Nurses in distress? An explorative study into the relation between distress and individual neuropsychiatric symptoms of people with dementia in nursing homes

Authors

  • S. A. Zwijsen,

    Corresponding author
    1. Department of General Practice and Elderly Care Medicine/EMGO + Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands
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  • A. Kabboord,

    1. Trainings Center for Residents in Elderly Care Medicine Gerion/VU Medical Center, Amsterdam, The Netherlands
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  • J. A. Eefsting,

    1. Zonnehuisgroep IJssel-Vecht, Zwolle, The Netherlands
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  • C. M. P. M. Hertogh,

    1. Department of General Practice and Elderly Care Medicine/EMGO + Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands
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  • A. M. Pot,

    1. Department of Clinical Psychology, Faculty of Psychological and Educational Sciences, EMGO + Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
    2. Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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  • D. L. Gerritsen,

    1. Department of Primary and Community Care: Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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  • M. Smalbrugge

    1. Department of General Practice and Elderly Care Medicine/EMGO + Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands
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Abstract

Objectives

To optimize care and interventions to improve care, and to reduce staff burden, it is important to have knowledge of the relation between individual neuropsychiatric symptoms and distress of care staff. We therefore explored the relation between frequency and severity of individual neuropsychiatric symptoms and distress of care staff.

Design

This is an explorative study with a cross-sectional design.

Participants and setting

Care staff was interviewed regarding 432 residents of 17 nursing homes for people with dementia.

Measurements

Behavioural problems were assessed using the Nursing Home version of the Neuropsychiatric Inventory (NPI-NH) questionnaire. The distress scale of the NPI-NH was used to determine the distress of care staff.

Results

Agitation/aggression had the highest mean distress score and was also the most prevalent symptom. Disinhibition and irritability/lability also had high mean distress scores, whereas euphoria/elation, hallucinations and apathy had the lowest mean distress score. The symptom severity of each symptom strongly predicted the distress score, whereas the frequency of the symptoms was a less important factor.

Conclusions

Although some of these findings are in accordance with studies among informal caregivers, there are also notable differences. Apathy caused little distress among care staff. Therefore, care staff might not feel the urgency to explore the causes of this symptom. The findings of this study emphasize the importance of supporting care staff in the management of behavioural problems, especially aggression and apathy. Copyright © 2013 John Wiley & Sons, Ltd.

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