title: Is an unhealthy work environment in nursing home care for people with dementia associated with the prescription of psychotropic drugs and physical restraints?
abstract: 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.
  
  
  
  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).
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Program on Aging,Netherlands Institute of Mental Health and Addiction,P.O Box 725,3500 AS Utrecht,the Netherlands.
authors.forename: Bernadette M
authors.initials: BM
authors.lastname: Willemse
authors.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.
authors.forename: Jan
authors.initials: J
authors.lastname: de Jonge
authors.affiliation: Program on Aging,Netherlands Institute of Mental Health and Addiction,P.O Box 725,3500 AS Utrecht,the Netherlands.
authors.forename: Dieneke
authors.initials: D
authors.lastname: Smit
authors.affiliation: Program on Aging,Netherlands Institute of Mental Health and Addiction,P.O Box 725,3500 AS Utrecht,the Netherlands.
authors.forename: Wouter
authors.initials: W
authors.lastname: Dasselaar
authors.affiliation: Department of Nursing-home medicine,Institute for Research in Extramural Medicine,VU University Medical Center,De Boelelaan 1117,1081 HV Amsterdam,the Netherlands.
authors.forename: Marja F I A
authors.initials: MF
authors.lastname: Depla
authors.affiliation: Program on Aging,Netherlands Institute of Mental Health and Addiction,P.O Box 725,3500 AS Utrecht,the Netherlands.
authors.forename: Anne Margriet
authors.initials: AM
authors.lastname: Pot
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003704:Dementia / Q000188:drug therapy*; D005260:Female; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009426:Netherlands; D009735:Nursing Homes / Q000458:organization & administration*; D009740:Nursing Staff; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012149:Restraint, Physical; D017132:Workplace
chemical_list: D014150:Antipsychotic Agents; D011619:Psychotropic Drugs; D001569:Benzodiazepines
keywords: antipsychotics; chemical restraints; dementia care; job autonomy; long-term care; time pressure; work control; work environment