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• W3201355938 abstract "In nursing homes, the prevalence of dementia andmental illness (depression/anxiety) is high. However, nursinghomes generally do not have adequate resources to providegeriatric psychiatric services. While the quality of care innursing homes is a persistent national concern, relatively littleis known about the impact of dementia and depression/anxiety onnursing home care. The first objective of this dissertation is toexamine the impact of dementia and depression/anxiety on quality ofcare for nursing home residents with and without theseconditions. Quality of mental health care in nursing homes,measured by residents’ depressive/anxious symptoms, did notimprove in the past two decades. At the same time, wide variationin this measure has been shown across nursing homes. Severalstudies have suggested that nursing home environment, measured bythe work relationships among staff, may influence residents’outcomes. The second objective of this study is to investigate theassociation between nursing home work environment and residents’mental health outcome, measured by changes in depressive/anxioussymptoms. Methods The analyses employed five secondary datasets,including the national Minimum Data Set, the Medicare beneficiarysummary file, Medicare Provider Analysis and Review file,LTCFocUS.org data, and a staff survey in New York State nursinghomes. The impact of dementia and mental illness on quality ofnursing home care was examined at both the individual and facilitylevels, with the national samples of nursing home residents. Atthe individual level, multivariate logistic and Poisson regressionmodels with facility fixed-effects were estimated to examine thewithin-facility differences in physical restraint use and numberof potentially avoidable hospitalizations (PAHs) between residentswith and without dementia or depression/anxiety residing in thesame facility. At the facility level, I fit logistic and Poissonregression models with facility random-effects to examine theassociation between facility-level prevalence of dementia /prevalence of depression/anxiety and four quality measures amongresidents with and without these diagnoses. The four qualitymeasures were urinary incontinence, pressure ulcer, PAHs, anddepressive/anxious symptoms. The association between workenvironment, measured by staff relational coordination, andresidents’ depressive/anxious symptoms was tested with a sample ofnursing homes and residents from New York State. Multivariatelogistic regression models with facility random-effects wereestimated to examine this association. Results The results showedthat residents with dementia or depression/anxiety were morelikely to be physically restrained, and less likely to behospitalized for potentially avoidable conditions, compared toresidents without these conditions in the same facility. Theassociation between facility-level prevalence of dementia andquality of care in nursing homes was found to be non-linear, tovary across different…" @default.
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• W3201355938 date "2014-01-01" @default.
• W3201355938 modified "2023-09-27" @default.
• W3201355938 title "Quality of Care in Nursing Homes: The Impact of Dementia,Mental Illness, and Work Environment" @default.
• W3201355938 hasPublicationYear "2014" @default.
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