Activities of Daily Living in Residents of Nursing Home and Assisted Living Facilities: A Multilevel Analysis

2.50
Hdl Handle:
http://hdl.handle.net/10755/603226
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Title:
Activities of Daily Living in Residents of Nursing Home and Assisted Living Facilities: A Multilevel Analysis
Author(s):
Liu, Wen; Unick, Jay; Resnick, Barbara; Galik, Elizabeth; Unick, Jay; Resnick, Barbara; Galik, Elizabeth
Lead Author STTI Affiliation:
Pi
Author Details:
Wen Liu, RN, wen.liu@umaryland.edu; Jay Unick; Barbara Resnick, RN, CRNP, FAAN, FAANP; Elizabeth Galik, CRNP
Abstract:
Session presented on Saturday, November 7, 2015 and Sunday, November 8, 2015: Background The ability to perform activities of daily living (ADLs) is the most basic function for older adults living in long-term care (LTC). Various personal and institutional factors can be associated with functional performance in ADLs among LTC residents. Purpose The purposes of this study were to examine the trajectory of functional performance in ADLs over time, the variance in functional performance that is attributable to individual and institutional variations, as well as the impact of individual and institutional characteristics on functional performance among residents living in LTC settings. Methods This study was a secondary analysis of longitudinal data of 788 residents from 8 Nursing Home (NH) and 16 Assisted Living (AL) facilities from four cluster-randomized controlled trials. The independent variables included time nested within resident (level 1), resident characteristics including demographics, balance, cognition and length of stay in the long-term care setting (level 2), and facility characteristics including type of intervention and facility (level 3). The dependent variable was resident functional performance of ADLs (level 2) measured by Barthel Index. Covariates were determined based on prior research and bivariate analysis of the data. Multilevel modeling approach was used to distinguish resident and facility level variations on functional performance. Both Random Intercept (RI) and Random Coefficient models were examined, and model fit was compared using likelihood ratio difference. Inter-class correlation was reported to demonstrate the percentage of variance attributable to the resident and facility level variations, as well as the variance explained by covariates. Results The 3-level RI model with covariates was a better fit to the data. Functional performance of ADLs declined over time, decreased as residents’ balance and cognition deteriorated and among those who lived longer in the long-term care facility. Functional performance of ADLs was higher among male, white and AL residents with higher education compared to their counterparts, while such difference decreased between male and female and increased between AL and NH residents over time. More than 78% of variance in function was accounted for by the resident (28%) and facility level (50.5%) variation, while the individual and institutional covariates captured around 20% of the variance, mostly from the facility level. Discussion This study provided preliminary information to support the effects of individual and institutional characteristics on functional performance among long-term care residents. Attentions that are paid to improve balance, alleviate progression of cognitive decline, and reduce the length of stay in NH settings may hold promise for maintaining or improving functional performance in ADLs.
Keywords:
activities of daily living; long-term care; multilevel modeling
Repository Posting Date:
21-Mar-2016
Date of Publication:
21-Mar-2016
Other Identifiers:
CONV15RS1.53
Conference Date:
2015
Conference Name:
43rd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Las Vegas, Nevada, USA
Description:
43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.`

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.titleActivities of Daily Living in Residents of Nursing Home and Assisted Living Facilities: A Multilevel Analysisen
dc.contributor.authorLiu, Wenen
dc.contributor.authorUnick, Jayen
dc.contributor.authorResnick, Barbaraen
dc.contributor.authorGalik, Elizabethen
dc.contributor.authorUnick, Jayen
dc.contributor.authorResnick, Barbaraen
dc.contributor.authorGalik, Elizabethen
dc.contributor.departmentPien
dc.author.detailsWen Liu, RN, wen.liu@umaryland.edu; Jay Unick; Barbara Resnick, RN, CRNP, FAAN, FAANP; Elizabeth Galik, CRNPen
dc.identifier.urihttp://hdl.handle.net/10755/603226en
dc.description.abstractSession presented on Saturday, November 7, 2015 and Sunday, November 8, 2015: Background The ability to perform activities of daily living (ADLs) is the most basic function for older adults living in long-term care (LTC). Various personal and institutional factors can be associated with functional performance in ADLs among LTC residents. Purpose The purposes of this study were to examine the trajectory of functional performance in ADLs over time, the variance in functional performance that is attributable to individual and institutional variations, as well as the impact of individual and institutional characteristics on functional performance among residents living in LTC settings. Methods This study was a secondary analysis of longitudinal data of 788 residents from 8 Nursing Home (NH) and 16 Assisted Living (AL) facilities from four cluster-randomized controlled trials. The independent variables included time nested within resident (level 1), resident characteristics including demographics, balance, cognition and length of stay in the long-term care setting (level 2), and facility characteristics including type of intervention and facility (level 3). The dependent variable was resident functional performance of ADLs (level 2) measured by Barthel Index. Covariates were determined based on prior research and bivariate analysis of the data. Multilevel modeling approach was used to distinguish resident and facility level variations on functional performance. Both Random Intercept (RI) and Random Coefficient models were examined, and model fit was compared using likelihood ratio difference. Inter-class correlation was reported to demonstrate the percentage of variance attributable to the resident and facility level variations, as well as the variance explained by covariates. Results The 3-level RI model with covariates was a better fit to the data. Functional performance of ADLs declined over time, decreased as residents’ balance and cognition deteriorated and among those who lived longer in the long-term care facility. Functional performance of ADLs was higher among male, white and AL residents with higher education compared to their counterparts, while such difference decreased between male and female and increased between AL and NH residents over time. More than 78% of variance in function was accounted for by the resident (28%) and facility level (50.5%) variation, while the individual and institutional covariates captured around 20% of the variance, mostly from the facility level. Discussion This study provided preliminary information to support the effects of individual and institutional characteristics on functional performance among long-term care residents. Attentions that are paid to improve balance, alleviate progression of cognitive decline, and reduce the length of stay in NH settings may hold promise for maintaining or improving functional performance in ADLs.en
dc.subjectactivities of daily livingen
dc.subjectlong-term careen
dc.subjectmultilevel modelingen
dc.date.available2016-03-21T16:46:01Zen
dc.date.issued2016-03-21en
dc.date.accessioned2016-03-21T16:46:01Zen
dc.conference.date2015en
dc.conference.name43rd Biennial Conventionen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationLas Vegas, Nevada, USAen
dc.description43rd Biennial Convention 2015 Theme: Serve Locally, Transform Regionally, Lead Globally.`en
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