Author

Yuanshuo Ma

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Review Open access Jul 2026

User concerns and satisfaction drivers in Chinese nursing homes: insights from online review data.

BACKGROUND By 2024, 23% of China's population was aged 60 and above, with more than 2.3 million older adults residing in nursing homes. Understanding how service users evaluate nursing homes and the factors influencing their satisfaction can provide actionable recommendations for policymakers and nursing home managers. This helps better align care provision with the needs and expectations of older adults and their families. METHODS Utilizing data from Dianping.com, this study employed BERTopic for overall topic modeling, alongside LDA to compare variations in user concerns across different identities and different city tiers. Furthermore, multivariate regression and random forest models were integrated to identify the factors driving user satisfaction. RESULTS We analyzed 14,525 nursing home user reviews and identified four primary themes and twenty secondary themes of user concerns. Regression analysis and random forest modeling revealed that "Staff Attitude" and "Atmosphere" were the factors most strongly associated with user satisfaction. Thematic attention varies by user identity: prospective users prioritize physical infrastructure, relatives focus on clinical care, and actual residents emphasize daily activities. Furthermore, users in second- and third-tier cities express higher satisfaction than their counterparts in first-tier cities. CONCLUSIONS This study identifies staff attitude and atmosphere as important factors influencing satisfaction in Chinese nursing homes, with user concerns varying by identity and city tier. Nursing home operators should prioritize staff training to foster a warm living atmosphere, while policymakers should build user-centered evaluation systems and implement targeted regulation. Promoting personalized care for older adults nationwide will ultimately improve satisfaction with institutional care.

Zhilu Fan, Yuanshuo Ma, Lu Li et al. · BMC Health Services Research · 0 citations

Aug 2026

Latent Profile Analysis of Childhood Trauma and Loneliness Among Community-Dwelling Older Adults and Their Association with Depressive Symptoms.

BACKGROUND Depression is a leading mental health concern among community dwelling older adults, with childhood trauma and current loneliness identified as critical risk factors. However, existing research has predominantly examined these variables in isolation, obscuring heterogeneity in their co-occurring patterns and differential depression risk across subgroups. OBJECTIVES To identify latent profiles based on co-occurrence patterns of childhood trauma and current loneliness and examine differences in depressive symptoms across profiles. METHODS A cross-sectional study recruited 740 older adults from three communities. Childhood trauma, loneliness, and depressive symptoms were assessed. Latent profile analysis identified subgroups, and the Bolck-Croon-Hagenaars method examined differences in depressive symptoms across profiles. RESULTS Three profiles were identified: "Low Trauma-Low Loneliness", "Low Trauma-High Loneliness", and "High Trauma-High Loneliness". The High Trauma-High Loneliness profile exhibited the highest depressive symptom. Community activity participation, chronic disease, empty-nest status, and marital status were significant predictors of profile membership. . CONCLUSIONS Community-dwelling older adults demonstrate heterogeneous co-occurrence patterns of childhood trauma and current loneliness. Individuals in the High Trauma-High Loneliness profile warrant prioritized clinical attention and targeted community-based intervention. CLINICAL IMPLICATIONS Screening childhood trauma and loneliness jointly identifies the highest-risk subgroup, for whom trauma-informed care combined with community activity participation is preferable to loneliness-focused intervention alone.

Xiang-Zi Ji, Jiayuan Zhang, Jinping Zhao et al. · Clinical Gerontologist · 0 citations