Predictors of Quality of Life among Older Adults in Nursing Homes in Wenzhou, China
Keywords:
Quality of life, Predictors, Older adults, Nursing homesAbstract
The quality of life (QOL) of older adults is a key indicator of their physical and mental health and overall well-being. This study aimed to examine the factors influencing QOL among older adults in nursing homes in Wenzhou, China. The four predictive factors included the older adults' functional status, care satisfaction, perceived social support, and depression. The samples consisted of 142 older adults in nursing homes in Wenzhou. Simple random sampling was used to recruit the samples. Data were collected from March 1 to June 2, 2024. QOL, functional status, perceived social support, care satisfaction, and depression were measured using the Chinese versions of the World Health Organization Quality of Life Instrument—Older Adults Module (WHOQOL-OLD), Barthel Index, Multidimensional Scale of Perceived Social Support (MSPSS), Satisfaction with the Nursing Home Instrument (SNHI), and 15-item Geriatric Depression Scale (GDS-15), respectively. Descriptive statistics and multiple regression analysis were used for data analysis. The mean QOL score was 68.05 (SD = 9.60). The multiple regression analysis showed that perceived social support, care satisfaction, depression, functional status could explain 65.2% of the variance in QOL (F (4, 142) = 66.972, p < 0.05). The strongest predictor was perceived social support (β= 0.786, p < 0.001), followed by care satisfaction (β= 0.728, p < 0.001), depression (β= -0.536, p < 0.001), and functional status (β= 0.110, p = 0.001). These findings provided preliminary evidence on factors influencing QOL among older adults in nursing homes. Interventions targeting social support, care satisfaction, depression, and functional status might help improve their QOL.
References
Organization WH. Decade of healthy ageing: baseline report. 2021. Geneva: World Health Organization.
Su SW and Wang D. Health-related quality of life and related factors among elderly persons under different aged care models in Guangzhou, China: a cross-sectional study. Qual Life Res 2019; 28: 1293-303. 2019/01/17. DOI: 10.1007/s11136-019-02107-x
Qin S, Cheng Y, Zhang H, et al. Home/community-based medical and elderly care services utilization in China: a cross-sectional study from the middle-aged and elderly population. In: Healthcare 2023, p.2431. MDPI.
Kelley-Gillespie N. Quality of Life for Older Adults, an Integrated Conceptual Model. Encyclopedia of quality of life and well-being research. Springer, 2024, pp.5696-714.
Adhikari R, Shah R, Ghimire K, et al. The Quality of Life and Associated Factors Among Older Adults in Central Nepal: A Cross-Sectional Study Using the WHOQOL-OLD Tool. International Journal of Environmental Research and Public Health 2025; 22: 693.
Yoon JY. Relationships among person-centered care, nursing home adjustment, and life satisfaction: a cross-sectional survey study. International psychogeriatrics 2018; 30: 1519-30.
Xin X, Yuan Z, Siyou X, et al. Quality of Life and Its Influencing Factors Among Centenarians in Nanjing, China: A Cross-Sectional Study. Social Indicators Research 2020; 160: 735-55. DOI: 10.1007/s11205-020-02399-4
Semra G, Fatma A and Gökhan K. Dependence Level and Quality of Life of Older Adults Living in Nursing Home. Journal of Geriatric Medicine and Gerontology 2019; 5. DOI: 10.23937/2469-5858/1510081
Huang C. Technology Empowerment and Smart Elderly Care: A Strategic Study on Wenzhou's Approach to Building a Benchmark Wellness City. Academic Journal of Management and Social Sciences 2025; 10: 96-100. DOI: 10.54097/8t0yvb50
Kang H. Sample size determination and power analysis using the G* Power software. Journal of educational evaluation for health professions 2021; 18.
Qin F, Luo M, Xiong Y, et al. Prevalence and associated factors of cognitive impairment among the elderly population: a nationwide cross-sectional study in China. Frontiers in public health 2022; 10: 1032666.
Liu J, Yu W, Zhou J, et al. Relationship between the number of noncommunicable diseases and health-related quality of life in Chinese older adults: a cross-sectional survey. International journal of environmental research and public health 2020; 17: 5150.
Zhang C, Zhang X, Zhang H, et al. Psychometric properties of the Barthel Index for evaluating physical function among Chinese oldest‐old. JCSM Clinical Reports 2022; 7: 33-43.
Pei Z, Hu F, Qin W, et al. The relationship between living arrangements and depression among older adults in Shandong, China: The mediating role of social support. Frontiers in Psychiatry 2022; 13: 896938.
Liu Z, Li Z, Zhang J, et al. A new scale for older resident satisfaction with residential integrated care in China: development and validation. Geriatric Nursing 2024; 57: 224-31.
Xu Y, Liang Y-T, Li J-W, et al. Network analysis of the association between depression and quality of life in the elderly. Psychology, Health & Medicine 2026; 31: 155-69.
Khadgi D. Quality of Life of Elderly Residing at Old Age Homes of Biratnagar Metropolitan City. Tribhuvan University Journal 2021; 36: 14-25.
Mulya AP, Sumarni N and Fajari S. Description of the Quality of Life in Elderly at Nursing Home. Indonesian Journal of Global Health Research 2025; 7: 429-36. DOI: 10.37287/ijghr.v7i2.5670
Made N, Bambang Hadi K, Putu Chris S, et al. Education and Training Improve Quality of Life and Decrease Depression Score in Elderly Population. SSRN Electronic Journal 2018. DOI: 10.2139/ssrn.3394858
Xiao Z, Yaqing X, Fang D, et al. The association between health-promoting-lifestyles, and socioeconomic, family relationships, social support, health-related quality of life among older adults in china: a cross sectional study. Health and Quality of Life Outcomes 2022; 20. DOI: 10.1186/s12955-022-01968-0
Andrea Paola Capuz T and Luis Geovanny Rojas C. Self-care and quality of life in older adults: a literature review. Enfermería Cuidándote 2025. DOI: 10.51326/ec.7.9825354
Hussenoeder FS, Jentzsch D, Matschinger H, et al. Depression and quality of life in old age: a closer look. European Journal of Ageing 2021; 18: 75-83.
Cheng HWB. Advance care planning in Chinese seniors: cultural perspectives. Journal of palliative care 2018; 33: 242-46.
Gupta MK, Nagdeve DA and Kumar J. Exploring the relationship between perceived social support and quality of life among Indian elderly population: A cross-sectional study. Global Health Economics and Sustainability 2024; 2. DOI: 10.36922/ghes.2358
Şahin DS, Özer Ö and Yanardağ MZ. Perceived social support, quality of life and satisfaction with life in elderly people. Educational Gerontology 2019; 45: 69-77.
You J, Fung H and Vitaliano P. The pattern of social support seeking and its socio-demographic variations among older adults in China. European Journal of Ageing 2020; 17: 341-48.
Wu M, Yang Y, Zhang D, et al. Association between social support and health-related quality of life among Chinese rural elders in nursing homes: the mediating role of resilience. Quality of Life Research 2018; 27: 783-92.
von der Warth R, Brühmann BA and Farin-Glattacker E. The association of care satisfaction and COVID-19 contact restrictions with quality of life in long-term care homes residents in Germany: a cross-sectional study. European geriatric medicine 2022; 13: 1335-42.
Shippee TT, Ng W, Duan Y, et al. Changes over time in racial/ethnic differences in quality of life for nursing home residents: Patterns within and between facilities. Journal of aging and health 2020; 32: 1498-509.
Lalic S, Wimmer BC, Tan EC, et al. Satisfaction with care and health-related quality of life among residents of long-term care facilities. Journal of the American Medical Directors Association 2016; 17: 180-2.
Manav Aİ, Yeşilot SB, Demirci PY, et al. An evaluation of cognitive function, depression, and quality of life of elderly people living in a nursing home. Journal of Psychiatric Nursing/Psikiyatri Hemsireleri Dernegi 2018; 9.
Wang P, Yap P, Koh G, et al. Quality of life and related factors of nursing home residents in Singapore. Health and Quality of Life Outcomes 2016; 14: 1-9.
Medhi GK, Sarma J, Pala S, et al. Association between health related quality of life (HRQOL) and activity of daily living (ADL) among elderly in an urban setting of Assam, India. Journal of family medicine and primary care 2019; 8: 1760-64.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Creative Commons License CC-BY-ND
