Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-06-01T23:14:27.427Z Has data issue: false hasContentIssue false
  • English
  • Français

Determinants of the nurses’ and nursing assistants’ request for antipsychotics for people with dementia

Published online by Cambridge University Press:  21 November 2016

Sarah I. M. Janus ,
Jeannette G. van Manen ,
Maarten J. IJzerman ,
Marloes Bisseling ,
Constance H. C. Drossaert  and
Sytse U. Zuidema
Sarah I. M. Janus*
Affiliation:
Department Health Technology and Services Research, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands
Jeannette G. van Manen
Affiliation:
Department Health Technology and Services Research, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands
Maarten J. IJzerman
Affiliation:
Department Health Technology and Services Research, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands
Marloes Bisseling
Affiliation:
Department Health Technology and Services Research, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands
Constance H. C. Drossaert
Affiliation:
Department Psychology, Health and Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands
Sytse U. Zuidema
Affiliation:
Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
*
Correspondence should be addressed to: Sarah Janus, University of Twente, Health Technology and Services Research, PO Box 217, 7500 AE Enschede, the Netherlands. Phone: +31 53 489 3915. Email: s.i.m.janus@utwente.nl.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Although physicians are responsible for writing the antipsychotic prescriptions for patients with dementia, the initiative is often taken by nurses or nursing assistants. To reduce antipsychotics uses, one needs to understand the reasons for nurses and nursing assistants to request them. This study gives an overview of the influencing factors for this request based on the Theory of Planned Behavior in which attitude, beliefs, and behavioral control is thought to influence the intention to request, which in turn affects the behavior to request for a prescription.

Methods:

Eighty-one nurses and nursing assistants of one Dutch nursing home organization completed an online survey.

Results:

Nurses and nursing assistants frequently agreed on items related to the positive effects of antipsychotics for the resident and for the staff. Nurses and nursing assistants with a lower job satisfaction were more likely to call for antipsychotics. Having more positive beliefs about treatment effects and feel of being more in control toward asking for antipsychotics were positively associated with intention to call. All variables explained 59% of the variance of intention. The current position (nurse/nursing assistant) was associated with actual behavior to call. The explained variance was 25%.

Conclusions:

Policy-makers should focus on the nurses’ and nursing assistants’ belief in positive effects of antipsychotics for the resident, which is not in line with available evidence. Nurses and nursing assistants should be educated about the limited effectiveness of antipsychotics.

Keywords

dementiapsychopharmacologynursing homes
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 3 , March 2017 , pp. 475 - 484
Copyright
Copyright © International Psychogeriatric Association 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.Google Scholar
Ajzen, I. and Fishbein, M. (1980). Understanding Attitudes and Predicting Social Behaviour. Englewood Cliffs: Prentice-Hall.Google Scholar
Albers, G., Francke, A. L., de Veer, A. J., Bilsen, J. and Onwuteaka-Philipsen, B. D. (2014). Attitudes of nursing staff towards involvement in medical end-of-life decisions: a national survey study. Patient Education and Counseling, 94, 4–9.Google Scholar
Backhouse, T., Killett, A., Penhale, B., Burns, D. and Gray, R. (2014). Behavioural and psychological symptoms of dementia and their management in care homes within the East of England: a postal survey. Aging and Mental Health, 18, 187–193.Google Scholar
Baker, J. A., Lovell, K. and Harris, N. (2007). Mental health professionals' psychotropic pro re nata (PRN) medication practices in acute inpatient mental health care: a qualitative study. General Hospital Psychiatry, 29, 163–168.Google Scholar
Black, W. and Almeida, O. P. (2004). A systematic review of the association between the behavioral and psychological symptoms of dementia and burden of care. International Psychogeriatrics, 16, 295–315.Google Scholar
Brodaty, H. et al. (2001). Psychosis, depression and behavioural disturbances in Sydney nursing home residents: prevalence and predictors. International Journal of Geriatric Psychiatry, 16, 504–512.CrossRefGoogle ScholarPubMed
Chen, Y. et al. (2010). Unexplained variation across US nursing homes in antipsychotic prescribing rates. Archives of Internal Medicine, 170, 89–95.Google Scholar
Cornegé-Blokland, E., Kleijer, B. C., Hertogh, C. M. and van Marum, R. J. (2012). Reasons to prescribe antipsychotics for the behavioral symptoms of dementia: a survey in Dutch nursing homes among physicians, nurses, and family caregivers. Journal of the American Medical Directors Association, 13, 80. e81–80. e86.Google Scholar
Gill, S. S. et al. (2007). Antipsychotic drug use and mortality in older adults with dementia. Annals of Internal Medicine, 146, 775–786.Google Scholar
Godin, G. and Kok, G. (1996). The theory of planned behavior: a review of its applications to health-related behaviors. American Journal of Health Promotion, 11, 87–98.Google Scholar
Hoffmann, F., Kaduszkiewicz, H., Glaeske, G., van den Bussche, H. and Koller, D. (2014). Prevalence of dementia in nursing home and community-dwelling older adults in Germany. Aging Clinical and Experimental Research, 26, 555–559. doi:10.1007/s40520-014-0210-6 Google Scholar
Janus, S. I. M., van Manen, J. G., IJzerman, M. J. and Zuidema, S. U. (2016). Psychotropic drug prescriptions in Western European nursing homes. International Psychogeriatrics, 1–16. doi:10.1017/S1041610216001150 [Epub ahead of print]Google Scholar
Kamble, P., Chen, H., Sherer, J. T. and Aparasu, R. R. (2009). Use of antipsychotics among elderly nursing home residents with dementia in the US. Drugs and Aging, 26, 483–492.Google Scholar
Koponen, M. et al. (2015). Incidence of antipsychotic use in relation to diagnosis of Alzheimer's disease among community-dwelling persons. The British Journal of Psychiatry, 207, 444–449. doi: 10.1192/bjp.bp.114.162834 Google Scholar
Lemay, C. A. et al. (2013). Knowledge of and perceived need for evidence-based education about antipsychotic medications among nursing home leadership and staff. Journal of the American Medical Directors Association, 14, 895–900.CrossRefGoogle ScholarPubMed
Lovheim, H., Sandman, P. O., Kallin, K., Karlsson, S. and Gustafson, Y. (2006). Relationship between antipsychotic drug use and behavioral and psychological symptoms of dementia in old people with cognitive impairment living in geriatric care. International Psychogeriatrics, 18, 713–726.Google Scholar
Pulsford, D. and Duxbury, J. (2006). Aggressive behaviour by people with dementia in residential care settings: a review. Journal of Psychiatric and Mental Health Nursing, 13, 611–618.Google Scholar
Redfern, S., Hannan, S., Norman, I. and Martin, F. (2002). Work satisfaction, stress, quality of care and morale of older people in a nursing home. Health and Social Care in the Community, 10, 512–517.Google Scholar
Sink, K. M., Holden, K. F. and Yaffe, K. (2005). Pharmacological treatment of neuropsychiatric symptoms of dementia: a review of the evidence. Journal of the American Medical Association, 293, 596–608.CrossRefGoogle ScholarPubMed
Smeets, C. H. et al. (2014). Factors related to psychotropic drug prescription for neuropsychiatric symptoms in nursing home residents with dementia. Journal of the American Medical Directors Association, 15, 835–840.Google Scholar
Steinberg, M. et al. (2008). Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: the cache county study. International Journal of Geriatric Psychiatry, 23, 170.Google Scholar
Usher, K., Lindsay, D. and Sellen, J. (2001). Mental health nurses’ PRN psychotropic medication administration practices. Journal of Psychiatric and Mental Health Nursing, 8, 383–390.Google Scholar
van de Ven, G. et al. (2013). Effects of dementia-care mapping on residents and staff of care homes: a pragmatic cluster-randomised controlled trial. PLoS ONE, 8, e67325.Google Scholar
van der Spek, K. et al. (2013). PROPER I: frequency and appropriateness of psychotropic drugs use in nursing home patients and its associations: a study protocol. BMC Psychiatry, 13, 307.Google Scholar
Wang, P. S. et al. (2005). Risk of death in elderly users of conventional vs. atypical antipsychotic medications. New England Journal of Medicine, 353, 2335–2341.CrossRefGoogle ScholarPubMed
Ypma-Bakker, M. et al. (2008). Richtlijn Probleemgedrag [Guideline for the Treatment of Behavioural Disturbances]. Arnhem: Roos en Roos Press.Google Scholar
Zuidema, S. U., de Jonghe, J. F. M., Verhey, F. R. and Koopmans, R. T. (2011). ‘Psychotropic drug prescription in nursing home patients with dementia: influence of environmental correlates and staff distress on physicians’ prescription behavior’, International Psychogeriatrics, 23, 1632–1639.Google Scholar
Zuidema, S. U., de Jonghe, J. F., Verhey, F. R. and Koopmans, R. T. (2011). Psychotropic drug prescription in nursing home patients with dementia: influence of environmental correlates and staff distress on physicians’ prescription behavior. International Psychogeriatrics, 23, 1632–1639.Google Scholar
Zuidema, S. U., Derksen, E., Verhey, F. R. and Koopmans, R. T. (2007). Prevalence of neuropsychiatric symptoms in a large sample of Dutch nursing home patients with dementia. International Journal of Geriatric Psychiatry, 22, 632–638.Google Scholar