Chinese Nursing Home Residents Research Articles

Validation of the Chinese version of the Satisfaction with the Nursing Home Instrument

To assess the psychometric properties of the Chinese version of the Satisfaction with the Nursing Home Instrument. Resident's satisfaction has been regarded by the literature as a gold standard for quality of nursing home care. Accurate assessment of resident's satisfaction can provide valuable information for implementation of quality nursing home care. However, there is not a validated Chinese tool to serve the purpose. A cross-sectional descriptive survey design. Content validity of the Chinese version of the Satisfaction with the Nursing Home Instrument was assessed by the use of expert panel. Construct validity of the Chinese version of the Satisfaction with the Nursing Home Instrument was determined by assessing the correlation between satisfaction with other theoretically related constructs. Internal consistency and stability of the Chinese version of the Satisfaction with the Nursing Home Instrument were determined by Cronbach's method and two-week test-retest reliability. The six-factor structure of the Chinese version of the Satisfaction with the Nursing Home Instrument was assessed by confirmatory factor analysis. Testing was performed on a cluster sample of 330 residents from 16 nursing homes in Hong Kong. The Chinese version of the Satisfaction with the Nursing Home Instrument demonstrated good content validity by having content validity index of 0.93. High construct validity of the Chinese version of the Satisfaction with the Nursing Home Instrument was supported by its significant correlation with depression (r = -0.42, P = 0.000), health-related quality of life (physical component) (r = 0.16, P = 0.042), health-related quality of life (mental component) (r = 0.41, P = 0.000) and global quality of care (r = 0.49, P = 0.000). The Chinese version of the Satisfaction with the Nursing Home Instrument demonstrated satisfactory internal consistency and good stability by having Cronbach's alpha of 0.79 and intra-class correlation coefficient of 0.94, respectively. The six-factor structure of the Chinese version of the Satisfaction with the Nursing Home Instrument was not fully supported by confirmatory factor analysis. The Chinese version of the Satisfaction with the Nursing Home Instrument is a useful instrument for assessing satisfaction of cognitively intact Chinese nursing home residents. Findings provided initial evidence on its validity and reliability. Further empirical testing is recommended to explore its factor structure. The Chinese version of the Satisfaction with the Nursing Home Instrument can provide guidance to enhance delivery of high-quality nursing home care for the Chinese population.

The Experience of Dying for Chinese Nursing Home Residents: CULTURAL CONSIDERATIONS

Given the increase of cultural diversity of the elderly population in the United States, there is a need for increased sensitivity of culturally diverse residents. Research on the care of terminally ill Chinese elderly individuals in nursing homes is limited. As part of a larger study on end-of-life care in nursing homes, data were obtained on 34 Chinese residents. Data were obtained through participant observation, event analysis, and in-depth interviews with residents and their families, nursing staff, and physicians. The process of providing care was observed from the time residents were identified as terminally ill until their death. The most significant factors influencing the care Chinese residents received were communication barriers, dislike of Western food, and differing cultural beliefs and customs. These findings offer valuable information in helping to develop and implement interventions to improve the terminal care of Chinese elderly individuals in nursing homes.

Assessing Life Expectancies of Institutionalized Older Persons in Hong Kong

Background: In Hong Kong, it has been projected that, by the year 2010, there will be 0.86 million persons aged 65 or older. The demand for residential care places continues to rise. Information on the survival of older persons will allow better management of care in institutional settings. Objective: The Weibull model was developed to predict the 18-month survival of a group of Chinese nursing home residents. Methods: In this prospective cohort study, 590 older residents from four nursing homes with different levels of care were enrolled. The main outcome measure was survival at 18 months. Information on subject demographics, clinical data and disability levels as measured by the Patient Assessment Instrument (PAI) was collected at baseline. Life expectancies were derived from accelerated failure time models. Results: Independent predictors of decreased survival derived from the Weibull model included increased age, male gender, diagnosis of cancer, presence of malnutrition and functional dependence. Significant interaction was observed between male gender and PAI score. The goodness of fit of the model was satisfactory. Conclusions: From this study, the model for predicting life expectancy in nursing home residents can assist policy makers in planning long-term care. It can also guide clinicians to make more appropriate management decisions for their older patients.