Community nursing on subjective well-being of the elderly: evidence from CLASS data

With the acceleration of the global aging process, Subjective Well-being (SWB) of the elderly which focuses on their inner true feelings and reflects the meaning and happiness of their lives, has drawn extensive attention from all walks of life. However, due to factors like the flow of the labor force, the miniaturization and flattening of family structures, the traditional function of family care has been continuously weakened, and it's hard for families to take on the all-round care for the elderly.

This study utilized the micro-panel data from the China Longitudinal Aging Social Survey (CLASS) in 2018 and 2020, covering a sample of 8,179 elderly people aged over 60 in China. The fixed effects model was employed for the benchmark regression. The two-stage least squares method (2SLS) was used to overcome the endogeneity problem. Replacing variables and samples as well as the propensity score matching (PSM) was adopted for the robustness test, and the mediating effect model was utilized for the mechanism analysis.

The findings of this study are as follows: (1) Community nursing increases the SWB of the elderly by 0.101 standard deviations. (2) Mechanism analysis demonstrates that community nursing can improve the SWB of the elderly by means of health improvement (0.029/0.003/0.006), social participation (0.014), and social identity (0.018/0.012). (3) Heterogeneity analysis discloses that for different types of elderly groups, community nursing plays a more crucial role in enhancing the SWB of vulnerable elderly individuals with low incomes (0.145, p < 0.01), low educational attainment (0.092, p < 0.01), living in rural areas (0.447, p < 0.01), and not living with their children (0.296, p < 0.01).

This study has confirmed the crucial role of community nursing in enhancing the SWB of the elderly. Moreover, this positive influence has a multi-dimensional impact mechanism and shows characteristics of group differences. Based on this, Special training programs for community nurses can be carried out, with a focus on enhancing their capabilities in elderly health assessment and planning, humanistic qualities, as well as communication and coordination abilities. Community institutions can implement a stratified nursing strategy, designing customized interventions for vulnerable elderly groups.