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IntroductionIn response to the call for active aging, improving the quality of residential environments for older people is becoming a worldwide concern. Over the past decade, China has witnessed a significant increase in the construction of long-term care facilities (LTCFs) catering to the older adult with physical and mental limitations. However, the fast pace of LTCF development has led to substandard physical environments that compromise the quality of life for older individuals. Consequently, there is an urgent need to conduct comprehensive post-occupancy evaluations (POEs) in order to systematically assess the current state of LTCF physical environments and identify prevailing problems therein.MethodsThis study conducted POEs on 37 existing LTCFs from both objective and subjective perspectives, using self-developed environmental assessment tools and user satisfaction questionnaires.ResultsThe results reveal substantial room for improvement within LTCF physical environments, particularly concerning outdoor areas, resident rooms and staff spaces. The psychological needs of residents and working requirements of staff are not adequately addressed or supported.DiscussionA total of ninety-two typical problems are identified across eight categories, and relevant causes associated with programming, design, construction, and operation are discussed. The findings are expected to serve as warnings for future designs, provide empirical evidence for the revision of relevant standards, and promote the sustainable development of LTCF construction.

Introduction: In response to the call for active aging, improving the quality of residential environments for older people is becoming a worldwide concern. Over the past decade, China has witnessed a significant increase in the construction of long-term care facilities (LTCFs) catering to the older adult with physical and mental limitations. However, the fast pace of LTCF development has led to substandard physical environments that compromise the quality of life for older individuals. Consequently, there is an urgent need to conduct comprehensive post-occupancy evaluations (POEs) in order to systematically assess the current state of LTCF physical environments and identify prevailing problems therein., Methods: This study conducted POEs on 37 existing LTCFs from both objective and subjective perspectives, using self-developed environmental assessment tools and user satisfaction questionnaires., Results: The results reveal substantial room for improvement within LTCF physical environments, particularly concerning outdoor areas, resident rooms and staff spaces. The psychological needs of residents and working requirements of staff are not adequately addressed or supported., Discussion: A total of ninety-two typical problems are identified across eight categories, and relevant causes associated with programming, design, construction, and operation are discussed. The findings are expected to serve as warnings for future designs, provide empirical evidence for the revision of relevant standards, and promote the sustainable development of LTCF construction., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Zhang, Yang and Qiu.)

Background: Results of patient satisfaction questionnaires can contain a spike at the value corresponding to a complete satisfaction. A possible interpretation is that there are two types of respondents, those who are willing to provide a negative evaluation to one or more items proposed in the questionnaire and those who will always provide a completely positive evaluation irrespective of the item. The aim of the present study is to compare various statistical approaches to the analysis of such data using data from a rehabilitation patient survey of the German Statutory Pension Insurance Scheme as an example.Method: We used data from 272,806 respondents who participated in the survey from 2008 to 2011. We illustrate four models: linear regression, logistic regression, a two-part model based on the assumption of two underlying populations and quantile regression, which does not require any distributional assumptions. For each model we consider the relationship of the satisfaction score with two covariates.Results: While providing correct estimates of the mean values (marginal effects), the assumptions of the linear model are violated which can lead to false interpretations. A two-part regression which consists of a logistic regression followed by a linear regression conditional on not being fully satisfied is a useful alternative. For research questions focusing on specific parts of the distribution, logistic regression as well as quantile regression are to be considered.Discussion: Data with a spike represents a statistical challenge but a range of modeling approaches is available to provide sound interpretations and correct answers to research questions.