Yoon Ju Young, Kim Hongsoo, Jung Young-Il, Ha Jung-Hwa
College of Nursing and Research Institute of Nursing Science,Seoul National University,Seoul,110-799,South Korea.
Department of Public Health,Graduate School of Public Health and Institute of Aging,Seoul National University,Seoul,151-742,South Korea.
Int Psychogeriatr. 2016 Dec;28(12):1965-1973. doi: 10.1017/S1041610216001198. Epub 2016 Sep 9.
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.
本研究旨在描述社会参与水平，并探讨韩国养老院规模分组与社会参与之间的关系。
从韩国三个大城市地区的10家养老院提供的名册中随机抽取314名居民。结果变量是通过修订后的社会参与指数（RISE）衡量的社会参与，关键自变量是养老院规模（小型、中型和大型）。个体因素（年龄、性别、日常生活活动能力、认知功能和抑郁症状）和组织因素（地点、所有权和人员配备水平）在模型中作为协变量进行控制。本研究使用多水平逻辑回归。
本研究中约一半（46%）的居民在其居住的养老院中没有社会参与（RISE = 0）。在控制个体和组织层面因素后，养老院设施规模是预测居民社会参与可能性的一个重要因素，大型养老院的居民比中型养老院的居民社会参与可能性更低（优势比 = 0.457；p值 = 0.005）。
本研究支持了先前研究的证据，即与大型养老院相比，小型养老院可能提供更多以人为主的护理。后续需要进行质量研究，以考察小型养老院在护理提供过程中如何增强居民社会参与的机制。
