Activity-engagement and its effect on mood from nursing home residents’ perspective: a qualitative study

Introduction: The positive effect of engaging in activities on the mood and wellbeing of nursing home (NH) residents has been confirmed by numerous studies. However, the extent to which nursing home residents engage in activities and how this engagement improves residents’ mood is highly individual and depends on various factors. More insight into these factors are needed to support healthcare professionals to promote residents’ engagement in activities. This can contribute to a better understanding of potential mechanisms that improve residents’ mood.

Objective: This study aimed to explore which factors residents themselves perceive as relevant to their engagement in activities (RQ1) and what engagement in activities entails for their mood (RQ2).

Methods: A qualitative study was employed. Semi-structured interviews were held with residents in their room and guided by the Actions to Improve Mood - Residents Inventory that was used as a topic list. An inductive and iterative approach was used to analyze and structure the provided quotations into overarching themes. Data were collected among Dutch and Flemish nursing home residents.

Results: 1571 quotations regarding factors relevant for engaging in mood-improving activities were collected amongst 206 participants. Next to personal factors, residents expressed various examples of how contextual factors influenced their activity engagement and its perceived effect on mood. Three themes were identified as relevant to engagement in activities (RQ1): residents’ personal portfolio (e.g., residents’ preferences, demographics, and previous profession), agency, and growth-oriented triggers found in activities that are challenging and promote personal development. Six themes were identified as relevant to residents’ mood in relation to activity engagement (RQ2): residents’ mental state (e.g., feelings of irritation and satisfaction), health-related factors (e.g., pain), coping with emotions and situations, social bonding, and the physical and social environment such as the positive and negative impact of fellow residents on mood.

Conclusion: With the aim of improving mood, the findings of this study suggested that activities are not fixed as pleasant or meaningful for a specific residents. Yet, the pleasantness and meaningfulness of activities should be understood as dynamic processes influenced by individual, social and contextual factors requiring ongoing attention from professionals.