Need fulfillment in the nursing home: resident and observer perspectives in relation to resident well-being

Annette F.J. Custers, Gerben Johan Westerhof, Y. Kuin, D.L. Gerritsen, J.M. Riksen-Walraven

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)


Self-reports in nursing homes generally show highly satisfied residents, whereas observational studies provide more nuanced results. In this study, which is based on self-determination theory, the perspective of nursing home residents (self-reports) is compared to the perspective of trained “neutral” observers (video-observations). The experiences of physically frail older residents are measured with regard to the fulfillment of their needs for relatedness, autonomy, and competence. Self-reports of need fulfillment in general, in the caring relationship, and during a caregiving episode recorded on videotape of 36 residents (64 % female, mean age 80 years) were compared with observer ratings of resident need fulfillment during the latter caregiving episode. Furthermore, it was investigated which measure relates best to residents’ self-reported well-being. The results show that residents rate their need fulfillment higher than observers. There is weak to moderate agreement between resident and observer ratings. Furthermore, only residents’ self-reported need fulfillment in general is related with self-reported well-being. Different explanations are provided, including the “barrier of happiness,” the use of cognitive strategies, a change in identity and existing power relations. There seems to be a paradox in caregiving: Residents and their needs should be central, but because residents might adapt their needs and wishes it is hard to assess these. Suggestions for practical applications are given
Original languageEnglish
Pages (from-to)201-209
Number of pages9
JournalEuropean journal of ageing
Issue number3
Publication statusPublished - 1 Mar 2013


  • IR-85548
  • METIS-295855


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