The Challenging Behaviour Scale (CBS): Development of a scale for staff caring for older people in residential and nursing homes

Abstract

The CBS is quick to complete and may have potential for the evaluation of psychosocial interventions in care settings. It is, as far as we know, the first staff observational rating scale that is based on the reports of care staff, who constitute the backbone of residential care provision. Suggestions for improvements in criterion and content validity are outlined.

What do we know about quality of life in dementia? A review of the emerging evidence on the predictive and explanatory value of disease specific measures of health related quality of life in people with dementia

“…Hoe et al (2006) found behavioural disturbance as measured by the Clifton Assessment Procedures for the Elderly Behavioural Rating Scale (CAPE-BRS; Pattie et al, 1978) to be highly correlated with staffratings of the QOL-AD but not self-ratings (À0.53, compared with 0.00). The results from the Challenging Behaviour Scale (CBS; Moniz-Cook et al, 2001) were very similar with staff-rated decreased patient quality of life associated with increasing challenging behaviour (À0.40) but not in self-ratings (À0.14). In severe dementia, Hoe et al (2005) reported no statistically significant correlations between self-rated QOL-AD score and NPI total score (À0.11), with only its apathy subscale associated with decreased quality of life (À0.40).…”

A cluster randomised controlled trial to reduce the unmet needs of people with dementia living in residential care

“…Challenging Behaviour Scale (CBS) (Moniz-Cook et al, 2001). A 25-item checklist that rates the frequency and severity of challenging behaviour presented by older people with dementia with higher scores indicating more problematic behaviour.…”

Validation of the Chinese Challenging Behaviour Scale: clinical correlates of challenging behaviours in nursing home residents with dementia

“…The Challenging Behaviour Scale (CBS) was developed to meet the need for a measure of resident behaviours that formal caregivers in long-term care facilities find difficult to manage (Moniz-Cook et al, 2001). It defines challenging behaviour as 'behaviour of such an intensity, duration or frequency, that the physical safety of the person or another is placed in serious jeopardy, or behaviour which is likely to seriously limit or deny access to ordinary community facilities' (Emerson et al, 1988).…”

“…The challenging behaviours can be explained by a behavioural model that encourages the analysis of staff/client interactions and the implementation of behavioural modification programmes (Harborne and Solly, 1996). The strength of the CBS is that it covers both global and specific behaviours in residents with dementia such as lack of occupation, agitation, aggression, eating and sleep problems (Moniz-Cook et al, 2001). It describes the challenging behaviours in common language and incorporates a measurement of 'challenge' (MonizCook et al, 2000).…”

“…It describes the challenging behaviours in common language and incorporates a measurement of 'challenge' (MonizCook et al, 2000). The CBS can be used by both trained and untrained formal caregivers and is particularly useful in residential settings (Moniz-Cook et al, 2001). The present study reported the psychometric properties of the CCBS and clinical correlates of challenging behaviours in nursing home residents with dementia in Hong Kong.…”