title: Factors associated with nursing assistant quality-of-life ratings for residents with dementia in long-term care facilities.
abstract: OBJECTIVE
  We identify resident, nursing assistant, and facility factors associated with nursing assistant quality-of-life ratings for residents with dementia in long-term care.
  
  
  METHODS
  We used a cross-sectional survey of 143 nursing assistants providing care to 335 residents in 38 residential care/assisted living (RC/AL) facilities and nursing homes in four states. We assessed resident quality of life by using the Quality of Life-Alzheimer's Disease Scale (QOL-AD).
  
  
  RESULTS
  Scores on the quality-of-life scale were most strongly associated with resident clinical conditions, including severity of cognitive and functional impairments, depression, and behavioral symptoms of dementia. There was also an independent positive association between nursing assistants' ratings of resident quality of life and their own attitudes regarding dementia-person-centered care as well as training. However, the results of hierarchical linear modeling suggest that some sources of nursing assistant variability in quality-of-life ratings remain unidentified.
  
  
  CONCLUSIONS
  Quality-of-life ratings by nursing assistants may be influenced by their attitudes about dementia and their confidence in addressing residents' fundamental care needs.
authors.affiliation: Division of Geriatric Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599-7550, USA. garywinz@med.unc.edu
authors.forename: Gary S
authors.initials: GS
authors.lastname: Winzelberg
authors.forename: Christianna S
authors.initials: CS
authors.lastname: Williams
authors.forename: John S
authors.initials: JS
authors.lastname: Preisser
authors.forename: Sheryl
authors.initials: S
authors.lastname: Zimmerman
authors.forename: Philip D
authors.initials: PD
authors.lastname: Sloane
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D003430:Cross-Sectional Studies; D003704:Dementia / Q000451:nursing*; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009728:Nursing Assistants / Q000523:psychology*; D009735:Nursing Homes; D011788:Quality of Life