title: "And mostly they have a need for sleeping pills": physicians' views on treatment of sleep disorders with drugs in nursing homes.
abstract: The percentage of nursing home residents treated with hypnotic medications is high, as many authors report, despite the fact that such medications are almost always associated with undesirable effects for old people. This article takes a closer look at nursing home physicians' views of prescriptions when treating sleep disorders of nursing home residents. How do physicians characterize the treatment strategy for residents suffering from sleep disorders? How do they balance the benefits and risks of the hypnotic medication? Under what circumstances do they accept negative consequences? To answer these questions, N=20 physicians (aged 36 to 68 years) in 16 nursing homes in a German city were interviewed. The physicians were either employed by nursing homes or worked on a contract basis. Comparative categorization of the data produced a typology across cases. Three interpretative patterns concerning the use of drugs for treating sleep disorders were identified--"by request," "ambivalence," and "reflected prescription." Differences between them were determined by the significance of residents' wishes, neglect of risks, particularly that of addiction, and the attempt to balance benefits and disadvantages. The study showed deficits in professional management of sleep disorders in nursing homes.
authors.affiliation: Alice Salomon University of Applied Sciences, Berlin, Germany; University of Vienna, Austria. flick@asfh-berlin.de
authors.forename: Uwe
authors.initials: U
authors.lastname: Flick
authors.forename: Vjenka
authors.initials: V
authors.lastname: Garms-Homolová
authors.forename: Gundula
authors.initials: G
authors.lastname: Röhnsch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D063506:Ageism / Q000523:psychology*; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000451:nursing; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006707:Homes for the Aged; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects* / Q000627:therapeutic use*; D008019:Life Style; D008297:Male; D009735:Nursing Homes; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment; D020178:Sleep Disorders, Circadian Rhythm / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000451:nursing; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000451:nursing; D012893:Sleep Wake Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000451:nursing*; D012931:Social Environment; D013240:Stereotyping; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000451:nursing / Q000517:prevention & control / Q000523:psychology; D014851:Wakefulness
chemical_list: D006993:Hypnotics and Sedatives