Living Well With Dementia: Factors Associated With Nursing Home Residents' Affect Balance.
Ann Kolanowski, Liza Behrens, Erik Lehman and 7 others
PMID 31454406WHAT IT FOUND
Positive staff interactions and better daily living function were independently associated with more positive than negative affect among nursing home residents with cognitive impairment.
Staff knowledge and more RN and nurse assistant hours also tracked with better affect.
Key findings
01Quality of staff interaction and resident function were independently associated with higher affect balance after controlling for other variables.
02In bivariate analyses, staff knowledge, RN hours, and CNA hours were positively associated with resident affect balance.
0355.1% of participants had affect ratios below 3.0, which some investigators consider high-level well-being.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional secondary analysis of baseline data, so it shows association rather than cause. The original trial was not powered to detect small effects linked to affect balance. Psychoactive medication use and staff job satisfaction or turnover were not measured or controlled. Staff knowledge, RN, LPN, CNA hours, environment, and policies were facility averages assigned to each resident, so they could not be tied to individual care. Negative staff interactions were rare, with only 12 episodes rated solely negative, limiting what the study could show about negative interactions.
Declared interests
The supplied publication types list NIH extramural research support. No author conflict-of-interest or funding statement appears in the supplied article text.
The easy way to misread this
Do not conclude that increasing RN or CNA hours, training staff, or changing environment will improve resident affect. This was a cross-sectional secondary analysis, and staff knowledge, RN hours, and CNA hours were significant only in bivariate analyses; after adjustment, quality of staff interaction and function remained independently associated.