Ludwin Brian M, Meeks Suzanne
a Department of Psychological and Brain Sciences , University of Louisville , Louisville Kentucky , USA.
Clin Gerontol. 2019 May-Jun;42(3):302-313. doi: 10.1080/07317115.2018.1427643. Epub 2018 Jan 25.
To examine whether exposure to a message to avoid antipsychotic medications and a salient sense of managerial oversight influenced nurses' treatment intentions.
158 nurses from 28 long-term care facilities were randomized to one of four conditions within a 2 × 2 between-participants design. The nurses responded to a case study depicting a resident with dementia-related behavioral problems with their intent to initiate an antipsychotic or a psychosocial intervention. Self-efficacy, descriptive norms, and attitudes were measured via self-report.
Perceived local antipsychotic prevalence was related to the nurses' treatment intentions. There were no main or interactive effects of the avoid antipsychotic or manager oversight conditions on the nurses' treatment intentions. However, there was a significant interaction of actual facility antipsychotic prevalence and the avoid antipsychotics message on intentions to initiate an antipsychotic.
Nurses' perceptions of local antipsychotic prevalence were positively associated with intentions to initiate an antipsychotic and negatively associated with intentions to initiate a psychosocial intervention. However, a salient message to avoid antipsychotics had limited influence on nurses' treatment intentions and was associated with increased intentions to initiate antipsychotics in facilities with higher rates of antipsychotic use. The oversight condition did not demonstrate adequate internal validity, which may have caused its lack of effect on treatment intentions.
Nurses' perceptions of the local prevalence of antipsychotic use is associated with their treatment intentions. However, increasing the visibility of a message discouraging antipsychotic use may have limited utility in influencing nurses' intentions to initiate an antipsychotic or psychosocial intervention.
探讨接触避免使用抗精神病药物的信息以及显著的管理监督意识是否会影响护士的治疗意图。
来自28个长期护理机构的158名护士在2×2组间设计中被随机分配到四种情况之一。护士们针对一个描述患有痴呆相关行为问题居民的案例研究，给出他们启动抗精神病药物或心理社会干预的意图。通过自我报告测量自我效能、描述性规范和态度。
感知到的当地抗精神病药物使用率与护士的治疗意图相关。避免使用抗精神病药物或管理监督情况对护士的治疗意图没有主效应或交互效应。然而，实际机构抗精神病药物使用率与避免使用抗精神病药物信息在启动抗精神病药物意图方面存在显著交互作用。
护士对当地抗精神病药物使用率的认知与启动抗精神病药物的意图呈正相关，与启动心理社会干预的意图呈负相关。然而，一条突出的避免使用抗精神病药物的信息对护士的治疗意图影响有限，并且在抗精神病药物使用率较高的机构中，与启动抗精神病药物的意图增加有关。监督情况未显示出足够的内部效度，这可能导致其对治疗意图缺乏影响。
护士对当地抗精神病药物使用流行率的认知与他们的治疗意图相关。然而，提高一条劝阻使用抗精神病药物信息的可见性在影响护士启动抗精神病药物或心理社会干预的意图方面可能效用有限。
