Janus Sarah I M, van Manen Jeannette G, IJzerman Maarten J, Bisseling Marloes, Drossaert Constance H C, Zuidema Sytse U
Department Health Technology and Services Research,University of Twente,P.O. Box 217,7500 AE Enschede,the Netherlands.
Department Psychology,Health and Technology,University of Twente,P.O. Box 217,7500 AE Enschede,the Netherlands.
Int Psychogeriatr. 2017 Mar;29(3):475-484. doi: 10.1017/S1041610216001897. Epub 2016 Nov 21.
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.
Eighty-one nurses and nursing assistants of one Dutch nursing home organization completed an online survey.
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%.
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.
尽管医生负责为痴呆症患者开具抗精神病药物处方，但提出这一要求的往往是护士或护理助理。为了减少抗精神病药物的使用，需要了解护士和护理助理提出此类要求的原因。本研究基于计划行为理论概述了这一要求的影响因素，该理论认为态度、信念和行为控制会影响提出要求的意图，进而影响开具处方的行为。
荷兰一家养老院机构的81名护士和护理助理完成了一项在线调查。
护士和护理助理在与抗精神病药物对居民和工作人员的积极影响相关的项目上经常达成一致。工作满意度较低的护士和护理助理更有可能要求使用抗精神病药物。对治疗效果有更积极的信念以及对要求使用抗精神病药物更有掌控感与提出要求的意图呈正相关。所有变量解释了意图差异的59%。当前职位（护士/护理助理）与实际提出要求的行为相关。解释的差异为25%。
政策制定者应关注护士和护理助理对抗精神病药物对居民有积极影响的信念，而这与现有证据不符。应教育护士和护理助理了解抗精神病药物的有限疗效。
