TY - JOUR
T1 - Prescribing of Psychoactive Drugs for Older People in Nursing Homes: An Analysis of Treatment Culture
AU - Shaw, Catherine
AU - McCormack, Brendan
AU - Hughes, Carmel M.
PY - 2016/3
Y1 - 2016/3
N2 - Background There is increasing interest in how culture
may affect the quality of healthcare services, and previous
research has shown that ‘treatment culture’—of which
there are three categories (resident centred, ambiguous and
traditional)—in a nursing home may influence prescribing
of psychoactive medications.
Objective The objective of this study was to explore and
understand treatment culture in prescribing of psychoactive
medications for older people with dementia in nursing
homes.
Method Six nursing homes—two from each treatment
culture category—participated in this study. Qualitative
data were collected through semi-structured interviews
with nursing home staff and general practitioners (GPs),
which sought to determine participants’ views on prescribing
and administration of psychoactive medication,
and their understanding of treatment culture and its
potential influence on prescribing of psychoactive drugs.
Following verbatim transcription, the data were analysed
and themes were identified, facilitated by NVivo and
discussion within the research team.
Results Interviews took place with five managers, seven
nurses, 13 care assistants and two GPs. Four themes
emerged: the characteristics of the setting, the characteristics
of the individual, relationships and decision making.
The characteristics of the setting were exemplified by
views of the setting, daily routines and staff training. The
characteristics of the individual were demonstrated by
views on the personhood of residents and staff attitudes.
Relationships varied between staff within and outside the
home. These relationships appeared to influence decision
making about prescribing of medications. The data analysis
found that each home exhibited traits that were indicative
of its respective assigned treatment culture.
Conclusion Nursing home treatment culture appeared to
be influenced by four main themes. Modification of these
factors may lead to a shift in culture towards a more
flexible, resident-centred culture and a reduction in prescribing
and use of psychoactive medication.
AB - Background There is increasing interest in how culture
may affect the quality of healthcare services, and previous
research has shown that ‘treatment culture’—of which
there are three categories (resident centred, ambiguous and
traditional)—in a nursing home may influence prescribing
of psychoactive medications.
Objective The objective of this study was to explore and
understand treatment culture in prescribing of psychoactive
medications for older people with dementia in nursing
homes.
Method Six nursing homes—two from each treatment
culture category—participated in this study. Qualitative
data were collected through semi-structured interviews
with nursing home staff and general practitioners (GPs),
which sought to determine participants’ views on prescribing
and administration of psychoactive medication,
and their understanding of treatment culture and its
potential influence on prescribing of psychoactive drugs.
Following verbatim transcription, the data were analysed
and themes were identified, facilitated by NVivo and
discussion within the research team.
Results Interviews took place with five managers, seven
nurses, 13 care assistants and two GPs. Four themes
emerged: the characteristics of the setting, the characteristics
of the individual, relationships and decision making.
The characteristics of the setting were exemplified by
views of the setting, daily routines and staff training. The
characteristics of the individual were demonstrated by
views on the personhood of residents and staff attitudes.
Relationships varied between staff within and outside the
home. These relationships appeared to influence decision
making about prescribing of medications. The data analysis
found that each home exhibited traits that were indicative
of its respective assigned treatment culture.
Conclusion Nursing home treatment culture appeared to
be influenced by four main themes. Modification of these
factors may lead to a shift in culture towards a more
flexible, resident-centred culture and a reduction in prescribing
and use of psychoactive medication.
U2 - 10.1007/s40801-016-0066-5
DO - 10.1007/s40801-016-0066-5
M3 - Article
VL - 3
SP - 121
EP - 130
JO - Drugs, Real World Outcomes
JF - Drugs, Real World Outcomes
SN - 2199-1154
IS - 1
ER -