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Biopsychosocial model & direct observation of behavior.

While reading the first issue of Research in Gerontological Nursing, I was particularly interested in the review by Curyto, Van Haitsma, and Vriesman entitled “Direct Observation of Behavior: A Review of Current Measures for Use with Older Adults with Dementia” (Vol. 1, No. 1, pp. 52-76). I did not read very far before I was troubled. In the first section of the article, Theory Underlying Direct Observation of Behavior, the authors state, “Although direct observation has a long history of use in the field of behavior analysis, its use with the dementia population is relatively new and often not guided by theory” (pp. 52-53). The authors discuss several instruments to measure pain in older adults with dementia (Feldt, 2000; Horgas, Nichols, Schapson, & Vietes, 2007; Krulewitch et al., 2000; Lane et al., 2003; Leong, Chong, & Gibson, 2006; Richards, Nepomuceno, Riles, & Suer, 1982; Villanueva, Smith, Erickson, Lee, & Singer, 2003; Warden, Hurley, & Volicer, 2003). Theory-guided direct observation of behavior in older adults with dementia is well established in the literature, especially in the pain literature. One of these theories is the biopsychosocial model of pain management (Davis & Srivastava, 2003; Ferrell & Ferrell, 1996; Ferrell, Ferrell, & Osterweil, 1990; Gatchel, 2004; Killinger, Morley, Kettner, & Kaurie, 2001).