Development of a quality of life questionnaire for nursing home residents in mainland China

  • Dongjuan Xu
  • Jie Gao
  • Liqin Chen
  • Huanyu Mou
  • Xiaorong Wang
  • Jiying Ling
  • Kefang WangEmail author



To develop and validate a quality of life (QOL) questionnaire for nursing home (NH) residents in mainland China.


A cross-sectional study including a development sample (n = 176) and validation sample (n = 371) of NH residents aged 60 and older was conducted between 2015 and 2016 in Jinan, Shandong Province, China. Resident interviews, literature reviews, expert panels, and pilot studies were used to identify QOL domains and items pertinent to NH life. Exploratory and confirmatory factor analysis were used to develop and validate a QOL questionnaire. Reliability (internal consistency, spilt-half reliability, and test–retest reliability) and validity (construct and criterion validity) were evaluated for the questionnaire.


The self-report Chinese NH QOL questionnaire had 9 domains and 38 items including physical health (4 items), food enjoyment (6 items), security (3 items), environmental comfort (5 items), autonomy (2 items), meaningful activity (3 items), interrelationship (6 items), family relationships (3 items), and mood (6 items). The nine-factor model was confirmed with the following fit indices: χ2/df = 1.872, root mean square error of approximation = 0.049, comparative fit index = 0.913, and Tucker-Lewis index = 0.903. The 38-item NH QOL questionnaire showed satisfactory construct validity, criterion validity, internal consistency (Cronbach’s alpha = 0.89, spilt-half reliability = 0.73, test–retest reliability = 0.76).


The NH QOL questionnaire appears to be a reliable and valid instrument and should be incorporated into a set of quality measures for use with NH residents in mainland China


Quality of life Nursing home Instrument development Validity Reliability 



The authors would like to thank all the participants in this study.

Author contributions

WK and XD initiated, participated in the design of, and coordinated the study and helped in the drafting and editing of the article. XD, GJ, WX and LJ prepared the database and performed the statistical analyses. GJ, CL and MH participated in the implementation of the study, prepared the database, and participated in the drafting of the article. All the authors have read and approved the final version of the manuscript.


This study was funded by the National Social Sciences Fund of China (14CSH063).

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of Shandong University.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11136_2019_2180_MOESM1_ESM.pdf (408 kb)
Supplementary material 1 (PDF 408 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.School of NursingShandong UniversityJinanChina
  2. 2.School of NursingPurdue UniversityWest LafayetteUSA
  3. 3.Department of Nursing CareHenan Vocational College of NursingAnyangChina
  4. 4.Department of GerontologyJinan Central HospitalJinanChina
  5. 5.College of NursingMichigan State UniversityEast LansingUSA

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