1
|
Ramezani A, Sharafkhaneh A, BaHammam AS, Kuna ST, Razjouyan J. Effects of COVID-19 on Sleep Services Use and Its Recovery. Nat Sci Sleep 2024; 16:761-768. [PMID: 38882925 PMCID: PMC11179655 DOI: 10.2147/nss.s456214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 06/05/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose The COVID-19 pandemic affected the utilization of various healthcare services differentially. Sleep testing services utilization (STU), including Home Sleep Apnea Testing (HSAT) and Polysomnography (PSG), were uniquely affected. We assessed the effects of the pandemic on STU and its recovery using the Veterans Health Administration (VHA) data. Patients and Methods A retrospective cohort study from the VHA between 01/2019 and 10/2023 of veterans with age ≥ 50. We extracted STU data using Current Procedural Terminology codes for five periods based on STU and vaccination status: pre-pandemic (Pre-Pan), pandemic sleep test moratorium (Pan-Mor), and pandemic pre-vaccination (Pan-Pre-Vax), vaccination (Pan-Vax), and postvaccination (Pan-Post-Vax). We compared STU between intervals (Pre-Pan as the reference). Results Among 261,371 veterans (63.7±9.6 years, BMI 31.9±6.0 kg/m², 80% male), PSG utilization decreased significantly during Pan-Mor (-56%), Pan-Pre-Vax (-61%), Pan-Vax (-42%), and Pan-Post-Vax (-36%) periods all compared to Pre-Pan. HSAT utilization decreased significantly during the Pan-Mor (-59%) and Pan-Pre-Vax (-9%) phases compared to the Pre-Pan and subsequently increased during Pan-Vax (+6%) and Pan-Post-Vax (-1%) periods. Over 70% of STU transitioned to HSAT, and its usage surged five months after the vaccine Introduction. Conclusion Sleep testing services utilization recovered differentially during the pandemic (PSG vs HSAT), including a surge in HSAT utilization post-vaccination.
Collapse
Affiliation(s)
- Amin Ramezani
- VA's Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA
- Big Data Scientist Training Enhancement Program, VA Office of Research and Development, Washington, DC, 20420, USA
- VA Quality Scholars Coordinating Center, Iquest, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Amir Sharafkhaneh
- VA's Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Ahmed S BaHammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia
- The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | - Samuel T Kuna
- Department of Medicine, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Javad Razjouyan
- VA's Health Services Research and Development Service (HSR&D), Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA
- Big Data Scientist Training Enhancement Program, VA Office of Research and Development, Washington, DC, 20420, USA
- VA Quality Scholars Coordinating Center, Iquest, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| |
Collapse
|
2
|
Sennfält S, Hedman C, Fürst CJ. Associations between the spread of COVID-19 and end-of-life circumstances in the non-infected population of Sweden. Scand J Public Health 2024; 52:290-298. [PMID: 38153142 PMCID: PMC11067408 DOI: 10.1177/14034948231216197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/15/2023] [Accepted: 11/06/2023] [Indexed: 12/29/2023]
Abstract
AIMS Since its outbreak in 2020, the COVID-19 pandemic has directly caused the premature death of millions. However, indirect consequences, such as social restrictions, have affected a far greater number. We explored the association between the spread of COVID-19 and end-of-life circumstances in the infected and non-infected population in Sweden. METHODS In this descriptive, population-based, observational study, we primarily used data from the Swedish National Registry of Palliative Care, which covers about 60% of all deaths in Sweden. We explored the association between the spread of COVID-19 and place of death, people present at death and end-of-life symptoms using regression analyses. RESULTS The study included 190,291 individuals who died in any region of Sweden from 1 January 2019 to 30 June 2022, of which 10,646 were COVID-19 cases. Correlated to the temporal and geographical spread of COVID-19, there was a greater proportion of individuals dying without the presence of their next-of-kin, and consequently more people dying alone, both in those with and without COVID-19. There was a similar pattern of a greater proportion of deaths taking place in nursing homes and in the individual's own home. However, we did not find substantial associations to reported symptoms, such as anxiety or confusion. CONCLUSIONS This study shows the profound effects of the COVID-19 pandemic on end-of-life circumstances in both the infected and non-infected population in Sweden. As we prepare for future pandemics, there is a need to develop strategies to minimise the impact on non-infected individuals.
Collapse
Affiliation(s)
- Stefan Sennfält
- Department of Neurology, Karolinska University Hospital, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Christel Hedman
- Department of Clinical Sciences, Lund University, Sweden
- Institute for Palliative Care, Lund University and Region Skåne, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Sweden
- R&D Department, Stockholms Sjukhem Foundation, Sweden
| | - Carl Johan Fürst
- Department of Clinical Sciences, Lund University, Sweden
- Institute for Palliative Care, Lund University and Region Skåne, Sweden
| |
Collapse
|
3
|
Greindl S, Di Gangi S, Plate A, Senn O, Neuner-Jehle S. Perceived dilemma between protective measures and social isolation in nursing homes during the COVID-19 pandemic: a mixed methods study among Swiss nursing home directors. Front Public Health 2024; 12:1292379. [PMID: 38528858 PMCID: PMC10962325 DOI: 10.3389/fpubh.2024.1292379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/18/2024] [Indexed: 03/27/2024] Open
Abstract
Background Coronavirus pandemic (COVID-19) particularly affected older adults, with the highest risks for nursing home residents. Stringent governmental protective measures for nursing homes unintendedly led to social isolation of residents. Nursing home directors (NDs) found themselves in a dilemma between implementing protective measures and preventing the social isolation of nursing home residents. Objectives The objectives of this study were to describe protective measures implemented, to investigate NDs' perception of social isolation and its burden for nursing home residents due to these measures, and to explore experiences of NDs in the context of the dilemma. Methods Cross-sectional embedded mixed-method study carried out by an online survey between April 27 and June 09, 2022, among NDs in the German-speaking part of Switzerland. The survey consisted of 84 closed-ended and nine open-ended questions. Quantitative findings were analyzed with descriptive statistics and qualitative data were evaluated using content analysis. Results The survey was completed by 398 NDs (62.8% female, mean age 55 [48-58] years) out of 1'044 NDs invited.NDs were highly aware of the dilemma. The measures perceived as the most troublesome were restrictions to leave rooms, wards or the home, restrictions for visitors, and reduced group activities. NDs and their teams developed a variety of strategies to cope with the dilemma, but were burdened themselves by the dilemma. Conclusion As NDs were burdened themselves by the responsibility of how to deal best with the dilemma between protective measures and social isolation, supportive strategies for NDs are needed.
Collapse
|
4
|
Boamah SA, Yous ML, Gao H, Weldrick R, Dal Bello-Haas V, Durepos P. Insight into the experiences of caregivers of older adults in long-term care homes: A photovoice study. J Adv Nurs 2024; 80:1084-1096. [PMID: 37775476 DOI: 10.1111/jan.15888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/11/2023] [Accepted: 09/11/2023] [Indexed: 10/01/2023]
Abstract
AIMS To explore the lived experiences of caregivers of people living in long-term care (LTC) homes during the initial phases of the COVID-19 pandemic and potential supports and resources needed to improve caregivers' quality of life. BACKGROUND Carers (or care partners) of adults in LTC contribute substantially to the health and well-being of their loved ones by providing physical care, emotional support and companionship. Despite their critical role, little is known about how caregivers have been impacted by the pandemic. DESIGN An interpretive descriptive approach that incorporated the photovoice method was used. METHODS Using a purposive sampling strategy, six family carers in Ontario, Canada were recruited between September and December 2021. Over a 4-week period, caregivers took pictures depicting their experience of the pandemic that were shared in a virtual focus group. Visual and text data were analysed using thematic analysis with an inductive approach. FINDINGS Caregivers expressed feelings of frustration, confusion and joy. Emerging themes included: (i) feeling like a 'criminal' amidst visitor restrictions and rules; (ii) experiencing uncertainty and disappointment in the quality of care of long-term care homes; (iii) going through burnout; and (iv) focusing on small joys and cherished memories. CONCLUSIONS The combination of visual and textual methods provided unique insight into the mental distress, isolation and intense emotional burdens experienced by caregivers during the pandemic. IMPACT Our findings underscore the need for LTC organizations to work in unison with caregivers to optimize the care of residents and support the mental health of caregivers. REPORTING METHOD This work adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. PUBLIC CONTRIBUTIONS The caregivers included in the study were involved in the co-creative process as active contributors informing the design and validation of the codes and themes.
Collapse
Affiliation(s)
- Sheila A Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Marie-Lee Yous
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Harrison Gao
- Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Rachel Weldrick
- Department of Gerontology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Pamela Durepos
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| |
Collapse
|
5
|
De Witte J, Noten S, Vinckers F, Stoop A, Hovenga N, Landeweer E, Van Regenmortel T. "You Needed to Accept the Situation": Resilience of Nursing Home Residents in Times of COVID-19. Can J Aging 2024; 43:75-83. [PMID: 37665004 DOI: 10.1017/s0714980823000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
The restrictive measures taken by nursing homes during the COVID-19 outbreak in 2020 (e.g., quarantine) may have been important stressors for which residents needed resilience to safeguard their well-being. Based on 30 semi-structured interviews with nursing home residents and close relatives, this study explored the lived experiences with respect to the restrictive measures. The data were collected in psychogeriatric, somatic, and mixed wards in The Netherlands and Flanders, Belgium. The restrictive measures were important stressors for residents, indicated by feelings of loneliness, sadness, and powerlessness. To deal with these measures, residents used various resources, which were determined by factors in the individual (e.g., health), interactional (e.g., possibilities for social interactions) and contextual (e.g. nursing home policy) domains. Because the lived experiences with respect to the restrictive measures seemed to relate to the resilience of nursing home residents, it is crucial to reinforce resources in the individual, interactional, and contextual domains.
Collapse
Affiliation(s)
| | - Suzie Noten
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Floor Vinckers
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Annerieke Stoop
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Nina Hovenga
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Elleke Landeweer
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Tine Van Regenmortel
- HIVA KU Leuven, Leuven, Belgium
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
6
|
Waddington C, Flanagan K, Clements H, Harding E, van der Byl Williams M, Walton J, Crutch S, Stott J. Grief and loss in people living with dementia: a review and metasynthesis of qualitative studies. Aging Ment Health 2024; 28:408-421. [PMID: 37970882 DOI: 10.1080/13607863.2023.2280925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES This review seeks to synthesise qualitative studies that focus on the experience of grief and loss in people living with dementia. METHODS Included studies were quality appraised, synthesised and analysed using inductive thematic analysis. RESULTS 19 studies were selected for inclusion in the final review and metasynthesis, including 486 participants (115 participants living with dementia, 152 family carers, 219 professionals). Five key dimensions of grief in people living with dementia were identified during the analysis process: grieving for the person I used to be, grieving for how others see me, grieving for the person I will become, grieving for those who have died and what helps me with my grief. CONCLUSION It is evident that people living with dementia can experience grief related to a range of previous, current and anticipated losses. Many of the studies included in this review did not directly include people living with dementia in their research and did not ask participants directly about their experience of grief and loss. As grief is a highly personal and individual experience, further research addressing the experience of grief that directly includes participants living with dementia is required, in order to improve awareness of grief-related needs and to develop and deliver support to meet these needs.
Collapse
Affiliation(s)
- Claire Waddington
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Katie Flanagan
- Centre for Ageing Population Studies, Primary Care and Population Health, University College London, London, UK
| | - Henry Clements
- Clinical Education and Health Psychology, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | | | - Jill Walton
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Sebastian Crutch
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Joshua Stott
- ADAPT Lab, Clinical Education and Health Psychology, University College London, London, UK
| |
Collapse
|
7
|
Vasseur D, Ipakchian Askari S, Suijkerbuijk S, Nap HH, IJsselsteijn W. Sensory, Affective, and Social Experiences with Haptic Devices in Intramural Care Practice. NURSING REPORTS 2024; 14:230-253. [PMID: 38391064 PMCID: PMC10885019 DOI: 10.3390/nursrep14010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 02/24/2024] Open
Abstract
Previous work has shown that technology can facilitate the communication of emotions, social touch, and social presence through haptic devices, meaning devices that provide a haptic stimulation. However, for special user groups living in long-term care facilities, such as people with dementia, the applications of these haptic devices are not apparent. The aim of this study is to understand how haptic devices can be used in intramural care facilities in times of social isolation, focusing on haptic devices that utilize haptic sensation. Five haptic devices were tested at three care facilities. Insights from this study highlight the potential of haptic devices to enhance sensory, affective, and social experiences during video calling between residents and their relatives. Moreover, the importance of the tactile sensation and form factor of haptic devices in the care context is addressed, along with insights on how to create the appropriate atmosphere during video calling.
Collapse
Affiliation(s)
- Dianne Vasseur
- Vilans, Centre of Expertise Long-Term Care, P.O. Box 8228, 3503 RE Utrecht, The Netherlands
| | - Sima Ipakchian Askari
- Vilans, Centre of Expertise Long-Term Care, P.O. Box 8228, 3503 RE Utrecht, The Netherlands
| | - Sandra Suijkerbuijk
- Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| | - Henk Herman Nap
- Vilans, Centre of Expertise Long-Term Care, P.O. Box 8228, 3503 RE Utrecht, The Netherlands
- Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| | - Wijnand IJsselsteijn
- Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands
| |
Collapse
|
8
|
Morgan T, Wiles J, Morgan K, Williams L, Black S, Koh A, Fanueli E, Moeke-Maxwell T, Xu J, Goodwin H, Gott M. Older people's views on loneliness during COVID-19 lockdowns. Aging Ment Health 2024; 28:142-150. [PMID: 37178140 DOI: 10.1080/13607863.2023.2211549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/29/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND AND OBJECTIVES There have been growing concerns that social distancing and stay-at-home mandates have exacerbated loneliness for older people. Empirical evidence about older people's experiences of loneliness and COVID-19 have quantified this phenomena without considering how older people themselves define and understand loneliness. This paper explores how older New Zealanders conceptualized and experienced loneliness under 'lockdown' stay-at-home measures. METHODS This multi-methods qualitative study combines data from letters (n = 870) and interviews (n = 44) collected from 914 people aged over 60 and living in Aotearoa, New Zealand during the COVID-19 pandemic. We conducted a reflexive thematic analysis to conceptualise this data. FINDINGS We identify three interconnected ways in which older people conceptualised and experienced loneliness: (1) feeling disconnected relating to lack of emotional closeness to another often resulting from being physically separated from others and not being able to touch; (2) feeling imprisoned relating to separation from preferred identities and activities and was frequently associated with boredom and frustration; and (3) feeling neglected which often related to feeling let down by generalised and idealised forms of support, such as one's neighbourhood and health care system. DISCUSSION Older New Zealanders experienced lockdown loneliness in three interconnected ways rather than as a stable and homogenous experience. Māori, Pacific, Asian and New Zealand European older people often discussed loneliness in different ways; attesting to loneliness being a culturally-mediated concept shaped by expectations around desirable social interaction. We conclude the paper with implications for research and policy.
Collapse
Affiliation(s)
- Tessa Morgan
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Janine Wiles
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Kathryn Morgan
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Lisa Williams
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Stella Black
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Anne Koh
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Elizabeth Fanueli
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tess Moeke-Maxwell
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jing Xu
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Hetty Goodwin
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
9
|
Garnett A, Pollock H, Prentice K, Floriancic N, Donelle L, Hand C, Oudshoorn A, Babenko-Mould Y, Forchuk C. Health Provider Experiences in Supporting Social Connectedness Between Families and Older Adults Living in Long-Term Care Homes. SAGE Open Nurs 2024; 10:23779608241239314. [PMID: 38515527 PMCID: PMC10956142 DOI: 10.1177/23779608241239314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 02/15/2024] [Accepted: 02/25/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Many people, often older adults, living in long-term care homes (OA-LTCH) became socially isolated during the COVID-19 pandemic due to variable restrictions on in-person visits and challenges associated with using technology for social connectivity. Health providers were key to supporting these OA by providing additional care and facilitating their connections with family using technology such as smartphones and iPads. It is important to learn from these experiences to move forwards from the COVID-19 pandemic with evidence-informed strategies that will better position health providers to foster social engagement for OA-LTCH across a range of contextual situations. Objective This exploratory qualitative description study sought to explore health provider experiences in supporting social connectedness between family members and OA-LTCH within the COVID-19 context. Methods Qualitative, in-depth semistructured interviews were conducted with 11 health providers. Results Using inductive qualitative content analysis study findings were represented by the following themes: (a) changes in provider roles and responsibilities while challenging for health providers did not impact their commitment to supporting OA-LTCH social and emotional health, (b) a predominant focus on OA-LTCH physical well-being with resultant neglect for emotional well-being resulted in collective trauma, and (c) health providers faced multiple challenges in using technology to support social connectivity. Conclusion Study findings suggest the need for increased funding for LTC to support activities and initiatives that promote the well-being of health providers and OA living in LTC, the need to prioritize social well-being during outbreak contexts, and more formalized approaches to guide the appropriate use of technology within LTC.
Collapse
Affiliation(s)
| | | | | | | | | | - Carri Hand
- Western University, London, Ontario, Canada
| | | | | | | |
Collapse
|
10
|
Thompson CA, Daffu-O'Reilly A, Willis T, Gordon A, Noakes C, Khaliq K, Farrin A, Kemp A, Hall T, Bojke C, Spilsbury K. 'Smart' BLE wearables for digital contact tracing in care homes during the COVID-19 pandemic-a process evaluation of the CONTACT feasibility study. Implement Sci Commun 2023; 4:155. [PMID: 38049924 PMCID: PMC10694939 DOI: 10.1186/s43058-023-00533-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/21/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Rapid and mass transmission of the SARS-CoV-2 virus amongst vulnerable people led to devastating effects from COVID-19 in care homes. The CONTACT intervention introduced Bluetooth Low Energy 'smart' wearable devices (BLE wearables) as a basis for automated contact tracing in, and feedback on infection risks and patterns to, care homes to try and improve infection prevention and control (IPC). We planned a cluster randomised controlled trial (RCT) of CONTACT. To be feasible, homes had to adopt CONTACT's technology and new ways of working. This paper reports on the process evaluation conducted alongside CONTACT's feasibility study and explains why it lacked the feasibility and acceptability for a definitive RCT. METHODS This mixed method process evaluation used Normalisation Process Theory (NPT) qualitative (interviews, field notes, study case report forms and documents, and observation) and quantitative (survey instruments, counts of activity) data to plan, implement, and analyse the mechanisms, effects, and contextual factors that shaped the feasibility and acceptability of the CONTACT intervention. RESULTS Thirteen themes within four core NPT constructs explained CONTACT's lack of feasibility. Coherence: the home's varied in the scale and extent of commitment and understanding of the technology and study procedures. Leadership credibility was important but compromised by competing priorities. Management and direct care staff saw CONTACT differently. Work to promote (cognitive participation) and enact (collective action) CONTACT was burdensome and failed to be prioritised over competing COVID-19-related demands on time and scarce human and cognitive resources. Ultimately, staff appraisal of the value of CONTACT-generated information and study procedures (reflexivity) was that any utility for IPC was insufficient to outweigh the perceived burden and complexity involved. CONCLUSIONS Despite implementation failure, dismissing BLE wearables' potential for contact tracing is premature. In non-pandemic conditions, with more time, better co-design and integration of theory-driven implementation strategies tailored to care homes' unique contexts, researchers could enhance normalisation in readiness for future pandemic challenges. TRIAL REGISTRATION ISRCTN registration: 11,204,126 registered 17/02/2021.
Collapse
Affiliation(s)
- Carl A Thompson
- School of Healthcare, University of Leeds, Leeds, LS2 9JT, UK.
| | | | - Thomas Willis
- Trials Research, Leeds Institute of Clinical, University of Leeds, Leeds, LS2 9JT, UK
| | - Adam Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, DE22 3NE, UK
| | - Catherine Noakes
- School of Civil Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Kishwer Khaliq
- School of Civil Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Amanda Farrin
- Trials Research, Leeds Institute of Clinical, University of Leeds, Leeds, LS2 9JT, UK
| | - Andrew Kemp
- School of Electronics and Electrical Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - Tom Hall
- South Tyneside Council, South Shields, NE33 2RL, UK
| | - Chris Bojke
- Academic Unit of Health Economics, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - Karen Spilsbury
- School of Healthcare, University of Leeds, Leeds, LS2 9JT, UK
| |
Collapse
|
11
|
Friedman C, VanPuymbrouck L. People with Disabilities' Access to Medical Care During the COVID-19 Pandemic. SOCIAL WORK IN PUBLIC HEALTH 2023; 38:373-386. [PMID: 38032296 DOI: 10.1080/19371918.2023.2288352] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Delaying and forgoing medical care intensifies the health disparities and unmet needs people with disabilities already face. While many people with disabilities were at high risk for COVID-19, less is known about their access to medical care during the pandemic. This study explored people with disabilities' access to medical care during the COVID-19 pandemic. We analyzed United States Census Bureau COVID-19 Household Pulse Survey data from the second year of the pandemic (April-July 2021) from people with (n = 38,512) and without (n = 296,260) disabilities. During the second year of the pandemic, 30.8% of people with disabilities delayed getting medical care and 28.9% forwent needed care. People with disabilities were also significantly more likely to delay and forgo medical care than people without disabilities. Attention must be drawn to the unmet needs of people with disabilities and efforts must be made to expand their access to health care.
Collapse
Affiliation(s)
- Carli Friedman
- The Council on Quality and Leadership (CQL), Towson, Maryland, USA
| | | |
Collapse
|
12
|
Manohar S, Oloyede O, Kollmer Horton ME. Evaluating an intergenerational art and storytelling program with older adults and medical students. Int Rev Psychiatry 2023; 35:608-618. [PMID: 38461399 DOI: 10.1080/09540261.2023.2278717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/30/2023] [Indexed: 03/11/2024]
Abstract
Older adults in residential communities face loneliness and isolation, challenges exacerbated by COVID-19, leading to adverse physical and mental health outcomes. Intergenerational arts and humanities programs have been successful in addressing these challenges while also enabling medical learners to better understand aging populations. Draw YOUR Story, a program at a Houston residential senior living community, connects premedical and medical student volunteers with older adults through an art and storytelling activity. To evaluate the program, we conducted a focus group with older adults and pre and post-volunteering student surveys with questions about attitudes towards older adults and an Interpersonal Reactivity Index. Student surveys (n = 18) showed increased comfort working with older adults after volunteering (p = 0.02). Students who spent less time volunteering reported a decline in their perceptions of older adult quality of life, when compared to more frequent volunteers (p = 0.02). Older adults shared that the program encouraged learning new skills, offered time for reflection, connected them to medicine, and furthered desire for community. Draw YOUR Story benefitted students and older adults, increasing student comfort with older adults, providing aging adults opportunities to learn new skills and reflect, and building intergenerational connections.
Collapse
Affiliation(s)
- Sujal Manohar
- Student Affairs, Baylor College of Medicine, Houston, Texas, USA
| | - Oluwapelumi Oloyede
- Student Affairs, Tilman J. Fertitta Family College of Medicine at the University of Houston, Houston, Texas, USA
| | - Mary E Kollmer Horton
- McGovern Center for Humanities and Ethics at McGovern Medical School, Houston, Texas, USA
| |
Collapse
|
13
|
Garnett A, Yurkiv H, Booth R, Connelly D, Donelle L. Web-Based Presence for Social Connectedness in Long-Term Care: Protocol for a Qualitative Multimethods Study. JMIR Res Protoc 2023; 12:e50137. [PMID: 37889518 PMCID: PMC10638636 DOI: 10.2196/50137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and resultant restrictions on social gatherings significantly impacted many peoples' sense of social connectedness, defined as an individual's subjective sense of having close relationships with others. Older adults living in long-term care homes (LTCHs) experienced extreme restrictions on social gatherings, which negatively impacted their physical and mental health as well as the health and well-being of their family caregivers. Their experiences highlighted the need to reconceptualize social connectedness. In particular, the pandemic highlighted the need to explore novel ways to attain fulfilling relationships with others in the absence of physical gatherings such as through the use of a hybridized system of web-based and in-person presence. OBJECTIVE Given the potential benefits and challenges of web-based presence technology within LTCHs, the proposed research objectives are to (1) explore experiences regarding the use of web-based presence technology (WPT) in support of social connectedness between older adults in LTCHs and their family members, and (2) identify the contextual factors that must be addressed for successful WPT implementation within LTCHs. METHODS This study will take place in south western Ontario, Canada, and be guided by a qualitative multimethod research design conducted in three stages: (1) qualitive description with in-depth qualitative interviews guided by the Technology Acceptance Model (TAM) and analyzed using content analysis; (2) qualitative description and document analysis methodologies, informed by content and thematic analysis methods; and (3) explicit between-methods triangulation of study findings from stages 1 and 2, interpretation of findings and development of a guiding framework for technology implementation within LTCHs. Using a purposeful, maximum variation sampling approach, stage 1 will involve recruiting approximately 45 participants comprising a range of older adults, family members (30 participants) and staff (15 participants) within several LTCH settings. In stage 2, theoretical sampling will be used to recruit key LTCH stakeholders (directors, administrators, and IT support). In stage 3, the findings from stages 1 and 2 will be triangulated and interpreted to develop a working framework for WPT usage within LTCHs. RESULTS Data collection will begin in fall 2023. The findings emerging from this study will provide insights and understanding about how the factors, barriers, and facilitators to embedding and spreading WPT in LTCHs may benefit or negatively impact older adults in LTCHs, family caregivers, and staff and administrators of LTCHs. CONCLUSIONS The results of this research study will provide a greater understanding of potential approaches that could be used to successfully integrate WPTs in LTCHs. Additionally, benefits as well as challenges for older adults in LTCHs, family caregivers, and staff and administrators of LTCHs will be identified. These findings will help increase knowledge and understanding of how WPT may be used to support social connectedness between older adults in LTCHs and their family members. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50137.
Collapse
Affiliation(s)
- Anna Garnett
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada
| | - Halyna Yurkiv
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada
| | - Richard Booth
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada
| | - Denise Connelly
- School of Physical Therapy, University of Western Ontario, London, ON, Canada
| | - Lorie Donelle
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada
- University of South Carolina, Columbia, SC, United States
| |
Collapse
|
14
|
Benzinger P, Wahl HW, Bauer JM, Keilhauer A, Dutzi I, Maier S, Hölzer N, Achterberg WP, Denninger NE. Consequences of contact restrictions for long-term care residents during the first months of COVID-19 pandemic: a scoping review. Eur J Ageing 2023; 20:39. [PMID: 37847318 PMCID: PMC10581973 DOI: 10.1007/s10433-023-00787-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 10/18/2023] Open
Abstract
During the early stages of the COVID-19 pandemic, stringent measures were implemented in most countries to limit social contact between residents of long-term care facilities (LTCF) and visitors. The objective of this scoping review was to identify and map evidence of direct and indirect consequences of contact restrictions, guided by three conceptual perspectives: (1) stress and learned helplessness (i.e., failure to use coping behaviors even when they are available and actionalble); (2) social contact loss; and (3) 'total institution' (i.e., a facility operates following a fixed plan due to spelled-out rules and norms, controlled by institutional representatives). We used the framework for conducting a scoping review by Arksey and O'Malley; included were peer-reviewed manuscripts reporting on the outcomes of contact restrictions from the beginning of the pandemic until the end of 2020. After removing duplicates, 6,656 records were screened and 62 manuscripts included. Results pertaining to the stress and learned helplessness perspective primarily focused on depressive symptoms, showing substantial increases compared to the pre-pandemic period. Studies examining cognitive and functional decline, as well as non-COVID-19 related mortality, were limited in number and presented mixed findings. The majority of study outcomes related to the social contact loss perspective focused on loneliness, but the study designs did not adequately allow for comparisons with the pre-pandemic status. The evidence concerning outcomes related to the 'total Institution' perspective was inconclusive. Although detrimental effects of social isolation in the long-term care context found support particularly in the negative affect domain, other outcome areas did not allow for definitive conclusions due to considerable variations in findings and, in some cases, insufficient statistical power.
Collapse
Affiliation(s)
- Petra Benzinger
- Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Krankenhaus Heidelberg, Rohrbacher Strasse 149, 69126, Heidelberg, Germany.
- Institute of Health and Generations, University of Applied Sciences Kempten, Bahnhofstrasse 61, 87435, Kempten, Germany.
| | - Hans-Werner Wahl
- Network Aging Research (NAR), Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Jürgen M Bauer
- Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Krankenhaus Heidelberg, Rohrbacher Strasse 149, 69126, Heidelberg, Germany
- Network Aging Research (NAR), Heidelberg University, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Anne Keilhauer
- Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Krankenhaus Heidelberg, Rohrbacher Strasse 149, 69126, Heidelberg, Germany
| | - Ilona Dutzi
- Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Krankenhaus Heidelberg, Rohrbacher Strasse 149, 69126, Heidelberg, Germany
| | - Simone Maier
- Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Krankenhaus Heidelberg, Rohrbacher Strasse 149, 69126, Heidelberg, Germany
| | - Natalie Hölzer
- Center for Geriatric Medicine, Heidelberg University Hospital, AGAPLESION Bethanien Krankenhaus Heidelberg, Rohrbacher Strasse 149, 69126, Heidelberg, Germany
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Natascha-Elisabeth Denninger
- Centre for Research, Development and Technology Transfer, Technical University of Applied Sciences Rosenheim, Hochschulstraße 1, 83024, Rosenheim, Germany
- Medical Faculty, Institute for Health and Nursing Science, International Graduate Academy, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
- Medical Faculty Heidelberg, Department of General Practice and Health Services Research, Nursing Science and Interprofessional Care, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| |
Collapse
|
15
|
Schneider P, Abt M, Cohen C, Marmier N, Ortoleva Bucher C. The impact of protective measures against COVID-19 on the wellbeing of residents in nursing homes and their relatives: a rapid review. BMC Geriatr 2023; 23:649. [PMID: 37821833 PMCID: PMC10568910 DOI: 10.1186/s12877-023-04300-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 09/08/2023] [Indexed: 10/13/2023] Open
Abstract
During the COVID-19 pandemic and compared to other population groups, older people were at a heightened risk of developing lethal disease symptoms. Thus, many countries put in place protective measures to protect this "at-risk" population, especially in nursing homes, to limit the number of infections. These measures consisted mostly in the absence of social gatherings, the impossibility for relatives to enter the nursing homes, limitations in group activities, and the ban of group-eating. Although these measures were helpful to mitigate the spread of the disease, they also induced long periods of social isolation for the residents of nursing homes. This could have impacted the wellbeing and quality of life of residents and their relatives, with a possible impact on the overall health of residents. We designed this rapid review to investigate the literature on the impact of COVID-19 protective measures in nursing homes on the quality of life, wellbeing and physical health of residents and their relatives. Our results showed that most of the articles included in the review, either using qualitative or quantitative methods, evidenced a detrimental impact of protective measures on resident's and their relatives' wellbeing. We argue that, in the event of a new pandemic similar to the COVID-19, protective measures should also take into account their psychological impact, and not only their physical impact.
Collapse
Affiliation(s)
- P Schneider
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.
| | - M Abt
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - C Cohen
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - N Marmier
- Faculty of Biology and Medicine, Institute of Higher Education and Research in Health Care (IUFRS), Lausanne, Switzerland
| | - C Ortoleva Bucher
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| |
Collapse
|
16
|
López EP, González S, Sánchez M. Educational intervention for the main caregiver of primiparous women to promote breastfeeding and the association between prolactin and nutritional parameters. J Glob Health 2023; 13:04046. [PMID: 37083003 PMCID: PMC10119807 DOI: 10.7189/jogh.13.04046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Background In the last two years, breastfeeding rates have experienced a notable decline worldwide. Only 46% of women breastfeed their children, the figure being much lower in primiparous women. Breastfed milk is the ideal food for babies; its benefits for the health of mothers and babies are scientifically proven. Several studies show that babies who are not breastfed have a higher risk of getting sick. This fact gives rise to an important public health problem. The aim of this paper is to describe the association between presence of the caregiver in health education and increasing rates of breastfeeding. Methods We conducted an observational study (cohort) in a population of primiparous pregnant women (n = 88), and their main caregivers belonging to a region of central Spain. The development, content and implementation of the intervention consisted of: 1) obtaining the blood levels of pregnant women (prolactin, folic acid, vitamin B12 and transferrin) before health education (13-26 weeks of pregnancy), 2) carry out health education with two groups: A (44 pregnant women with caregivers) and B (44 without caregivers), 3) obtain the same blood levels as in the first intervention, 15 days after delivery, and finally the evaluation of the intervention with breastfeeding rates. Results The levels of prolactin (288.57 ± 107.46 nanogrammes per millilitre (ng / ml)), folic acid (16.93 ± 4.09 ng / ml), vitamin B12 (505.05 ± 213.97 picogrammes (pg) / ml) and transferrin (296.82 ± 67.61 milligrammmes per decilitre (mg / dl)) were higher in pregnant women who attended the health education program with a caregiver than in pregnant women who attended alone: prolcoactin (103.61 ± 45.48 ng / ml), folic acid (7.16 ± 5.88 ng / ml), vitamin B12 (160.59 ± 36.92 pg / ml) and transferrin (223.86 ± 44.14 mg / dl). Of the sample size of 44 primiparous people who attended the talks with caregivers, 35 (79.54%) breastfed their babies, while the other 44 primiparous women who attended alone, only seven (15.91%) established breastfeeding successfully. Conclusions The implications for public health research are that the presence of a caregiver in health education programs modifies levels of prolactin, folic acid, vitamin B12, and transferrin, as well as increasing breastfeeding rates.
Collapse
Affiliation(s)
- Eva Pilar López
- Doctoral School in translational Medicine San Pablo CEU University, Madrid, Spain
| | - Sergio González
- Department of Nursing, Santa Teresa de Jesus, Catholic University, Avila, Spain
| | - Mercedes Sánchez
- Department of Preventive Medicine and Public Health, Santa Teresa de Jesus, Catholic University, Avila, Spain
| |
Collapse
|
17
|
Dymchuk E, Mirhashemi B, Chamberlain S, Beeber A, Hoben M. The impact of COVID-19 on relationships between family/friend caregivers and care staff in continuing care facilities: a qualitative descriptive analysis. BMC Nurs 2023; 22:121. [PMID: 37059999 PMCID: PMC10102683 DOI: 10.1186/s12912-023-01289-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/04/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and related public health measures added a new dynamic to the relationship between caregivers and care staff in congregate care settings. While both caregivers and staff play an important role in resident quality of life and care, it is common for conflict to exist between them. These issues were amplified by pandemic restrictions, impacting not only caregivers and care staff, but also residents. While research has explored the relationship between caregivers and care staff in long-term care and assisted living homes, much of the research has focused on the caregiver perspective. Our objective was to explore the impact of COVID-19-related public health measures on caregiver-staff relationships from the perspective of staff in long-term care and assisted living homes. METHODS We conducted 9 focus groups and 2 semi-structured interviews via videoconference. RESULTS We identified four themes related to caregiver-staff relationships: (1) pressure from caregivers, (2) caregiver-staff conflict, (3) support from caregivers, and (4) staff supporting caregivers. CONCLUSIONS The COVID-19 pandemic disrupted long-standing relationships between caregivers and care staff, negatively impacting care staff, caregivers, and residents. However, staff also reported encouraging examples of successful collaboration and support from caregivers. Learning from these promising practices will be critical to improving preparedness for future public health crises, as well as quality of resident care and life in general.
Collapse
Affiliation(s)
- Emily Dymchuk
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Bita Mirhashemi
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Chamberlain
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Anna Beeber
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthias Hoben
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada.
- School of Health Policy and Management, Faculty of Health, York University, Room 301E Stong College 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| |
Collapse
|
18
|
Hui Z, Wang X, Wang X, Zhao J, Pan Y, Liu F, Zheng R, Wang M. Satisfaction with care quality and anxiety among family members during nursing home visiting restrictions: The chain mediating effect of emotional regulation and perceived stress. Front Public Health 2023; 11:1117287. [PMID: 37089513 PMCID: PMC10116063 DOI: 10.3389/fpubh.2023.1117287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/15/2023] [Indexed: 04/08/2023] Open
Abstract
IntroductionThis study aimed to investigate the psychological well-being (perceived stress and anxiety) of Chinese family members during nursing home visiting restrictions and to elucidate the relationships among satisfaction with care quality, emotion regulation, perceived stress, and anxiety.MethodsAn online survey was conducted with a cross-sectional study design. From 18 to 29 January 2022, a total of 571 family members of nursing home residents completed online questionnaires comprising socio-demographic characteristics, satisfaction with care quality, emotion regulation, perceived stress, and anxiety. Mediation analyses were performed to estimate the direct and indirect effects of satisfaction with care quality on anxiety using the PROCESS macro for SPSS.ResultsThe results showed that approximately one-quarter of Chinese family members had anxiety symptoms during nursing home visiting restrictions. Satisfaction with care quality affected anxiety via three mediating paths: (a) through cognitive reappraisal (effect = 0.028); (b) through cognitive reappraisal and perceived stress sequentially (effect = −0.057); and (c) through perceived stress (effect = −0.212). The chain mediating effect (path b) accounted for 23.7% of the total effect.ConclusionsThese findings corroborated our hypothesis that cognitive reappraisal (a kind of emotion regulation strategy) and perceived stress mediated the relationship between satisfaction with care quality and anxiety during nursing home visiting restrictions. Efforts to address family members’ psychological well-being by focusing on cognitive reappraisal should be considered.
Collapse
Affiliation(s)
- Zhaozhao Hui
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Xiaoqin Wang
- School of Nursing, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Xun Wang
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Jinping Zhao
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Yunjin Pan
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Feng Liu
- Shaanxi Provincial Hospital of Occupational Disease Control and Prevention, Tongchuan, China
| | - Ruishi Zheng
- Songhe Nursing Home, Xi’an Tangcheng Hospital, Xi’an, China
| | - Mingxu Wang
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- *Correspondence: Mingxu Wang,
| |
Collapse
|
19
|
Bae-Shaaw YH, Shier V, Sood N, Seabury SA, Joyce G. Potentially Inappropriate Medication Use in Community-Dwelling Older Adults Living with Dementia. J Alzheimers Dis 2023; 93:471-481. [PMID: 37038818 DOI: 10.3233/jad-221168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Background: The Beers Criteria identifies potentially inappropriate medications (PIMs) that should be avoided in older adults living with dementia. Objective: The aim of this study was to provide estimates of the prevalence and persistence of PIM use among community-dwelling older adults living with dementia in 2011-2017. Methods: Medicare claims data were used to create an analytic dataset spanning from 2011 to 2017. The analysis included community-dwelling Medicare fee-for-service beneficiaries aged 65 and older who were enrolled in Medicare Part D plans, had diagnosis for dementia, and were alive for at least one calendar year. Dementia status was determined using Medicare Chronic Conditions Date Warehouse (CCW) Chronic Condition categories and Charlson Comorbidity Index. PIM use was defined as 2 or more prescription fills with at least 90 days of total days-supply in a calendar year. Descriptive statistics were used to report the prevalence and persistence of PIM use. Results: Of 1.6 million person-year observations included in the sample, 32.7% used one or more PIMs during a calendar year in 2011-2017. Breakdown by drug classes showed that 14.9% of the sample used anticholinergics, 14.0% used benzodiazepines, and 11.0% used antipsychotics. Conditional on any use, mean annual days-supply for all PIMs was 270.6 days (SD = 102.7). The mean annual days-supply for antipsychotic use was 302.7 days (SD = 131.2). Conclusion: Significant proportion of community-dwelling older adults with dementia used one or more PIMs, often for extended periods of time. The antipsychotic use in the community-dwelling older adults with dementia remains as a significant problem.
Collapse
Affiliation(s)
- Yuna H. Bae-Shaaw
- University of Southern California School of Pharmacy, Los Angeles, CA, USA
| | - Victoria Shier
- University of Southern California Sol Price School of Public Policy, Los Angeles, CA, USA
| | - Neeraj Sood
- University of Southern California Sol Price School of Public Policy, Los Angeles, CA, USA
| | - Seth A. Seabury
- University of Southern California School of Pharmacy, Los Angeles, CA, USA
| | - Geoffrey Joyce
- University of Southern California School of Pharmacy, Los Angeles, CA, USA
| |
Collapse
|
20
|
de Sandes-Guimarães LV, Dos Santos PC, Alves CPGP, Cervato CJ, Silva APA, Leão ER. The effect of volunteer-led activities on the quality of life of volunteers, residents, and employees of a long-term care institution: a cohort study. BMC Geriatr 2023; 23:151. [PMID: 36941534 PMCID: PMC10025785 DOI: 10.1186/s12877-023-03898-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 03/15/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic primarily impacted long-term care facilities by restricting visiting and circulation of visitors, affecting the quality of life (QoL) of older adults living in these institutions. Volunteer activities, essential for older adults' daily life, were also interrupted and potentially negatively impacted the QoL of older adults, volunteers themselves, and also employees in these institutions. In this context, this study aims to evaluate the impact of the return of volunteer-led activities in a long-term care institution on the QoL of older adult residents, employees, and volunteers. METHODS This study used a pre-test and post-test design within the same group. The first round of data collection was conducted before volunteer-led activities returned and the second round after 1 month of return. The instrument used to assess QoL was the EUROHIS-QoL-8 scale. This study was conducted within a nursing home in São Paulo, Brazil, created in 1937 by members of the Israeli community living in Brazil. Volunteer-led activities were part of residents' daily life before the COVID-19 pandemic, when these activities were interrupted for about 20 months. A total of 79 individuals participated in both rounds (pre and post), of which: 29 residents, 27 volunteers, and 23 employees of the long-term care institution. RESULTS Using a Wilcoxon signed-rank test, the analyses indicated improvements after the 1 month return in different QoL aspects for the three groups. Volunteers improved their personal relationships (Z - 2.332, p < .05), residents their overall health (Z - 2.409, p < .05) and employees in their overall QoL perception (Z - 2.714, p < .05). Influencing factors for residents were the number of activities (3 or more), gender (male), and education (undergraduate/graduate). For employees, those who assumed additional activities due to the volunteer-led activities interruption had a significant impact on their overall QoL. CONCLUSIONS Evidence from this study suggests that volunteers' return positively impacted different QoL aspects for volunteers, residents, and employees.
Collapse
|
21
|
Cooke HA, Wu SA, Bourbonnais A, Baumbusch J. Disruptions in Relational Continuity: The Impact of Pandemic Public Health Measures on Families in Long-Term Care. JOURNAL OF FAMILY NURSING 2023; 29:6-17. [PMID: 35674340 PMCID: PMC9850387 DOI: 10.1177/10748407221102462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Although the value of family caregivers' involvement with relatives in long-term care (LTC) is well recognized, tensions remain regarding their role. Such tensions were exacerbated during the COVID-19 pandemic as strict public health measures restricted family access to LTC homes. Using interpretive description, we examined the impact of visitation restrictions on family caregivers' experiences caring for a relative in LTC between March 2020 and June 2021. In-depth interviews were conducted with 14 family caregivers (five spouses and nine adult daughters) and two key themes were identified. The first theme, "seeking to maintain relational continuity," illustrates how caregivers sought to sustain connections with residents prior to and during the pandemic. The second theme, "disrupted relational continuity," highlights the impact of severed relational connections on caregivers' sense of self and ongoing feelings of loss and anger. Findings call for a trauma-informed approach that recognizes the pervasiveness of trauma for family caregivers and the avoidance of re-traumatization.
Collapse
Affiliation(s)
| | - Sarah A. Wu
- The University of British Columbia, Vancouver, Canada
| | | | | |
Collapse
|
22
|
Wu S, Xiao LD, Nan J, Zhao S, Yin P, Zhang D, Liao L, Li M, Yang X, Feng H. Nursing Home Residents' Perceptions of Challenges and Coping Strategies during COVID-19 Pandemic in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1485. [PMID: 36674245 PMCID: PMC9862260 DOI: 10.3390/ijerph20021485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/02/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Older people in nursing homes are at a high risk of being infected by coronavirus disease 2019 (COVID-19). They also experienced nursing home lockdowns that harm their psychological wellbeing. Better support for this vulnerable population requires understanding their perceptions of challenges and coping strategies during the COVID-19 pandemic. A qualitative descriptive study was conducted using semi-structured interviews. Thematic analysis approach was used to analyze the data. Participants were recruited from six nursing homes in three cities in Hunan Province, China. Fourteen nursing home residents participated in the study. Four themes were identified from interviews and described as: mental stress and coping strategies, self-regulation to respond to lockdown, the lack of social connection and coping strategies, and the need for medical care services and coping strategies. This study revealed that nursing home residents perceived stress during the nursing home lockdown, but they reported initiating activities to maintain health and connections with their families and peers. Resilience improvement interventions are necessary to enable residents' autonomy and develop their resilience in coping with difficulties and hardship during crises. The findings also indicate that a supportive environment with interactions from families, peers, and staffs played a key role in enabling residents' positive health and wellbeing during the lockdown.
Collapse
Affiliation(s)
- Shuang Wu
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
| | - Jiahui Nan
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Si Zhao
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Ping Yin
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Dou Zhang
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Lulu Liao
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Mengqi Li
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Xiufen Yang
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha 410013, China
- Xiangya-Oceanwide Health Management Research Institute, Central South University, No. 172, Tongzipo Road, Yuelu District, Changsha 410013, China
| |
Collapse
|
23
|
Cimino S, Cerniglia L. Impact of Maternal-Newborn Separation in Italian Women with Suspected COVID-19 Infection on Psychopathological Symptoms and Quality of Interactions during Breastfeeding. Psychopathology 2023; 56:335-341. [PMID: 36599310 PMCID: PMC9893000 DOI: 10.1159/000528410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/28/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Before the COVID-19 pandemic, proximity between mothers and their newborn infants was at the core of sanitary guidelines. With the aim of stopping the virus transmission from mothers to infants and possible physical dangers due to the infection, some hospitals discouraged or even prohibited skin-to-skin contact and breastfeeding. METHOD This study recruited 180 dyads in private and public hospitals in Italy with the aim of verifying whether mother-infant separation after delivery is associated with higher maternal psychopathological distress (assessed through the SCL-90-R) and poorer quality of dyadic interactions during breastfeeding (evaluated through the SVIA). RESULTS Our results showed that mothers separated from their infants displayed more anxiety, depression, and obsessive-compulsive symptoms and a lower quality of feeding interactions on all the subscales of the SVIA (mother's affective state; interactive conflict; food refusal behavior; dyad's affective state). CONCLUSION In light of these results, our study suggests that separating mothers from their newborns is associated with increased psychopathological symptoms in mothers and poorer feeding interactions. These issues have been posited as key predictors of maladaptive outcomes in infants' later lives; therefore, health services must fully consider the short- and long-term consequences of separating mothers and infants in their policies in the event of future pandemics.
Collapse
Affiliation(s)
- Silvia Cimino
- Department of Dynamic Clinical and Health Psychology, Sapienza, University of Rome, Rome, Italy
| | - Luca Cerniglia
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| |
Collapse
|
24
|
Tingvold L, Moholt JM, Førland O, Jacobsen FF, Tranvåg O. Intended, Unintended, Unanticipated? Consequences of Social Distancing Measures for Nursing Home Residents During the Covid-19 Pandemic. Glob Qual Nurs Res 2023; 10:23333936231176204. [PMID: 37261277 PMCID: PMC10227487 DOI: 10.1177/23333936231176204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 06/02/2023] Open
Abstract
During the outbreak of the COVID-19 pandemic, Norwegian health authorities introduced social distancing measures in nursing homes. The aim was to protect vulnerable residents from contracting the potentially deadly infection. Drawing on individual interviews with nursing home managers and physicians, and focus groups with nursing staff, we explore and describe consequences the social distancing measures had on nursing home residents' health and wellbeing. The analysis indicates that most residents became socially deprived, while some became calmer during the nursing home lockdown. Nursing home staff, physicians and managers witnessed that residents' health and functional capacity declined when services to maintain health, such as physiotherapy, were put on hold. In conclusion, we argue that although Norwegian health authorities managed to keep the infection rates low in nursing homes, this came at a high price for the residents however, as the social distancing measures also negatively impacted their health and wellbeing.
Collapse
Affiliation(s)
- Laila Tingvold
- Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | | | - Oddvar Førland
- Western Norway University of Applied Sciences, Bergen, Norway
| | | | - Oscar Tranvåg
- Western Norway University of Applied Sciences, Bergen, Norway
- Norwegian Research Centre for Women’s Health, University Hospital, Oslo, Norway
| |
Collapse
|
25
|
Rodriguez-Rodriguez V, Rojo-Perez F, Perez de Arenaza Escribano C, Molina-Martínez MÁ, Fernandez-Mayoralas G, Sánchez-González D, Rojo-Abuin JM, Rodríguez-Blázquez C, Forjaz MJ, Martín García S. The Impact of COVID-19 on Nursing Homes: Study Design and Population Description. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16629. [PMID: 36554508 PMCID: PMC9779101 DOI: 10.3390/ijerph192416629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 05/15/2023]
Abstract
Nursing homes for the elderly in Spain have experienced high rates of infection and mortality from COVID-19, although rates have varied from one region to another. Madrid is the region where most institutionalized older adults have died from the coronavirus. However, there is little known about the psychosocial and environmental factors involved in the high incidence of COVID-19 among the institutionalised population in this region. This article describes the protocol of a study on nursing homes during the SARS-CoV-2 pandemic in the Autonomous Community of Madrid (hereafter: Region of Madrid or Madrid Region) and provides information on the study design, measures used, and characteristics of the population studied. A questionnaire about life in nursing homes during the COVID-19 pandemic was designed and a total of 447 persons over 60 years of age without cognitive impairment-220 in private nursing homes and 227 in public nursing homes-participated by answering questions about different topics: personal situations during the pandemic, feelings and methods of coping, residential environment, health, quality of life, ageism, and self-perception of ageing. The institutionalised person profile discussed in this study was an old woman, widowed, without children, with a low level of education, with multimorbidity, and who perceived her health and quality of life positively. Most of the participants were very concerned about COVID-19 and its effects. In fact, 38% had been diagnosed with COVID-19, of whom 20% were admitted to hospital and 20% had suffered negative impacts, such as pain and neurological problems. In addition, 70% of the residents remained confined to their rooms, which increased their perceptions of loneliness and social isolation. The worst-rated aspects of the nursing home resulted from the restrictive measures imposed on nursing homes during the pandemic. This research offers useful material for understanding the pandemic and its consequences from the perspective of the older institutionalised population, which could provide insights for designing public policies.
Collapse
Affiliation(s)
| | - Fermina Rojo-Perez
- Grupo de Investigacion sobre Envejecimiento (GIE), IEGD, CSIC, 28037 Madrid, Spain
| | | | - María-Ángeles Molina-Martínez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain
| | | | - Diego Sánchez-González
- Departamento de Geografía, Universidad Nacional de Educación a Distancia (UNED), 28040 Madrid, Spain
| | | | - Carmen Rodríguez-Blázquez
- National Epidemiology Centre, Carlos III Institute of Health, Network Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Maria João Forjaz
- National Epidemiology Centre, Carlos III Institute of Health, Health Service Research Network on Chronic Diseases (REDISSEC) and Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 28029 Madrid, Spain
| | | |
Collapse
|
26
|
Lai VSK, Yau SY, Lee LYK, Li BSY, Law SSP, Huang S. Caring for Older People during and beyond the COVID-19 Pandemic: Experiences of Residential Health Care Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15287. [PMID: 36430006 PMCID: PMC9692584 DOI: 10.3390/ijerph192215287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Older people and health care workers in residential care homes are particularly vulnerable to the adverse impacts of the COVID-19 pandemic. As COVID-19 has been spreading around the world for more than two years, the nature of care delivery has been substantially transformed. This study aims at understanding the long-term and ongoing impacts of COVID-19 on the delivery of care in residential care homes. It investigates how the delivery of care has been transformed by the COVID-19 pandemic and how health care workers adapted to these changes from the perspectives of frontline health care workers. Semi-structured interviews were conducted from February to December 2021 with a purposive sample of 30 health care workers from six residential care homes in Hong Kong. Thematic analysis identified three themes, including (1) enhancing infection prevention and control measures; (2) maintaining the psychosocial wellbeing of residents; and (3) developing resilience. Discussions and implications were drawn from these findings.
Collapse
Affiliation(s)
- Veronica Sze-Ki Lai
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Sui-Yu Yau
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Linda Yin-King Lee
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Becky Siu-Yin Li
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Susan Sin-Ping Law
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Shixin Huang
- Department of Sociology and Social Policy, Lingnan University, Hong Kong, China
| |
Collapse
|
27
|
Robinson K, Fitzgerald C, Galvin R, O' Connor A. Exploring the facilitation of meaningful leisure activities in designated centres for older persons (nursing homes) in Ireland: A protocol for content documentary analysis of HIQA inspection reports. HRB Open Res 2022. [DOI: 10.12688/hrbopenres.13639.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Nursing homes (NHs) in Ireland are regulated by the Health Information and Quality Authority (HIQA). Regulations for nursing homes under the Health Act 2007 (as amended) states that registered providers must provide residents with facilities for occupation and recreation, and opportunities to participate in activities in accordance with their interests and capacities (Government of Ireland, 2013 - S.I. No. 415/2013). Despite the proven benefits of engagement in meaningful activities, when an older person enters a NH, they often lose autonomy in occupational roles, and engagement in meaningful activities (Causey-Upton, 2015). In 2019, HIQA highlighted that there were relatively high levels of non-compliance in the area of residents’ rights (HIQA, 2020). Aim: Given the central role of leisure activities to older adults’ health and well-being, this study aims to understand how NH residents in Ireland were afforded opportunities for meaningful engagement in activities prior to and throughout the COVID-19 pandemic (2019 – 2021). This will be conducted through analysing a sample of publicly available HIQA inspection reports for NHs from 2019 – 2021. Methods: A content documentary analysis will be conducted using a qualitative deductive approach. Purposive sampling will be used to select 21 nursing home reports for the years 2019, 2020 and 2021. The sample will include nursing homes reported to be non-compliant, substantially compliant and compliant in the regulation of residents’ rights. An inspection report for each of these NHs (n=21) for the year 2019, 2020 and 2021 will create a sample of 63 reports for analysis. This sample will capture three time points for the 21 NHs pre-pandemic and throughout the pandemic.
Collapse
|
28
|
de Rosa CB, Zhou Y, Lyons A, Chang YP. COVID-19 Experiences of Relatives of Nursing Home Residents. Clin Nurs Res 2022; 31:1399-1404. [PMID: 36062527 PMCID: PMC9444825 DOI: 10.1177/10547738221121028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Nursing home residents comprise a disproportionate share of coronavirus-related deaths in the United States. Additionally, lockdown restrictions disrupted residents' relationships with their family members to an unknown extent. This study explored family members' perceived family role and interactions with nursing home residents and staff during the COVID-19 pandemic. Using a qualitative descriptive approach, 10 family members were interviewed using a semi-structured guide. Interviews were audio-recorded and transcribed verbatim, and data were analyzed using Braun and Clarke's Reflexive Thematic analysis. Themes and subthemes indicated that family members accounted for residents' care in new ways, found existing relationships becoming amplified under stress, maintained connections through creative alternatives, and also felt powerless to provide care, despite their knowledge and experience. Family members increasingly relied on staff to meet residents' care needs and provide updates, and often desired to provide assistance and companionship beyond what policy permitted, representing a major opportunity for improving experiences.
Collapse
Affiliation(s)
| | - Yanjun Zhou
- University at Buffalo, The State
University of New York, USA
| | - Amy Lyons
- University at Buffalo, The State
University of New York, USA
| | - Yu-Ping Chang
- University at Buffalo, The State
University of New York, USA
| |
Collapse
|
29
|
Kazawa K, Kubo T, Akishita M, Ishii S. Restrictions on visits and outings in geriatric care facilities during the COVID-19 pandemic. Geriatr Gerontol Int 2022; 22:982-983. [PMID: 36151770 PMCID: PMC9538313 DOI: 10.1111/ggi.14484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/25/2022] [Accepted: 09/01/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Kana Kazawa
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinya Ishii
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
30
|
Salcedo‐Pérez‐Juana M, García‐Bravo C, Jimenez‐Antona C, Martinez‐Piédrola RM, Fernández‐De‐Las‐Peñas C, Palacios‐Ceña D. Relatives experiences during the COVID-19 pandemic: A qualitative study set in Spanish locked-down nursing homes. Jpn J Nurs Sci 2022; 20:e12510. [PMID: 36134638 PMCID: PMC9538796 DOI: 10.1111/jjns.12510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/26/2022] [Accepted: 08/08/2022] [Indexed: 01/05/2023]
Abstract
AIM To describe the experience of relatives of residents with dementia residing in locked-down nursing homes during the first outbreak of the COVID-19 pandemic, concerning their relationships with nurses and the nursing care applied. METHODS A qualitative descriptive study was carried out and purposive sampling was applied. Participants were first- and second-degree relatives of residents with dementia, who lived permanently in a nursing home and who were admitted prior to the COVID-19 pandemic. Sixteen participants, of which 10 were women (mean age 57.1 years), participated in the study. Data were collected through in-depth interviews and reflective notes, using a digital platform. An inductive thematic analysis was carried out. This study was approved by the University Research Ethics Committee and followed the COREQ guidelines. The Guba and Lincoln criteria (credibility, transferability, dependability, and confirmability) were applied for quality control. RESULTS Families' relationships with nurses before the first wave relied on closeness and involvement in care. Families had difficulty maintaining a close relationship with nurses due to turnover and lack of time. The nursing care applied in the first wave resulted in limited family access to the nursing home, limited contact time with residents, and limited close physical contact. CONCLUSIONS The first outbreak has affected the relationships among relatives and nurses in nursing homes. Changes should be made in the organization of care within nursing homes in order to adapt to restrictions due to the pandemic.
Collapse
Affiliation(s)
- María Salcedo‐Pérez‐Juana
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and RehabilitationResearch Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS)AlcorcónSpain
| | - Cristina García‐Bravo
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and RehabilitationResearch Group in Evaluation and Assessment of Capacity, Functionality and Disability of Universidad Rey Juan Carlos (TO+IDI)AlcorcónSpain
| | - Carmen Jimenez‐Antona
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and RehabilitationResearch Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS)AlcorcónSpain
| | - Rosa María Martinez‐Piédrola
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and RehabilitationResearch Group in Evaluation and Assessment of Capacity, Functionality and Disability of Universidad Rey Juan Carlos (TO+IDI)AlcorcónSpain
| | - Cesar Fernández‐De‐Las‐Peñas
- Research Group of Manual Therapy, Dry Needling and Therapeutic Exercise (GITM‐URJC). Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical MedicineUniversidad Rey Juan CarlosMadridSpain
| | - Domingo Palacios‐Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and RehabilitationResearch Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS)AlcorcónSpain
| |
Collapse
|
31
|
Dujmovic M, Roederer T, Frison S, Melki C, Lauvin T, Grellety E. COVID-19 in French nursing homes during the second pandemic wave: a mixed-methods cross-sectional study. BMJ Open 2022; 12:e060276. [PMID: 36127110 PMCID: PMC9490301 DOI: 10.1136/bmjopen-2021-060276] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION French nursing homes were deeply affected by the first wave of the COVID-19 pandemic, with 38% of all residents infected and 5% dying. Yet, little was done to prepare these facilities for the second pandemic wave, and subsequent outbreak response strategies largely duplicated what had been done in the spring of 2020, regardless of the unique needs of the care home environment. METHODS A cross-sectional, mixed-methods study using a retrospective, quantitative data from residents of 14 nursing homes between November 2020 and mid-January 2021. Four facilities were purposively selected as qualitative study sites for additional in-person, in-depth interviews in January and February 2021. RESULTS The average attack rate in the 14 participating nursing facilities was 39% among staff and 61% among residents. One-fifth (20) of infected residents ultimately died from COVID-19 and its complications. Failure to thrive syndrome (FTTS) was diagnosed in 23% of COVID-19-positive residents. Those at highest risk of death were men (HR=1.78; 95% CI: 1.18 to 2.70; p=0.006), with FTTS (HR=4.04; 95% CI: 1.93 to 8.48; p<0.001) or in facilities with delayed implementation of universal FFP2 masking policies (HR=1.05; 95% CI: 1.02 to 1.07; p<0.001). The lowest mortality was found in residents of facilities with a partial (HR=0.30; 95% CI: 0.18 to 0.51; p<0.001) or full-time physician on staff (HR=0.20; 95% CI: 0.08 to 0.53; p=0.001). Significant themes emerging from qualitative analysis centred on (1) the structural, chronic neglect of nursing homes, (2) the negative effects of the top-down, bureaucratic nature of COVID-19 crisis response, and (3) the counterproductive effects of lockdowns on both residents and staff. CONCLUSION Despite high resident mortality during the first pandemic wave, French nursing homes were ill-prepared for the second, with risk factors (especially staffing, lack of medical support, isolation/quarantine policy, etc) that affected case fatality and residents' and caregivers' overall well-being and mental health.
Collapse
Affiliation(s)
- Morgane Dujmovic
- Department of Epidemiology and Training, Epicentre, Paris, France
| | - Thomas Roederer
- Department of Epidemiology and Training, Epicentre, Paris, France
| | - Severine Frison
- Department of Epidemiology and Training, Epicentre, Paris, France
| | - Carla Melki
- Emergency Cell, Médecins Sans Frontières, Paris, France
| | - Thomas Lauvin
- Emergency Cell, Médecins Sans Frontières, Paris, France
| | | |
Collapse
|
32
|
COVID-19 related visiting ban in nursing homes as a source of concern for residents’ family members: a cross sectional study. BMC Nurs 2022; 21:255. [PMID: 36104683 PMCID: PMC9472187 DOI: 10.1186/s12912-022-01036-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Visiting a close relative who resides in a nursing home is an opportunity for family members to extend their caring roles and find reassurance that the older person’s life is continuing as well as possible. At the same time, visits allow family members to observe the quality of formal care in the facility. In Finland, the COVID-19 pandemic led to the imposition of visiting bans in nursing homes in March 2020, thereby preventing customary interaction between residents and their family members. The aim of this study is to investigate family members’ experiences of the visiting ban and its effects on their concern over the wellbeing of close relatives living in nursing homes.
Methods
A cross-sectional study was conducted to explore family members’ self-reported concerns and the factors associated with those concerns. In the context of this unpredictable pandemic, this was considered an appropriate approach, as information at the very beginning of the visiting ban was sought, and causal relations were not investigated. The data consist of a quantitative survey (n = 366) conducted among family members in May–June 2020. Binary logistic regression analyses were performed to explore the association between the independent variables and reported concern.
Results
The results showed that increased concern was extremely common (79%). The factors associated with this notable increase were adequacy of contact and information, observations of changes in the wellbeing of the relative in question, and doubts over the appropriateness of the visiting restriction.
Conclusions
In light of the findings, care providers should improve their information provision to residents’ family members and find new ways of allowing visits to nursing homes in the future in all circumstances.
Collapse
|
33
|
Kazawa K, Kubo T, Akishita M, Ishii S. Long-term impact of the COVID-19 pandemic on facility- and home-dwelling people with dementia: Perspectives from professionals involved in dementia care. Geriatr Gerontol Int 2022; 22:832-838. [PMID: 36068077 PMCID: PMC9538434 DOI: 10.1111/ggi.14465] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/13/2022] [Accepted: 07/28/2022] [Indexed: 12/21/2022]
Abstract
Aim The present study aimed to investigate the impact of the coronavirus disease 2019 (COVID‐19) pandemic on facility‐ and home‐dwelling people with dementia (PWD). Methods This observational study included two anonymous online survey questionnaires to explore the impact of the first wave of the COVID‐19 pandemic in Japan and the long‐term impact during the 2 years from the onset of the pandemic. The participants were medical and long‐term care facilities representatives for older people (945 facilities in the first survey, 686 in the second), and care managers (751 in the first survey, 241 in the second). A χ2‐test was carried out between the two surveys. Results For facility‐dwelling PWD, activities that stimulate cognitive and physical functioning increased significantly compared with the first wave of the pandemic (P < 0.05). Also, a decline in cognitive and walking functions and falls increased in the second survey compared with the first (P < 0.01). For home‐dwelling PWD, the broader impact of the pandemic on support for activities of daily living, social interaction and provision of medical care did not mitigate. The high prevalence of cognitive and physical functional decline in the first survey was similar in the second. Conclusions The prolonged COVID‐19 pandemic produced changes in the lives of home‐ and facility‐dwelling PWD, with widespread negative consequences for them. Our findings are useful to consider preventive supports to mitigate or avoid functional decline and symptom exacerbation in PWD due to changes in their living environment and the care they receive in the COVID‐19 era. Geriatr Gerontol Int 2022; 22: 832–838.
Collapse
Affiliation(s)
- Kana Kazawa
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinya Ishii
- Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
34
|
Gangnus A, Hering C, Kohl R, Henson CS, Schwinger A, Steinhagen-Thiessen E, Kuhlmey A, Gellert P. Soziale Teilhabe in Pflegeheimen mit Covid-19-Schutzmaßnahmen in der zweiten Pandemiewelle? Pflege 2022; 36:168-178. [DOI: 10.1024/1012-5302/a000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Hintergrund: Die Umsetzung von Schutzmaßnahmen in Pflegeheimen während der Covid-19-Pandemie war mit dem Wegfall sozialer Teilhabeangebote in der ersten Covid-19-Welle verbunden, für die zweite Covid-Welle ist dies unzureichend untersucht. Ziel: Die Evaluation des Zusammenhangs von Schutzmaßnahmen und Einschränkungen der sozialen Teilhabe für die zweite Covid-19-Welle zur Ausarbeitung von Handlungsempfehlungen. Methode: Mixed-Methods-Online-Survey von Pflegeheimleitungen ( n = 873) in der zweiten Welle. Mithilfe binärlogistischer verallgemeinerter Schätzgleichungen wurde die Wahrscheinlichkeit für das Wegfallen sozialer Teilhabeangebote in den Pflegeheimen in Abhängigkeit gesetzlicher Schutzmaßnahmen evaluiert. Offene Antworten zur Aufrechterhaltung sozialer Teilhabe wurden inhaltsanalytisch untersucht ( n = 1042). Ergebnisse: Mehr als jede zweite Pflegeheimleitung berichtet über untersagte Gruppenveranstaltungen (66,6%), mehr als jede dritte untersagte kreative Angebote (42,3%). Besuchseinschränkungen (85,2%) waren in der zweiten Welle weit verbreitet. Der Wegfall von Teilhabeangeboten und die angeordneten Schutzmaßnahmen waren eng assoziiert. Qualitative Daten zeigten, dass zum Beispiel das Anschaffen mobiler Einkaufsläden Maßnahmen waren, der sozialen Exklusion der Bewohnenden entgegenzuwirken. Diskussion: Der Zusammenhang zwischen dem Wegfall sozialer Teilhabeangebote und der Umsetzung von Schutzmaßnahmen war deutlich ausgeprägt. Die Pflegepraxis sollte die Umsetzung von sozialer Teilhabe ermöglichen und gleichzeitig einen bestmöglichen Infektionsschutz garantieren.
Collapse
Affiliation(s)
- Annabell Gangnus
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Deutschland
| | - Christian Hering
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Deutschland
| | - Raphael Kohl
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Deutschland
| | - Clara-Sophia Henson
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Deutschland
| | - Antje Schwinger
- Forschungsinstitut der kommunalen Krankenkassen (WIdO), Berlin, Deutschland
| | | | - Adelheid Kuhlmey
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Deutschland
| | - Paul Gellert
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Deutschland
| |
Collapse
|
35
|
Cornally N, Kilty C, Buckley C, O’Caoimh R, O’Donovan MR, Monahan MP, O’Connor CD, Fitzgerald S, Hartigan I. The Experience of COVID-19 Visitor Restrictions among Families of People Living in Long-Term Residential Care Facilities during the First Wave of the Pandemic in Ireland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116559. [PMID: 35682143 PMCID: PMC9180630 DOI: 10.3390/ijerph19116559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 01/10/2023]
Abstract
Public health responses to COVID-19 in long-term residential care facilities (LTRCFs) have restricted family engagement with residents. These restrictions impact on quality of care and the psychosocial and emotional well-being of family caregivers. Following a national cross-sectional web-based survey, respondents were invited to provide personal reflections on visitor restrictions. This study aims to describe the consequences of these restrictions for individuals living in LTRCF and their families during the first wave of the COVID-19 pandemic. Data from open-ended questions contained within the survey were analyzed using Braun and Clarke’s (2006) method of thematic analysis. Four themes were identified: 1. Altered Communication and Connection; 2. Emotional and Psychological Impact; 3. Protecting and Caring Role of Staff; 4. Family Role. Throughout the narrative accounts, it is evident that the visitor restrictions impacted on the emotional and mental well-being of families. Some respondents expressed frustration that they could not assist staff in essential care provision, reducing meaning and purpose in their own lives. COVID-19 LTRCF visitor restrictions made little distinction between those providing essential personal care and those who visit for social reasons. A partnership approach to care provision is important and should encompass strategies to maintain the psychosocial and emotional well-being of families and their relatives during times of self-isolating or restrictive measures.
Collapse
Affiliation(s)
- Nicola Cornally
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
- Correspondence:
| | - Caroline Kilty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
| | - Catherine Buckley
- Northridge House Education and Research Centre, St. Luke’s Home, T12H970 Cork, Ireland;
| | - Rónán O’Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, T12WE28 Cork, Ireland;
- Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, T12WE28 Cork, Ireland;
| | - Mark R. O’Donovan
- Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, T12WE28 Cork, Ireland;
| | - Margaret P. Monahan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
| | - Caroline Dalton O’Connor
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
| | - Serena Fitzgerald
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
| | - Irene Hartigan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
| |
Collapse
|
36
|
Hong W, Lu X, Wu L, Pu X. Analysis of factors influencing public attention to masks during the COVID-19 epidemic-Data from Sina Weibo. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:6469-6488. [PMID: 35730267 DOI: 10.3934/mbe.2022304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
As we all know, vaccination still does not protect people from novel coronavirus infections, and wearing masks remains essential. Research on mask attention is helpful to understand the public's cognition and willingness to wear masks, but there are few studies on mask attention in the existing literature. The health belief model used to study disease prevention behaviors is rarely applied to the research on mask attention, and the research on health belief models basically entails the use of a questionnaire survey. This study was purposed to establish a health belief model affecting mask attention to explore the relationship between perceived susceptibility, perceived severity, self-efficacy, perceived impairment, action cues and mask attention. On the basis of the establishment of the hypothesis model, the Baidu index of epidemic and mask attention, the number of likes and comments on Weibo, and the historical weather temperature data were retrieved by using software. Keyword extraction and manual screening were carried out for Weibo comments, and then the independent variables and dependent variables were coded. Finally, through binomial logistic regression analysis, it was concluded that perceived susceptibility, perceived severity and action cues have significant influences on mask attention, and that the accuracy rate for predicting low attention is 93.4%, and the global accuracy is 84.3%. These conclusions can also help suppliers make production decisions.
Collapse
Affiliation(s)
- Wei Hong
- Food Safety Research Base of Jiangsu Province, Jiangnan University, Wuxi 214122, China
- School of Business, Jiangnan University, Wuxi 214122, China
- Institute for Food Safety Risk Management, Jiangnan University, Wuxi 214122, China
| | - Xinhang Lu
- School of Business, Jiangnan University, Wuxi 214122, China
| | - Linhai Wu
- Food Safety Research Base of Jiangsu Province, Jiangnan University, Wuxi 214122, China
- School of Business, Jiangnan University, Wuxi 214122, China
- Institute for Food Safety Risk Management, Jiangnan University, Wuxi 214122, China
| | - Xujin Pu
- Food Safety Research Base of Jiangsu Province, Jiangnan University, Wuxi 214122, China
- School of Business, Jiangnan University, Wuxi 214122, China
- Institute for Food Safety Risk Management, Jiangnan University, Wuxi 214122, China
| |
Collapse
|
37
|
Bridging skin, brain, and behavior to understand pleasurable social touch. Curr Opin Neurobiol 2022; 73:102527. [PMID: 35453001 DOI: 10.1016/j.conb.2022.102527] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 02/07/2023]
Abstract
Social touch-the affiliative skin-to-skin contact between individuals-can rapidly evoke emotions of comfort, pleasure, or calm, and is essential for mental and physical well-being. Physical isolation from social support can be devastating. During the COVID-19 pandemic, we observed a global increase in suicidal ideation, anxiety, domestic violence, and worsening of pre-existing physical conditions, alerting society to our need to understand the neurobiology of social touch and how it promotes normal health. Gaining a mechanistic understanding of how sensory neuron stimulation induces pleasure, calm, and analgesia may reveal untapped therapeutic targets in the periphery for treatment of anxiety and depression, as well as social disorders and traumas in which social touch becomes aversive. Bridging the gap between stimulation in the skin and positive affect in the brain-especially during naturally occurring social touch behaviors-remains a challenge to the field. However, with advances in mouse genetics, behavioral quantification, and brain imaging approaches to measure neuronal firing and neurochemical release, completing this mechanistic picture may be on the horizon. Here, we summarize some exciting new findings about social touch in mammals, emphasizing both the peripheral and central nervous systems, with attempts to bridge the gap between external stimulation and internal representations in the brain.
Collapse
|
38
|
Kalantari S, Xu TB, Mostafavi A, Lee A, Barankevich R, Boot WR, Czaja SJ. Using a Nature-based Virtual Reality Environment for Improving Mood States and Cognitive Engagement in Older Adults: A Mixed-method Feasibility Study. Innov Aging 2022; 6:igac015. [PMID: 35592668 PMCID: PMC9113189 DOI: 10.1093/geroni/igac015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background and Objectives Exposure to nature and nature-based imagery has been shown to improve mood states and stave off cognitive decline in older adults. Even “micro-doses” of natural scenery can provide beneficial effects in situations where more extensive interactions with nature are not feasible. In the current study, we evaluated the use of virtual reality (VR) for delivering interactive nature-based content with the goal of prompting active engagement and improving mood states in older adults. Research Design and Methods The researchers developed a novel VR environment that combined 360-degree videos of natural areas and botanical gardens with interactive digital features that allowed users to engage with aspects of the environment. We recruited 50 older adults to try out this VR environment and measured changes in mood states and attitudes toward VR from before versus after the sessions. We controlled for variables such as age, education level, and exposure to nature in everyday life, and we looked for differences in responses to the VR among participants with cognitive impairments (CIs) versus without, and participants with physical disabilities versus without. Results The findings indicated significant improvements in “good” mood and “calm” mood dimensions after exposure to the VR, as well as improvements in attitudes toward the technology. These positive outcomes were significantly greater for participants with physical disabilities compared to those without disabilities. No differences were found in the responses of participants with CIs versus those without. Exit interviews provided a variety of helpful suggestions about ways to improve the VR equipment design and content to meet the needs of an older adult population. Discussion and Implications The study demonstrates that VR can provide a cost-effective, noninvasive, and nonpharmaceutical approach for improving the lives of older adults in both clinical and recreational settings, particularly when real-world access to nature is limited.
Collapse
Affiliation(s)
- Saleh Kalantari
- Department of Human Centered Design, Cornell University, Ithaca, NY, USA
| | - Tong Bill Xu
- Department of Human Centered Design, Cornell University, Ithaca, NY, USA
| | - Armin Mostafavi
- Department of Human Centered Design, Cornell University, Ithaca, NY, USA
| | - Angella Lee
- Department of Human Centered Design, Cornell University, Ithaca, NY, USA
| | - Ruth Barankevich
- Department of Human Centered Design, Cornell University, Ithaca, NY, USA
| | - Walter R Boot
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Sara J Czaja
- Division of Geriatrics and Palliative Medicine, Center on Aging and Behavioral Research, Weill Cornell Medicine, New York, NY, USA
| |
Collapse
|
39
|
Sims S, Harris R, Hussein S, Rafferty AM, Desai A, Palmer S, Brearley S, Adams R, Rees L, Fitzpatrick JM. Social Distancing and Isolation Strategies to Prevent and Control the Transmission of COVID-19 and Other Infectious Diseases in Care Homes for Older People: An International Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063450. [PMID: 35329137 PMCID: PMC8955170 DOI: 10.3390/ijerph19063450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 12/18/2022]
Abstract
Older people living in care homes are at high risk of poor health outcomes and mortality if they contract COVID-19 or other infectious diseases. Measures used to protect residents include social distancing and isolation, although implementation is challenging. This review aimed to assess the social distancing and isolation strategies used by care homes to prevent and control the transmission of COVID-19 and other infectious diseases. Seven electronic databases were searched: Medline, CINAHL, Embase, PsycINFO, HMIC, Social Care Online, and Web of Science Core Collection. Grey literature was searched using MedRxiv, PDQ-Evidence, NICE Evidence Search, LTCCovid19.org and TRIP. Extracted data were synthesised using narrative synthesis and tabulation. 103 papers were included (10 empirical studies, seven literature reviews, and 86 policy documents). Strategies used to prevent and control the transmission of COVID-19 and other infectious diseases included social distancing and isolation of residents and staff, zoning and cohorting of residents, restriction of resident movement/activities, restriction of visitors and restriction of staff working patterns. This review demonstrates a lack of empirical evidence and the limited nature of policy documentation around social distancing and isolation measures in care homes. Evaluative research on these interventions is needed urgently, focusing on the well-being of all residents, particularly those with hearing, vision or cognitive impairments.
Collapse
Affiliation(s)
- Sarah Sims
- The Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE1 8WA, UK; (S.S.); (R.H.); (A.M.R.); (A.D.)
| | - Ruth Harris
- The Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE1 8WA, UK; (S.S.); (R.H.); (A.M.R.); (A.D.)
| | - Shereen Hussein
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Anne Marie Rafferty
- The Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE1 8WA, UK; (S.S.); (R.H.); (A.M.R.); (A.D.)
| | - Amit Desai
- The Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE1 8WA, UK; (S.S.); (R.H.); (A.M.R.); (A.D.)
| | - Sinead Palmer
- Personal Social Services Research Unit, University of Kent, Canterbury CT2 7NZ, UK;
| | - Sally Brearley
- School of Nursing, Kingston University and St George’s University London, London SW17 0RE, UK;
| | | | - Lindsay Rees
- Encore Care Homes Management Ltd., Bournemouth BH8 9RL, UK;
| | - Joanne M. Fitzpatrick
- The Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE1 8WA, UK; (S.S.); (R.H.); (A.M.R.); (A.D.)
- Correspondence:
| |
Collapse
|
40
|
Giebel C, Hanna K, Marlow P, Cannon J, Tetlow H, Shenton J, Faulkner T, Rajagopal M, Mason S, Gabbay M. Guilt, tears and burnout—Impact of
UK
care home restrictions on the mental well‐being of staff, families and residents. J Adv Nurs 2022; 78:2191-2202. [PMID: 35188292 PMCID: PMC9303866 DOI: 10.1111/jan.15181] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/07/2021] [Accepted: 01/12/2022] [Indexed: 12/23/2022]
Abstract
Aims The aim of this study was to explore the impact of the pandemic on the emotional and mental well‐being of family carers, care home staff and residents, in light of changing restrictions, increased testing and vaccination rollout in the UK. Design Longitudinal, qualitative semi‐structured interview study. Methods Remote semi‐structured interviews were conducted with family carers of care home residents with dementia and care home staff from different care homes across the UK. Baseline and follow‐up interviews were conducted in October/November 2020 and March 2021, respectively. Data were analysed using inductive thematic analysis involving members of the public with caring experiences. Results In all, 42 family carers and care home staff participated at baseline, with 20 family carers and staff followed up. We identified four themes: (1) Developing anger and frustration; (2) Impact on relationships; (3) Stress and burnout; and (4) Behavioural changes, and perceived impact on residents. The mental health of everyone involved, including family carers, care home staff and residents, has been negatively affected, and relationships between family carers and staff have been severely strained. There was a general lack of adequate mental health support, with little relief. Conclusions The pandemic has had a detrimental impact on the lives of those surrounding care homes—from residents and staff to family carers. Consideration should be given on how to best support the mental health needs of all three groups, by providing adequate easily accessible mental health care for all. This should also focus on rebuilding the relationships between family carers and care home staff. Impact This is the first paper to highlight the effects of the long‐lasting and miscommunicated restrictions on residents, carers and care home staff, and highlight the urgent need for continued mental health support.
Collapse
Affiliation(s)
- Clarissa Giebel
- Department of Primary Care & Mental Health University of Liverpool Liverpool UK
- NIHR ARC NWC Liverpool UK
| | - Kerry Hanna
- NIHR ARC NWC Liverpool UK
- School of Health Sciences University of Liverpool Liverpool UK
| | | | | | - Hilary Tetlow
- NIHR ARC NWC Liverpool UK
- SURF Liverpool Liverpool UK
| | | | | | - Manoj Rajagopal
- NIHR ARC NWC Liverpool UK
- Lancashire & South Cumbria NHS Trust Lancaster UK
| | - Stephen Mason
- NIHR ARC NWC Liverpool UK
- Institute of Life Course and Medical Sciences University of Liverpool Liverpool UK
| | - Mark Gabbay
- Department of Primary Care & Mental Health University of Liverpool Liverpool UK
- NIHR ARC NWC Liverpool UK
| |
Collapse
|
41
|
Place-Making through Media: How Media Environments Make a Difference for Long-Term Care Residents’ Agency. SOCIETIES 2022. [DOI: 10.3390/soc12010027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This paper explores the unique relationships care home residents have with communication media. Drawing on findings from an ethnographic case study at a long-term care site in British Columbia, Canada, I describe how care home residents’ everyday media practices are intertwined with their negotiations of longstanding attachments and new living spaces. The research draws connections between the spatiotemporal contexts of media use and residents’ experiences of social agency. Long-term care residents in this research were challenged to engage with the wider community, maintain friendships, or stay current with events and politics because their preferred ways of using communication media were not possible in long-term care. The communication inequalities experienced by care home residents were not simply about their lack of access to media or content but about their inability to find continuity with their established media habits in terms of time and place. While most research about communication media in care homes has been intervention oriented, this research suggests that long-term care service and funding policies require greater attention to create flexible, diverse, and supportive media environments.
Collapse
|
42
|
Introducing the International Journal of Nursing Studies – Advances. Int J Nurs Stud 2022; 127:104177. [DOI: 10.1016/j.ijnurstu.2022.104177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
43
|
van Tol LS, Smaling HJA, Groothuijse JM, Doornebosch AJ, Janus SIM, Zuidema SU, Caljouw MAA, Achterberg WP, de Waal MWM. COVID-19 management in nursing homes by outbreak teams (MINUTES) - study description and data characteristics: a qualitative study. BMJ Open 2021; 11:e053235. [PMID: 34848521 PMCID: PMC8634633 DOI: 10.1136/bmjopen-2021-053235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/11/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Nursing homes are hit relatively hard by the COVID-19 pandemic. Dutch long-term care (LTC) organisations installed outbreak teams (OTs) to coordinate COVID-19 infection prevention and control. LTC organisations and relevant national policy organisations expressed the need to share experiences from these OTs that can be applied directly in COVID-19 policy. The aim of the 'COVID-19 management in nursing homes by outbreak teams' (MINUTES) study is to describe the challenges, responses and the impact of the COVID-19 pandemic in Dutch nursing homes. In this first article, we describe the MINUTES Study and present data characteristics. DESIGN This large-scale multicentre study has a qualitative design using manifest content analysis. The participating organisations shared their OT minutes and other meeting documents on a weekly basis. Data from week 16 (April) to week 53 (December) 2020 included the first two waves of COVID-19. SETTING National study with 41 large Dutch LTC organisations. PARTICIPANTS The LTC organisations represented 563 nursing home locations and almost 43 000 residents. RESULTS At least 36 of the 41 organisations had one or more SARS-CoV-2 infections among their residents. Most OTs were composed of management, medical staff, support services staff, policy advisors and communication specialists. Topics that emerged from the documents were: crisis management, isolation of residents, personal protective equipment and hygiene, staff, residents' well-being, visitor policies, testing and vaccination. CONCLUSIONS OT meeting minutes are a valuable data source to monitor the impact of and responses to COVID-19 in nursing homes. Depending on the course of the COVID-19 pandemic, data collection and analysis will continue until November 2021. The results are used directly in national and organisational COVID-19 policy.
Collapse
Affiliation(s)
- Lisa S van Tol
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Hanneke J A Smaling
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Janneke M Groothuijse
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Arno J Doornebosch
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Sarah I M Janus
- General Practice & Elderly Care Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Sytse U Zuidema
- General Practice & Elderly Care Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Monique A A Caljouw
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilco P Achterberg
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Margot W M de Waal
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|