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The Gerontologist Advance Access originally published online on April 6, 2009
The Gerontologist 2009 49(2):175-184; doi:10.1093/geront/gnp026
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Changing the Philosophy of Care in Long-Term Care: Testing of the Restorative Care Intervention

Barbara Resnick, PhD, CRNP, FAAN, FAANP1,2, Ann L. Gruber-Baldini, PhD3, Elizabeth Galik, PhD, CRNP2, Ingrid Pretzer-Aboff, PhD, RN4, Karin Russ, BSN2, J. Richard Hebel, PhD3 and Sheryl Zimmerman, PhD5

2 Department of Organizational Systems & Adult Health, University of Maryland School of Nursing, Baltimore
3 Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore
4 School of Nursing, College of Health Sciences, University of Delaware, Newark, Delaware
5 School of Social Work, University of North Carolina, Chapel Hill

1 Address correspondence to Barbara Resnick, PhD, CRNP, FAAN, FAANP, University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21201. E-mail: barbresnick{at}aol.com; bresnick{at}umaryland.edu


  Abstract

Purpose: The purpose of this study was to test the effectiveness of a 12-month restorative care (Res-Care) intervention on the beliefs related to Res-Care, knowledge of Res-Care, observed performance of Res-Care with residents, and job satisfaction among nursing assistants (NAs) in nursing home (NH) settings. Design and Methods: This was a randomized controlled trial including 12 sites and used a repeated measure design with follow-up testing done at 4 and 12 months. An intention-to-treat principle was followed in all analyses, and generalized estimating equations were used to perform repeated measures. A total of 556 NAs consented to participate and completed baseline assessments (265 in treatment and 258 in control sites), 427 completed 4-month follow-up (218 in treatment and 195 in control sites), and 357 completed 12-month follow-up (168 in treatment and 158 in control sites). Results: There was a statistically significant increase in the treatment group participants’ outcome expectations related to Res-Care activities (p = .04) and performance of Res-Care (p < .001) at 4 months, and an increase in knowledge of Res-Care (p < .001) and job satisfaction (p < .001) at 12 months. There was no difference between the groups with regard to self-efficacy expectations. Implication: This study provides an important step in understanding the implementation of a Res-Care philosophy in NH settings and the benefit this can have for NAs.

Keywords: Restorative care, Long-term care, Nursing assistants

Received March 16, 2008; Accepted June 9, 2008

Decision Editor: William J. McAuley, PhD


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