Table 3.
Observed signs and symptoms by nursing assistants (NA) in nursing home residents (NHR) in habitual condition (base line; N = 68) , when infection suspected by NA (first event of suspected infection; N = 68), and when these suspected infections later on were assessed by researchers as “no infection” (n = 17), “possible infection” (n = 16) or “ infection” (n = 35)
| Observed signs and symptoms | Present in habitual conditiona | Change when suspected infectionb | Change when no infectionb | Change when possible infectionc | Change when infectionb | Wald valuesc |
|---|---|---|---|---|---|---|
| n (%) | 68 (100) | 68 (100) | 17/68 (25) | 16/68 (23) | 35/68 (51) | |
| Confusion n (%) | 13 (19) | 19 (28) | 5 (29) | 5 (31) | 9 (26) | 0.23 |
| Aggressiveness n (%) | 12 (18) | 10 (15) | 3 (18) | 1 (6) | 6 (17) | 0.09 |
| Infirmity/ Apathy n (%) | 27 (40) | 54 (79) | 15 (88) | 7 (44) | 32 (91) | 0.38 |
| Unrestrained behaviour (n (%) | 15 (22) | 12 (18) | 3 (18) | 3 (19) | 6 (17) | 0.38 |
| Restlessness n (%) | 24 (35) | 20 (29) | 7 (41) | 4 (25) | 9 (26) | 0.32 |
| Food intake n (%) | 22 (32) | 32 (47) | 11 (65) | 5 (31) | 16 (46) | 0.53 |
| Pain n (%) | 42 (62) | 21 (31) | 6 (35) | 6 (38) | 9 (26) | 0.46 |
| General signs and symptoms of illness n (%) (e.g. fever, hot or cold, shaking, shivering, pale, flushed face) | 25 (37) | 4 (24) | 5 (31) | 16 (46) | 4.63* | |
| Expression (of illness) in the eyes n (%) (e.g. vacant/hazy/glassy/roaming eyes) | 47 (60) | 11 (65) | 8 (50) | 28 (80) | 2.04 | |
| Urinary tract symptoms n (%) | 24 (35) | 5 (29) | 6 (38) | 13 (37) | 0.01 | |
| Respiratory symptoms n (%) | 33 (49) | 7 (41) | 4 (25) | 22 (63) | 4.81* | |
| Symptoms of wound infection n (%) | 5 (7) | 2 (12) | 0 (0) | 3 (9) | 0.08 | |
| Temperature °C mean ± SD (range) | 36.3 ± 0.5 (34.9 – 37.3) | 37.3 ± 1.0 (35.5 – 39.5) | 36.7 ± 0.8 (35.5 – 39.1) | 37.1 ± 0.6 (35.8 – 38.0) | 37.8 ± 0.9 (36.0 – 39.5) | 15.29** |
| Temperature difference °C from baseline mean ± SD (range) | 1.1 ± 1.0 (–0.7 – + 3.4) | 0.3 ± 0.7 (−0.7 – +2.0) | 0.9 ± 0.6 (−0.6 – +1.8) | 1.6 ± 1.0 (−0.7 – +3.4) | 15.78** |
*p < 0.05. **p < 0.01
aAccording to Neuropsychiatric Inventory – Nursing Home version (NPI-NH)
bData from NAs collected via EDIS (Early Detection of Infection Scale); Partly agree and Fully agree has been merged in the analyses
cWald = 4 is approximately equivalent to p = 0.05; Wald = 6 is approximately equivalent to p = 0.01