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Background and Objectives: Smart technology in nursing home settings has the potential to elevate an operation that manages more significant number of older residents. However, the concepts, definitions, and types of smart technology, integrated medical services, and stakeholders' acceptability of smart nursing homes are less clear. This scoping review aims to define a smart nursing home and examine the qualitative evidence on technological feasibility, integration of medical services, and acceptability of the stakeholders.Methods: Comprehensive searches were conducted on stakeholders' websites (Phase 1) and 11 electronic databases (Phase 2), for existing concepts of smart nursing home, on what and how technologies and medical services were implemented in nursing home settings, and acceptability assessment by the stakeholders. The publication year was inclusive from January 1999 to September 2021. The language was limited to English and Chinese. Included articles must report nursing home settings related to older adults ≥ 60 years old with or without medical demands but not bed-bound. Technology Readiness Levels were used to measure the readiness of new technologies and system designs. The analysis was guided by the Framework Method and the smart technology adoption behaviours of elder consumers theoretical model. The results were reported according to the PRISMA-ScR.Results: A total of 177 literature (13 website documents and 164 journal articles) were selected. Smart nursing homes are technology-assisted nursing homes that allow the life enjoyment of their residents. They used IoT, computing technologies, cloud computing, big data and AI, information management systems, and digital health to integrate medical services in monitoring abnormal events, assisting daily living, conducting teleconsultation, managing health information, and improving the interaction between providers and residents. Fifty-five percent of the new technologies were ready for use in nursing homes (levels 6-7), and the remaining were proven the technical feasibility (levels 1-5). Healthcare professionals with higher education, better tech-savviness, fewer years at work, and older adults with more severe illnesses were more acceptable to smart technologies.Conclusions: Smart nursing homes with integrated medical services have great potential to improve the quality of care and ensure older residents' quality of life. [ABSTRACT FROM AUTHOR]

Nursing homes integrated with smart information such as the Internet of Things, cloud computing, artificial intelligence, and digital health could improve not only the quality of care but also benefit the residents and health professionals by providing effective care and efficient medical services. However, a clear concept of a smart nursing home, the expectations and acceptability from the perspectives of the elderly people and their family members are still unclear. In addition, instruments to measure the expectations and acceptability of a smart nursing home are also lacking. The study aims to explore and determine the levels of these expectations, acceptability and the associated sociodemographic factors. This exploratory sequential mixed methods study comprises a qualitative study which will be conducted through a semi-structured interview to explore the expectations and acceptability of a smart nursing home among Chinese elderly people and their family members (Phase I). Next, a questionnaire will be developed and validated based on the results of a qualitative study in Phase I and a preceding scoping review on smart nursing homes by the same authors (Phase II). Lastly, a nationwide survey will be carried out to examine the levels of expectations and acceptability, and the associated sociodemographic factors with the different categories of expectations and acceptability (Phase III). With a better understanding of the Chinese elderly people's expectations and acceptability of smart technologies in nursing homes, a feasible smart nursing home model that incorporates appropriate technologies, integrates needed medical services and business concepts could be formulated and tested as a solution for the rapidly ageing societies in many developed and developing countries. [ABSTRACT FROM AUTHOR]

The one-child policy and longer life expectancies have transformed China into an ageing society. 'Ageing in place' becomes hardly feasible because of family structure change, and it is difficult for a single adult child in the family to provide care for two parents or four grandparents. Increasingly, Chinese older people are looking for nursing homes as a possible alternative shelter and care. The objective of this study was to explore the perception of Chinese older people on quality nursing homes, and their expectation and acceptability of a smart nursing home that provides nursing care using smart technologies to integrate nursing home operation and medical services. A qualitative case study approach was used to study the perception of Chinese older people and family members in Hainan Island and Dalian city. Participants were sampled purposively through snowball sampling. Semistructured interviews were conducted on WeChat by using voice calls or voice messages, and audio-recorded. The field notes were recorded and voice messages were converted into texts in English. The Framework Method was used to apply and categorise the data into codes and themes. The qualitative analysis was guided by Golant's (2017) elder consumers smart technology adoption behaviours theoretical model. In this study, thirty-three (33) participants were interviewed, including twenty-seven (27) older people aged 65-75 years old and six (6) adult children, and data saturation was reached. Of these, twenty-two (22) participants were from Dalian and eleven (11) were from Hainan. Nine (9) of these older people had one or one more chronic disease, while the others were reported to be in healthy condition. The perceptions of Chinese older people towards the traditional nursing home included; 1) dissatisfaction with the quality of care; 2) lack of integration of medical services; 3) inadequate healthcare providers (HCPs); and 4) uncomfortable environment in current nursing homes. Their expectation on smart nursing homes was: 1) future implementation needs government support; 2) improving quality of care by using smart technologies; 3) adequate HCPs and skilled caregivers, and 4) integration of medical services. The acceptability of smart nursing homes is associated with stakeholders' perception of perceived efficaciousness, usability and collateral damages to decide on adopting the smart solutions. This coping process is also influenced by the older people's greater resilience to new information, their past experiences and external persuasiveness. Institutional care was perceived as an alternative to replacing home-based care. In addition, the attributes of the older people which included age, education attainment, health condition (severity of illness) were linked to the adoption of smart solutions. People with a better economic status would like to pay more for a higher level of nursing service in meeting their demands. In conclusion, the findings from this study indicate that the Chinese older people and family members perceived positively about the smart nursing home model. The older people's unmet needs and expectations on smart nursing homes are relevant to a broad base of stakeholders interests, and it provided qualitative evidence to the Chinese government to implement a smart solution for rapid ageing. The smart nursing home model will involve multi-disciplinary collaboration from health sciences, computer science, engineering and business to realise. [ABSTRACT FROM AUTHOR]

Smart technology in nursing home settings has the potential to elevate an operation that manages a larger number of elderly residents through efficient services and safer 24-hour functional care. However, the concepts, definitions, and scopes of 'smartness' integrated medical services, and stakeholders' acceptability of smart nursing homes are less clear. This scoping review aimed to define a smart nursing home and to examine the extent (size), range (variety), and nature (characteristics) of evidence on technological feasibility and integration of medical services in a smart nursing home and acceptability of it by older people and their caregivers. In this study, comprehensive searches were conducted on stakeholders' websites and eleven (11) electronic databases for existing definitions, concepts, and criteria of a smart nursing home (Phase 1), and on what and how technologies and medical services were implemented in nursing home settings, as well as acceptability assessment by the stakeholders (Phase 2). The publication year was limited to and inclusive of January 1999 to June 2020. Included articles must report nursing home settings and related to older people = 60 years old with or without medical demands. The Framework Method was used to summarize and reduce texture data by applying thematic analysis in both inductive and deductive approaches. We synthesized and provided a definition of a smart nursing home, and evaluated the feasibility of technologies by adopting a Technology Readiness Level assessment to measure the new technology developments. The analysis was guided by a theoretical model proposed by Golant (2017) and reported according to the PRISMA-ScR. The findings reveal that a total of one hundred and fifty-nine (159) literature were included and data retrieved. A clear concept of smart nursing homes was defined. As a collective or individual aged care model, the smart nursing homes were supported by physical devices that are connected to the internet, Internet of Things (IoT), digital health, information management system (IMS), big data, and artificial intelligence (AI), computing technologies and cloud computing to provide integrated and personalized nursing care. The feasible technologies related to 'smartness' in nursing home settings were mainly implemented on monitoring of abnormal events, remote clinical services, clinical information management, big data analysis, and device developments for activities of daily living assistance. Electronic clinical information, telemedicine, and mHealth (mobile self-care smartphones or tablet apps enabling consumers to monitor their own health data) were more likely to be integrated with other forms of medical services in the nursing care delivery to support the complex nursing and medical cares that would be convenient, comfortable and safe to their residents. The technology appraisal process was determined by the perceived efficaciousness, perceived usability and perceived collateral damages of adopting smart technology. The attributes of direct users such as their sociodemographic factors and the severity of elderly residents' illnesses were associated with stakeholders' acceptability. This was also influenced by the persuasiveness of external and internal information of the smart solutions. It is therefore concluded that smart nursing homes with integrated medical services have great potential to improve the quality of care. With a clear concept of smart nursing homes, the stakeholders and policymakers will be able to effectively develop the smart nursing home models that embed with appropriate technologies, integrate relevant medical services to benefit the ageing societies. [ABSTRACT FROM AUTHOR]