title: The role of nurses/social workers in using a multidimensional guideline for diagnosis of anxiety and challenging behaviour in people with intellectual disabilities.
abstract: OBJECTIVE
  This study seeks (1) to investigate the impact of the implementation of the 'Diagnostic Guideline for Anxiety and challenging behaviours in clients with intellectual disability' on nurses/social workers' knowledge and self-efficacy; and (2) to evaluate the role of nurses/social workers in the diagnostic process when applying the guideline.
  
  
  BACKGROUND
  Nurses/social workers have extensive contact with clients with intellectual disabilities. Despite this key position, the contribution of nurses/social workers to the diagnosis of mental health problems and challenging behaviours is rather limited. The authors developed the multidimensional 'Diagnostic Guideline for Anxiety and challenging behaviours'. In this article, the implementation of this guideline is evaluated concerning knowledge and self-efficacy of nurses/social workers, as well the role of nurses/social workers in the diagnostic process.
  
  
  METHODS
  This study employed a comparative multiple case study design.
  
  
  METHODS
  Qualitative and quantitative research methods.
  
  
  RESULTS
  Working with the 'Diagnostic Guideline for Anxiety and challenging behaviours' led to a statistically significant increase in knowledge and self-efficacy among the nurses/social workers in the experimental condition, compared with nurses/social workers in the control condition. Nurses/social workers and psychologists appreciated the more active contribution of the nurses/social workers in the diagnostic process.
  
  
  CONCLUSIONS
  Working with the guideline increased the knowledge and self-efficacy of nurses/social workers, and led to more active participation of nurses/social workers in the diagnostic process.
  
  
  CONCLUSIONS
  After following a training programme, nurses/social workers can effectively contribute to the diagnostic process in clients with anxiety and related challenging behaviours.
authors.affiliation: Department of Health, Sports & Welfare/Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, The Netherlands.|Esdégé-Reigersdaal, a service provider for people with (intellectual) disabilities, Broek op Langedijk, The Netherlands.
authors.forename: Addy
authors.initials: A
authors.lastname: Pruijssers
authors.affiliation: Department of Health, Sports & Welfare/Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, The Netherlands.|Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.|Parnassia Psychiatric Institute, Parnassia Academy, The Hague, The Netherlands.
authors.forename: Berno
authors.initials: B
authors.lastname: van Meijel
authors.affiliation: Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.|Stichting Pergamijn is a service provider for people with intellectual disabilities, Echt, The Netherlands.
authors.forename: Marian
authors.initials: M
authors.lastname: Maaskant
authors.affiliation: Esdégé-Reigersdaal, a service provider for people with (intellectual) disabilities, Broek op Langedijk, The Netherlands.
authors.forename: Noortje
authors.initials: N
authors.lastname: Keeman
authors.affiliation: Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Steven
authors.initials: S
authors.lastname: Teerenstra
authors.affiliation: Centre for Health Services and Nursing Research, KU Leuven, Leuven, Belgium.|Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Theo
authors.initials: T
authors.lastname: van Achterberg
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D017410:Practice Guidelines as Topic; D020377:Self Efficacy; D000068217:Social Workers
keywords: anxiety; challenging behaviours; guidelines; intellectual disabilities; nurses/social workers