Learning Objective #1: Understand the phenomenon of catastrophic reactions in elders with dementia as a clinical problem in nursing homes

Learning Objective #2: Apply cluster analysis techniques to understanding mid-range nursing theories

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The purpose of this study was to describe the nature and patterns of temporally antecedent variables of catastrophci reactions (CRs) in elders with dementia. This study was a secondary analysis using primary data collected by Watson et al. (1998). From the primary data, ten temporally antecedent variables were selected as study variables and a total of 229 CRs were used as the sample for this study. The study variables were obtained from field observation and data from a structured recording form completed by a project nurse over a 6-week period covering seven days and all three shifts (i.e., 21 shifts total) in two nursing homes. Descriptive statistics and cluster analysis were used to answer the proposed study questions and hypotheses. As the results of this study, two patterns of antecedents of CRs were emerged: a cluster composed with physical environment (public location, dementia unit, olfactory stimulation, use of media, and sundowning hours) and a cluster composed of mixed domain of physical and social environment (olfactory stimulation, dementia unit, ADL-related care activities, and demands of tasks). The findings of this study suggest that nurses in nursing homes might decreased the occurrence of CR events in nursing home residents with dementia by making the two patterns of clusters presented above avoided to occur simultaneously.