title: Longitudinal psychological outcomes of the small-scale nursing home model: a latent growth curve zero-inflated Poisson model.
abstract: BACKGROUND
  This study aims to examine the longitudinal effects of a small-scale nursing home model on the change rates of psychological outcomes by comparing green house (GH) and traditional nursing home residents.
  
  
  METHODS
  A total of 242 residents (93 GH and 149 traditional home residents) who resided at the home least 6 months from admission. Four minimum dataset assessments every six months from admission were included. The main psychological outcomes were depressive mood, and social engagement. The main independent variable was the facility type that the resident resided in: a GH or traditional unit. Age, gender, ADL function, and cognitive function at admission were controlled in the model. A zero-inflated Poisson (ZIP) growth curve model was utilized to compare change rates of two psychological outcomes between the two groups taking into account many zero counts of two outcome measures.
  
  
  RESULTS
  A rate of increase in depressive symptoms for GH home residents was higher than that of traditional home residents (β = 0.135, p-value = 0.025). GH home residents had a lower rate of increase of the probability of "not being socially engaged" over time compared to traditional home residents (β = -0.274, p-value = 0.010).
  
  
  CONCLUSIONS
  The GH nursing home model had a longitudinal effect on increasing the probability of residents' social engagement over time, but also increasing the recognition of depressive symptoms compared to traditional nursing homes.
authors.affiliation: School of Nursing,University of Wisconsin-Madison,701 Highland Avenue,Madison,WI,53792-2455,USA.
authors.forename: Ju Young
authors.initials: JY
authors.lastname: Yoon
authors.affiliation: School of Nursing,University of Wisconsin-Madison,701 Highland Avenue,Madison,WI,53792-2455,USA.
authors.forename: Roger L
authors.initials: RL
authors.lastname: Brown
authors.affiliation: School of Nursing,University of Wisconsin-Madison,701 Highland Avenue,Madison,WI,53792-2455,USA.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Bowers
authors.affiliation: Health Management Strategies,9600 Escarpment Blvd,Suite 745-21,Austin,TX 78749,USA.
authors.forename: Siobhan S
authors.initials: SS
authors.lastname: Sharkey
authors.affiliation: International Severity Information Systems/Institute for Clinical Outcomes Research,699 East South Temple,Suite 300 Salt Lake City,UT 84102-1282,USA.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Horn
mesh_terms: D000369:Aged, 80 and over; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006707:Homes for the Aged / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D017146:Models, Organizational; D009735:Nursing Homes / Q000458:organization & administration* / Q000592:standards; D016012:Poisson Distribution
keywords: nursing home