The effects of nursing home culture change on resident quality of life in U.S. nursing homes

Culture change is intended to transform nursing homes from impersonal institutions into person-centered homes. Despite a growing interest in studying culture change, empirical evidence for its effects on quality of life (QOL) has not been synthesized. The current integrative review examined how QOL outcomes were measured in culture change studies and analyzed the current evidence for culture change effects on QOL. Guided by a conceptual framework, this review systematically searched for literature in multiple databases and identified 11 eligible studies. QOL measures varied across studies, rang-ing from overall perception of life to specific measures associated with physical and psychosocial well-being. Overall, culture change demonstrated a positive trend in benefiting QOL. Although inconsistent evidence existed for most QOL measures, relatively consistent evidence was found to support positive effects on resident satisfaction and autonomy. Rigorous designs are needed for future studies to gener-ate strong evidence.