title: Knowledge of and attitudes toward nonpharmacological interventions for treatment of behavior symptoms associated with dementia: a comparison of physicians, psychologists, and nurse practitioners.
abstract: OBJECTIVE
  Behavior problems are common in nursing homes. Current guidelines recommend nonpharmacological interventions (NPHIs) as first-line treatment, but pharmacological regimens (PIs) continue to be used. Given differences in background and training of those who treat behavior problems in residents, we compared attitudes of physicians (MDs), psychologists (PhDs), and nurse practitioners (NPs) concerning PI and NPHI usage as well as knowledge of NPHIs.
  
  
  METHODS
  One hundred and eight MDs, 36 PhDs, and 89 NPs responded to a web-based questionnaire that captured level of agreement with statements concerning treatment of behavior symptoms and familiarity with NPHIs.
  
  
  RESULTS
  NPs were the most favorable toward NPHIs. MDs were significantly more favorable to the use of PIs than were PhDs, with attitudes of NPs falling in between. All felt that NPHI usage should increase and that NPHIs should be implemented before using PIs but also believed that PIs work well for behavior problems. MDs had significantly lower knowledge of NPHIs than PhDs or NPs. Overall, NPHI knowledge was similar for PhDs and NPs, although they differed on their use of specific interventions.
  
  
  CONCLUSIONS
  As levels of knowledge and familiarity with NPHIs differed among providers, it is conceivable that all might benefit from training and experience with a wider range of NPHIs. Future studies might evaluate the impact of a uniform understanding of NPHI on communication and teamwork in nursing homes and examine ways to enhance a multidisciplinary approach that would allow for the tailoring and individualization that is required of successful interventions.
authors.affiliation: Department of Health Care Sciences, George Washington University Medical Center, Washington, DC, USA. hcsjcm@gwumc.edu
authors.forename: Jiska
authors.initials: J
authors.lastname: Cohen-Mansfield
authors.forename: Barbara
authors.initials: B
authors.lastname: Jensen
authors.forename: Barbara
authors.initials: B
authors.lastname: Resnick
authors.forename: Margaret
authors.initials: M
authors.lastname: Norris
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001521:Behavior Therapy / Q000379:methods / Q000706:statistics & numerical data; D001526:Behavioral Symptoms / Q000150:complications / Q000628:therapy*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003704:Dementia / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000523:psychology / Q000706:statistics & numerical data*; D009735:Nursing Homes; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D011584:Psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires