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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)

From: Nursing assistants: “He seems to be ill” – a reason for nurses to take action: validation of the Early Detection Scale of Infection (EDIS)

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**
  1. *p < 0.05. **p < 0.01
  2. aAccording to Neuropsychiatric Inventory – Nursing Home version (NPI-NH)
  3. bData from NAs collected via EDIS (Early Detection of Infection Scale); Partly agree and Fully agree has been merged in the analyses
  4. cWald = 4 is approximately equivalent to p = 0.05; Wald = 6 is approximately equivalent to p = 0.01