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Nursing Home Resident Outcomes from the Res-Care Intervention
Authors:Barbara Resnick  PhD  GNP-BC    Ann L. Gruber-Baldini  PhD    Sheryl Zimmerman  PhD    Elizabeth Galik  PhD  CRNP    Ingrid Pretzer-Aboff  PhD  RN    Karin Russ  BSN     J. Richard Hebel  PhD
Affiliation:From the Department of Organizational Systems and Adult Health,;School of Nursing and;Department of Epidemiology, School of Medicine, University of Maryland, Baltimore, Maryland;;Program on Aging, Disability and Long-Term Care, Cecil G. Sheps Center for Health Services Research,;Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, North Carolina;and;School of Nursing, University of Delaware, Newark, Delaware.
Abstract:
OBJECTIVES: To test the effectiveness of a restorative care (Res-Care) intervention on function, muscle strength, contractures, and quality of life of nursing home residents, with secondary aims focused on strengthening self-efficacy and outcome expectations.
DESIGN: A randomized controlled repeated-measure design was used, and generalized estimating equations were used to evaluate status at baseline and 4 and 12 months after initiation of the Res-Care intervention.
SETTING: Twelve nursing homes in Maryland.
PARTICIPANTS: Four hundred eighty-seven residents consented and were eligible: 256 from treatment sites and 231 from control sites. The majority were female (389, 80.1%) and white (325, 66.8%); 85 (17.4%) were married and the remaining widowed, single, or divorced/separated. Mean age was 83.8 ± 8.2, and mean Mini-Mental State Examination score was 20.4 ± 5.3.
INTERVENTION: Res-Care was a two-tiered self-efficacy-based intervention focused on motivating nursing assistants and residents to engage in functional and physical activities.
MEASUREMENTS: Barthel Index, Tinetti Gait and Balance, grip strength, Dementia Quality-of-Life Scale, self-efficacy, and Outcome Expectations Scales for Function.
RESULTS: Significant treatment-by-time interactions ( P <.05) were found for the Tinetti Mobility Score and its gait and balance subscores and for walking, bathing, and stair climbing.
CONCLUSION: The findings provide some evidence for the utility and safety of a Res-Care intervention in terms of improving function in NH residents.
Keywords:restorative care    function    nursing home residents    self-efficacy    outcome expectations
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