-transparent.png){kind=logo}
OBJECTIVE To evaluate the usefulness and reliability of the Caretaker Obstreperous-Behavior Rating Assessment (COBRA), a new test instrument for caretaker assessment of types and severity of "obstreperous behaviors" (OBs) in demented patients. METHODS COBRA was completed by caretakers of 31 outpatients and 36 nursing home inpatients with dementia. Test-retest reliability was determined when 25 of the outpatient caretakers re-evaluated their demented relative 1 week later; inter-rater reliability was determined on nursing home inpatients by comparing the reports of two nurse's aids with equivalent knowledge of seven of the patients. METHODS (1) University medical center Alzheimer's Disease and Related Disorders Clinic; (2) community nursing home. METHODS Thirty-one sequentially-seen outpatients with dementia; 36 nursing home patients with dementia. METHODS Following instruction in the use of the COBRA Scale, caretakers provided scores for their demented patient. The instrument has three unique features: (1) it divides OBs into four categories for ease of comprehension: Aggressive/Assaultive; Mechanical/Motor; Ideational/Personality; and Vegetative; (2) a companion videotape shown to caretakers in advance illustrates each behavior to improve reliability of reporting; (3) the significance of each OB is estimated with severity and frequency measures. METHODS Frequency and severity of OBs are epitomized in 12 summary scores. Test-retest correlations (for outpatients) and inter-rater correlations (for inpatients) were analyzed with Pearson Product Moment and Spearman Rank Order correlations. RESULTS Prevalence of OBs and severity was reported for the experimental groups. Summary scores revealed test-retest correlations of .95 to .73 for 11 of 12 scores (outpatients), and inter-rater correlations of .99 to .73 for 8 of 12 scores (inpatients). Age, gender, and disease etiology were not significantly related to OBs; clinical severity correlated with type and severity of OBs. CONCLUSIONS The COBRA scale provides a convenient, comprehensive, and reliable means for caretakers to identify the types and measure the severity of OBs in demented outpatients and nursing home inpatients. If additional studies confirm these observations, COBRA will be a useful instrument for assessing the effects of interventions on OBs in patients with dementia.
D A Drachman, and
J M Swearer, and
B F O'Donnell, and
A L Mitchell, and
A Maloon
January 1981,
Child welfare,
D A Drachman, and
J M Swearer, and
B F O'Donnell, and
A L Mitchell, and
A Maloon
January 1961,
The American journal of occupational therapy : official publication of the American Occupational Therapy Association,
D A Drachman, and
J M Swearer, and
B F O'Donnell, and
A L Mitchell, and
A Maloon
March 1985,
American journal of mental deficiency,
D A Drachman, and
J M Swearer, and
B F O'Donnell, and
A L Mitchell, and
A Maloon
February 2000,
The Journal of head trauma rehabilitation,
D A Drachman, and
J M Swearer, and
B F O'Donnell, and
A L Mitchell, and
A Maloon
January 1996,
International psychogeriatrics,
D A Drachman, and
J M Swearer, and
B F O'Donnell, and
A L Mitchell, and
A Maloon
October 1962,
Journal of clinical psychology,
D A Drachman, and
J M Swearer, and
B F O'Donnell, and
A L Mitchell, and
A Maloon
January 2016,
Psychotherapy research : journal of the Society for Psychotherapy Research,
D A Drachman, and
J M Swearer, and
B F O'Donnell, and
A L Mitchell, and
A Maloon
May 2001,
Drug and alcohol dependence,
D A Drachman, and
J M Swearer, and
B F O'Donnell, and
A L Mitchell, and
A Maloon
January 1977,
Journal of abnormal child psychology,
D A Drachman, and
J M Swearer, and
B F O'Donnell, and
A L Mitchell, and
A Maloon
November 1991,
Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics,
