ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1612187
This article is part of the Research TopicThe Costs of Caring for Older AdultsView all articles
Assessment of Mutual Aid Elderly Care Needs for Older Adults with Multimorbidity in Urban China: A Kano Model-Based Study
Provisionally accepted
- 1School of Nursing, Bengbu Medical University, Bengbu, China
- 2Department of Human Resources, Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
- 3Philippine Women's University, Manila, Philippines
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Introduction: China faces escalating challenges in elderly care because of rapid population aging and the high prevalence of multimorbidity among urban older adults. Traditional family-based and institutional care models are increasingly inadequate, necessitating innovative solutions like mutual aid elderly care. However, research gaps persist in understanding the prioritised needs of urban older adults with multimorbidity within mutual aid elderly care frameworks. This study evaluates and prioritises mutual aid elderly care needs for older adults with multimorbidity in urban Chinese communities, by integrating Maslow’s Hierarchy of Needs with the Kano Model. Methods: A cross-sectional survey was conducted among 240 older adults (aged ≥65, with ≥2 chronic conditions) across 25 urban communities in Hefei, China. Using a validated questionnaire, 43 service items across safety/health, daily life, learning/socialisation, spiritual, and entertainment domains were assessed. Kano Model categorisation and better-worse coefficient analysis were applied to classify needs (must-be, one-dimensional, attractive, indifferent) and rank priorities via sensitivity calculations. Results: Key must-be needs included cooking, washing hair, and psychological counselling, while one-dimensional priorities emphasised exercise and travelling. Attractive needs featured telemedicine and cultural activities (e.g., Red Song Club). Indifferent items, such as pest control, had minimal impact on satisfaction. The analysis highlighted the centrality of physical health services, mental health support, and social engagement in enhancing quality of life. Discussion: Urban older adults with multimorbidity prioritise integrated care models addressing both basic survival needs and higher-order psychosocial well-being. Mutual aid elderly care frameworks must therefore balance healthcare accessibility with opportunities for social participation and emotional fulfilment. Future policies should adopt evidence-based, culturally tailored strategies to optimise resource allocation and foster sustainable aging-in-place solutions. Limitations include geographic specificity and cross-sectional design, warranting broader longitudinal and mixed-method research.
Keywords: Mutual aid, Elderly care needs, multimorbidity, Kano model, Population aging
Received: 22 May 2025; Accepted: 02 Sep 2025.
Copyright: © 2025 Zhang, Chen and Ochoa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qian Yong Chen, Department of Human Resources, Third Affiliated Hospital of Anhui Medical University, Hefei, 230061, Anhui Province, China
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