Nursing Home Resident Outcomes from the Res-Care Intervention

Authors

  • Barbara Resnick PhD, GNP-BC,

    1. From the *Department of Organizational Systems and Adult Health, **School of Nursing and Department of Epidemiology, School of Medicine, University of Maryland, Baltimore, MarylandProgram 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 CarolinaSchool of Nursing, University of Delaware, Newark, Delaware.
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  • Ann L. Gruber-Baldini PhD,

    1. From the *Department of Organizational Systems and Adult Health, **School of Nursing and Department of Epidemiology, School of Medicine, University of Maryland, Baltimore, MarylandProgram 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 CarolinaSchool of Nursing, University of Delaware, Newark, Delaware.
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  • Sheryl Zimmerman PhD,

    1. From the *Department of Organizational Systems and Adult Health, **School of Nursing and Department of Epidemiology, School of Medicine, University of Maryland, Baltimore, MarylandProgram 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 CarolinaSchool of Nursing, University of Delaware, Newark, Delaware.
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  • Elizabeth Galik PhD, CRNP,

    1. From the *Department of Organizational Systems and Adult Health, **School of Nursing and Department of Epidemiology, School of Medicine, University of Maryland, Baltimore, MarylandProgram 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 CarolinaSchool of Nursing, University of Delaware, Newark, Delaware.
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  • Ingrid Pretzer-Aboff PhD, RN,

    1. From the *Department of Organizational Systems and Adult Health, **School of Nursing and Department of Epidemiology, School of Medicine, University of Maryland, Baltimore, MarylandProgram 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 CarolinaSchool of Nursing, University of Delaware, Newark, Delaware.
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  • Karin Russ BSN,

    1. From the *Department of Organizational Systems and Adult Health, **School of Nursing and Department of Epidemiology, School of Medicine, University of Maryland, Baltimore, MarylandProgram 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 CarolinaSchool of Nursing, University of Delaware, Newark, Delaware.
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  • J. Richard Hebel PhD

    1. From the *Department of Organizational Systems and Adult Health, **School of Nursing and Department of Epidemiology, School of Medicine, University of Maryland, Baltimore, MarylandProgram 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 CarolinaSchool of Nursing, University of Delaware, Newark, Delaware.
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Address correspondence to Barbara Resnick, Sonya Ziporkin Gershowitz Chair in Gerontology, University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21201. E-mail: barbresnick@aol.com

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.

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