Self-Reported Satisfaction of Older Adult Residents in Nursing Homes: Development of a Conceptual Framework

Background and objectives: Resident satisfaction is an integral part of nursing home (NH) quality of care. However, there is no uniform categorization framework to classify the self-reported satisfaction of older adult residents in NHs. This scoping review systematically investigated the studies reporting data on older residents' satisfaction to evaluate the quality of NH service and to create a conceptual model for older residents' satisfaction.

Research design and methods: We used Donabedian's structure-process-outcome model as a theoretical framework. In 3 electronic databases (PubMed, Scopus, and CINAHL), potential studies were searched using specific inclusion criteria identifying original studies that investigated older adult residents' satisfaction in NHs.

Results: Fifteen studies, including 264,133 residents and 15,577 NHs, were selected for this review. Although a wide variety of resident satisfaction measures were used in the included studies, all these indicators reflect 5 primary domains: psychological, clinical, social, environmental, and spiritual, with the common focus of improving the quality of life of residents. Though technical competence is a fundamental aspect of health care service, we found autonomy, environment, meaningful activities, and interpersonal quality of professionals as the most important predictors for the resident's satisfaction.

Discussion and implications: The current review has synthesized a broad range of satisfaction measures, which will help future researchers and policymakers provide guidance for further improvement of NH care services and as a heuristic device to spur research. Additional research is needed to apply this conceptual framework for comparisons of self-reported resident satisfaction in other institutional settings across countries.