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@ARTICLE{Schmdderich:155544,
      author       = {Schmüdderich, Kathrin and Holle, Daniela and Ströbel,
                      Armin and Holle, Bernhard and Palm, Rebecca},
      title        = {{R}elationship between the severity of agitation and
                      quality of life in residents with dementia living in
                      {G}erman nursing homes - a secondary data analysis.},
      journal      = {BMC psychiatry},
      volume       = {21},
      number       = {1},
      issn         = {1471-244X},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DZNE-2021-00722},
      pages        = {191},
      year         = {2021},
      abstract     = {Severe agitation and its relation to single dimensions of
                      quality of life are not well understood. The aim of this
                      study was to gain more knowledge about severe agitation and
                      to examine the relationships between the severity of
                      agitation and single dimensions of quality of life among
                      residents with dementia living in German nursing homes.This
                      exploratory secondary analysis included data from 1947
                      residents of 66 German nursing homes from the DemenzMonitor
                      study. The construct of agitation was defined as a composite
                      score of the items agitation/aggression,
                      irritability/lability and disinhibition from the
                      Neuropsychiatric Inventory Questionnaire (NPI-Q); the
                      resident was classified as severely agitated if at least one
                      of these symptoms was rated as 'severe'. The single
                      dimensions of quality of life were measured with the short
                      version of the QUALIDEM instrument. To avoid selection bias,
                      two controls with mild or no agitation were selected for
                      each resident with severe agitation using propensity score
                      matching. Mixed linear regression models were then generated
                      to determine the differences in the dimensions of quality of
                      life for the severity of agitation and the defining
                      items.For four out of five dimensions of quality of life of
                      the short version of QUALIDEM, residents with severe
                      agitation had significantly lower values than residents
                      without severe agitation. Converted to scale size, the
                      greatest difference between both groups was found in the
                      dimension social isolation with $23.0\%$ (-2.07 $(95\%$ CI:
                      -2.57, -1.57)). Further differences were found in the
                      dimensions restless tense behaviour with $16.9\%$ (-1.52
                      $(95\%$ CI: -2.04, -1.00)), positive affect with $14.0\%$
                      (-1.68 $(95\%$ CI: -2.28, -1.09)) and social relations with
                      $12.4\%$ (-1.12 $(95\%$ CI: -1.54, -0.71)).Severe agitation
                      is a relevant phenomenon among nursing home residents with
                      dementia and is associated with lower values of quality of
                      life in the dimensions social isolation, restless tense
                      behaviour, positive affect and social relations from the
                      QUALIDEM instrument. Therefore, more attention should be
                      paid to severe agitation in nursing practice and research.
                      Moreover, care strategies used to reduce severe agitation
                      should be considered in terms of their impact on the
                      dimensions of quality of life.},
      keywords     = {Aggression / Data Analysis / Dementia: complications /
                      Humans / Nursing Homes / Psychomotor Agitation / Quality of
                      Life / Aggression (Other) / Agitation (Other) / Dementia
                      (Other) / Nursing home (Other) / Quality of life (Other)},
      cin          = {AG Roes / Wissensch. $\&$ stud. Hilfskräfte / AG Holle},
      ddc          = {610},
      cid          = {I:(DE-2719)1610003 / I:(DE-2719)1640001 /
                      I:(DE-2719)1610002},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33849487},
      pmc          = {pmc:PMC8042694},
      doi          = {10.1186/s12888-021-03167-5},
      url          = {https://pub.dzne.de/record/155544},
}