Assessment by nurses of mood, general behaviour and functional ability in patients with dementia receiving nursing home care

The aim of this study was to investigate the reliability of the Patient Moo d Assessment Scale (PMAS), the General Behaviour Assessment Scale (GBAS) an d the Gottfries Brane Steen scale and to investigate mood, general behaviou r, degree of dementia and symptoms for patients with dementia living perman ently in nursing home care (n = 75). Interviews were conducted with the con tact nurses, focussing on their view of the patients during the preceding w eek, based on the above-mentioned assessment scales. In 29 cases a second i nterview was conducted with another nurse in order to investigate the inter -rater reliability. The inter-rater reliability was high for items associat ed with ADL and intellectual functions, but low for items associated with e motional aspects. The nurses' difficulties in assessing the patients' emoti onal state could arise because these matters are not regularly discussed am ong the staff or could reflect the nurse's inner state rather than that of the patient. The varying understanding that the nurses had of the patients raises the question of whether the care provided is based on the nurses' op inions rather than on the patients' needs. There is a need for continuous a nd reflective discussions in the staff group, focusing on the patients' phy sical as well as emotional needs.