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



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

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


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

Author information




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.

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Correspondence to Kefang Wang.

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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.

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

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Xu, D., Gao, J., Chen, L. et al. Development of a quality of life questionnaire for nursing home residents in mainland China. Qual Life Res 28, 2289–2297 (2019).

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  • Quality of life
  • Nursing home
  • Instrument development
  • Validity
  • Reliability