UMBC School of Social Work

Permanent URI for this collectionhttp://hdl.handle.net/11603/14023

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Racial differences in the quality of care interactions among nursing home residents with dementia
(Taylor & Francis, 2024-05-20) McPherson, Rachel; Resnick, Barbara; Galik, Elizabeth; Gruber-Baldini, Ann L.; Holmes, Sarah; Kusmaul, Nancy
The resident population in nursing homes is increasingly racially diverse. The purpose of this study was to assess racial differences in the quality of care interactions among nursing home residents with dementia. The study utilized baseline data from the Testing the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD), a randomized controlled pragmatic trial. The Quality of Interaction Scale (QuIS) was used to measure quality of staff-resident care interactions. The sample included 531 residents. An analysis of covariance was conducted to address the aim. The majority of interactions were positive social (42%) or positive care (37%). Black residents living with dementia had higher QuIS scores (M = 5.98, SD = 1.66) than White residents with dementia (M = 5.40, SD = 1.75), whereas higher QuIS scores indicating more positive interactions. However, the results of the analysis of covariance indicated that there was not a significant difference in QuIS scores between Black versus White residents living with dementia (p =.203). The findings suggest that care interactions in nursing homes are consistent between Black residents and White residents. Future research should evaluate the impact of staff race on the quality of care interaction among nursing home residents.
The Sibling Leadership Network: Ethical Considerations and Policy Recommendations Impacting Sibling Caregivers
(Sibling Leadership Network, 2024-08-20) Banks, Tiffany; DeVries, Lindsey; Saxena, Mamta; Weaver, Gracie Lee; Gregory, Emma
The Sibling Leadership Network (SLN) is a non-profit organization dedicated to supporting siblings of individuals with disabilities. Siblings play an important role as caregivers in the disability community, but also deserve to be recognized as individuals with their owns needs, identities, and roles. One area in which we support siblings is through advocacy and support for sibling caregiver roles.Caregiving is misunderstood. It is providing someone with formal and informal care that may take the form of emotional, physical, or financial support. Caregiving can occur daily or even temporarily, depending on the experience of the individual. There is no one-size-fits-all definition of caregiving, but all care is essential and valued.The Family Medical Leave Act (FMLA) is a policy that allows employees to take unpaid time from work to care for themselves, their spouse, their parent, or their child. Siblings are not included, unless they are providing caregiving for an individual whose disability prevents them from caring for themselves. We believe that this needs to change to acknowledge the important role siblings play in each other’s lives.Home and Community Based Services (HCBS), funds services that allow people with disabilities to live in their community. HCBS is currently struggling with limited funding and a shortage of direct service providers. Investing in HCBS would decrease demands on family caregivers like siblings.
Measuring Perception of College Welcome Provided to Foreign-Born Students: Validation with Pilot Data
(BON VIEW PUBLISHING, 2024-05-06) Evans, Kerri
Immigrant and foreign-born students are one of the fastest growing populations in higher education across the US, and yet there is a dearth of research around their sense of belonging on campus and in the classroom. Therefore, this paper will cover the development and evaluation process for a scale designed to evaluate the perception of college welcome provided to immigrant students. Data from 94 college students was used to conduct a series of factor analyses to assess the survey questions and their utility for measuring college welcome. The scale is made up of four factors. The Cognitive awareness of college welcome factor showed a Cronbach's alpha of 0.72, the Emotional college welcome factor showed a Cronbach's alpha of 0.732 Behaviors of college welcome showed a Cronbach's alpha of 0.75 and the Relational college welcome showed a Cronbach's alpha 0.767. Overall, Cronbach's alpha is 0.864 for the perception of college welcome which is excellent. While the results are promising that this scale could indeed be measuring college welcome, it is important that more data be collected, reflect a higher percentage of immigrant students, and that future research be done to continue to assess the reliability and validity of this scale. This scale is the first step in better understanding the perception of welcome provided to foreign-born students, which is critical so that social workers can intervene and help improve the social and emotional well-being of students.
Developing and Testing a Model of the Assisted Living Environment
(Taylor & Francis, 2020-07-21) Holmes, Sarah; Resnick, Barbara; Galik, Elizabeth; Kusmaul, Nancy
The assisted living (AL) environment plays an important role in supporting residents’ satisfaction and helping them to age in place. The AL environment is multidimensional and has many interrelated components including staffing (e.g. direct care workers, nursing, activity staff), services provided (e.g. medical, mental health, pharmacy), amenities offered at the setting (e.g. beauty salon, library, exercise facilities), and the physical environment. Evidence suggests that aspects of the AL environment can enhance or detract from the physical function, well-being, social engagement, and behavioral outcomes among residents. The purpose of this study was to develop and test a multidimensional AL environment measurement model that includes indicators of staffing, services, amenities, and the physical environment. Baseline data was used from a study testing the Dissemination and Implementation of Function Focused Care in AL. A total of 54 AL facilities across three states were included in the sample. Settings ranged in size from 31 to 164 beds with an average size of 82.2 (SD = 26.2) beds and the majority were for profit facilities (n = 41, 74.5%). Structural equation modeling was used to test the proposed model. Results showed that the model fit the data (χ²/df = 1.861, p < .05; CFI = .858, RMSEA = .126). Having a comprehensive AL environment measurement model will advance future research that explores the impact of the environment on resident outcomes. Findings from this study will inform interventions and programs designed to modify AL environments to optimize residents’ satisfaction with AL.
My loved one might need more care than I can provide. What do I do?
(The University of Alabama, 2022-07-07) Kusmaul, Nancy
Caring for another person can be rewarding, challenging, and overwhelming . Many caregivers choose to care for family members and friends out of a sense of love, or paying someone back for care they have received earlier in life. But what happens when you can no longer provide that care?
Professional Social Workers in the Nursing Home
(ELSEVIER, 2022-11-01) Hector, Paige; Kusmaul, Nancy
The International Federation of Social Work defines social work as “a practice-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people. Principles of social justice, human rights, collective responsibility and respect for diversities are central to social work. Underpinned by theories of social work, social sciences, humanities and indigenous knowledges, social work engages people and structures to address life challenges and enhance wellbeing” (“Global Definition of Social Work,” IFSW, July 2014, https://bit.ly/3TsJszN). Social work practice is also shaped by a professional code of ethics that focuses on person-directed care and competent practice that supports ethical decision-making when there are conflicts of interest.
Discharge Planning Best Practices to Avoid Hospital Readmissions
(American Association of Post-Acute Care Nursing, 2023-09-19) Stewart, Amy; Kusmaul, Nancy
In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Dr. Nancy Kusmaul, PhD, MSW, associate professor in the baccalaureate social work program at the University of Maryland, Baltimore County, discuss discharge planning best practices to avoid hospital readmissions.
Addressing the Needs of an Aging Population Through Health Professions Education: Proceedings of a Workshop
(National Academy of Sciences, 2023-10-12) Cuff, Patricia A.; Forstag, Erin Hammers; Kusmaul, Nancy
Guide to Elder Abuse and Home Safety
(Today's Homeowner, 2024-04-15) Bennett, Alexis; Kusmaul, Nancy; Mosqueda, Laura
Our respected elders, who harbor a lifetime of experiences and wisdom, are a vital part of our communities. Unfortunately, it’s a sobering reality that approximately one in six individuals aged 60 and above experienced some form of abuse in 2021. The COVID-19 pandemic exacerbated the problem, with incidents of elder abuse seeing a concerning increase. It’s high time we took a closer look at the issues surrounding elder abuse and how we can ensure safety at home for our seniors.
Addressing the Rising Mental Health Needs of an Aging Population: Proceedings of a Workshop
(National Academy of Sciences, 2023-05) Andrada, Alexandra; Andrada, Kat M.; Nass, Sharyl J.; Kusmaul, Nancy
“Knowing when it's time to take a break”: Nursing home social workers’ coping during COVID-19
(ELSEVIER, 2023-06) Fields, Noelle L.; Schuman, Donna L.; Miller, Vivian J.; Kunz-Lomelin, Alan; Kusmaul, Nancy; Anderson, Keith A.
BackgroundNursing home (NH) social workers face many challenges in meeting the psychosocial needs of residents while balancing their own well-being needs.MethodsThis study employed a cross-sectional survey of NH social workers via social media and professional networks about their coping strategies during COVID-19. Open-ended responses were analyzed qualitatively using the rigorous and accelerated data reduction technique (RADaR).ResultsThe study included a sample of 63 (N = 63) NH social workers. Four themes defined ways the in which NH social workers coped with stress during COVID-19, including relying on friends and family, mindfulness and spirituality/religion, self-care strategies, and setting boundaries at work.ConclusionThese techniques appear to be effective; however there remains a need for institutional programs and policies to provide the time and space to holistically support coping in NH social workers and to prevent burnout and turnover, particularly during times of crisis.
Nursing Home Characteristics and Resident Quality of Care Outcomes: A Scoping Review of Recent Empirical Research
(LSE Press, 2024-05-01) Millar, Roberto J.; Diehl, Christin; Blake, Elizabeth; Fakeye, Oludolapo; Kusmaul, Nancy
Context: Nursing facilities are an essential part of the long-term care continuum, providing a setting where older adults and persons with disabilities receive critical services and supports. Despite extensive research linking facility characteristics to resident outcomes, the facility and resident factors under investigation vary in the context of a diverse industry landscape and poor understanding of key quality of care outcomes.Objectives: This scoping review focused on identifying key concepts, summarising existing findings, and identifying gaps in research linking nursing facility characteristics and resident outcomes.Methods: Guided by PRISMA-ScR guidelines, this scoping review focused on empirical, English-language research published in five databases between 2005 and 2022. The research studies meeting specified inclusion criteria were subjected to thematic analysis for the extraction of key concepts and synthesis of findings.Findings: The 91 research studies in the final analytic sample conceptualised facility-level characteristics and resident outcomes using six and nine broad domains, respectively. The subcategories making up these discrete domains varied widely across studies. While evidence of linkages between facility environments and resident outcomes varied, there was general support that higher staffing capacity and home-like environments with support for autonomy and social integration were linked to better functional outcomes and higher overall subjective well-being of residents.Implications: It is imperative to understand how facility-level characteristics influence resident outcomes, and this scoping review provides insight into these complex relationships. A better understanding of this area is key to improving policies and regulatory oversight, as well as more broadly inform data driven decision-making.
2024 Nancy Kusmaul, Social Work, Receives “Outstanding Individual In Academia” Award From The Congressional Research Institute For Social Work And Policy
(2024-04-26) Duque, Catalina Sofia Dansberger; Demond, Marlayna
UMBC's Nancy Kusmaul, associate professor of social work, a scholar and advocate for the rights of older adults and professional caregivers, received the “Outstanding Individual in Academia” award from the Congressional Research Institute for Social Work and Policy in March 2024 at a ceremony on Capitol Hill. Kusmaul’s work is informed by her 10 years of experience as a social worker and over a decade of novel scholarship.
An Assessment of MSW Social Work Curricula: Semester-Long Courses Specifically Related to Immigrants and Immigration
(Taylor & Francis, 2024-03-14) Evans, Kerri; Figuereo, Victor; Rosales, Robert; Woo, Bongki; Perez-Aponte, Jaime
Social workers are well positioned to meet the needs of the immigrant population in the United States (U.S.) and social workers across all fields and specializations should both feel competent and have the appropriate skills to work with immigrant clients. In this paper, we provide context around the immigrant population in the U.S. and discuss social work’s role in helping immigrants, and the role of the MSW degree in helping to prepare social workers to work with immigrants. Using publicly available data on MSW school websites, we analyze the prevalence of courses that specifically focus on immigrants or immigration. We found a lack of semester-long immigrant-specific courses in that only 12% of the programs offered these courses. We also noted the geographic clustering of some programs that offer these courses. We propose that schools do one of the following depending on their current course offerings, faculty expertise, and other resources: ensuring that basic content and case examples about immigrants are included in foundational social work courses, and when feasible or appropriate create elective courses, or create a concentration for those wishing to specialize in social work practice with immigrants.
CARE COMPARE STAR RATINGS AND FAMILY SATISFACTION IN MARYLAND NURSING FACILITIES
(Oxford University Press, 2023-12-21) Millar, Roberto; Diehl, Christin; Kusmaul, Nancy; Stockwell, Ian
Nursing facilities provide critical services and supports to individuals with long-term care needs. The quality of care in nursing facilities varies depending on facility structural characteristics. Moreover, the measurement and perceptions of what constitutes quality of care varies across stakeholders. We used publicly available data to examine the association between family satisfaction with care and the Centers for Medicare & Medicaid Services’(CMS’s) Care Compare five-star quality ratings in the context of facility characteristics. Facility-level data of family satisfaction with care were merged with CMS’s five-star star ratings of 220 Maryland nursing facilities in 2021. Using univariate and bivariate statistics, we explored differences in family ratings and five-star ratings across facility ownership (for-profit vs. non-profit), geographic location (urban vs. rural), and average resident occupancy (1-60, 61-120, and 121+). Relationships were examined across overall ratings, as well as across subdomain of the two quality rating frameworks (e.g., staffing, autonomy, health inspections). Family members of residents in non-profit, rural, and low-occupancy facilities rated facilities higher. Non-profit and low-occupancy facilities were statistically more likely to be rated four or five stars, while no significant association was observed across geographic location. The association between subdomain-specific family satisfaction and star ratings varied across facilities of different structures. Findings emphasize the need for comprehensive quality of care frameworks that consider views of quality across stakeholders and types of facilities. A clear understanding of nursing facility structure and quality of care is critical to advance data-driven decision making.
Relationships, parental involvement, and community support: Differences in school environment for boys and girls in rural Guatemala
(Sage, 2024-01-09) Evans, Kerri; Iriarte, Antonia Díaz-Valdés; Drummer, Emily; Urizar, Brenda; Crea, Thomas M.
Literacy rates in Guatemala range from 40% to 90% but widespread poverty and malnutrition hinder school attendance and educational attainment. The Western Highlands region of Guatemala has a large indigenous population and a bilingual Spanish and K’iche’ curriculum. This study explores how child, family, and community factors influence positive school environment, using a sample of 1590 sixth grade students. For male students, increased parental involvement had a positive and direct influence on healthy school environment. For female students, increased parental involvement had a positive and direct influence on healthy school environment. Teacher–student relationships may be a critical point of intervention.
Individuals Who Experience Intimate Partner Violence and Their Engagement with the Legal System: Critical Considerations for Agency and Power
(UMD, 2024-01-19) Cardenas, Iris; Graham, Laurie M.; Mellinger, Marcela Sarmiento; Ting, Laura
This Article explores the complexities of intimate partner violence (“IPV”) victim-survivors’ engagement with the legal system, emphasizing the need for culturally responsive and trauma-informed legal interventions. It highlights how intersectional identities and systemic factors shape the experience and decisions of a victim-survivor regarding legal involvement. The Article critiques current legal responses to IPV for often exacerbating trauma and undermining victim survivors’ autonomy. It argues for a multifaceted approach that acknowledges the unique needs and challenges faced by diverse victim-survivors and advocates for systemic reforms. The Article underscores the importance of incorporating intersectional and social-ecological perspectives in legal responses, recommending trauma-informed, healing-centered practices and culturally responsive interventions to better support IPV victim-survivors and facilitate their recovery.
Trauma and Trauma-Informed Care: How Prostitution Diversion Programs Miss the Mark
(UMD, 2024-01-19) Wiechelt, Shelly A.
This paper is a summary of a panel presentation Trauma and Trauma-Informed Care: Prostitution Diversion Programs, given at the Journal of Health Care Law and Policy’s Spring 2023 Symposium, Uneasy Alignments: The Mental Health Turn in the American Legal System. The Article will introduce trauma and other trauma related concepts including PTSD, complex-trauma, and trauma-informed care and consider the challenges inherent in addressing trauma in a trauma- informed manner via prostitution diversion programs.
Enhanced ILRS analysis for ITRF2020
(2022-11-07) Luceri, V.; Pavlis, Erricos C.; Basoni, A.; Sarrocco, D.; Kuzmicz-Cieslak, M.; Evans, Keith; Bianco, G.
The time series of station positions and EOP provided by ILRS for the realization of the ITRF2020 was obtained as the combination of loosely constrained individual solutions from the seven ILRS Analysis Centers: ASI, BKG, DGFI, ESA, GFZ, JCET and NSGF. Everyone followed strict standards agreed within the ILRS Analysis Standing Committee (ASC) and used SLR data from LAGEOS, LAGEOS-2, Etalon-1 and Etalon-2. The ILRS ASC devised an innovative approach in handling systematic errors in the network, never before utilized. A series of long-term mean bias estimates for each station were generated during a pilot project including the time intervals of applicability and their statistics. They were obtained from freely adjusted station position and EOP solutions for the period 1993.0 to 2020.5, using the latest satellite CoM model. The simultaneous estimation of the station heights and measurement biases resulted in a self-consistent set of weekly bias estimates for each site and the utilized CoM model. Breaks and “jumps” were used to define the periods of applicability and to calculate the mean bias and its standard deviation. These mean biases were pre-applied in the reanalysis for ITRF2020, limiting the remaining jitter of the bias to negligible level. This approach strengthened the estimation process without a compromise of the final results’ accuracy. As a result, the ILRS contribution to ITRF2020 minimized the scale difference between SLR and VLBI to roughly 1 mm (ITRF2014 ~9 mm). We present an overview of the procedures, models, and the improvement over previous ILRS products, focusing especially on the Core ILRS sites.
A Facility-Level Analysis of Nursing Home Compare Five Star Rating and Maryland’s Family Satisfaction with Care Survey Get access Arrow
(Oxford University Press, 2023-12-18) Kusmaul, Nancy; Millar, Roberto J; Diehl, Christin; Stockwell, Ian
Background and Objectives: Nursing facilities care for individuals with cognitive and/or physical disabilities. Poor quality is associated with greater disease and mortality. Quality comprises many factors and different stakeholders value different factors. This study aimed to compare two care quality frameworks, one based on observable factors and one on family satisfaction. Research Design and Methods: We merged publicly available 2021 Maryland nursing facility data. The Maryland Health Care Commission surveys long-term care residents’ family satisfaction across seven domains. CMS’ five-star ratings aggregate inspections, staffing, and quality measures. We used univariate and bivariate statistics to compare the frameworks. Results: The dataset included 220 facilities and 4,610 survey respondents. The average facility rating was 7.70/10 and overall 77% of respondents would recommend the facility. Eighty-six percent of respondents from 5-star facilities, 79% from 4-star facilities, and 76% from 3-star facilities would recommend the facility compared to 65% from 1-star facilities (p < 0.001, p < 0.01 and p < 0.05, respectively). Four or 5-star facilities received significantly higher ratings (8.33, p < 0.001; 7.75, p < 0.05, respectively) than 1-star facilities (7.07). Discussion and Implications: Our results corroborated earlier findings of strong associations between CMS ratings and satisfaction at the extremes of the five-star system. These associations are inconsistent across family-reported domains. This suggests overlap between the frameworks. CMS ratings address care quality; family satisfaction measures quality of life and care quality. High satisfaction is associated with high care quality and quality of life; lower satisfaction is associated with lower care quality.

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