Document Type


Date of Degree


Degree Name

PhD (Doctor of Philosophy)

Degree In


First Advisor

Janet K. Specht

First Committee Member

David Reed

Second Committee Member

Bern-Klug Mercedes

Third Committee Member

Sue moorhead

Fourth Committee Member

Timothy Ansley

Fifth Committee Member

Mary Dyck


The purpose of this study was to investigate the relationship between nursing staffing and quality of life (QOL) in nursing homes (NHs). The relationships between nursing staff hours per resident day, nursing staffing skill mix, turnover of nursing staff, and the answers given to QOL questions by 231 residents in Iowa NHs were investigated. Unexpectedly, only part of staffing variables were statistically significantly correlated with QOL of residents and nurse staffing variables seemed to have little influence on predicting QOL of residents in this study. The major differences between this study and previous studies are that previous research focused on quality of care (QOC) and this study measured QOL by measuring residents' outcomes. Previous studies found that nurse staffing is an important factor in improving QOC (and by implication, QOL) of NH residents. Based on the statistically significant relationships, RNs' unique contributions were supported by the findings that NHs with more RNs, compared with LPNs/LVNs and CNAs, had residents with higher scores in the functional competence domain and overall QOL summary items. This study found that nurse staffing turnover is positively correlated with QOL, especially in the individuality domain. However, the whole study takes place in one state, Iowa. Iowa has a homogeneous population with limited racial diversity. Only Iowa NHs were selected and it is questionable whether the findings may be generalizable to the rest of the United States. Further research is required to confirm the relationship and provide policy guidelines, including nurse staffing recommendations, to guarantee optimal QOL for NH residents.


nursing home, quality of life, nurse staffing, minimum data set


x, 211 pages


Includes bibliographical references (pages 190-211).


Copyright 2008 Juh Hyun Shin

Included in

Nursing Commons