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

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%, ꭓ 2 = 28.89, p <0.001) and acceptability (68/83, 81.9%, ꭓ 2 = 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.