Program to Enhance Adjustment to Residential Living (PEARL): Effect on Adjustment, Anxiety, Quality of Life, and Stress

ABSTRACT

Objectives

The Program to Enhance Adjustment to Residential Living (PEARL) is a five session intervention primarily designed to address high rates of depression in newly admitted residents. This study reports the efficacy of PEARL on secondary outcomes of resident adjustment, symptoms of anxiety, quality of life, and stress.

Methods

A cluster randomized controlled trial was conducted with 219 newly admitted nursing home residents (M age = 85.5 years) from 42 nursing homes. Outcomes were assessed at baseline, post-intervention, and at two and six month post-intervention follow-up, compared to a standard care condition.

Results

There was a significant overall condition by time interaction for adjustment (p = .027) and quality of life (p = .015), but not for stress (p = .309). While the overall condition by time interaction was not significant for anxiety (p = .221), there was a significant interaction contrast six-month post-intervention, indicating a greater decrease in anxiety scores in the intervention group relative to control (p = .039).

Conclusions

This study demonstrates the broad effects of PEARL on the wellbeing of newly admitted residents.

Clinical Implications

PEARL is a brief intervention that may be feasible for routine use in nursing homes to facilitate adjustment and improve residents’ quality of life.

KEYWORDS:

• Adjustment
• anxiety
• residential aged care
• nursing home
• long term care
• psychological treatment
• quality of life

Acknowledgements

The authors acknowledge the clinicians who delivered the intervention (Julie Kelly, Brittany Watson, Fiona Lynch, Mayio Konidaris-Kozirakis, and Alexandra Creighton), and the researchers who collected the data (Sofie Dunkerley, Olivia Trencher, Lauren Pigdon, Priscilla Marietta, and Jacqueline Noble) and coordinated recruitment and data collection (Anastasia Konis and Vera Camões Costa). The authors also acknowledge Daniel O’Connor for input into the design of the trial and Jessica Byers for designing the clinician manual. The authors thank the residents and staff who participated in this trial. The ideas and opinions expressed herein are those of the authors alone, and endorsement by the authors’ institutions or the National Health and Medical Research Council is not intended and should not be inferred.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability of statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Ethical principles

The authors affirm having followed professional ethical guidelines in preparing this work. These guidelines include obtaining informed consent from human participants, maintaining ethical treatment and respect for the rights of human or animal participants, and ensuring the privacy of participants and their data, such as ensuring that individual participants cannot be identified in reported results or from publicly available original or archival data.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website

Additional information

Funding

This work was supported by Grant GNT1102997 from the National Health and Medical Research Council.