CONCORDANCE BETWEEN DIRECT OBSERVATION AND STAFF RATING OF BEHAVIOR IN NURSING-HOME RESIDENTS WITH ALZHEIMERS-DISEASE

This study examined concordance between staff ratings and direct obser vations of behavior in 177 nursing home residents with Alzheimer's dis ease. During a structured interview, the staff member who had the most frequent contact with each resident completed three standardized beha vioral rating scales. Direct observation of behavior (60 observations per resident) was conducted concurrently by trained nonparticipant obs ervers using a structured time-sampling technique. We found moderate a greement between the two sources for the occurrence of 12 target behav iors during the monitoring period, but generally low agreement regardi ng the frequency of these behaviors. Discrepancies regarding occurrenc e of behavior were non-random with a higher rate of detection by direc t observation. Thus, the practical advantages of staff ratings of beha vior in institutional settings may be partly offset by some reduction in the accuracy of enumeration.