The study will examine the relationship of organizational factors to residents' autonomy in assisted living (AL). AL is growing nationwide, but no comprehensive data exist to address its benefits to residents. Resident autonomy is stressed as a core value of AL, but little is known about how much autonomy residents have in AL. In nursing homes a lack of autonomy is associated with physical decline, whereas opportunities for self-determination are associated with better health outcomes.
The aims of this study are to examine how organizational factors, such as 1) facility relationship to its environment (i.e., financial dependence and organizational interconnectedness). 2) management processes (culture, leadership, and resident-oriented policies), 3) social structure (i.e., staff-residents relationships) and 4) aggregate residents' characteristics (i.e., disability level, social resources) are associated with residents' autonomy at the facility level of analysis. A cross-sectional survey of 60 licensed AL facilities in Maryland will be undertaken. Facility level data will be collected from administrators, staff, and residents using self-administered questionnaires and interviews. Eight scales from the Multiphasic Environmental Assessment Procedure (MEAP) will be used to assess residents' autonomy, staff- residents relationships, policies, and aggregate residents' characteristics. The short version of the Organization Culture Inventory (OCI) and the Multifactor Leadership Questionnaire (MLQ) will be used to assess management processes. Path analysis will be used to simultaneously examine the effects of several groups of variables and isolate the linkages proposed in the conceptual model (with an alpha of .05, two-tailed test as the significance level). Knowledge about the relationship of organizational factors to residents' autonomy can be used to devise strategies for maximizing the quality of resident life in AL. The data collected in this pilot study will serve as a basis for a larger national study to examine the impact of organizational behavior on the quality of care and quality of resident life in AL.
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