Quality of life of nursing home residents in mainland China: The role of children and family support.

BACKGROUND AND OBJECTIVES: Recently China ended its one-child policy and all married couples were permitted to have two children. The objectives were to investigate: 1) whether having more children (3+ vs. ≤ 2) is positively associated with quality of life (QOL); and 2) the role of child visit frequency and family support in the relationship between number of children and QOL among nursing home residents in mainland China. RESEARCH DESIGN AND METHODS: This is a cross-sectional study. A total 371 residents from 33 nursing homes in Jinan, Shandong Province who completed the survey from May to September 2016 were analyzed. The mixed-effects multivariate linear or ordered logistic regression models were used to test the mediating effect of child visit frequency and family support on the relationship between the number of children and QOL. All statistical models were adjusted for resident- and facility-level variables. RESULTS: Nursing home residents with 3+ children received more frequent child visits and family support, and had better QOL compared with those with ≤2 children. However, the relationship between number of children and QOL was attenuated and no longer significant with the inclusion of child visit frequency and family support in the model. DISCUSSION AND IMPLICATIONS: The findings emphasized the importance of the role of children for the QOL of the older adults in a traditionally family-care oriented society like China. As China's population continues to age, having two children is necessary but may be insufficient in the context of improving nursing home residents' QOL.