{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T13:49:14Z","timestamp":1775051354183,"version":"3.50.1"},"reference-count":33,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018683","name":"Agence R\u00e9gionale de Sant\u00e9 Martinique","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018683","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Conseil D\u00e9partemental de la Guadeloupe"},{"name":"Agence R\u00e9gionale de Sant\u00e9 de la Guadeloupe, Saint-Martin et Saint-Barth\u00e9l\u00e9my","award":["grant 2020\/DPAPH\/DRM"],"award-info":[{"award-number":["grant 2020\/DPAPH\/DRM"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,11,19]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Older adults transitioning to nursing homes face challenges in adapting to a new environment and imposed lifestyle changes. This study aimed to identify factors associated with poor nursing home adjustment and to assess their impact on 1-year mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and settings<\/jats:title>\n                    <jats:p>This study is a secondary analysis of the KArukera Study of Ageing in \u2018\u00c9tablissement d'H\u00e9bergement pour Personnes Ag\u00e9es D\u00e9pendantes\u2019 (EHPAD) (KASEHPAD) cohort, a prospective observational study conducted over 1 year in six nursing homes in the French Caribbean.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>159 older adults (aged 60 years or older) living in nursing homes who were able to complete the self-administered adaptation scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Nursing home adjustment was assessed at baseline using the adaptation scale for older adults to their residence (EAPAR). Bivariate analysis was used to assess associations between adjustment status and sociodemographic or clinical characteristics at baseline. Poisson regressions were used to assess the relationship between 1-year mortality and adjustment status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 159 older adults (mean age: 79.6 years; male\/female ratio: 84\/75) were included. The mean length of stay was 4.1 years. Among older adults, 78 (49.1%) were classified as poorly adapted. Age, gender, education level, dependency, cognition and comorbidities were not significantly associated with poor adjustment. In contrast, depressive symptoms, lower social support, lower health-related quality of life, lower subjective quality of life, malnutrition and sleep disturbances were associated with poor adjustment. After 12 months, 14 deaths (17.9%) occurred in the poor adjustment group, compared with 4 (4.9%) in the no major adjustment difficulties group (adjusted relative risk for age, gender and baseline activities of daily living score=4.64 (95% CI 1.53 to 17.5; p=0011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a sample of older adults with moderate cognitive impairment, poor adjustment to nursing home was associated with depressive symptomatology and increased 1-year mortality. The issue of adjustment in nursing homes represents an emerging research area that warrants further investigation through dedicated interventional studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04587466\">NCT04587466<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-106682","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T10:13:15Z","timestamp":1764843195000},"page":"e106682","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Poor adjustment to nursing homes and 1-year mortality: a secondary analysis of the KASEHPAD cohort study"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct04587466","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04587466","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7797-241X","authenticated-orcid":false,"given":"Denis","family":"Boucaud-Maitre","sequence":"first","affiliation":[{"name":"Centre Hospitalier Le Vinatier, Bron, France"},{"name":"EPICLIV, Universit\u00e9 des Antilles, Fort-de-France, Martinique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9l\u00e8ne","family":"Amieva","sequence":"additional","affiliation":[{"name":"Inserm U1219 Bordeaux Population Health Center, University of Bordeaux, Talence, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oc\u00e9ane","family":"Pic","sequence":"additional","affiliation":[{"name":"Inserm U1219 Bordeaux Population Health Center, University of Bordeaux, Talence, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurys","family":"Letchimy","sequence":"additional","affiliation":[{"name":"EPICLIV, Universit\u00e9 des Antilles, Fort-de-France, Martinique"},{"name":"Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadine","family":"Simo","sequence":"additional","affiliation":[{"name":"EPICLIV, Universit\u00e9 des Antilles, Fort-de-France, Martinique"},{"name":"Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Francois","family":"Dartigues","sequence":"additional","affiliation":[{"name":"Inserm U1219 Bordeaux Population Health Center, University of Bordeaux, Talence, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moustapha","family":"Dram\u00e9","sequence":"additional","affiliation":[{"name":"EPICLIV, Universit\u00e9 des Antilles, Fort-de-France, Martinique"},{"name":"Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Michel","family":"Dorey","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Le Vinatier, Bron, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maturin","family":"Tabu\u00e9-Teguo","sequence":"additional","affiliation":[{"name":"EPICLIV, Universit\u00e9 des Antilles, Fort-de-France, Martinique"},{"name":"Inserm U1219 Bordeaux Population Health Center, University of Bordeaux, Talence, France"},{"name":"Centre Hospitalo-Universitaire de Martinique, Fort-de-France, Martinique"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"2026010703463908000_15.12.e106682.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12877-022-03503-8","article-title":"The factors that influence care home residents\u2019 and families\u2019 engagement with decision-making about their care and support: an integrative review of the literature","volume":"22","author":"Lynch","year":"2022","journal-title":"BMC Geriatr"},{"key":"2026010703463908000_15.12.e106682.2","unstructured":"Centre de Recherche pour l\u2019\u00e9tude et l\u2019observation des conditions de vie (Cr\u00e9doc), enqu\u00eate \u00ab\u202fConditions de vie et aspirations, 2018. 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