Changing the philosophy of care in long-term care: testing of the restorative care intervention.
OBJECTIVE
The purpose of this study was to test the effectiveness of a 12-month restorative care (Res-Care) intervention on the beliefs related to Res-Care, knowledge of Res-Care, observed performance of Res-Care with residents, and job satisfaction among nursing assistants (NAs) in nursing home (NH) settings.


METHODS
This was a randomized controlled trial including 12 sites and used a repeated measure design with follow-up testing done at 4 and 12 months. An intention-to-treat principle was followed in all analyses, and generalized estimating equations were used to perform repeated measures. A total of 556 NAs consented to participate and completed baseline assessments (265 in treatment and 258 in control sites), 427 completed 4-month follow-up (218 in treatment and 195 in control sites), and 357 completed 12-month follow-up (168 in treatment and 158 in control sites).


RESULTS
There was a statistically significant increase in the treatment group participants' outcome expectations related to Res-Care activities (p = .04) and performance of Res-Care (p < .001) at 4 months, and an increase in knowledge of Res-Care (p < .001) and job satisfaction (p < .001) at 12 months. There was no difference between the groups with regard to self-efficacy expectations.


CONCLUSIONS
This study provides an important step in understanding the implementation of a Res-Care philosophy in NH settings and the benefit this can have for NAs.
University of Maryland School of Nursing, Baltimore, MD 21201, USA. barbresnick@aol.com
Barbara
B
Resnick
Ann L
AL
Gruber-Baldini
Elizabeth
E
Galik
Ingrid
I
Pretzer-Aboff
Karin
K
Russ
J Richard
JR
Hebel
Sheryl
S
Zimmerman
D000328:Adult; D005260:Female; D005851:Geriatric Nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010687:Philosophy, Nursing; D019145:Rehabilitation Nursing