International Psychogeriatrics

Research Article

The reliability and validity of the Norwegian version of the Neuropsychiatric Inventory, Nursing Home Version (NPI-NH)

Geir Selbæka1a3 c1, Øyvind Kirkevolda2a5, Oskar H. Sommera1 and Knut Engedala1a3a4

a1 Research Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway

a2 The Norwegian Centre for Dementia Research, Vestfold Mental Health Care Trust, Norway

a3 The Norwegian Centre for Dementia Research, Ullevaal University Hospital, Norway

a4 University of Oslo, Norway

a5 Agder University College, Faculty of Health and Sports, Kristiansand, Norway

ABSTRACT

Background: Psychiatric symptoms and behavioral disturbances are highly prevalent in the residents of nursing homes. The Neuropsychiatric Inventory (NPI) is a commonly used scale for the assessment of such symptoms in diverse settings. We have conducted a study of the reliability and the validity of the Norwegian version of the NPI nursing home version (NPI-NH).

Methods: The reliability study comprised 41 patients. We established inter-rater reliability between raters with various levels of health education using κ statistics. Fifty patients were included in the validity study. The patients were examined by a physician, who also rated the patient's behavior using “behavioral pathology in Alzheimer's disease” (BEHAVE-AD). Subsequently, a research nurse performed a standardized interview using the NPI and the Cornell scale. Concurrent validity of the NPI and the BEHAVE-AD was analyzed.

Results: Internal consistency, as measured by Cronbach's α was above 0.8. Inter-rater reliability was, except for one item, between 0.85 and 1.0 across assessors with different levels of health education. All correlations between the NPI and the BEHAVE-AD were significant, ranging from 0.38 to 0.72. The weakest correlations were between items assessing affective and anxiety symptoms.

Conclusion: The Norwegian version of the NPI-NH is a reliable and valid instrument for assessing psychiatric symptoms and behavioral disturbances in the residents of nursing homes. The investigation of depressive symptoms merits particular attention.

(Received March 05 2007)

(Online publication March 14 2007)

(Revised March 20 2007)

(Accepted March 23 2007)

(Online publication June 11 2007)

Correspondence:

c1 Correspondence should be addressed to: Geir Selbæk, Research Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Post Box 68, 2312 Ottestad, Norway. Phone: +47 9588 3535; Fax: +47 6127 2569. Email: geir.selbaek@aldringoghelse.no.

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