Abstract
Objective
The aims of this study were (1) to investigate the relationship between different
neuropsychiatric symptoms (NPS) and the level of distress experienced by nurses caring
for residents with young-onset dementia (YOD) and (2) to compare these findings with
those for nurses caring for residents with late-onset dementia (LOD).
Design/Setting
This is a retrospective study conducted in Dutch long-term care facilities. Data were
used from the Behavior and Evolution of Young-ONset Dementia studies (BEYOND) Parts
I and II and the WAAL Behavior in Dementia-II (Waalbed-II) study.
Participants
A total of 382 nursing home residents with YOD and 261 nursing home residents with
LOD were included.
Measurements
The Neuropsychiatric Inventory, nursing home version, was used to assess nursing staff
distress and the frequency (F) and severity (S) of NPS. Multilevel logistic regression
analysis was used to investigate the relationships between nursing staff distress
related to NPS and YOD and LOD care units, the F × S score per symptom, gender, dementia
subtype, and dementia severity.
Results
Nurses working in YOD care units rated sleep and nighttime behavior disorders, delusions,
and agitation/aggression most often as highly distressing and euphoria most often
as not distressing. Multivariate analyses indicated that the frequency and severity
of NPS were significantly associated with staff distress in all symptoms, except for
apathy. Comparison of the 2 groups of nurses demonstrated that the odds for distress
related to sleep and nighttime behavior disorders were higher for nurses in YOD care
units than for nurses in LOD units. For both the YOD and LOD nurses, irritability
in male residents had higher impact than similar behavior in female residents.
Conclusion
This study provides important insight into distress related to individual NPS and
the interaction with residents' characteristics. All NPS result in distress. The frequency
and severity of the behavior is an important predictor. Sleep and nighttime behavior
disorders are more likely to result in distress in YOD nurses than in LOD nurses.
The amount of distress related to NPS emphasizes the urgent need for adequate management
of NPS and the support of professional caregivers.
Keywords
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Article info
Publication history
Published online: November 14, 2017
Footnotes
This study was funded by the Netherlands Organization for Health Research and Development (ZonMW, no. 733050402), the Archipel Care Group in the Netherlands, the Florence Care Group in the Netherlands, the Dutch YOD Knowledge Center, and the Dutch Alzheimer Society.
The authors declare no conflicts of interest.
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© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
