A taxonomy of passive behaviors in people with Alzheimer's disease.

PURPOSE To construct a taxonomy of passive behaviors for understanding people with Alzheimer's disease. Passive behaviors are those associated with decreased motor movements, decreasing interactions with the environment, and feelings of apathy and listlessness. Little is known about behaviors associated with passivity, and these behaviors have not been categorized. ORGANIZING CONSTRUCT Taxonomy construction. Passive behaviors in people with Alzheimer's disease were conceptualized as disturbing behaviors, patterns of personality change, and negative symptoms. METHODS The taxonomy was developed using critical reviews of 15 empirical studies published 1985 through 1998. Procedures included listing behaviors; clustering behaviors into inductively derived groupings; conducting an expert panel-review, making revisions, and conducting a second review; establishing global and category-by-category reliability using Cohen's Kappa. FINDINGS The nonhierarchic, natural taxonomy indicated five categories of behaviors associated with passivity in Alzheimer's disease: diminutions of cognition, psychomotor activity, emotions, interactions with people, and interactions with the environment. Analysis indicated substantial agreement beyond chance and showed statistically significant agreement among the six nurse-expert rates. Areas of synchrony between the taxonomy and the Need-Driven Dementia Compromised Behavior Model were identified. CONCLUSIONS This taxonomy of passive behaviors in patients with Alzheimer's disease showed empirical rigor and compatibility with a middle-range theory and can be viewed as a sensitizing analytic scheme to guide future practice, research, and theory development.