Format

Send to

Choose Destination
See comment in PubMed Commons below
Scand J Prim Health Care. 2011 Dec;29(4):252-6. doi: 10.3109/02813432.2011.628240.

Treatment decisions on antidepressants in nursing homes: a qualitative study.

Author information

1
Research Unit for General Practice, Uni Health, Bergen, Norway. kristina.iden@gmail.com

Abstract

OBJECTIVE:

To explore decision-making on treatment with antidepressants among doctors and nurses in nursing homes.

DESIGN AND SUBJECTS:

A qualitative study based on interviews with three focus groups comprising eight physicians engaged full time, eight physicians engaged part time, and eight registered nurses, respectively. The interview guide comprised questions on initiating, evaluating, and withdrawing treatment with antidepressants. The interviews were audio-recorded, transcribed, and analysed by systematic text condensation.

RESULTS:

The first theme was the diagnostic process. The informants expressed difficulty in differentiating between depression and sorrow resulting from loss in old age. Further, the doctors reported that they relied on nurses' observations and rarely carried out systematic diagnostic work and follow-up of patients with depression. The second theme was treatment. Antidepressants were usually the only type of treatment provided, and patients were kept on medication even though staff felt uncertain whether this was effective. The third theme was who really determines the treatment. Registered nurses reported that unskilled and auxiliary nursing staff requested drug treatment, and doctors felt some pressure from the nurses to prescribe antidepressants.

CONCLUSIONS:

This study suggests that the quality of diagnosis and treatment for depression in nursing homes needs to be improved in Norway. Doctors should be more available and take responsibility and leadership in medical decisions.

PMID:
22126226
PMCID:
PMC3308458
DOI:
10.3109/02813432.2011.628240
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Taylor & Francis Icon for PubMed Central
    Loading ...
    Support Center