Exploring resident thriving in relation to the nursing home environment: A cross-sectional study

Aim To explore the extent to which environmental factors are associated with resident thriving. Background Thriving is a concept that denotes experiences of well-being in relation to the living environment. Although there is a substantial body of research into quality of life in nursing homes, less is known about what contributes to thriving among residents. Recent research on resident thriving has focused mainly on resident characteristics and activities associated with thriving. Less attention has been given to explore associations with the physical and psychosocial environment of the nursing home. This study explores facility- and unit-level factors associated with resident thriving. Design A cross-sectional national survey. Methods Data on 4,205 residents, 3,509 staff, and environment of 147 nursing home facilities collected in 2013-2014 were analysed using descriptive statistics, multilevel simple, and multiple linear regression to explore resident thriving in relation to environmental factors. Results Multilevel analysis revealed that residents' thriving varied significantly across nursing home units. Several environmental factors were associated with thriving in univariate analyses. However, a positive psychosocial climate of units, having access to newspapers, living in a special care unit, and living in an unlocked facility showed significant positive associations with resident thriving when controlling for resident characteristics. The psychosocial climate showed the strongest association of the environment variables with resident thriving. Conclusions Nursing home environments may have an impact on residents' thriving. A positive psychosocial climate of units seems to have an important role in facilitating thriving in nursing home residents.