The expectations and acceptability of a smart nursing home model among Chinese older adults: A mixed methods study

Abstract

Background Integrated smart technologies in nursing homes can enhance the quality of care. This study expands upon prior research, including a scoping review defining smart nursing homes and a qualitative study exploring the expectations and acceptability of such facilities among Chinese older adults and their families. It investigates the levels of these expectations, acceptability, and related sociodemographic factors. Methods This study presents the development and validation of the 24-item Expectation and Acceptability of Smart Nursing Homes Questionnaire (EASNH-Q), and a cross-sectional study conducted in four major cities in China in an exploratory sequential mixed methods study design. Results The newly developed EASNH-Q with Likert Scale from 1 (strongly disagree) to 5 (strongly agree) demonstrated commendable validity, reliability, and stability. The overall mean (SD) scores for expectations and acceptability were 4.0 (0.60) for each. The highest tertile of expectations (62/70, 88.6%, ꭓ2=28.89, p<0.001) and acceptability (68/83, 81.9%, ꭓ2=25.64, p<0.001) towards smart nursing homes were significantly associated with the willingness to relocate to such facilities. Older adults with self-efficacy in applying smart technologies (OR: 28.0, 95% CI: 5.92-132.66) and those expressing a willingness to move to a nursing home (OR: 3.0, 95% CI: 1.06-8.37) were more likely to have the highest tertile of expectations compared to those in the lowest tertile. Similarly, older adults with self-efficacy in applying smart technologies were more likely to be in the highest tertile of acceptability of smart nursing homes compared to those in the lowest tertile (OR: 13.8, 95% CI: 4.33-43.95). Conclusions The majority of Chinese older adults were willing to move to a smart nursing home. Self-efficacy in applying smart technologies links to the high expectations and acceptability of smart nursing homes. The willingness to relocate to a nursing home increased the high expectations of smart nursing homes.