关键词: 老年人, 养老机构, 日常生活能力, 养老服务, 期望, 满意度

Abstract: Background　The growing ageing population is a serious problem in China. To satisfy older people's elderly care needs，institution-based elderly care has become an effective supplement to home-based elderly care. Understanding the expectation and satisfaction on care in elderly people in nursing homes is essential for improving the quality of nursing home care as well as the elderly care system. Objective　To explore the expectation and satisfaction on nursing home services among older people. Methods　Based on the ERG（Existence，Relatedness and Growth） theory，we developed a nursing home services expectation-satisfaction model，for exploring older people's expectations on life care，medical services，cultural entertainment，mental comfort，health checkups，health education and rehabilitation training，as well as their satisfaction with daily care，food supply，sick care，living environment and charging levels. Then we developed a questionnaire based on the model，and used it to survey 203 older people in 11 nursing homes in Nanjing's Pukou District from July to September 2017. Results　Among the services expected by the elderly，life care project took the first place〔76.4%（155/203）〕，the second was medical service〔57.1%（116/203）〕，and the lowest was health education〔16.3%（33/203）〕. The elderly with different characteristics had different expectations on various services（P<0.05）. In terms of daily care，a decrease of 66% in the rate of lower satisfaction with daily care was found in those with a physical examination in the past year compared with those without，and a decrease of 46% in the rate of lower satisfaction with daily care was found in those with impaired function compared with those with intact function. Moreover，those with chronic diseases had greater OR（2.67-fold） of lower satisfaction with daily care compared with those without. In respect of food supply，a decrease of 63% in the rate of lower satisfaction with food supply was found in those with a physical examination in the past year compared with those without. Those with chronic diseases had greater OR（2.35-fold） of lower satisfaction with food supply compared with those without. A decrease of 39% in the rate of lower satisfaction with living environment was found in those with impaired function compared with those with intact function. Those with impaired function had greater OR（2.00-fold） of lower satisfaction with the cost of care compared with those with intact function. Those with no medical insurance had greater OR（3.63-fold） of lower satisfaction with the cost of care compared with those with urban employee basic medical insurance. Conclusion　The individual characteristics of the elderly including age，hukou location，activities of daily living，type of medical insurance，physical examination in the past year and chronic disease prevalence，are the important factors influencing the expectation and satisfaction on nursing home care. In view of this，nursing homes are suggested to improve the care quality to satisfy multi-level needs of the elderly.

Key words: Aged, Pension institution, Activity of daily living, Pension service, Expectation, Satisfaction