research: the INTERDEM manifesto. Aging & Mental Health, 15, 283–290.CrossRefGoogle ScholarPubMed
Petrovic, M. et al. (2007). Clustering of behavioural and psychological symptoms in dementia (BPSD): a European Alzheimer's disease consortium (EADC) study. Acta Clinica Belgica, 62, 426–432.CrossRefGoogle ScholarPubMed
Polit, D. F. (2014). Statistics and Data Analysis for Nursing Research. Upper Saddle River, NJ: Prentice Hall.Google Scholar
Reisberg, B. (1988). Functional assessment staging (FAST). Psychopharmacology Bulletin, 24, 653–659.Google Scholar
Reisberg, B. (2007). Global measures: utility in defining and measuring treatment response in dementia. International Psychogeriatrics, 19, 421–456.CrossRefGoogle ScholarPubMed
Reuther, S. et al. (2014). Effect evaluation of two types of dementia-specific case conferences in German nursing homes (FallDem) using a stepped-wedge design: study protocol for a randomized controlled trial. Trials, 15, 319.CrossRefGoogle Scholar
Robert, P. H. et al. (2005). Grouping for behavioral and psychological symptoms in dementia: clinical and biological aspects. Consensus paper of the European Alzheimer disease consortium. European Psychiatry, 20, 490–496.CrossRefGoogle ScholarPubMed
Schmidt, S. G., Dichter, M. N., Palm, R. and Hasselhorn, H. M. (2012). Distress experienced by nurses in response to the challenging behaviour of residents - evidence from German nursing homes. Journal of Clinical Nursing, 21, 3134–3142.CrossRefGoogle Scholar
Selbaek, G. and Engedal, K. (2012). Stability of the factor structure of the neuropsychiatric inventory in a 31-month follow-up study of a large sample of nursing-home patients with dementia. International Psychogeriatrics, 24, 62–73.CrossRefGoogle Scholar
Swart, E. et al. (2015). Good practice of secondary data analysis (GPS): guidelines and recommendations. Gesundheitswesen, 77, 120–126.Google ScholarPubMed
van der Linde, R. M., Dening, T., Matthews, F. E. and Brayne, C. (2014). Grouping of behavioural and psychological symptoms of dementia. International Journal of Geriatric Psychiatry, 29, 562–568.CrossRefGoogle ScholarPubMed
van der Steen, J. T. et al. (2008). Benefits and pitfalls of pooling datasets from comparable observational studies: combining US and Dutch nursing home studies. Palliative Medicine, 22, 750–759.CrossRefGoogle ScholarPubMed
Wetzels, R., Zuidema, S., Jansen, I., Verhey, F. and Koopmans, R. (2010). Course of neuropsychiatric symptoms in residents with dementia in long-term care institutions: a systematic review. International Psychogeriatrics, 22, 1040–1053.CrossRefGoogle ScholarPubMed
Whall, A. L. and Kolanowski, A. M. (2004). The need-driven dementia-compromised behavior model– a framework for understanding the behavioral symptoms of dementia. Aging & Mental Health, 8, 106–108.CrossRefGoogle Scholar
Zuidema, S. U. et al. (2011). Assessing neuropsychiatric symptoms in nursing home patients with dementia: reliability and reliable change index of the neuropsychiatric inventory and the cohen-mansfield agitation inventory. International Journal of Geriatric Psychiatry, 26, 127–134.CrossRefGoogle ScholarPubMed
Zuidema, S. U., de Jonghe, J. F., Verhey, F. R. and Koopmans, R. T. (2007a). Agitation in dutch institutionalized patients with dementia: factor analysis of the dutch version of the cohen-mansfield agitation inventory. Dementia and Geriatric Cognitive Disorders, 23, 35–41.CrossRefGoogle ScholarPubMed
Zuidema, S. U., de Jonghe, J. F., Verhey, F. R. and Koopmans, R. T. (2007b). Neuropsychiatric symptoms in nursing home patients: factor structure invariance of the dutch nursing home version of the neuropsychiatric inventory in different stages of dementia. Dementia and Geriatric Cognitive Disorders, 24, 169–176.CrossRefGoogle ScholarPubMed