A COMPARISON OF PHYSICALLY AGGRESSIVE-BEHAVIOR IN 2 VA NURSING-HOMES

Objective: To investigate an apparent difference in the prevalence of physically aggressive behavior in two Veterans Affairs (VA) nursing ho mes, the authors compared ratings by nurses of residents' assaultive b ehaviors at the beginning and end of two six-month periods in 1987 and 1991. Methods. The prevalence of assaultive behavior in each of three diagnostic subgroups (neurologic, psychiatric, and medical) at nursin g homes A and B was determined using standarized biannual ratings of p atients' behavior. Chi square analysis was used to compare prevalence rates and to compare the proportions of nonaggressive patients who wer e rated as aggressive at the end of each six-month period. Results: Nu rsing 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 p ercentage of medical patients, Both in 1987 and in 1991, the prevalenc e of assaultive behavior in nursing home A in all three diagnostic sub groups was higher than that in nursing home B, usually by a statistica lly significant margin, A significantly higher proportion of nursing h ome A residents in each subgroup who were rated as nonaggressive at th e beginning of the two periods were rated as aggressive at the end of each period. Conclusions: Further studies are needed to learn whether the substantial difference in assaultive behavior resulted from intrin sic characteristics of the facilities' populations or from the qualiti es of their environments.