Nursesʹ acceptance of behavioral treatments and pharmacotherapy for behavioral disturbances in older adults

Behavioral disturbances are common in elderly individuals, particularly in those suffering from dementia. Nurses are called on to manage these problem behaviors both in the nursing home and through home health care. There has been growing interest in nonpharmacological interventions for these problems, most notably behavioral therapies. However, until recently, no information was available regarding the acceptance by health care professionals on the use of these treatments with elderly individuals. The purpose of this study was to assess geriatric nursesʹ acceptance of two behavioral treatments (differential reinforcement of incompatible behavior and time-out from positive reinforcement) and the most commonly used treatment at this time, pharmacotherapy. Nurses were asked to read a clinical case vignette and three treatment descriptions, rating the treatments with Kazdinʹs Treatment Evaluation Inventory. Results show that both behavioral treatments, including a mildly aversive treatment (time-out), were rated more positively than pharmacotherapy. Nurses modified their ratings in response to described differences in the patientʹs cognitive functioning and place of residence. Most interesting, acceptability ratings were influenced by characteristics of nurse raters, including the nursesʹ educational background and the amount of contact with geriatric patients.