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Longitudinal psychological outcomes of the small-scale nursing home model: a latent growth curve zero-inflated Poisson model

Published online by Cambridge University Press:  13 January 2015

Ju Young Yoon ,
Roger L. Brown ,
Barbara J. Bowers ,
Siobhan S. Sharkey  and
Susan D. Horn
Ju Young Yoon*
Affiliation:
School of Nursing, University of Wisconsin-Madison, 701 Highland Avenue, Madison, WI, 53792-2455, USA
Roger L. Brown
Affiliation:
School of Nursing, University of Wisconsin-Madison, 701 Highland Avenue, Madison, WI, 53792-2455, USA
Barbara J. Bowers
Affiliation:
School of Nursing, University of Wisconsin-Madison, 701 Highland Avenue, Madison, WI, 53792-2455, USA
Siobhan S. Sharkey
Affiliation:
Health Management Strategies, 9600 Escarpment Blvd, Suite 745-21, Austin, TX 78749, USA
Susan D. Horn
Affiliation:
International Severity Information Systems/Institute for Clinical Outcomes Research, 699 East South Temple, Suite 300 Salt Lake City, UT 84102-1282, USA
*
Correspondence should be addressed to: Ju Young Yoon, Assistant Professor, 3117, Cooper Hall, 701 Highland Avenue, Madison, WI, 53792–2455, USA. Phone: +608-263-8238; Fax: +608-263-5332. Email: [email protected].
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Abstract

Background:

This study aims to examine the longitudinal effects of a small-scale nursing home model on the change rates of psychological outcomes by comparing green house (GH) and traditional nursing home residents.

Methods:

A total of 242 residents (93 GH and 149 traditional home residents) who resided at the home least 6 months from admission. Four minimum dataset assessments every six months from admission were included. The main psychological outcomes were depressive mood, and social engagement. The main independent variable was the facility type that the resident resided in: a GH or traditional unit. Age, gender, ADL function, and cognitive function at admission were controlled in the model. A zero-inflated Poisson (ZIP) growth curve model was utilized to compare change rates of two psychological outcomes between the two groups taking into account many zero counts of two outcome measures.

Results:

A rate of increase in depressive symptoms for GH home residents was higher than that of traditional home residents (β = 0.135, p-value = 0.025). GH home residents had a lower rate of increase of the probability of “not being socially engaged” over time compared to traditional home residents (β = −0.274, p-value = 0.010).

Conclusion:

The GH nursing home model had a longitudinal effect on increasing the probability of residents’ social engagement over time, but also increasing the recognition of depressive symptoms compared to traditional nursing homes.

Keywords

person-centered careculture changegreen house nursing homedepressionsocial engagementbehaviorsnursing home
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 6 , June 2015 , pp. 1009 - 1016
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Annerstedt, L. (1993). Development and consequences of group living in Sweden. A new mode of care for the demented elderly. Social Science and Medicine, 37, 1529–1538.Google Scholar
Bowers, B. J. and Nolet, K. (2014). Developing the green house nursing care team: variations on development and implementation. The Gerontologist, 54, S53–S64.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Dakheel-Ali, M., Jensen, B., Marx, M. S. and Thein, K. (2012). An analysis of the relationships among engagement, agitated behavior, and affect in nursing home residents with dementia. International Psychogeriatrics, 24, 742–752.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Marx, M. S., Thein, K. and Dakheel-Ali, M. (2010). The impact of past and present preferences on stimulus engagement in nursing home residents with dementia. Aging and Mental Health, 14, 67–73.Google Scholar
Dean, R., Proundfoot, R. and Lindesay, J. (1993). The quality of interactions schedule (quis): development, reliability and use in the evaluation of two domus units. International Journal of Geriatric Psychiatry, 8, 819–826.Google Scholar
De Rooij, A. H. P. M., Luijkx, K. G., Schaafsma, J., Declercq, A. G., Emmerink, P. M. J. and Schols, J.M.G. A. (2012). Quality of life of residents with dementia in traditional versus small-scale long-term care settings: a quasi-experimental study. International Journal of Nursing Studies, 49, 931–940.Google Scholar
Eliopoulos, C. (2010). Guest editorial: cultural transformation in nursing homes. International Journal of Older People Nursing, 5, 1–2.CrossRefGoogle ScholarPubMed
Hedeker, D. and Gibbons, R. D. (1997). Application of random-effects pattern-mixture models for missing data in longitudinal studies. Psychological Methods, 2, 64–78.Google Scholar
Kane, R. A., Lum, T. Y., Cutler, L. J., Degenholtz, H. B. and Yu, T.-C. (2007). Resident outcomes in small-house nursing homes: a longitudinal evaluation of the initial Green House program. Journal of the American Geriatrics Society, 55, 832–839.Google Scholar
Lee, A. H., Wang, K., Scott, J. A., Yau, K. K. W. and McLachlan, G. J. (2006). Multi-level zero-inflated poisson regression modelling of correlated count data with excess zeros. Statistical Methods in Medical Research, 15, 47–61.Google Scholar
Lindessay, J., Briggs, K., Lawes, M., MacDonald, A. and Herzberg, J. (1991). The domus philosophy: a comparative evaluation of a new approach to residential care for the demented elderly. International Journal of Geriatric Psychiatry, 6, 727–736.CrossRefGoogle Scholar
Molony, S. L., Evans, L. K., Jeon, S., Rabig, J. and Straka, L. A. (2011). Trajectories of at-homeness and health in usual care and small house nursing homes. The Gerontologist, 51, 504–515.Google Scholar
Mor, V., Berg, K., Angelelli, J., Gifford, D., Morris, J. and Moore, T. (2003). The quality of quality measurement in U.S. nursing homes. The Gerontologist, 43, 37–46.Google Scholar
Mor, V. et al. (1995). The structure of social engagement among nursing home residents. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 50, P1–P8.Google ScholarPubMed
Morris, J. N. et al. (1994). MDS cognitive performance scale. Journal of Gerontology, 49, M174–M182.Google Scholar
Morris, J. N., Fries, B. E. and Morris, S. A. (1999). Scaling ADLs within the MDS. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 54, M546–M553.CrossRefGoogle ScholarPubMed
Muthén, B. and Muthén, L. K. (2000). Integrating person-centered and variable-centered analyses: growth mixture modeling with latent trajectory classes. Alcoholism, clinical and experimental research, 24, 882–891.CrossRefGoogle ScholarPubMed
Muthén, B. and Satorra, , A. (1995). Complex sample data in structural equation modeling. Sociological Methodology, 25, 267–316.CrossRefGoogle Scholar
Power, G. A. (2014). Optimal staffing to prevent nursing home hospitalizations. Medical Care, 52, 93.CrossRefGoogle ScholarPubMed
Rabig, J. (2009). Home again: small houses for individuals with cognitive impairment. Journal of Gerontological Nursing, 35, 10–15.Google Scholar
Rabig, J., Thomas, W., Kane, R. A., Cutler, L. J. and McAlilly, S. (2006). Radical redesign of nursing homes: applying the green house concept in Tupelo, Mississippi. The Gerontologist, 46, 533–539.Google Scholar
Ragsdale, V. and McDougall, G. J. (2008). The changing face of long-term care: looking at the past decade. Issues in Mental Health Nursing, 29, 992–1001.Google Scholar
Saliba, D., Difilippo, S., Edelen, M. O., Kroenke, K., Buchanan, J. and Steim, J. (2012) Testing the PHQ-9 Interview and observational versions (PHQ-9 OV) for MDS 3.0. Journal of the American Medical Directors Association, 13, 618–625.CrossRefGoogle ScholarPubMed
Seok, J. E. (2010). Public long-term care insurance for the elderly in Korea: design, characteristics, and tasks. Social Work in Public Health, 25, 185–209.CrossRefGoogle ScholarPubMed
Smit, D., de Lange, J., Willemse, B. and Pot, A. M. (2012). The relationship between small-scale care and activity involvement of residents with dementia. International Psychogeriatrics, 24, 722–732.Google Scholar
Temkin-Greener, H., Zheng, N., Katz, P., Zhao, H. and Mukamel, D. B. (2009) Measuring work environment and performance in nursing homes. Medical Care, 47, 482–491.Google Scholar
Verbeek, H., Zwakhalen, S. M. G., van Rossum, E., Ambergen, T., Kempen, G. I. J. M. and Hamers, J. P. H. (2010). Dementia care redesigned: effects of small-scale living facilities on residents, their family caregivers, and staff. Journal of the American Medical Directors Association, 11, 662–670.CrossRefGoogle ScholarPubMed
Verbeek, H., Zwakhalen, S. M. G., van Rossum, E., Ambergen, T., Kempen, G. I. J. M., and Hamers, J. P. H. (2014). Effects of small-scale, home-like facilities in dementia care on residents’ behavior, and use of physical restraints and psychotropic drugs: a quasi-experimental study. International psychogeriatrics, 1–12.Google Scholar
Zimmerman, S. and Cohen, L. W. (2010). Evidence behind The Green House and similar models of nursing home care. Aging Health, 6, 717–737.Google Scholar