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.
Copyright © 2012 Elsevier Inc. All rights reserved.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Aged
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Aged, 80 and over
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Ageism / psychology*
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Attitude of Health Personnel*
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Cross-Sectional Studies
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Disorders of Excessive Somnolence / drug therapy
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Disorders of Excessive Somnolence / epidemiology
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Disorders of Excessive Somnolence / etiology
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Disorders of Excessive Somnolence / nursing
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Drug Utilization / statistics & numerical data
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Female
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Germany
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Homes for the Aged*
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Humans
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Hypnotics and Sedatives / adverse effects*
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Hypnotics and Sedatives / therapeutic use*
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Life Style
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Male
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Nursing Homes*
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Patient Satisfaction
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Physician-Patient Relations
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Practice Patterns, Physicians'
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Risk Assessment
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Sleep Disorders, Circadian Rhythm / drug therapy
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Sleep Disorders, Circadian Rhythm / epidemiology
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Sleep Disorders, Circadian Rhythm / etiology
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Sleep Disorders, Circadian Rhythm / nursing
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Sleep Initiation and Maintenance Disorders / drug therapy
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Sleep Initiation and Maintenance Disorders / epidemiology
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Sleep Initiation and Maintenance Disorders / etiology
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Sleep Initiation and Maintenance Disorders / nursing
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Sleep Wake Disorders / drug therapy*
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Sleep Wake Disorders / epidemiology
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Sleep Wake Disorders / etiology
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Sleep Wake Disorders / nursing*
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Social Environment
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Stereotyping*
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Substance-Related Disorders / epidemiology
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Substance-Related Disorders / nursing
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Substance-Related Disorders / prevention & control
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Substance-Related Disorders / psychology
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Wakefulness