Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2018 Sep 5;8(9):e021741.
doi: 10.1136/bmjopen-2018-021741.

What factors influence older people's intention to enrol in nursing homes? A cross-sectional observational study in Shanghai, China

Mengyun Luo #  1 , Yajiong Xue #  2 , Shunxing Zhang  3 , Yuanyuan Dong  1 , Dandan Mo  1 , Wei Dong  1 , Kun Qian  1 , Yue Fang  1 , Huigang Liang  2 , Zhiruo Zhang  1
Affiliations
Observational Study

What factors influence older people's intention to enrol in nursing homes? A cross-sectional observational study in Shanghai, China

Mengyun Luo et al. BMJ Open. .

Abstract

Objectives: Given the increasing need of long-term care and the low occupancy rate of nursing homes in Shanghai, this study attempts to explore what factors influence older people's intention to enrol in nursing homes.

Design: A cross-sectional observational study based on the theory of reasoned action was conducted. Survey data were collected from subjects during face-to-face interviews. Structural equation modelling was employed for data analysis.

Setting: This study was conducted in six community health service centres in Shanghai, China. Two service centres were selected in urban, suburban and rural areas, respectively.

Participants: A total of 641 Shanghai residents aged over 60 were surveyed.

Results: Structural equation modelling analysis showed that the research model fits the data well (χ2/df=2.948, Comparative Fit Index=0.972 and root mean squared error of approximation =0.055). Attitude (β=0.41, p<0.01), subjective norm (β=0.28, p<0.01) and value-added service (β=0.16, p<0.01) were directly associated with enrolment intention, explaining 32% of variance in intention. Attitude was significantly influenced by loneliness (β=-0.08, p<0.05), self-efficacy (β=0.32, p<0.01) and stigma (β=-0.24, p<0.01), while subjective norm was significantly influenced by life satisfaction (β=-0.15, p<0.01) and stigma (β=-0.43, p<0.01).

Conclusions: This study advances knowledge regarding the influencing factors of older people's intention to enrol in nursing homes. It suggests that Chinese older persons' perceived stigma has the strongest indirect effect on their intention to enrol in nursing homes. This is unique to the Chinese context and has practical implications for eldercare in China and other Asian countries with similar sociocultural contexts.

Keywords: attitude; eldercare; stigma; structural equation modeling; subjective norm; survey.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Model estimating results of intention to enrol in nursing homes among 641 elders in Shanghai (*P<0.05, **P<0.01).
See this image and copyright information in PMC

References

    1. Yang SL, Zheng-Long LI. The impact of aging population on the burden of elderly in Shanghai. Northwest Population Journal 2010;31:61–6.
    1. SRCo A. Statistics of old people ’s population and aging in Shanghai in 2016. Shanghai, 2017.
    1. Sciences SAoS. Shanghai academy of social sciences blue book: 2020 Shanghai "demographic dividend" will disappear. Shanghai, 2016.
    1. Swan JH, Kitchener M, Harrington C. Medicaid nursing facility rates, capacity, and utilization: a structural analysis. Soc Work Public Health 2009;24:380–400. 10.1080/19371910802672221 - DOI - PubMed
    1. Liu C, Feng Z, Mor V. Case-mix and quality indicators in Chinese elder care homes: are there differences between government-owned and private-sector facilities? J Am Geriatr Soc 2014;62:371–7. 10.1111/jgs.12647 - DOI - PMC - PubMed

Publication types