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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: yoon26@wisc.edu.
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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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