| The purpose of this study is to investigate the effects of a small-scale nursing home model from the longitudinal health outcome trajectories. This study used GH homes in the U.S as a representative small-scale nursing home model, and compared the change patterns of health outcomes over time in GH homes and traditional nursing homes (Main homes) controlling for age and gender. This study is a retrospective longitudinal analysis using minimum dataset (MDS). The total sample size included in this study was 242 residents: 93 GH home residents and 145 Main home residents. The main health outcome measures were ADL function, cognitive function, aggressive behavior symptoms, and negative mood symptoms. Latent growth curve modeling including quadratic term was utilized to examine the effect of the facility type on the residents' health outcome trajectories. After controlling for age and gender, there were several significant conclusions: 1) the ADL function of both groups' of nursing home residents were reported to become worse over time with no statistically significant differences of intercept, slope, and quadratic term; 2) Cognitive function was quite stable over time in both GH home and Main home residents; 3) GH home residents were reported to have a higher linear rate of aggressive behavior symptoms with more significant deceleration over time compared to the Main home residents who showed a stable pattern; and 4) GH home residents were reported to have a higher baseline and slope of negative mood compared to the stable change pattern of Main home residents' mood trajectory. The increasing patterns of behavioral symptoms and negative mood in GH homes are not necessarily negative findings because it may suggest that small-scale nursing homes provide more environmental freedom to express behavioral symptoms and more proactive care to identify and handle residents' negative mood. Furthermore, this study was based on MDS assessed by RNs in nursing homes, in which nursing staff might be more sensitive to recognize residents' changes in behaviors and mood and more likely to report these changes due to the close relationships between staff and residents in small-scale units. |
