Development of the Nurses' Observation Scale for Cognitive Abilities (NOSCA)
Table 5
Nursesβ observation scale for cognitive abilities (NOSCA).
(a) Consciousness
The patient
1
0
A
responds to being spoken to during the day.
Yes
No
B
has to be shaken awake during the day or evening if you want to communicate with him/her.
No
Yes
C
falls asleep when no activities are going on.
No
Yes
D
dozes off during a conversation or activity
No
Yes
Total Consciousness: points/number of answers = points. Note: if any of the above items are scored in the right-hand column, then the results of the observations below must be interpreted with cautin, because the outcomes might change when consciousness is restored.
(b) Attention
The patient
3
2
1
0
β
1
loses the thread of the conversation (e.g., when giving long answers).
Never
Sometimes
Usually
Repeatedly
?
2
stops with the current activity if someone walks by or if he/she hears another voice.
Never
Sometimes
Usually
Repeatedly
?
3
can easily switch to a different topic of conversation.
Repeatedly
Usually
Sometimes
Never
?
4
can easily switch to a different activity.
Repeatedly
Usually
Sometimes
Never
?
Total Attention: points/number of answers = points.
(c) Visual Perception
The patient
3
2
1
0
β
5
recognizes an object and knows what it is (e.g., a comb to comb his/her hair, a toilet to relieve him/herself).
Repeatedly
Usually
Sometimes
Never
?
6
mistakes an object for something else (e.g., pattern in the curtains for an animal).
Never
Sometimes
Usually
Repeatedly
?
Total Visual Perception: points/number of answers = points.
(d) Orientation
The patient
3
2
1
0
β
7
is able to locate his/her own bed.
Repeatedly
Usually
Sometimes
Never
?
8
thinks that he/she is at home or somewhere else.
Never
Sometimes
Usually
Repeatedly
?
9
recognizes other patients and/or staff..
Repeatedly
Usually
Sometimes
Never
?
10
recognizes family and/or friends..
Repeatedly
Usually
Sometimes
Never
?
11
knows whether it is morning, evening or night.
Repeatedly
Usually
Sometimes
Never
?
12
knows what time it is.
Repeatedly
Usually
Sometimes
Never
?
Total Orientation: points/number of answers = points.
(e) Memory
The patient
3
2
1
0
β
13
cannot remember what has just been said.
Never
Sometimes
Usually
Repeatedly
?
14
cannot remember where he/she has just left something.
Never
Sometimes
Usually
Repeatedly
?
15
can remember the task or instruction during the ADL activities.
Repeatedly
Usually
Sometimes
Never
?
16
can remember appointments made today or yesterday.
Repeatedly
Usually
Sometimes
Never
?
17
is able to find an object or piece of clothing that he/she has tidied up.
Repeatedly
Usually
Sometimes
Never
?
18
knows whether or not objects belong to him/her.
Repeatedly
Usually
Sometimes
Never
?
Total Memory: points/number of answers = points.
(f) Thoughts
The patient
3
2
1
0
β
19
responds very slowly to a question and/or instruction.
Never
Sometimes
Usually
Repeatedly
?
20
gives answers that are relevant to the question.
Repeatedly
Usually
Sometimes
Never
?
21
switches from one subject to another.
Never
Sometimes
Usually
Repeatedly
?
22
has unrealistic thoughts (e.g., says that he/she does not have any money or clothes, but does really).
Never
Sometimes
Usually
Repeatedly
?
23
is distrustful of others (e.g., does not dare to take his/her medicine; says that people are βlisteningβ, etc.).
Never
Sometimes
Usually
Repeatedly
?
Total Thoughts: points/number of answers = points.
(g) Higher cognitive functions
The patient
3
2
1
0
β
24
can oversee where to start an activity (e.g., collects all the necessary articles together before going to wash)
Repeatedly
Usually
Sometimes
Never
?
25
works efficiently and systematically.
Repeatedly
Usually
Sometimes
Never
?
26
asks questions about his/her illness.
Never
Sometimes
Usually
Repeatedly
?
27
says that he/she is able to do something although it is clear that they cannot (e.g., walk without the rollator).
Never
Sometimes
Usually
Repeatedly
?
28
says that there is nothing wrong with him/her although there clearly is.
Repeatedly
Usually
Sometimes
Never
?
29
undertakes activities on his/her own initiative (e.g., starting a conversation, going for a walk)
Repeatedly
Usually
Sometimes
Never
?
30
keeps on repeating an action that is not necessary (e.g., keeps on spreading a slice of bread, keeps on drying his/her arm).
Never
Sometimes
Usually
Repeatedly
?
Total Thoughts: points/number of answers = points.
(h) Language
The patient
3
2
1
0
β
31
understands directions and/or instructions.
Repeatedly
Usually
Sometimes
Never
?
32
reads something and can show that he/she has understood what is says (e.g., a wrapper, a folder).
Repeatedly
Usually
Sometimes
Never
?
33
has to search for words.
Never
Sometimes
Usually
Repeatedly
?
34
uses vague terms in conversation (e.g., βYou knowβ or βthingyβ).
Never
Sometimes
Usually
Repeatedly
?
35
calls something by the wrong name (e.g., says vase instead of bread, lamp instead of table).
Never
Sometimes
Usually
Repeatedly
?
36
is able to make clear what he/she wants.
Repeatedly
Usually
Sometimes
Never
?
Total Language: points/number of answers = points.
(i) Praxis
The patient
3
2
1
0
β
37
does the ADL activities in the correct order (e.g., first takes off pay pyjamas, then gets dressed; first wets the flannel, than washes face).
Repeatedly
Usually
Sometimes
Never
?
38
puts on clothes in the correct manner (e.g., not back-to-front, or inside-out).
Repeatedly
Usually
Sometimes
Never
?
39
uses the items in the correct manner (e.g., is able to comb his/her hair with a comb, is able to eat with a fork).
