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Gerontologist. 2009 Apr;49(2):175-84. doi: 10.1093/geront/gnp026. Epub 2009 Apr 6.

Changing the philosophy of care in long-term care: testing of the restorative care intervention.

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  • 1University of Maryland School of Nursing, Baltimore, MD 21201, USA.



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.


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).


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.


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.

[PubMed - indexed for MEDLINE]
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