Validation of the NOSCA – nurses’ observation scale of cognitive abilities

Authors

  • Anke Persoon,

    1. Authors: Anke Persoon, PhD, Nurse Researcher, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Lisette Schoonhoven, PhD, Senior Research Fellow, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Rene JF Melis, PhD, Senior Research Fellow, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Theo van Achterberg, PhD, Professor, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Roy PC Kessels, PhD, Professor, Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour; Marcel GM Olde Rikkert, PhD, Professor, Department of Geriatrics, Radboud University Nijmegen Medical Centre and Alzheimer Centre Nijmegen, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands
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  • Lisette Schoonhoven,

    1. Authors: Anke Persoon, PhD, Nurse Researcher, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Lisette Schoonhoven, PhD, Senior Research Fellow, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Rene JF Melis, PhD, Senior Research Fellow, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Theo van Achterberg, PhD, Professor, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Roy PC Kessels, PhD, Professor, Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour; Marcel GM Olde Rikkert, PhD, Professor, Department of Geriatrics, Radboud University Nijmegen Medical Centre and Alzheimer Centre Nijmegen, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands
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  • Rene JF Melis,

    1. Authors: Anke Persoon, PhD, Nurse Researcher, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Lisette Schoonhoven, PhD, Senior Research Fellow, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Rene JF Melis, PhD, Senior Research Fellow, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Theo van Achterberg, PhD, Professor, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Roy PC Kessels, PhD, Professor, Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour; Marcel GM Olde Rikkert, PhD, Professor, Department of Geriatrics, Radboud University Nijmegen Medical Centre and Alzheimer Centre Nijmegen, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands
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  • Theo van Achterberg,

    1. Authors: Anke Persoon, PhD, Nurse Researcher, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Lisette Schoonhoven, PhD, Senior Research Fellow, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Rene JF Melis, PhD, Senior Research Fellow, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Theo van Achterberg, PhD, Professor, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Roy PC Kessels, PhD, Professor, Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour; Marcel GM Olde Rikkert, PhD, Professor, Department of Geriatrics, Radboud University Nijmegen Medical Centre and Alzheimer Centre Nijmegen, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands
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  • Roy PC Kessels,

    1. Authors: Anke Persoon, PhD, Nurse Researcher, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Lisette Schoonhoven, PhD, Senior Research Fellow, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Rene JF Melis, PhD, Senior Research Fellow, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Theo van Achterberg, PhD, Professor, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Roy PC Kessels, PhD, Professor, Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour; Marcel GM Olde Rikkert, PhD, Professor, Department of Geriatrics, Radboud University Nijmegen Medical Centre and Alzheimer Centre Nijmegen, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands
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  • Marcel GM Olde Rikkert

    1. Authors: Anke Persoon, PhD, Nurse Researcher, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Lisette Schoonhoven, PhD, Senior Research Fellow, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Rene JF Melis, PhD, Senior Research Fellow, Department of Geriatrics, Radboud University Nijmegen Medical Centre; Theo van Achterberg, PhD, Professor, Nursing Science Section, Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre; Roy PC Kessels, PhD, Professor, Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour; Marcel GM Olde Rikkert, PhD, Professor, Department of Geriatrics, Radboud University Nijmegen Medical Centre and Alzheimer Centre Nijmegen, Nijmegen Centre of Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands
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  • Sources of support: none.

Anke Persoon, Nurse Researcher, Department of Geriatrics – 925, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Telephone: +31 24 361 6772. E-mail:a.persoon@elg.umcn.nl

Abstract

Aims and objectives.  To examine the psychometric properties of the Nurses’ Observation Scale for Cognitive Abilities.

Background.  Nurses’ Observation Scale for Cognitive Abilities is a behavioural rating scale comprising eight subscales that represent different cognitive domains. It is based on observations during contact between nurse and patient.

Design.  Observational study.

Methods.  A total of 50 patients from two geriatric wards in acute care hospitals participated in this study. Reliability was examined via internal consistency and inter-rater reliability. Construct validity of the Nurses’ Observation Scale for Cognitive Abilities and its subscales were explored by means of convergent and divergent validity and post hoc analyses for group differences.

Results.  Cronbach’s αs of the total Nurses’ Observation Scale for Cognitive Abilities and its subscales were 0·98 and 0·66–0·93, respectively. The item–total correlations were satisfactory (overall > 0·4). The intra-class coefficients were good (37 of 39 items > 0·4). The convergent validity of the Nurses’ Observation Scale for Cognitive Abilities against cognitive ratings (MMSE, NOSGER) and severity of dementia (Clinical Dementia Rating) demonstrated satisfactory correlations (0·59–0·70, p < 0·01), except for IQCODE (0·30, p > 0·05). The divergent validity of the Nurses’ Observation Scale for Cognitive Abilities against depressive symptoms was low (0·12, p > 0·05). The construct validity of the Nurses’ Observation Scale for Cognitive Abilities subscales against 13 specific neuropsychological tests showed correlations varying from poor to fair (0·18–0·74; 10 of 13 correlations p < 0·05).

Conclusions.  Validity and reliability of the total Nurses’ Observation Scale for Cognitive Abilities are excellent. The correlations between the Nurses’ Observation Scale for Cognitive Abilities subscales and standard neuropsychological tests were moderate. More conclusive results may be found if the Nurses’ Observation Scale for Cognitive Abilities subscales were to be validated using more ecologically valid tests and in a patient population with less cognitive impairment.

Relevance to clinical practice.  Use of the Nurses’ Observation Scale for Cognitive Abilities yields standardised, reliable and valid information about patient’s cognitive behaviour in daily practice. The Nurses’ Observation Scale for Cognitive Abilities aids in tailoring nursing interventions to patients’ specific cognitive needs. We advocate the implementation of the Nurses’ Observation Scale for Cognitive Abilities both in research and at geriatric units in acute care hospitals.

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