Table 3.
Family and Staff Perceptions and Well-Being, by Setting Type
| Family Measures | Direction and range of scale | NH (N=135) | RC/AL (N=353) | Unadjusted | Adjusted | |||
|---|---|---|---|---|---|---|---|---|
| Mean | SD | Mean | SD | p | pa | |||
| Family Perceptions of Caregiving Role - conflict with staff | Neg | 1–5 | 2.47 | (0.62) | 2.46 | (0.63) | .92 | .61 |
| Family Perceptions of Caregiving Role - guilt | Neg | 1–5 | 2.29 | (0.72) | 2.27 | (0.68) | .99 | .008 |
| Family Perceptions of Caregiving Role - loss | Neg | 1–5 | 2.79 | (0.84) | 2.58 | (0.74) | .09 | .29 |
| Family Perceptions of Care - management | Pos | 1–5 | 3.13 | (0.53) | 3.22 | (0.64) | .47 | .76 |
| Family Perceptions of Care - physical care | Pos | 1–5 | 3.39 | (0.58) | 3.57 | (0.57) | .09 | .58 |
| Family Perceptions of Care - activities for residents | Pos | 1–5 | 3.08 | (0.73) | 3.16 | (0.73) | .61 | .37 |
| Interpersonal Conflict Scale | Neg | 7–35 | 10.16 | (3.91) | 9.80 | (3.59) | .45 | .21 |
| Center for Epidemiological Studies Depression Scale | Neg | 0–10 | 2.61 | (2.28) | 2.43 | (2.23) | .48 | .040 |
| Zarit Burden Interview - social consequences | Neg | 0–24 | 2.50 | (3.68) | 3.49 | (3.73) | .029 | .11 |
| Zarit Burden Interview - psychological burden | Neg | 0–24 | 3.45 | (3.59) | 5.62 | (4.18) | <.001 | .08 |
| Zarit Burden Interview - guilt | Neg | 0–16 | 4.69 | (3.32) | 4.95 | (2.93) | .49 | .11 |
| Lawton Caregiving Appraisal - burden | Neg | 10–50 | 17.12 | (6.34) | 18.87 | (6.73) | .05 | .035 |
| Lawton Caregiving Appraisal - satisfaction | Pos | 5–25 | 20.17 | (4.38) | 19.11 | (3.98) | .13 | .34 |
| Lawton Caregiving Appraisal - impact | Neg | 4–20 | 4.91 | (1.65) | 5.58 | (1.92) | .006 | .09 |
| Staff Measures | Direction and range of scale | NH (N=106) | RC/AL (N=291) | Unadjusted | Adjusted | |||
| Mean | SD | Mean | SD | p | pa | |||
| Staff Perceptions of Caregiving Role - burden | Neg | 1–5 | 2.21 | (0.43) | 2.16 | (0.49) | .43 | .12 |
| Staff Perceptions of Caregiving Role - frustration | Neg | 1–5 | 3.54 | (0.57) | 3.65 | (0.53) | .26 | .12 |
| Staff Perceptions of Caregiving Role - dominion | Neg | 1–5 | 3.10 | (0.54) | 3.12 | (0.53) | .83 | .72 |
| Staff Perceptions of Caregiving Role - exclusion | Neg | 1–5 | 2.14 | (0.36) | 2.14 | (0.37) | .94 | .54 |
| Attitudes Toward Families - disruption | Pos | 1–5 | 3.41 | (0.58) | 3.48 | (0.52) | .39 | .25 |
| Attitudes Toward Families - family partners | Pos | 1–5 | 3.95 | (0.45) | 3.93 | (0.48) | .79 | .71 |
| Attitudes Toward Families - family relevance | Pos | 1–5 | 2.97 | (0.59) | 3.04 | (0.56) | .41 | .72 |
| Family Empathy | Pos | 3–15 | 8.35 | (2.39) | 8.62 | (2.34) | .36 | .14 |
| Family Behaviors | Pos | 4–20 | 14.31 | (2.99) | 15.27 | (3.04) | .008 | .28 |
| Interpersonal Conflict Scale | Neg | 7–35 | 11.87 | (5.18) | 11.77 | (5.47) | .71 | .79 |
| Center for Epidemiological Studies Depression Scale | Neg | 0–10 | 2.62 | (1.98) | 2.38 | (1.99) | .31 | 51 |
| Work Stressors Inventory | Neg | 4–20 | 10.50 | (2.95) | 10.88 | (3.54) | .54 | .047 |
| Hasslesb | Neg | 17–85 | 47.35 | (9.98) | 44.81 | (9.55) | .08 | .14 |
| Upliftsb | Pos | 20–100 | 89.77 | (8.08) | 86.66 | (10.67) | .048 | .028 |
| Maslach Burnout Inventory - emotional exhaustion | Neg | 0–54 | 14.76 | (12.28) | 13.06 | (11.22) | .35 | .45 |
| Maslach Burnout Inventory - depersonalization | Neg | 0–30 | 2.31 | (3.16) | 1.89 | (2.94) | .30 | .92 |
| Maslach Burnout Inventory - personal accomplishment | Pos | 0–48 | 39.65 | (7.27) | 40.19 | (7.45) | .56 | .53 |
| Feel respected by families as part of healthcare team | Pos | 1–3 | 2.63 | (0.50) | 2.66 | (0.48) | .66 | .08 |
| Would recommend workplace | Pos | 1–4 | 3.38 | (0.70) | 3.31 | (0.77) | .67 | .020 |
| How likely will leave job | Neg | 1–3 | 1.41 | (0.60) | 1.63 | (0.78) | .040 | .62 |
| Absenteeism (average hours missed per month) | Neg | 0–32 | 4.9 | (3.0) | 3.4 | (1.5) | .13 | .004 |
| Turnover (percent) c | Neg | 0–100 | 34 | (16) | 30 | (17) | .61 | .31 |
Note: Under “Direction of Scale”, “Neg” indicates that higher values represent less favorable scores, and “Pos” indicates that higher values represent more favorable scores. The Family Perceptions of Caregiving Role instrument and Family Perceptions of Care Tool were scored 1–5, which differs from the 1–7 range used by the developers.
P values for models with adjustment for family, staff, resident, and site characteristics for which there was a significant difference between NHs and RC/AL settings. Variables for adjustment were: for family, minority race, relationship to resident, and general health; for staff, age and staff role; for residents, general health, ADLs, IADLs, cognitive status, quality of life, depression, and source of payment; for sites, years in operation, size, and proportion of residents receiving state assistance or Medicaid support.
The Hassles and Uplifts scales were scored on a scale of 1 (never experienced) to 5 (tremendous hassle/uplift), and a summary score was calculated.
Turnover is the proportion of staff enrolled in the study at baseline who left employment (quit or fired) during the following 12 months.