Purpose: This Taiwan study investigated the effect of a visual art-based friendly environment on nursing home residents' satisfaction with their living environment. Design: A pre-experimental design was used. Thirty-three residents in a nursing home were recruited in a one-group pre- and post-test study. Methods: The four-floor living environment was integrated using visual art, reminiscence, and gardening based on the local culture and history. Each floor was given a different theme, one that was familiar to most of the residents on the floor. The Satisfaction with Living Environment at Nursing Home Scale (SLE-NHS) was developed to measure outcomes. Findings: Of the 33 participants recruited, 27 (81.8%) were women and 6 (18.2%) were men. Their mean age was 79.24 ± 7.40 years, and 48.5% were severely dependent in activities of daily living. The SLE-NHS showed adequate reliability and validity. Its three domains were generated and defined using factor analysis. After the visual art-based intervention, the score on the "recalling old memories" subscale was significantly higher (t = -13.32, p < .001). However, there were no significant score changes on the "convenience" and "pretty and pleasurable" subscales. In general, the participants were satisfied with the redesigned environment and felt happy in the sunny rooms. Conclusions: Visual art in a nursing home is a novel method for representing the local culture and stressing the spiritual value of the elderly residents who helped create it. Older adults' aesthetic activities through visual art, including reminiscence and local culture, may enrich their spirits in later life. Clinical Relevance: Older adults' aesthetic activities through visual art have been shown to improve their satisfaction with their living environment. The SLE-NHS is a useful tool for evaluating their satisfaction.
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