Assessing Quality of Life in Nursing Home Residents: A Systematic Review of Measurement Tools.

BACKGROUND AND OBJECTIVES: Nursing homes (NHs) are key to supporting older adults' quality of life (QoL). With many QoL instruments available, selecting an appropriate tool is challenging. This study inventories instruments used with NH residents, and examines whether they conceptualize QoL as a multidimensional construct. RESEARCH DESIGN AND METHODS: A systematic review was conducted to identify QoL instruments used in NHs. Five databases were searched in March 2025 using terms related to "elderly", "nursing home", "questionnaire", "psychometrics", and "quality of life". Empirical English- or Dutch-language studies were eligible, with no geographic or date restrictions. Reference and citation searches were added. Quality was assessed using COSMIN Risk of Bias checklist, and questionnaire characteristics and QoL subdomains were analyzed using a QoL concept map. RESULTS: A total of 15,516 records were identified (MEDLINE n = 4,536; Web of Science n = 4,738; CINAHL n = 1,395; Scopus n = 3,395; Embase n = 1452), of which 6,680 duplicates were removed. After screening 8,836 titles and abstracts, 370 full texts were assessed, yielding 28 eligible studies. Most questionnaires were setting-specific, QoL-focused, and designed for self-report. Across all instruments, 157 unique themes were mapped onto seven QoL dimensions; 'context and environment' and 'social relationships' were most common, whereas 'relationship with staff' and 'physical health' were addressed less often. DISCUSSION AND IMPLICATIONS: This study provides an overview of conceptual and practical diversity in QoL tools for NH residents. It highlights the absence of a standardized, comprehensive tool tailored to both residents and the NH context.