Impact of the nursing home scale on residents' social engagement in South Korea.
This study aimed to describe the levels of social engagement and to examine the relationship between the nursing home scale groups and social engagement in nursing homes in South Korea.



A total of 314 residents were randomly selected from rosters provided by 10 nursing homes located in three metropolitan areas in South Korea. The outcome variable was social engagement measured by the Revised Index of Social Engagement (RISE), and the key independent variable was the nursing home scale (small, medium, and large). Individual factors (age, gender, activities of daily living and cognitive function, and depressive symptoms) and organizational factors (location, ownership, and staffing levels) were controlled in the model as covariates. Multilevel logistic regression was used in this study.



About half of the residents (46%) in this study were not socially engaged in the nursing home (RISE=0) where they resided. Controlling for individual- and organizational-level factors, the nursing home facility size was a significant factor to predict the likelihood of residents' social engagement, with that the residents in large-scale nursing homes being less likely to be socially engaged than those in medium-scale nursing homes (odds ratio = 0.457; p-value = 0.005).



This study supports evidence from previous studies that smaller-scale nursing homes are likely to provide more person-centered care compared to larger-scale nursing homes. Subsequent quality studies are needed to examine how the mechanisms for how smaller-scale nursing homes can enhance residents' social engagement in terms of care delivery processes.
College of Nursing and Research Institute of Nursing Science,Seoul National University,Seoul,110-799,South Korea.
Ju Young
JY
Yoon
Department of Public Health,Graduate School of Public Health and Institute of Aging,Seoul National University,Seoul,151-742,South Korea.
Hongsoo
H
Kim
Graduate School of Public Health and Institute of Health and Environment,Seoul National University,Seoul,151-742,South Korea.
Young-Il
YI
Jung
Department of Social Welfare,College of Social Sciences,Seoul National University,Seoul,151-742,South Korea.
Jung-Hwa
JH
Ha
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000145:classification / Q000458:organization & administration; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000145:classification / Q000458:organization & administration; D010358:Patient Participation / Q000379:methods / Q000706:statistics & numerical data; D011788:Quality of Life; D012924:Social Conditions; D012932:Social Facilitation; D013223:Statistics as Topic
culture; nursing homes; quality of life; service delivery