Social Climate Factors and Self-esteem among Residents of Nursing Homes with Differing Restraint Practices

2.50
Hdl Handle:
http://hdl.handle.net/10755/147480
Type:
Presentation
Title:
Social Climate Factors and Self-esteem among Residents of Nursing Homes with Differing Restraint Practices
Abstract:
Social Climate Factors and Self-esteem among Residents of Nursing Homes with Differing Restraint Practices
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Vallone, Doris
P.I. Institution Name:Widener University
Objective: The purpose of this study was to investigate the relationships between perceived social climate factors and resident self-esteem while further exploring the influence of facility restraint practices. Design: A descriptive correlational design was used to examine relationships among perceived social climate factors: cohesion, independence, and resident influence; and resident self-esteem, while controlling for type of facility and resident perceived functional and affective status. Sample: The total sample of 83 included 47 subjects from the restraint-free home and 36 subjects from the restraint limited home. The mean age of the sample was 85.87 (S.D 6.12, range 71-98). Women comprised 82 percent of the sample. Setting: This study was conducted in 2 religiously affiliated nursing homes. The restraint-free facility had policies and a mission stating that it was restraint-free. The restraint-limited facility had policies limiting the use of restraints to those instances specified by OBRA guidelines. The size of the homes was 120 and 110 beds respectively. Names of Variables or Concepts: Cohesion: The degree to which staff members of an institution are helpful and supportive of residents and residents are supportive of each other. Independence: The degree to which residents are self-sufficient. The degree of self-responsibility they exercise. Resident Influence: The extent to which residents can influence the rules and policies of an institution. Self-esteem: The evaluation that an individual makes with regard to himself or herself. Measurements/Instruments: Moos Sheltered Care Environment Scale-Real Form (SCES-R): Contains 7 subscales consisting of 9 yes-no items. Three subscales were used: Cohesion, Independence, and Resident Influence. Rosenberg Self-esteem Scale (SES): Consists of 10 items reported along a 4-point scale. Self-rated Health and Functional Status (SRHFI): Consists of 5 items about an individual's ability to perform ADL's. Perceived Affective Status (Depression): A single screening item for depression. Findings: Only the social climate factor of resident influence was found to be positively related to self-esteem once affective and functional status were controlled (b = .32, p = <.01). There were no differences in either the social climate factors or self-esteem by facility type (restraint-free or restraint-limited) once affective and functional status was controlled. Conclusions: While attention to psychosocial aspects of care of the nursing home resident is important, resident empowerment appears to be the most important factor for resident self-esteem. Once the effects of resident functional and affective status are controlled, restraint practices do not seem to influence the social climate or self-esteem. It may be that other contextual factors not measured moderate the effect of restraint practices on perceived social climate or self-esteem. Implications: Self-esteem in older adults has been called the "linchpin" of well being. This research adds to the body of knowledge suggesting the relationship between resident outcomes and control over the environment. Policy factors may inhibit facility staff from giving residents say in their daily lives. Regulations need to be evaluated from a perspective of resident freedom and influence. While the movement toward restraint-free facilities is an important goal, it is encouraging that that data from the restraint-limited facility were similar to those from the restraint-free facility.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSocial Climate Factors and Self-esteem among Residents of Nursing Homes with Differing Restraint Practicesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/147480-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Social Climate Factors and Self-esteem among Residents of Nursing Homes with Differing Restraint Practices</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Vallone, Doris</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Widener University</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">doris.vallone@widener.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: The purpose of this study was to investigate the relationships between perceived social climate factors and resident self-esteem while further exploring the influence of facility restraint practices. Design: A descriptive correlational design was used to examine relationships among perceived social climate factors: cohesion, independence, and resident influence; and resident self-esteem, while controlling for type of facility and resident perceived functional and affective status. Sample: The total sample of 83 included 47 subjects from the restraint-free home and 36 subjects from the restraint limited home. The mean age of the sample was 85.87 (S.D 6.12, range 71-98). Women comprised 82 percent of the sample. Setting: This study was conducted in 2 religiously affiliated nursing homes. The restraint-free facility had policies and a mission stating that it was restraint-free. The restraint-limited facility had policies limiting the use of restraints to those instances specified by OBRA guidelines. The size of the homes was 120 and 110 beds respectively. Names of Variables or Concepts: Cohesion: The degree to which staff members of an institution are helpful and supportive of residents and residents are supportive of each other. Independence: The degree to which residents are self-sufficient. The degree of self-responsibility they exercise. Resident Influence: The extent to which residents can influence the rules and policies of an institution. Self-esteem: The evaluation that an individual makes with regard to himself or herself. Measurements/Instruments: Moos Sheltered Care Environment Scale-Real Form (SCES-R): Contains 7 subscales consisting of 9 yes-no items. Three subscales were used: Cohesion, Independence, and Resident Influence. Rosenberg Self-esteem Scale (SES): Consists of 10 items reported along a 4-point scale. Self-rated Health and Functional Status (SRHFI): Consists of 5 items about an individual's ability to perform ADL's. Perceived Affective Status (Depression): A single screening item for depression. Findings: Only the social climate factor of resident influence was found to be positively related to self-esteem once affective and functional status were controlled (b = .32, p = &lt;.01). There were no differences in either the social climate factors or self-esteem by facility type (restraint-free or restraint-limited) once affective and functional status was controlled. Conclusions: While attention to psychosocial aspects of care of the nursing home resident is important, resident empowerment appears to be the most important factor for resident self-esteem. Once the effects of resident functional and affective status are controlled, restraint practices do not seem to influence the social climate or self-esteem. It may be that other contextual factors not measured moderate the effect of restraint practices on perceived social climate or self-esteem. Implications: Self-esteem in older adults has been called the &quot;linchpin&quot; of well being. This research adds to the body of knowledge suggesting the relationship between resident outcomes and control over the environment. Policy factors may inhibit facility staff from giving residents say in their daily lives. Regulations need to be evaluated from a perspective of resident freedom and influence. While the movement toward restraint-free facilities is an important goal, it is encouraging that that data from the restraint-limited facility were similar to those from the restraint-free facility.</td></tr></table>en_GB
dc.date.available2011-10-26T09:32:51Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T09:32:51Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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