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Is an unhealthy work environment in nursing home care for people with dementia associated with the prescription of psychotropic drugs and physical restraints?

Published online by Cambridge University Press:  02 February 2016

Bernadette M. Willemse ,
Jan de Jonge ,
Dieneke Smit ,
Wouter Dasselaar ,
Marja F. I. A. Depla  and
Anne Margriet Pot
Bernadette M. Willemse*
Affiliation:
Program on Aging, Netherlands Institute of Mental Health and Addiction, P.O Box 725, 3500 AS Utrecht, the Netherlands Department of Clinical Psychology, Faculty of Psychology and Education, VU University, Van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands
Jan de Jonge
Affiliation:
Department of Industrial Engineering and Innovation Sciences, Human Performance Management Group, Eindhoven University of Technology, Paviljoen J.06, P.O. Box 513 5600 MB Eindhoven, the Netherlands School of Psychology, Asia Pacific Centre for Work Health and Safety, University of South Australia, Adelaide, Australia
Dieneke Smit
Affiliation:
Program on Aging, Netherlands Institute of Mental Health and Addiction, P.O Box 725, 3500 AS Utrecht, the Netherlands Department of Clinical Psychology, Faculty of Psychology and Education, VU University, Van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands
Wouter Dasselaar
Affiliation:
Program on Aging, Netherlands Institute of Mental Health and Addiction, P.O Box 725, 3500 AS Utrecht, the Netherlands
Marja F. I. A. Depla
Affiliation:
Department of Nursing-home medicine, Institute for Research in Extramural Medicine, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
Anne Margriet Pot
Affiliation:
Program on Aging, Netherlands Institute of Mental Health and Addiction, P.O Box 725, 3500 AS Utrecht, the Netherlands Department of Clinical Psychology, Faculty of Psychology and Education, VU University, Van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands School of Psychology, University of Queensland, St Lucia, QLD 4072, Brisbane, Australia
*
Correspondence should be addressed to: B. M. Willemse, Program on Aging, Netherlands Institute of Mental Health and Addiction, Utrecht, P.O Box 725, 3500 AS Utrecht, the Netherlands. Phone: +31 30 2959210; Fax: +31-30-2971111. Email: bwillemse@trimbos.nl.
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Abstract

Background:

Research showed that long-term care facilities differ widely in the use of psychotropic drugs and physical restraints. The aim of this study is to investigate whether characteristics of an unhealthy work environment in facilities for people with dementia are associated with more prescription of psychotropic drugs and physical restraints.

Methods:

Data were derived from the first wave (2008–2009) of a national monitoring study in the Netherlands. This paper used data on prescription of psychotropic drugs and physical restraints from 111 long-term care facilities, residing 4,796 residents. Survey data of a sample of 996 staff and 1,138 residents were considered. The number of residents with prescribed benzodiazepines and anti-psychotic drugs, and physical restraints were registered. Work environment was assessed using the Leiden Quality of Work Questionnaire (LQWQ).

Results:

Logistic regression analyses showed that more supervisor support was associated with less prescription of benzodiazepines. Coworker support was found to be related to less prescription of deep chairs. Job demands and decision authority were not found to be predictors of psychotropic drugs and physical restraints.

Conclusions:

Staff's job characteristics were scarcely related to the prescription of psychotropic drugs and physical restraints. This finding indicates that in facilities with an unhealthy work environment for nursing staff, one is not more likely to prescribe drugs or restraints. Further longitudinal research is needed with special attention for multidisciplinary decision making – especially role of physician, staff's knowledge, philosophy of care and institutional policy to gain further insight into factors influencing the use of psychotropic drugs and restraints.

Keywords

work environmentwork controljob autonomytime pressuredementia carelong-term carechemical restraintsantipsychotics
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 6 , June 2016 , pp. 983 - 994
Copyright
Copyright © International Psychogeriatric Association 2016 

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