Based on literature review, expert consultation and pre-interview, we finally determined the semi-structured interview outline of the elderly. The main contents of the interview outline are listed as follows: 1) Basic information of the elderly; 2) The time and reason of living in nursing homes; 3) What is the overall feeling of living in nursing homes? 4) What kind of medical-nursing integrated services are provided by nursing homes? Are you satisfied with these services? 5) What are your opinions and suggestions medical-nursing integrated services in nursing homes? The interviewers informed the interviewees of research purpose

and significance, promised the confidentiality of the interview in advance, then conducts face-to-face in-depth interviews after obtaining informed consent. The interview time for each person is 40 - 60 minutes, and the interview contents are well recorded and saved by recording.

The Colaizi 7-step analysis method consists of seven steps, namely familiarization, identifying significant statements, formulating meanings, clustering themes, developing an exhaustive description, producing the fundamental structure, and seeking verification of the fundamental structure [6]. We transcribed the interview recordings into text materials within 24 hours after the interview, and strictly followed these seven steps to analyze the interview data so as to ensure the completeness, authenticity and credibility of the research results [6].

For the elderly in nursing homes, environmental conditions of nursing homes will affect the quality of life of the elderly [7], and it is also a necessary consideration for the elderly and their families to choose a nursing home. A6: “I have lived in the nursing home for more than 3 months. I choose this nursing home because of its good environment. My husband and I often take a walk in the nursing home.” A11: “This nursing home is far away from the city, green and fresh air, so the body will be healthier. Most people come to here for its environment.”

As the second place of the elderly, the cleanliness of room layout and the completeness of facilities are the primary considerations before they move into nursing home [8]. A3: “The facilities here are very good both inside and outside. There are fitness equipment, chess room, mahjong table outside the room, and there are air conditioners, water heaters, TVs, call bells in the room”. A5: “The facilities are OK, I’m very satisfied. The room is spacious, with heating in winter. The summer is cool, so do not need to turn on air conditioner, but there are too few mahjong tables, too many people”.

Basic living services are the key to service for the elderly. The reason why the elderly go to nursing homes is that most of them have difficulties in home-based care due to limited time and energy for their children, their old age and limited mobility. Previous researches show that the elderly in nursing homes value basic living services [9]. A9: “There are service staff here to help us fetch boiled water, do cleaning, wash the bedclothes and assist to walk. Their service is very attentive. In terms of food, there are not a wide variety of dishes, and the meal is scheduled too early, 7:10 in the morning, 11:10 at noon, 5:10 at night. Dinner is too early, so I’ll be hungry in the evening”. A10: “My wife and I have lived here for more than 3 years. The service staff helps us wash clothes, do cleaning, etc., but the food is getting worse and worse. There are not many varieties of dishes, and we often eat the same vegetables, and they do not wash vegetables carefully, so the food needs to be improved”.

As providers of elderly care services, caregivers’ quantity and quality will directly affect the satisfaction of the elderly. A6: “The caregivers here have a good working attitude and an affinity. They treat the elderly very well, like their own relatives. They will chat with us when they come to do cleaning, and they work very seriously, we are satisfied with them”. A7: “My ability to walk is not convenient, so I live in the intermediate nursing area. There is one nurse on each floor of intermediate nursing area, the caregiver usually care for me. A caregiver has to care for 6 elderly people, they are too busy”. A15: “The caregivers have a good service attitude, but they are not well-educated. Most of them are rural women around nursing homes, they don’t know how to care for the elderly, and they have not received any training on the job, so their professional quality is not good”.

Of the 16 elderly people, 14 suffered from diagnosed disease with a prevalence rate of 87.5%, which shows that the elderly have a very high demand for medical and health care.

A8: “The hospital in nursing home provides such services as seeing a doctor and hospitalization, and it also organize health talks, as well as traditional Chinese medicine and physical therapy, but medical technology is worse than that of hospital outside nursing home. I was hospitalized in the institution’s hospital for 18 days due to a cough, but it has not been well. The frequency of blood pressure measurement is low, only once a week. I suffer from high blood pressure, nursing home should pay attention to it and monitor blood pressure at any time”. A9: “The hospital can see a doctor and take medicine, but most elderly people are unwilling to go there, because they think its standard of medical care is not high. At the same time, there are not many doctors, and many doctors have resigned, the hospital can’t retain talents”.

The original intention of establishing hospital in nursing home is to facilitate the elderly to obtain professional medical services, but the reality is not optimistic, and there are still many restrictions on the medical services provision.A1: “I suffer from uremia and need dialysis twice a week, but the hospital in nursing home lacks dialysis equipment, so I have to pay for a ride from nursing home to other hospital for dialysis every time”. A11: “My special disease medical insurance can only be reimbursed in the designated hospital, but it cannot be reimbursed in the hospital of nursing home. I took Chinese medicine in the hospital of nursing home for several times, the doctors are very responsible and enthusiastic. However, there were few kinds of drugs in the hospital and the prices were expensive, so I always went to the outside hospital to see the doctor”.

As the elderly in nursing homes grow older, their various physiological functions gradually decline, and coupled with long-term separation from their families, they are more likely to experience anxiety, loneliness, and other negative psychology than those living at home [10], so they have a strong demand for family care. A1: “I still don’t get used to this nursing home. I can’t fall asleep every day since dialysis, I feel anxious and lonely all the time. My daughter is busy working in Shenzhen, and she hasn’t come to see me since she sent me to the nursing home”. A14: “As I get old, my personality has changed a bit. I feel depressed about a lot of things, my family is not around, I’m very lonely. When I see most of the elderly around me are sick, I feel very pessimistic about that. My children are usually busy at work, and they seldom came to see me, they just called to say a few words. In fact, I still want to go home and live with my children”. A8: “I am very anxious recently. I have lost my husband, so I feel unhappy and lonely”.

Abundant cultural and recreational activities are beneficial to physical and mental health of the elderly, and many elderly people expressed the need for cultural and recreational activities to enrich their leisure life. A7: “There are many activities in nursing homes, such as playing ball, singing and dancing, watching movies, playing mahjong, etc. Now I don’t participate in them due to my own health. I used to like to play everywhere. The activities are going well, but my body is not good enough to participate in them”. A10: “No personnel organizes the activities. The singing and dancing are all spontaneously organized by the elderly, but not many people take part in them. I still hope that nursing homes can organize everyone to participate together”. A12: “There are many activities in nursing home, and I feel very fulfilled. Now I’m sick, I can’t take part in the mand I’m not used to it. I hope to get better soon”.

The elderly in nursing home often suffer from negative emotions such as loneliness and anxiety due to the absence of their children and the unfamiliarness of old people around them. However, there is no special psychological consultation service in nursing homes at present, so the psychological problems of the elderly cannot be solved. A8: “I suffer from depression, and I usually take medicine to control my random thoughts. The nursing home does not have psychological counseling services, and I have little contact with other elderly people, so I often don’t know who to talk to”. A9: “The nursing home does not have psychological counseling services, sometimes caregiver chats with us. Most of the elderly are lonely, so we hope to have professional staff to ease our emotions”. A16: “It’s okay for me to live in nursing home with my husband, and I don’t feel lonely. Some elderly people live alone and children do not come to visit them often, so they are very lonely. The nursing home does not have psychological counseling services, we still need a professional psychologist”.