Journal of the American Medical Directors Association
Original StudyDementia Care Redesigned: Effects of Small-Scale Living Facilities on Residents, Their Family Caregivers, and Staff
Section snippets
Design and Sample
A quasi-experimental study was conducted from April 2008 to January 2010 (recruitment period April 2008–December 2008), including 3 measurements: at baseline and follow-ups after 6 and 12 months. A detailed report of the rationale and study design was published elsewhere.14
Two types of long-term institutional nursing care settings were included: small-scale living facilities and regular psychogeriatric wards in nursing homes. The experimental condition consisted of 28 houses in small-scale
Results
Figure 1 describes the number of participants at each stage of the study, including reasons for nonparticipation. In total, 259 residents were included, 124 in small-scale living and 135 in regular wards. Family caregivers were available for 253 residents, of whom 229 were willing to participate: 114 in small-scale living and 115 in regular wards. Finally, 305 nursing staff members participated in the study, 114 from small-scale living and 191 from regular wards.
Participants’ baseline
Discussion
We were unable to demonstrate convincing overall effects of small-scale living facilities for our primary outcome measures. No difference in residents’ total QoL was found and only few dimensions significantly differed. No effects were found for neuropsychiatric symptoms and agitation. Family caregivers in small-scale living were less burdened and were more satisfied with nursing staff contact than family caregivers in regular wards. No effect was found for nursing staff’s job satisfaction and
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This research was funded by Maastricht University, the Province of Limburg, and 5 health care organizations (i.e. MeanderGroep, Orbis, Sevagram, Vivre, de Zorggroep), all located in the Netherlands. None of the authors have any conflicts of interest or financial interests in the study described.