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Doody O, Lombard J, Delamere T, Rabbitte M. The palliative care experience in Irish nursing homes during the COVID-19 pandemic: a survey of residents, family, and staff. BMC Palliat Care 2024; 23:126. [PMID: 38773544 PMCID: PMC11110399 DOI: 10.1186/s12904-024-01458-8] [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: 02/05/2023] [Accepted: 05/15/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Nursing homes and other long-term care services account for a disparate share of COVID-19 cases and casualties worldwide. During COVID-19 there is a distinct need to preserve a holistic view of the wellbeing of residents of nursing homes, be mindful of their rights as citizens, and to be aware of protecting residents from infection. The delivery of health and social care throughout a pandemic must remain person-centred and adhere to a human rights-based approach. METHODS This study aimed to capture nursing home residents, their families and staff's perspective of the nursing homes residents experience, approaches of staff and the nursing home environment. An online survey was distributed via stakeholder networks and online platforms across Ireland. This study was performed and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). RESULTS 25 residents, 42 family members and 51 staff completed the survey (n = 118). Across the domains measured all but one aspect scored above 50% (residents get up and go to bed when they want 41.5%) with the highest score of 89.1% scored for the nursing home is comfortable and well-kept. Results highlight evidence of positive experiences and endeavours to preserve social connections, residents were in a safe place cared for by staff who did their best in a difficult position and who went above and beyond their duty of care. However, some families reported poor communication, no internet connections, not enough phones or tablets, and that staff were busy and unable at times to assist residents who needed help using phones/tablets. CONCLUSION This study highlights the importance of human rights and how they ought to inform and shape the advancement of public health advice and policy documents. Overall, nursing home residents, their families and staff reported favourably on the study measures. However, issues pertaining to communication are essential and there is a need to address issues such as the provision of accurate timely information, communication infrastructure and resources, and inconsistencies in communications. Of note is that while healthcare professionals have a duty to uphold the rights of nursing home residents, they themselves have human rights which must also be protected and supported.
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Affiliation(s)
- Owen Doody
- Health Research Institute, Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.
| | - John Lombard
- Health Research Institute, Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- School of Law, Faculty of Arts, Humanities and Social Sciences, University of Limerick, Limerick, Ireland
| | - Tara Delamere
- Health Research Institute, Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Project Manager, All Ireland Institute of Hospice and Palliative Care (AIIHPC), Dublin, Ireland
| | - Mary Rabbitte
- Health Research Institute, Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Research Programme Manager, All Ireland Institute of Hospice and Palliative Care (AIIHPC), Dublin, Ireland
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Navalpotro-Pascual S, Matellán-Hernández MP, Pastor-Benito E, Soto-Cámara R, Cárdaba-García RM, García-Santa-Basilia N, Onrubia-Baticón H, Mahtani-Chugani V. Experiences of Spanish out-of-hospital emergency workers with high levels of depression during the COVID-19 pandemic: a qualitative study. Arch Public Health 2024; 82:15. [PMID: 38291523 PMCID: PMC10826038 DOI: 10.1186/s13690-023-01233-w] [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: 08/23/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic had a major psychological impact on health care workers (HCWs). This study was embedded in a larger quantitative study on the mental health care of out-of-hospital HCWs in Spain. To better understand this, a qualitative study was conducted to explore the experiences, coping strategies, and influencing factors of out-of-hospital HCWs who scored high (> 25 points) on the Depression Anxiety Stress Scale (DASS-21) in a previous quantitative mental health study. METHODS A qualitative study was conducted using six in-depth interviews with individuals who scored high on the depression scale and agreed to be contacted by email between May and June 2021, using the phenomenological approach. The data were analysed using Brawn and Clare's method. RESULTS The main results findings related to four themes. The emotional impact of assuming a professional role with high self-demands and responsibilities; Factors influencing the development of negative emotions such as the cruelty of the pandemic, the helplessness in relation to health management and policy, the changing role of the professional and the relationship with society; Personal protection through coping strategies to manage negative emotions such as support from colleagues and family; Good practices for the future looking for different management strategies that can influence individuals and their personal, professional, and social relationships. CONCLUSION The strong impact of the circumstances experienced points to the need to develop psychological support programmes that can protect people's mental health from depression during a crisis and improve the relationship between workers and their managers.
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Affiliation(s)
- Susana Navalpotro-Pascual
- Nursing Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.
- Emergency Medical Service of Madrid-SUMMA 112, Madrid, Spain.
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain.
| | - María Paz Matellán-Hernández
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
- Emergency Medical Service of Castilla and León-Sacyl, Valladolid, Spain
| | - Elena Pastor-Benito
- Emergency Medical Service of Madrid-SUMMA 112, Madrid, Spain
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
| | - Raúl Soto-Cámara
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
- Emergency Medical Service of Castilla and León-Sacyl, Valladolid, Spain
- Department of Health Sciences, University of Burgos, Burgos, Spain
| | - Rosa M Cárdaba-García
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
- Faculty of Nursing of Valladolid, Valladolid, Spain
- Nursing Care Research Group (GICE), Department of Nursing, University of Valladolid, Valladolid, Spain
| | - Noemi García-Santa-Basilia
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
- Emergency Medical Service of Castilla and León-Sacyl, Valladolid, Spain
| | - Henar Onrubia-Baticón
- Prehospital Emergency Research Network (RINVEMER), Spanish Society of Emergency Medicine (SEMES), Madrid, Spain
- Emergency Medical Service of Castilla and León-Sacyl, Valladolid, Spain
| | - Vinita Mahtani-Chugani
- Healthcare Quality Assessment and Information Systems Service, Santa Cruz de Tenerife, Tenerife, Spain
- Primary Care Management of Tenerife, Santa Cruz de Tenerife, Tenerife, Spain
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Zhao L, Xu F, Zheng X, Xu Z, Osten B, Ji K, Ding S, Liu G, Yang S, Chen R. Mediation role of anxiety on social support and depression among diabetic patients in elderly caring social organizations in China during COVID-19 pandemic: a cross-sectional study. BMC Geriatr 2023; 23:790. [PMID: 38041007 PMCID: PMC10691130 DOI: 10.1186/s12877-023-04502-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Diabetes has become a prominent global public health problem, which is an important cause of death, disease burden, and medical and health economic burden. Previous studies have reported that majority of persons diagnosed with diabetes later presented with psychological and mental health diseases. The study aimed to explore the mediation role of anxiety on social support and depression among diabetic patents in elderly caring social organizations (SOs). METHODS A multi-stage stratified cluster random sampling method was used in this cross-sectional study, and a questionnaire consisting of demographic questionnaire, MSPSS, GAD-7, and CES-D-10 was utilized to gather data. SPSS 22.0 and MPLUS 7.4 were used for statistical analysis. Spearman correlation analysis was employed to investigate correlations of key variables. A generalized linear model was used to exam factors associated with depression. Finally, the mediation effect among study variables was investigated by structural equation modeling (SEM). RESULTS The average scores of social support, anxiety, and depression were 58.41 ± 14.67, 2.95 ± 3.95, and 7.24 ± 5.53, respectively. The factors of gender, social support, and anxiety were identified as significantly influential factors related to depression among diabetic patients in elderly caring SOs. The effect of social support on depression was significantly mediated by anxiety (β = -0.467, 95%CI: -0.813 to -0.251). Furthermore, anxiety partially mediated the relationship between family support and depression (β = -0.112, 95%CI: -0.229 to -0.012), and anxiety functioned as a complete mediator in the effect of significant others' support and depression (β = -0.135, 95%CI: -0.282 to -0.024). CONCLUSIONS The indirect effect of social support on depression through anxiety among diabetic patients in elderly caring SOs was elucidated. Social support played a key role in maintaining and regulating their mental health, particularly from family and significant others. Social support provided by both family and significant others exerted an important influence on maintaining and regulating their mental health. In light of this pathway, the elderly caring SOs should enhance the magnitude of social support from these two sources, thereby diminishing the likelihood of experiencing anxiety and depression.
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Affiliation(s)
- Lanlan Zhao
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Fuqin Xu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Xin Zheng
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Ziwen Xu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Benjamin Osten
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
- Registrars' Department, University of Cape Coast, Cape Coast, Ghana
| | - Kai Ji
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Shuo Ding
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Guoqing Liu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Shufan Yang
- School of Computing, Engineering and Built Environment, Edinburgh Napier University, Edinburgh, UK
- Research Department of Orthopaedics and Musculoskeletal Science, University College London, UCL, London, UK
| | - Ren Chen
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China.
- Key Laboratory of Public Health Social Governance, Philosophy and Social Sciences of Anhui Province, Hefei, China.
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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.
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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
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Bußmann A, Pomorin N, Gerling V, Wolthaus H, Teichmüller AK. Effects of the COVID-19 pandemic on hospice and palliative care in nursing homes-A qualitative study from a multiperspective view. PLoS One 2023; 18:e0286875. [PMID: 37796817 PMCID: PMC10553271 DOI: 10.1371/journal.pone.0286875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/24/2023] [Indexed: 10/07/2023] Open
Abstract
In Germany, nursing homes are characterised by challenging conditions for adequately supporting residents at their end of life, which have even amplified due to the COVID-19 pandemic. This article therefore analyses how hospice and palliative care in nursing homes has changed due to the COVID-19 pandemic and how the pandemic has affected residents, relatives and employees. Semi-structured interviews with employees, residents and relatives were conducted before and during the COVID-19 pandemic in two nursing homes in North Rhine-Westphalia, Germany. In a pre-post comparison, data were qualitatively evaluated using content analysis according to Mayring. Shifts, congruities and discrepancies in challenges in hospice and palliative care were identified between T0 and T1. Due to contact restrictions, important parts of end-of-life care were missing, and the roles of individuals providing hospice and palliative care were redefined. The interviewed groups experienced changes differently and contradictory statements on satisfaction and expectations about hospice and palliative care were reported. Employees and relatives predominantly perceived the pandemic to be very stressful, while residents endured this period more composedly. Employees stated that, despite the pandemic, they were mostly able to meet residents' requests. However, relatives and residents expressed that minor requests were not reliably fulfilled, neither at T0 nor at T1. Drawing together the different perspectives from employees, residents and relatives offers a bigger picture of challenges in hospice and palliative care in nursing homes and the pandemic effects. Stronger communication of requests and needs as well as greater collaboration, especially under crisis conditions, are essential for a better quality of end-of-life care. There is an urgent need to break down the taboos around the topics of dying and death in nursing homes.
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Affiliation(s)
- Anna Bußmann
- Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, North Rhine-Westphalia, Germany
| | - Natalie Pomorin
- Essener Forschungsinstitut für Medizinmanagement GmbH, Essen, North Rhine-Westphalia, Germany
- FOM Hochschule für Oekonomie & Management Gemeinnützige Gesellschaft mbH, Düsseldorf, North Rhine-Westphalia, Germany
| | - Vera Gerling
- Forschungsgesellschaft für Gerontologie e.V. Institut für Gerontologie an der TU Dortmund, Dortmund, North Rhine-Westphalia, Germany
| | - Hendrik Wolthaus
- Contilia Pflege und Betreuung GmbH, Essen, North Rhine-Westphalia, Germany
| | - Anne-Katrin Teichmüller
- Forschungsgesellschaft für Gerontologie e.V. Institut für Gerontologie an der TU Dortmund, Dortmund, North Rhine-Westphalia, Germany
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Urlings JHJ, Backhaus R, Verbeek H, de Boer B, Koopmans RTCM, Gerritsen DL, Hamers JPH. After COVID-19 vaccinations: what does living and working in nursing homes look like? BMC Geriatr 2023; 23:298. [PMID: 37193994 PMCID: PMC10186323 DOI: 10.1186/s12877-023-03987-y] [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: 06/11/2022] [Accepted: 04/21/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Nursing homes were disproportionally affected by the COVID-19 pandemic. Vaccination was considered critical for the normalization of daily live of nursing home residents. The present study investigates the impact of the prolonged COVID-19 pandemic and the effect of vaccinations on the daily lives of residents and staff in Dutch nursing homes. SETTING AND PARTICIPANTS The sample consisted of 78 nursing homes that participated in the Dutch national pilot on nursing home visits after the COVID-19 pandemic. One contact person per nursing home was approached for participation in this mixed-methods cross-sectional study. METHODS Data was collected twice through questionnaires in April and December 2021. Quantitative questions focused on recent COVID-19 outbreaks, progress of vaccination, effects of vaccination on daily living in the nursing home and burden experienced by staff. Open-ended questions addressed the prolonged effect of the pandemic on residents, family members and staff. RESULTS The overall vaccination rate of residents across nursing homes appeared to be high among both residents and staff. However, daily living in the nursing home had not returned to normal concerning personal interactions, visits, the use of facilities and work pressure. Nursing homes continued to report a negative impact of the pandemic on residents, family members and staff. CONCLUSIONS Restrictions to the daily lives of residents in nursing homes were stricter than restrictions imposed on society as a whole. Returning to a normal daily living and working was found to be complex for nursing homes. With the emergence of new variants of the virus, policies strongly focusing on risk aversion were predominantly present in nursing homes.
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Affiliation(s)
- Judith H J Urlings
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Postbus 616, 6200, MD Maastricht, the Netherlands.
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands.
| | - Ramona Backhaus
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Postbus 616, 6200, MD Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Postbus 616, 6200, MD Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Bram de Boer
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Postbus 616, 6200, MD Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Raymond T C M Koopmans
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
- De Waalboog "Joachim en Anna", Center for Specialized Geriatric Care, Nijmegen, the Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jan P H Hamers
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Postbus 616, 6200, MD Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
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Muntendorf LK, Balzer K, Friede T, Hummers E, König HH, Müller C, Scherer M, Steyer L, Tetzlaff B, Pfeiffer S, Konnopka A. Cost-Effectiveness of Inter-Professional Collaboration to Reduce Hospitalisations in Nursing Home Residents: Results from the German Interprof ACT Trial. Int J Integr Care 2023; 23:8. [PMID: 37091495 PMCID: PMC10120601 DOI: 10.5334/ijic.7001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/29/2023] [Indexed: 04/25/2023] Open
Abstract
Background The German multi-centre cluster-randomised controlled trial interprof ACT investigated interventions to increase inter-professional collaboration between nursing home (NH) staff and local general practitioners to reduce hospitalisations and improve nursing homes residents' (NHRs) quality of life. The trial was funded by the German Health Care Innovation Fund. Methods Cost-effectiveness of interprof ACT interventions was evaluated and compared to current standard of care (SOC) over 12 months, including 622 NHRs in 34 NHs in Germany. Multiplying resource use of healthcare services with German-specific unit costs generated costs. Health outcome was measured in quality-adjusted life-years QALYs), utility by multiplying EQ-5D-5L values with German-specific utility weights. Incremental cost-effectiveness analysis used an intention-to-treat approach and scenario analyses (SAs). Net-benefit-regression and cost-effectiveness acceptability curves addressed uncertainty. A German healthcare insurance perspective was assumed. Results Base case results showed non-significant cost savings of 851.88€ and non-significant QALY loss of -0,056. Discussion Dependency levels at baseline were non-significantly higher in IG compared to control group (CG). Lack of baseline costing data eliminated possibility to evaluate changes in costs due to the interprof ACT measures for both groups. Conclusion Interprof ACT interventions are not cost-effective compared to current SOC.
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Affiliation(s)
- Louisa-Kristin Muntendorf
- University Medical Center Hamburg-Eppendorf, Institute of Health Services Research and Health Economics, Martinistraße 52, D-20246 Hamburg, Germany
| | - Katrin Balzer
- Institute for Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Ratzeburger Allee 160, Haus 50, D-23538 Lübeck, Germany
| | - Tim Friede
- Department of Medical Statistics, University Medical Center Göttingen, Humboldtallee 32, D-37073 Göttingen, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, D-37073 Göttingen, Germany
| | - Hans-Helmut König
- University Medical Center Hamburg-Eppendorf, Institute of Health Services Research and Health Economics, Martinistraße 52, D-20246 Hamburg, Germany
| | - Christiane Müller
- Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, D-37073 Göttingen, Germany
| | - Martin Scherer
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
| | - Linda Steyer
- Institute for Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Ratzeburger Allee 160, Haus 50, D-23538 Lübeck, Germany
| | - Britta Tetzlaff
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Martinistraße 52, D-20246 Hamburg, Germany
| | - Sebastian Pfeiffer
- Department of Medical Statistics, University Medical Center Göttingen, Humboldtallee 32, D-37073 Göttingen, Germany
| | - Alexander Konnopka
- University Medical Center Hamburg-Eppendorf, Institute of Health Services Research and Health Economics, Martinistraße 52, D-20246 Hamburg, Germany
- Department Psychology, MSH Medical School Hamburg, Am Kaiserkai 1, D-20457 Hamburg, Germany
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Heudorf U, Domann E, Förner M, Kunz S, Latasch L, Trost B, Steul K. Development of morbidity and mortality of SARS-CoV-2 in nursing homes for the elderly in Frankfurt am Main, Germany, 2020-2022: What protective measures are still required? GMS HYGIENE AND INFECTION CONTROL 2023; 18:Doc05. [PMID: 36875328 PMCID: PMC9978453 DOI: 10.3205/dgkh000431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Introduction Nursing-home residents are among the highest risk group in the SARS-CoV-2 pandemic. At the onset of the SARS-CoV-2 pandemic, the majority of all deaths from or with SARS-CoV-2 occurred in long-term care facilities (LTCFs), so that maximum protective measures were mandated for these facilities. This study analyzed the impact of the new virus variants and the vaccination campaign on disease severity and mortality among nursing home residents and staff through 2022 as a basis for determining which protective measures remain necessary and appropriate. Methods In five homes in Frankfurt am Main, Germany, with a total capacity for 705 residents, all cases occurring in the facility among residents and staff were recorded and documented (date of birth and diagnosis, hospitalization and death, vaccination status) and were descriptively analyzed with SPSS. Results By 31st August 2022, 496 residents tested positive for SARS-CoV-2, 93 in 2020, 136 in 2021, and 267 in 2022; 14 residents presented with a second SARS-CoV-2 infection in 2022, having previously experienced an infection in 2020 or 2021. The percentage of hospitalizations decreased from 24.7% (2020) and 17.6% (2021) to 7.5% (2022), and the percentage of deaths decreased from 20.4% and 19.1% to 1.5%. In 2021, 61.8% of those infected were vaccinated (at least 2x); in 2022, 86.2% of residents had been vaccinated twice, 84% of whom had already had a booster vaccination. Hospitalization and death rates were significantly higher among the unvaccinated than the vaccinated throughout all years (unvaccinated 21.5% and 18.0%; vaccinated 9.8% and 5.5%; KW test p=0.000). However, this difference was no longer significant under the prevalence of the Omicron variant in 2022 (unvaccinated 8.3% and 0%; p=0.561; vaccinated 7.4% and 1.7%; p=0.604). From 2020 to 2022, 400 employees were documented as infected, with 25 having second infections in 2022. Only one employee showed a second infection in 2021 following the first in 2020. Three employees were hospitalized; no deaths occurred. Discussion and conclusion Severe COVID-19 courses occurred with the Wuhan Wild type in 2020, with a high death rate among nursing-home residents. In contrast, during the waves in 2022 with the relatively mildly pathogenic Omicron variant, many infections but few severe courses and deaths were observed among the now mostly vaccinated and boostered nursing-home residents. Given the high immunity of the population and the low pathogenicity of the circulating virus - even in nursing-home residents - protective measures in nursing homes that restrict people's right to self-determination and quality of life no longer seem justified. Instead, the general hygiene rules and the recommendations of the KRINKO (German Commission for Hospital Hygiene and Infection Prevention) on infection prevention should be followed, and the recommendations of the STIKO (German Standing Commission on Vaccination) on vaccination not only against SARS-CoV-2 but also against influenza and pneumococci should be observed.
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Affiliation(s)
| | - Eugen Domann
- Justus Liebig University Giessen, Giessen, Germany
| | | | - Sabine Kunz
- August-Stunz-Zentrum, Frankfurt am Main, Germany
| | - Leo Latasch
- Altenzentrum der Jüdischen Gemeinde, Frankfurt am Main, Germany
| | - Bernd Trost
- Franziska-Schervier Seniorenzentrum, Frankfurt am Main, Germany
| | - Katrin Steul
- Johannes Gutenberg University Mainz, Mainz, Germany
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9
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Bohórquez-Blanco S, Allande-Cussó R, Martín-López C, Gómez-Salgado J, García-Iglesias JJ, Fagundo-Rivera J, Ruiz-Frutos C. Effects of the COVID-19 pandemic on the mental health of rehabilitation area professionals: A systematic review. Front Public Health 2022; 10:1085820. [PMID: 36568762 PMCID: PMC9779931 DOI: 10.3389/fpubh.2022.1085820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Background The role of the physiotherapist is vital in the recovery of post-COVID-19 patients, but fear of contagion is a possible feeling among healthcare professionals. The objective of this study is to assess the mental health effects that COVID-19 has had on healthcare workers, including rehabilitation care, in times of pandemic. Methods A systematic review was conducted using the PRISMA format in the Pubmed, SCOPUS, and Web of Science databases between July and September 2022. Keywords included were "healthcare providers," "COVID-19," "Mental Health," and "Psychological Distress." Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Results A total of 14 studies were included in this review. The study population was healthcare professionals including the rehabilitation services. In total, 4 studies reported exclusively on anxiety and stress levels in physiotherapists providing care during the pandemic. Conclusions The mental health of healthcare professionals has been compromised during the pandemic. However, initially, research was only focused on physicians and nurses, so the need arises to include those professionals, such as physiotherapists, who are also in direct contact with COVID-19 patients. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=367664, identifier: CRD42022367664.
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Affiliation(s)
- Sandra Bohórquez-Blanco
- Physiotherapy School, Industrial University of Santander, Bucaramanga, Santander, Colombia,Labour Risks Prevention Master, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
| | - Regina Allande-Cussó
- Department of Nursing, Nursing, Physiotherapy, and Podiatry School, University of Seville, Seville, Spain
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador,*Correspondence: Juan Gómez-Salgado
| | - Juan Jesús García-Iglesias
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain,Juan Jesús García-Iglesias
| | | | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
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10
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Culture Change in Long-Term Care-Post COVID-19: Adapting to a New Reality Using Established Ideas and Systems. Can J Aging 2022; 42:351-358. [PMID: 36349718 DOI: 10.1017/s0714980822000344] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
The response to the COVID-19 pandemic in long-term care (LTC) has threatened to undo efforts to transform the culture of care from institutionalized to de-institutionalized models characterized by an orientation towards person- and relationship-centred care. Given the pandemic’s persistence, the sustainability of culture-change efforts has come under scrutiny. Drawing on seven culture-change models implemented in Canada, we identify organizational prerequisites, facilitatory mechanisms, and frontline changes relevant to culture change that can strengthen the COVID-19 pandemic response in LTC homes. We contend that a reversal to institutionalized care models to achieve public health goals of limiting COVID-19 and other infectious disease outbreaks is detrimental to LTC residents, their families, and staff. Culture change and infection control need not be antithetical. Both strategies share common goals and approaches that can be integrated as LTC practitioners consider ongoing interventions to improve residents’ quality of life, while ensuring the well-being of staff and residents’ families.
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11
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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.
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Barbosa MM, Paúl C, Teixeira L, Yanguas J, Afonso RM. From the drama of unoccupied time and isolation due to Covid-19's pandemic to the need for person-centered care at residential care facilities in Portugal. CURRENT PSYCHOLOGY 2022:1-10. [PMID: 35967500 PMCID: PMC9361953 DOI: 10.1007/s12144-022-03499-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/17/2022]
Abstract
During the pandemic, restrictive measures were implemented at Portuguese residential care facilities (PRCF), such as isolating residents and ceasing collective activities. It is important to understand how PRCF are implementing activities that allow residents to occupy their time and fight isolation. As such, we aim to analyze whether: 1. new activities were implemented for residents (identifying which were carried out); 2. occupation activities were provided to isolated residents in their rooms (identifying which were carried out); 3. the implementation of activities is associated with variables like the amount of staff. This is an exploratory, quantitative, and cross-sectional study. An online questionnaire was sent by email to 2325 PRCF and entities were asked to share it with their workers. The study was also divulged on social networks. Data collection occurred between July 8th and October 18th, 2020. The study had 784 staff members participating and 90.8% reported that new activities were implemented at their facilities, predominantly videocalls. Concerning isolated residents most respondents (64.4%) stated that providing activities was impossible. Results showed that those PRCF that expanded teams had a higher percentage of new activities and activities with residents isolated in bedrooms. These results are alarming because while residents should have had more resources to cope with the pandemic, higher risks of unoccupied time and isolation existed, a dramatic situation for its potentially harmful consequences. Focusing on sanitary issues (and less on older adults) may reinforce traditional care models that had shown negative impacts before the pandemic. This highlights the need to evolve the care paradigm during and beyond the pandemic at PRCF: with Person-Centered Care as an option.
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Affiliation(s)
- Maria Miguel Barbosa
- Health Sciences Research Centre of the University of Beira Interior (CICS-UBI) - Faculdade de Ciências da Saúde, Av. Infante D. Henrique, 6201-506 Covilhã, Portugal
- CINTESIS@RISE, ICBAS, University of Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Constança Paúl
- CINTESIS@RISE, ICBAS, University of Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Laetitia Teixeira
- CINTESIS@RISE, ICBAS, University of Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | | | - Rosa Marina Afonso
- CINTESIS@RISE, ICBAS, University of Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
- Faculdade de Ciências Sociais e Humanas, University of Beira Interior, Estrada do Sineiro, s/n, 6200-209 Covilhã, Portugal
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Bergmann S, Peper J, Bieber A. The use of formal care for dementia from a professional perspective: a scoping review. BMC Health Serv Res 2022; 22:825. [PMID: 35752801 PMCID: PMC9233851 DOI: 10.1186/s12913-022-08229-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/16/2022] [Indexed: 01/10/2023] Open
Abstract
Background and objectives The progressive character of dementia usually leads to a continuously increasing need for support. There is some evidence of late use of professional support during the disease course. We aim to provide an overview of aspects influencing access and use of formal care in dementia from the perspective of health and social care professionals. Additionally, the perspectives of professionals and people with dementia/informal carers will be compared. Methods We conducted a scoping review with a systematic literature search in Medline via Ovid in January 2019 and updated this in April 2020 and in May 2021. Publications were considered eligible when focusing on influencing aspects of the use of formal care or support for people with dementia in an outpatient setting from the perspective of health professionals. Included publications were critically appraised using the Mixed Method Appraisal Tool. We identified aspects of access to and use of formal care and support services. A consultation exercise with three specialised trained dementia care nurses was conducted to validate our results. Results We included 29 studies: n = 20 qualitative, n = 6 quantitative-descriptive, n = 3 mixed-methods. Various support services were identified, but a focus was on services for diagnostic and treatment of dementia. A wide range of influencing aspects (n = 15) describe the access to and use of formal care services. Aspects related to the complexity and structure of the healthcare system and the competence of professionals were frequently addressed. Second, attitudes and expectations of professionals, and experiences with people with dementia and their informal carers were identified. The dementia care nurses highlighted the importance of coordinated care to enhance dementia-specific competencies. Conclusions Health and social care professionals still describe barriers in accessing and using formal care due to various influences. Ways to improve access to and use of professional support in dementia should consider individual and system-level activities, as well as overarching aspects. Important topics are therefore education and training of professionals and coordinated dementia-specific care to provide adequate support for people with dementia and their relatives. Several professions may be involved in this increasingly important field, e.g., nurses with a dementia-specific training like dementia care nurses.
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Affiliation(s)
- Stefanie Bergmann
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Julia Peper
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Bieber
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
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Barbosa MM, Teixeira L, Paúl C, Yanguas J, Afonso RM. Caring and Working during the COVID-19 Pandemic: Perspective of Portuguese Residential Care Facility Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105963. [PMID: 35627500 PMCID: PMC9142040 DOI: 10.3390/ijerph19105963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023]
Abstract
Residential care facilities (RCF) for older people are facing high demands due to the COVID-19 pandemic. The aim of this study was to explore the workers’ perspectives on the changes in work and care dynamics amidst the first wave of the pandemic at Portuguese RCF. This is a descriptive, quantitative, and cross-sectional study. An online questionnaire about pandemic-induced changes in work and care dynamics was sent to 2325 RCF. These entities were then asked to share it with their workers. The participants (n = 784) were mostly women (92.7%) and mostly composed of technical directors (41.6%) and direct-care workers (17.1%). The respondents reported that during the first wave of the pandemic, when compared to the pre-pandemic period, there were greater difficulties in providing care related to the basic necessities of older people (52.7%); direct-care workers were required to work more consecutive hours in each shift (69.95%); direct-care workers had to live at RCF (14.8%), and there were changes concerning the possibility of promoting person-centered care (PCC) practices. It also revealed that focusing on disease prevention and sanitary measures alone facilitates practices that reinforce the traditional model of procedure-centered care and have negative consequences on the rights and well-being of those living and working at RCF, exposing and accentuating preexisting vulnerabilities. This study considers the pandemic’s serious implications and alarming questions about basic care, dignity, living, and working conditions at Portuguese RCF. These notions reinforce the need for change through redefining care policies and practices in Portuguese RCF beyond the pandemic. The current situation provides an opportunity to adopt a formal PCC model.
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Affiliation(s)
- Maria Miguel Barbosa
- Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal; (L.T.); (C.P.)
- Health Sciences Research Centre, Faculty of Health Sciences, University of Beira Interior (CICS-UBI), Avenida Infante D. Henrique, 6201-506 Covilhã, Portugal
- Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal;
- Correspondence:
| | - Laetitia Teixeira
- Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal; (L.T.); (C.P.)
- Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal;
| | - Constança Paúl
- Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal; (L.T.); (C.P.)
- Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal;
| | | | - Rosa Marina Afonso
- Center for Health Technology and Services Research (CINTESIS), Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal;
- Department of Psychology and Education, Faculty of Human and Social Sciences, University of Beira Interior, Estrada do Sineiro, s/n, 6200-209 Covilhã, Portugal
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15
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Is the Systemic Agency Capacity of Long-Term Care Organizations Enabling Person-Centered Care during the COVID-19 Pandemic? A Repeated Cross-Sectional Study of Organizational Resilience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095045. [PMID: 35564440 PMCID: PMC9103543 DOI: 10.3390/ijerph19095045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 01/27/2023]
Abstract
The COVID-19 pandemic has strained long-term care organization staff and placed new demands on them. This study examines the role of the general ability and power of a long-term care organization to act and react collectively as a social system, which is called systemic agency capacity, in safeguarding the provision of person-centered care during a crisis. The question of how the systemic agency capacity of long-term care organizations helps to ensure person-centered care during the pandemic is an open research question. We conducted a pooled cross-sectional study on long-term care organizations in Germany during the first and second waves of the pandemic (April 2020 and December 2020–January 2021). The sample consisted of 503 (first wave) and 294 leaders (second wave) of long-term care organizations. The top managers of these facilities were asked to report their perceptions of their facility’s agency capacity, measured by the AGIL scale, and the extent to which the facility provides person-centered care. We found a significant positive association between the leaders’ perceptions of systemic agency capacity and their perceptions of delivered person-centered care, which did not change over time. The results tentatively support the idea that fostering the systemic agency capacity of long-term care organizations facilitates their ability to provide quality routine care despite environmental shocks such as the COVID-19 pandemic.
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Reopening the doors of Dutch nursing homes during the COVID-19 crisis: results of an in-depth monitoring. Int Psychogeriatr 2022; 34:391-398. [PMID: 33818339 DOI: 10.1017/s1041610221000296] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES On May 11, the Dutch Government allowed 26 nursing homes to welcome 1 visitor per resident, after 2 months of lockdown. The study aimed to monitor in-depth the feasibility of the regulations and their impact on the well-being of residents, their visitors, and healthcare staff. DESIGN Mixed-methods study in 5 of the 26 facilities; the facilities were affiliated to an academic network of nursing homes. PARTICIPANTS Visitors and healthcare professionals. INTERVENTION Allowing visitors using local regulations based on national guidelines. MEASUREMENTS Digital questionnaire, analyzing documentation such as infection prevention control protocols, attending meetings of COVID-19 crisis teams, in-depth telephone or in-person interviews with visitors and healthcare professionals, and on-site observations. RESULTS National guidelines were translated with great variety into local care practice. Healthcare professionals agreed that reopening would increase the well-being of the residents and their loved ones. However, there were also great worries for increasing workload, increasing the risk of emotional exhaustion, and the risk of COVID-19 infections. Compliance with local regulations was generally satisfactory, but maintaining social distance and correctly wearing face masks appeared to be difficult. Care staff remained ambivalent for fear of infections. In general, allowing visitors was experienced as having a positive impact on the well-being of all stakeholders. Nevertheless, some residents with dementia showed negative effects. CONCLUSION The complete lockdown of Dutch nursing homes had a substantial impact on the well-being of the residents. The reopening was welcomed by all stakeholders, but provided a high organizational workload as well as feelings of ambivalence among care staff. In the second wave, a more tailored approach is being implemented. However, facilities are sometimes still struggling to find the right balance between infection control and well-being.
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Ruiz-Frutos C, Arias-Ulloa CA, Ortega-Moreno M, Romero-Martín M, Escobar-Segovia KF, Adanaque-Bravo I, Gómez-Salgado J. Factors Associated to Psychological Distress During the COVID-19 Pandemic Among Healthcare Workers in Ecuador. Int J Public Health 2022; 67:1604626. [PMID: 35392539 PMCID: PMC8980224 DOI: 10.3389/ijph.2022.1604626] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/02/2022] [Indexed: 12/23/2022] Open
Abstract
Objective: The global COVID-19 pandemic has challenged health systems. Healthcare professionals had to face harsh conditions that have caused psycho-emotional consequences. Ecuador has been one of the countries hit hardest by the pandemic in Latin America. The objective of this study was to analyse the levels of psychological distress among healthcare workers in Ecuador during the COVID-19 pandemic. Methods: A cross-sectional descriptive study was conducted with a convenience sample of 1,056 healthcare professionals, assessing their psychological distress, physical symptoms of COVID-19, state of health, the preventive measures adopted, and the history of contact with people infected with the SARS-CoV2 virus. Results: showed that 66.0% of the participants manifested psychological distress, with significantly higher levels in women with symptoms of COVID-19 and previous contact with infected people or objects (p < 0.001). However, adherence to preventive measures and perception of health were associated with less psychological distress (p < 0.001). Conclusions: The importance of monitoring the mental health of healthcare workers during the COVID-19 pandemic was confirmed, having identified factors associated with the development of psychological distress among professionals in Ecuador.
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Affiliation(s)
- Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | | | - Mónica Ortega-Moreno
- Department of Economy, University of Huelva, Huelva, Spain
- *Correspondence: Macarena Romero-Martín, ; Juan Gómez-Salgado,
| | - Macarena Romero-Martín
- Department of Nursing, University of Huelva, Huelva, Spain
- *Correspondence: Macarena Romero-Martín, ; Juan Gómez-Salgado,
| | - Kenny F. Escobar-Segovia
- Facultad de Ingeniería en Ciencias de la Tierra, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Ingrid Adanaque-Bravo
- Facultad de Ingeniería en Mecánica y Ciencias de la Producción, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
- *Correspondence: Macarena Romero-Martín, ; Juan Gómez-Salgado,
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Pregnancy Activity Levels and Impediments in the Era of COVID-19 Based on the Health Belief Model: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063283. [PMID: 35328974 PMCID: PMC8954454 DOI: 10.3390/ijerph19063283] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023]
Abstract
Physical activity (PA) and exercise benefit both the mother and the fetus. Many pregnant women avoid or severely limit PA, leading to complications before and after delivery. This study elucidated the precise effect of each moderator variable on prenatal physical activity (PPA) by examining demographic factors, the PPA-related health belief level (HBL), and the current PPA level. The health belief model (HBM) in conjunction with the international prenatal physical activity questionnaire was used. The HBL in pregnant parous women (PPW) (3.42) was significantly higher than that in nonpregnant nulliparous women (NNW) (3.06). The PPA level in pregnant nulliparous women (PNW) (5.67 metabolic equivalent-hours per week (MET-h/week)) was lower than in the PPW (6.01 MET-h/week). All HBM dimensions (except for perceived barriers) were positively correlated with exercise expenditure in both PNW and PPW. According to the regression tree, participants in PNW aged ≤ 23 years with annual household incomes > CNY 100,001−150,000 had the highest energy expenditure (10.75 MET-h/week), whereas participants in PPW with a perceived benefit score of >4 had the highest energy expenditure (10 MET-h/week). The results demonstrated that the HBL in all groups was acceptable, whereas the PPA level was lower than the recommended PA level. In both PPW and PNW, the HBL was most strongly correlated with exercise expenditure. There is an urgent need to organize public-interest courses to alleviate household expenditure, raise the HBL about PPA in pregnant and NNW, and ensure personal health in the context of COVID-19.
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Araujo O, Sequeira C, Ferré-Grau C, Sousa L. [Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future]. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32:83-91. [PMID: 35577413 PMCID: PMC9099353 DOI: 10.1016/j.enfcle.2021.09.001] [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: 03/13/2021] [Accepted: 09/18/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak. METHOD A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal. RESULTS The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support. CONCLUSIONS Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills.
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Affiliation(s)
- Odete Araujo
- School of Nursing, University of Minho, Portugal; Health Sciences Research Unit, Nursing (UICISA E: UMinho), Portugal; CINTESIS-Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal.
| | - Carlos Sequeira
- CINTESIS-Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal; Nursing School of Porto, Porto, Portugal
| | - Carme Ferré-Grau
- Department of Nursing, University Rovira i Virgili, Tarragona, España
| | - Lia Sousa
- Escola Superior de Saúde do Vale do Ave, CESPU, Vila Nova de Famalicão, Portugal
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20
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Araujo O, Sequeira C, Ferré-Grau C, Sousa L. [Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future]. ENFERMERIA CLINICA 2022; 32:83-91. [PMID: 34690492 PMCID: PMC8526444 DOI: 10.1016/j.enfcli.2021.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 09/18/2021] [Indexed: 11/16/2022]
Abstract
Objective This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak. Method A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal. Results The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support. Conclusions Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills.
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Affiliation(s)
- Odete Araujo
- School of Nursing, University of Minho, Portugal
- Health Sciences Research Unit, Nursing (UICISA E: UMinho), Portugal
- CINTESIS-Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal
| | - Carlos Sequeira
- CINTESIS-Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal
- Nursing School of Porto, Porto, Portugal
| | - Carme Ferré-Grau
- Department of Nursing, University Rovira i Virgili, Tarragona, España
| | - Lia Sousa
- Escola Superior de Saúde do Vale do Ave, CESPU, Vila Nova de Famalicão, Portugal
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21
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Good Care during COVID-19: A Narrative Approach to Care Home Staff’s Experiences of the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042106. [PMID: 35206293 PMCID: PMC8872056 DOI: 10.3390/ijerph19042106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/30/2022] [Accepted: 02/10/2022] [Indexed: 11/29/2022]
Abstract
Due to its major impact on Dutch care homes for older people, the COVID-19 pandemic has presented care staff with unprecedented challenges. Studies investigating the experiences of care staff during the COVID-19 pandemic have shown its negative impact on their wellbeing. We aimed to supplement this knowledge by taking a narrative approach. We drew upon 424 personal narratives written by care staff during their work in a Dutch care home during the COVID-19 pandemic. Firstly, our results show that care staff have a relational-moral approach to good care. Residents’ wellbeing is their main focus, which they try to achieve through personal relationships within the triad of care staff–resident–significant others (SOs). Secondly, our results indicate that caregivers experience the COVID-19 mitigation measures as obstructions to relational-moral good care, as they limit residents’ wellbeing, damage the triadic care staff–residents–SOs relationship and leave no room for dialogue about good care. Thirdly, the results show that care staff experiences internal conflict when enforcing the mitigation measures, as the measures contrast with their relational-moral approach to care. We conclude that decisions about mitigation measures should be the result of a dialogic process on multiple levels so that a desired balance between practical good care and relational-moral good care can be determined.
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Corbett T, Lee K, Cummings A, Calman L, Farrington N, Lewis L, Young A, Richardson A, Foster C, Bridges J. Self-management by older people living with cancer and multi-morbidity: a qualitative study. Support Care Cancer 2022; 30:4823-4833. [PMID: 35147757 PMCID: PMC8831683 DOI: 10.1007/s00520-022-06892-z] [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: 09/12/2021] [Accepted: 01/31/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Over half of individuals diagnosed with cancer are aged over 70 years, and more than 75% of those with cancer report at least one other medical condition. Having multiple conditions alongside cancer in old age may lower functional status, greater likelihood of treatment complications and less favourable prognoses. This qualitative study explored how older people with long-term chronic conditions manage their health and meet their health-related goals after they have completed treatment for cancer. METHODS One-to-one face-to-face qualitative interviews were conducted with 8 older people and 2 informal caregivers based in the UK. Older adults were eligible to participate if they were over 70 and had completed primary cancer treatment with curative intent and had at least one other chronic health condition. A semi-structured interview schedule developed a priori based on Shippee's cumulative complexity model was used. We aimed to explore experiences that could influence self-management, utilisation of healthcare services and health outcomes. A framework analysis was used to describe and interpret the data. RESULTS Four overarching themes were identified in the analysis. These themes related to factors that influenced the everyday health-related workload and capacity of the participants. These factors included their health, resources, and opportunities, as well their motivation and sense of perceived control over their lives. CONCLUSIONS Fragmented healthcare systems and relationships with healthcare professionals also influenced the participants' self-management of their health. Our findings highlight the interaction between an individuals' needs, capacity, treatment burden, and the services and resources available to them. These findings support calls to promote person-centred care to better support older adults to manage their health.
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Affiliation(s)
- Teresa Corbett
- Faculty of Sport, Health, and Social Sciences, Solent University, Southampton, SO14 0YN UK
| | - Kellyn Lee
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ UK
| | - Amanda Cummings
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, SO17 1BJ UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, SO17 1BJ UK
| | - Naomi Farrington
- University Hospital Southampton & University of Southampton, Tremona Road, Southampton, SO16 6YD UK
| | - Lucy Lewis
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Alexandra Young
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ UK
| | - Alison Richardson
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ UK
| | - Claire Foster
- Macmillan Survivorship Research Group, School of Health Sciences, University of Southampton, Southampton, SO17 1BJ UK
| | - Jackie Bridges
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ UK
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Thalen M, van Oorsouw WMWJ, Volkers KM, Frielink N, Embregts PJCM. Providing person-centred care to older people with intellectual disabilities during the COVID-19 pandemic: experiences of direct support workers. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:775-781. [PMID: 37547555 PMCID: PMC10402855 DOI: 10.1080/20473869.2021.2019921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/10/2021] [Accepted: 12/13/2021] [Indexed: 08/08/2023]
Abstract
Background: Although the current preventive measures relating to COVID-19 can lead to challenges in the daily work of direct support workers (e.g. keeping 1.5 m distance), it remains vital to uphold the principles of person-centred care when working with older people with intellectual disabilities. The current study explores the extent to which direct support workers have been able to apply a specific form of person-centred care (i.e. integrated emotion-oriented care, or IEOC) when working with older people with intellectual disabilities during the COVID-19 pandemic. Method: Six direct support workers from five facilities serving older people with intellectual disabilities in the Netherlands participated in this qualitative study. They participated in a two-hour focus group, which was transcribed verbatim, and the transcript was analysed thematically. Results: Three themes emerged: (i) the negative impact of changes due to the COVID-19 measures on service users; (ii) the adaptation of direct support workers to changes due to the COVID-19 measures; and (iii) putting the needs and wishes of service users first. Conclusion: This study provides first impressions into the experiences of direct support workers providing person-centred care to older people with intellectual disabilities during the COVID-19 pandemic.
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Affiliation(s)
- Marloes Thalen
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
- Philadelphia Care Foundation, Amersfoort, Netherlands
| | | | | | - Noud Frielink
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
| | - Petri J. C. M. Embregts
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
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24
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Arpacıoğlu S, Yalçın M, Türkmenoğlu F, Ünübol B, Çelebi Çakıroğlu O. Mental health and factors related to life satisfaction in nursing home and community-dwelling older adults during COVID-19 pandemic in Turkey. Psychogeriatrics 2021; 21:881-891. [PMID: 34545664 PMCID: PMC8661814 DOI: 10.1111/psyg.12762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/12/2021] [Accepted: 08/30/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The geriatric population is supposed to be at high risk for psychological distress as well as adverse outcomes and mortality during the COVID-19 pandemic. This study aimed to investigate the levels of depression, anxiety, death anxiety and life satisfaction levels and factors related to life satisfaction in individuals aged 65 years and older during the pandemic and to compare these variables between nursing home (NH) and community-dwelling older adults. METHOD This study has a cross-sectional and descriptive design, and a total of 133 nursing NH and community-dwelling older adults were enrolled in the study. Turkish death anxiety scale (TDAS), life satisfaction scale (SLS) and depression anxiety stress scale-21 (DASS-21) were used for the assessment. RESULTS The majority of the older adults had no or mild depression, anxiety and stress symptoms in spite of the prolonged confinements, and were slightly satisfied with their lives. However, depression, anxiety, stress and TDAS levels were higher in participants aged 80 years and older. Residents of NHs had higher TDAS, depression and anxiety levels and lower SLS levels than community-dwelling older adults. Participants who were meeting their children and/or grandchildren less than 2 h a week, were found to have significantly lower SLS and higher depression scores. The increase in depression and TDAS scores predicted a decrease in SLS scores in older adults. CONCLUSIONS As NH resident older adults have higher psychological distress and decreased life satisfaction due to the social isolation caused by the prolonged confinements, NH staff should be regularly informed on both preventive measures and mental health consequences of the pandemic, and should be trained for basic therapeutic interventions. Older adults should be supported to use telecommunication technologies to contact their families and friends, and participate in safe and accessible person-centred activity programs.
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Affiliation(s)
- Selim Arpacıoğlu
- Department of Psychiatry, School of MedicineAltınbaş UniversityIstanbulTurkey
| | - Murat Yalçın
- Department of PsychiatryUniversity of Health Sciences, Erenköy Mental Health and Neurological Diseases Training and Research HospitalIstanbulTurkey
| | | | - Başak Ünübol
- Department of PsychiatryUniversity of Health Sciences, Erenköy Mental Health and Neurological Diseases Training and Research HospitalIstanbulTurkey
| | - Oya Çelebi Çakıroğlu
- Department of Nursing Administration, Faculty of Health SciencesIstanbul Medeniyet UniversityIstanbulTurkey
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25
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Factors Related to Psychological Distress during the First Stage of the COVID-19 Pandemic on the Chilean Population. J Clin Med 2021; 10:jcm10215137. [PMID: 34768655 PMCID: PMC8584835 DOI: 10.3390/jcm10215137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/19/2021] [Accepted: 10/29/2021] [Indexed: 12/15/2022] Open
Abstract
The health effects of COVID-19 continue to raise doubts today. In some areas, such as mental health, these doubts have scarcely been addressed. The present study analyses the effects on psychological distress during the first phase of the pandemic in Chile. A cross-sectional descriptive study was performed by using a questionnaire validated in Spain and adapted for Chile. Between 22 April and 16 December 2020, 3227 questionnaires were collected from the 16 regions of Chile, using non-probabilistic snowball sampling. Bivariate analysis and binary logistic regression were performed. The variables that could predict psychological distress during the COVID-19 pandemic in Chile were: having a poor self-perception of health OR = 4.038, 95% CI = (2.831, 5.758); being younger than 29 OR = 2.287, 95% CI = (1.893, 2.762); having diarrhea OR = 2.093, 95% CI = (1.414, 3.098); having headache OR = 2.019, 95% CI = (1.662, 2.453); being a woman OR = 1.638, 95% CI = (1.363, 1.967); having muscle pain OR = 1.439, 95% CI = (1.114, 1.859); and having had casual contact with an infected person OR = 1.410, 95% CI = (1.138, 1.747). In Chile, with a better social, economic, cultural, and health environment compared to neighboring countries, there has been a high percentage of psychological distress. It is time to prioritize measures to safeguard the mental health of Chileans, especially focused on the most vulnerable population according to our results, i.e., young women with poorer health status.
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Prins M, Willemse B, van der Velden C, Pot AM, van der Roest H. Involvement, worries and loneliness of family caregivers of people with dementia during the COVID-19 visitor ban in long-term care facilities. Geriatr Nurs 2021; 42:1474-1480. [PMID: 34678687 PMCID: PMC8526350 DOI: 10.1016/j.gerinurse.2021.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 01/10/2023]
Abstract
To prevent COVID-19 from spreading in long-term care facilities (LTCFs), the Dutch government took restrictive measures, including a visitor-ban in LTCFs. This study examined the relationship between involvement of family caregivers (FCs) of people with dementia (PwD) living in LTCFs and FCs mental health during the visitor-ban, and whether this relationship was moderated by the frequency of alternative contact with PwD during the visitor-ban and FC resilience. This cross-sectional study collected data from 958 FCs. FCs who visited PwD more frequently before, were more worried during the visitor-ban than those with lower visiting frequency. FCs who visited the PwD daily before, but had minimal weekly contact during the visitor-ban, worried less. Resilient FCs who did social and task-related activities before, experienced less loneliness during the visitor-ban. It is advisable for healthcare professionals to reach out to these groups, to facilitate ongoing contact and help them overcome their loneliness.
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Affiliation(s)
- Marleen Prins
- Erasmus School of Health Policy & Management, Health Care Governance (HCG), Burg. Oudlaan 50, 3000 DR Rotterdam, Zuid-Holland, The Netherlands; Netherlands Institute of Mental Health and Addiction, Department on Aging, Da Costakade 45, 3500 AS, Utrecht, Utrecht, The Netherlands.
| | - Bernadette Willemse
- Care Farm Reigershoeve Foundation, Oosterweg 5B, 1968 KM, Heemskerk, Noord-Holland, The Netherlands
| | - Claudia van der Velden
- Netherlands Institute of Mental Health and Addiction, Department on Aging, Da Costakade 45, 3500 AS, Utrecht, Utrecht, The Netherlands
| | - Anne Margriet Pot
- Erasmus School of Health Policy & Management, Health Care Governance (HCG), Burg. Oudlaan 50, 3000 DR Rotterdam, Zuid-Holland, The Netherlands; Optentia Research Focus Area, P O Box 1174, North-West University, Vanderbijlpark, 1900 South Africa
| | - Henriëtte van der Roest
- Netherlands Institute of Mental Health and Addiction, Department on Aging, Da Costakade 45, 3500 AS, Utrecht, Utrecht, The Netherlands
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Pereiro AX, Dosil-Díaz C, Mouriz-Corbelle R, Pereira-Rodríguez S, Nieto-Vieites A, Pinazo-Hernandis S, Pinazo-Clapés C, Facal D. Impact of the COVID-19 Lockdown on a Long-Term Care Facility: The Role of Social Contact. Brain Sci 2021; 11:brainsci11080986. [PMID: 34439605 PMCID: PMC8394115 DOI: 10.3390/brainsci11080986] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Long-term care facilities (LTCFs) have been harmed by the coronavirus, and older adults have remained isolated for a long time with many restrictions. The aim of this study was to measure the decline in cognitive, functional, and affective status in a care facility after the lockdown in the first wave of the COVID-19 pandemic and to compare it with previous measures in order to determine if this decline was accelerated. (2) Methods: Ninety-eight participants were recruited. Data from three retrospective pre-lockdown assessments and an additional post-lockdown assessment were analyzed. Mixed ANOVA analyses were performed according to the Clinical Dementia Rating levels, considering social-contact frequency during the lockdown as a covariate. (3) Results: The cognitive and functional scores were lower and depression scores were higher after the strict lockdown, accelerating a general pattern of decline that was already present in LTCF residents. The frequency of social contact eliminated the measurement differences in the cognitive and functional scores and the group differences in depression scores. (4) Conclusions: The effects of the SARS-CoV-2 lockdown in an LTCF were mediated by the frequency of contact. Clinical implications: Preventive measures must be taken to ensure social contact with relatives and friends and reduce the negative consequences of social isolation in LTCFs.
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Affiliation(s)
- Arturo X. Pereiro
- Department of Developmental Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.X.P.); (C.D.-D.); (R.M.-C.); (A.N.-V.)
| | - Carlos Dosil-Díaz
- Department of Developmental Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.X.P.); (C.D.-D.); (R.M.-C.); (A.N.-V.)
- Gerontological Therapeutic Complex “A Veiga”, Serge Lucense, 27360 Láncara, Spain;
| | - Romina Mouriz-Corbelle
- Department of Developmental Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.X.P.); (C.D.-D.); (R.M.-C.); (A.N.-V.)
- Gerontological Therapeutic Complex “A Veiga”, Serge Lucense, 27360 Láncara, Spain;
| | | | - Ana Nieto-Vieites
- Department of Developmental Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.X.P.); (C.D.-D.); (R.M.-C.); (A.N.-V.)
| | | | | | - David Facal
- Department of Developmental Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.X.P.); (C.D.-D.); (R.M.-C.); (A.N.-V.)
- Correspondence: ; Tel.: +34-881-819-695
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28
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[COVID-19 in care homes: equity will be needed to avoid new catastrophes]. GACETA SANITARIA 2021; 36:3-5. [PMID: 34400008 PMCID: PMC8292036 DOI: 10.1016/j.gaceta.2021.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/01/2021] [Accepted: 06/29/2021] [Indexed: 11/21/2022]
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Leontjevas R, Knippenberg IAH, Smalbrugge M, Plouvier AOA, Teunisse S, Bakker C, Koopmans RTCM, Gerritsen DL. Challenging behavior of nursing home residents during COVID-19 measures in the Netherlands. Aging Ment Health 2021; 25:1314-1319. [PMID: 33291991 DOI: 10.1080/13607863.2020.1857695] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES From the perspective of the nursing home (NH) practitioners, to gain understanding of (1) whether challenging behavior in NH residents changed during the COVID-19 measures, (2) whether the practitioners' involvement in the treatment of challenging behavior changed, (3) what can be learned from the experience of NH staff. METHODS A mixed methods study with a survey in 323 NH practitioners (psychologists, elderly care physicians, nurse practitioners) in the Netherlands, and in-depth interviews in 16 NH practitioners. Nonparametric analyses were used to compare estimated proportions of residents with increased and with decreased challenging behavior. Content analyses were conducted for open-ended questions and in-depth interviews. RESULTS Participants reported changes in challenging behavior with slightly higher proportions for increased (Q1/Mdn/Q3: 12.5%, 21.7%, 30.8%) than for decreased (8.7%, 14.8%, 27.8%, Z = -2.35, p = .019) challenging behavior. Half of the participants reported that their work load increased and work satisfaction worsened during the measures. Different strategies were described to respond to the effects of COVID-19 measures, such as video calls, providing special areas for residents to meet their loved ones, adjusting activities, and reducing the exposure to negative news. CONCLUSIONS Because COVID-19 measures resulted in both increased and decreased challenging behavior in NH residents, it is important to monitor for their potential long lasting effects. Increased work load and worsened work satisfaction of the NH staff, together with the changes in type of challenging behavior, indicate that the harmful effects of the anti-pandemic measures should be taken seriously.
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Affiliation(s)
- Ruslan Leontjevas
- Department of Primary and Community Care, Radboud University Medical Centre, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, the Netherlands.,Faculty of Psychology, Open University of The Netherlands, Heerlen, the Netherlands
| | - Inge A H Knippenberg
- Department of Primary and Community Care, Radboud University Medical Centre, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, the Netherlands.,Faculty of Psychology, Open University of The Netherlands, Heerlen, the Netherlands
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Annette O A Plouvier
- Department of Primary and Community Care, Radboud University Medical Centre, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, the Netherlands
| | - Saskia Teunisse
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud University Medical Centre, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, the Netherlands.,Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, the Netherlands
| | - Raymond T C M Koopmans
- Department of Primary and Community Care, Radboud University Medical Centre, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, the Netherlands.,Joachim en Anna, Centre for Specialized Geriatric Care, Nijmegen, the Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Centre, Radboud Institute for Health Sciences, Radboudumc Alzheimer Center, Nijmegen, the Netherlands
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30
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Wang A, Liu L, Zhu J, Chen X, Tang S, Bai X. The experiences of cooperation among healthcare workers who participated in COVID-19 aid mission in China: A qualitative study. J Clin Nurs 2021; 30:2696-2707. [PMID: 34196060 PMCID: PMC8446990 DOI: 10.1111/jocn.15774] [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: 09/02/2020] [Revised: 02/01/2021] [Accepted: 03/11/2021] [Indexed: 11/26/2022]
Abstract
Aims and objectives To assist future offsite planning for pandemics, we documented lived experiences of cooperation among healthcare workers (HCWs) during the coronavirus disease (COVID‐19) pandemic. Background The COVID‐19 pandemic poses a global health crisis. Most recent studies on the COVID‐19 focus on frontline HCWs' physio‐psychological experiences, with few studies examining their experiences of cooperation. Design A descriptive phenomenological design reported based on COREQ checklist. Methods 25 HCWs (17 nurses and eight physicians) were interviewed, selected through convenience and purposive sampling, who participated in a medical aid mission in China during the COVID‐19 pandemic. Data were collected via semi‐structured online video interviews, and the transcripts were analysed using Colaizzi's phenomenological method. Results The HCWs experienced stressed and anxious, but rated their overall cooperation experience as positive. We categorised the reported experiences in five themes: (1) a multi‐level management structure; (2) nurse managers as internal and external team coordinators; (3) high morale and a mutual supportive context; (4) a continuous streamlined workflow; and (5) the value of multidisciplinary collaboration in care. Reasonable management structure and division of work were the basis for successful aid mission. High morale and a mutual supportive context were foundational for growth and stress mitigation. The HCWs continuously streamlined workflow through communication and met patients' individual need through multidisciplinary collaboration. Conclusions Planning for a pandemic aid mission is challenging, given the unpredictable nature of the working circumstances. Our results underline the importance of supportive strategies for COVID‐19 aid mission. Relevance to clinical practice Recommendations for future pandemic planning: (1) positive morale and supportive working text should be paid prioritised attention; (2) sufficient experienced and ancillary staff should be recruited; (3) multiple communication channels such as regular handover meetings, online chat applications and electronic recording devices are essential, and (4) multidisciplinary cooperation are is necessary in COVID‐19 wards.
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Affiliation(s)
- Anni Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Lei Liu
- Nephrology Department of the First Affiliated Hospital of Guizhou, University of Traditional Chinese Medicine, Guiyang, China
| | - Jianguo Zhu
- Urology Department of Guizhou Provincial People's Hospital, Guiyang, China
| | - Xue Chen
- Nursing Department of the Chinese Medicine Hospital of Longli County, Longli, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoling Bai
- Guizhou Nursing Vocational College, Guiyang, China
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31
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Mota-Romero E, Esteban-Burgos AA, Puente-Fernández D, García-Caro MP, Hueso-Montoro C, Herrero-Hahn RM, Montoya-Juárez R. NUrsing Homes End of Life care Program (NUHELP): developing a complex intervention. BMC Palliat Care 2021; 20:98. [PMID: 34174856 PMCID: PMC8234765 DOI: 10.1186/s12904-021-00788-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/04/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Nursing homes are likely to become increasingly important as end-of-life care facilities. Previous studies indicate that individuals residing in these facilities have a high prevalence of end-of-life symptoms and a significant need for palliative care. The aim of this study was to develop an end-of-life care program for nursing homes in Spain based on previous models yet adapted to the specific context and the needs of staff in nursing homes in the country. METHODS A descriptive study of a complex intervention procedure was developed. The study consisted of three phases. The first phase was a prospective study assessing self-efficacy in palliative care (using the SEPC scale) and attitudes towards end-of-life care (using the FATCOD-B scale) among nursing home staff before and after the completion of a basic palliative care training program. In the second phase, objectives were selected using the Delphi consensus technique, where nursing home and primary care professionals assessed the relevance, feasibility, and level of attainment of 42 quality standards. In phase 3, interventions were selected for these objectives through two focus group sessions involving nursing home, primary care, and palliative care professionals. RESULTS As a result of the training, an improvement in self-efficacy and attitudes towards end-of-life care was observed. In phase 2, 14 standards were selected and grouped into 5 objectives: to conduct a comprehensive assessment and develop a personalized care plan adapted to the palliative needs detected; to provide information in a clear and accessible way; to request and record advance care directives; to provide early care with respect to loss and grief; to refer patients to a specialized palliative care unit if appropriate, depending on the complexity of the palliative care required. Based on these objectives, the participants in the focus group sessions designed the 22 interventions that make up the program. CONCLUSIONS The objectives and interventions of the NUHELP program constitute an end-of-life care program which can be implemented in nursing homes to improve the quality of end-of-life care in these facilities by modifying their clinical practice, organization, and relationship with the health system as well as serving as an example of an effective health intervention program.
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Affiliation(s)
- Emilio Mota-Romero
- Salvador Caballero Primary Care Centre, Andalusian Health Service, Granada, Spain
| | - Ana Alejandra Esteban-Burgos
- Department of Nursing, Doctoral Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | - Daniel Puente-Fernández
- Doctoral Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain.
| | - María Paz García-Caro
- Department of Nursing, Brain and Behaviour Research Institute, University of Granada, Mind, Spain
| | | | | | - Rafael Montoya-Juárez
- Department of Nursing, Brain and Behaviour Research Institute, University of Granada, Mind, Spain
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Meier JV, Noel JA, Kaspar K. Alone Together: Computer-Mediated Communication in Leisure Time During and After the COVID-19 Pandemic. Front Psychol 2021; 12:666655. [PMID: 34234714 PMCID: PMC8255679 DOI: 10.3389/fpsyg.2021.666655] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
In spring 2020, the COVID-19 outbreak was declared a global pandemic and several lockdowns were followed in Germany. To weaken the spread of the virus, SARS-CoV-2, people were required to reduce their face-to-face contact with others. Computer-mediated communication (CMC) offers opportunities to stay in touch with important people and still meets social needs. During the first lockdown in spring 2020, we collected data from 679 participants to explore the role of CMC for social interaction in the context of leisure activities and how personal characteristics contribute to such media use. Results showed that people complied with the restriction and shifted their communication to several media, especially instant messengers and video calls. Many leisure activities were performed via CMC, especially low-key activities, such as just talking or simply spending time together. Perceived social closeness to others was positively related to the quality and quantity of CMC. The extent of leisure activities that people experienced with others via communication media was higher among younger individuals, males, and individuals with higher scores on positive state affect, extraversion, openness, and fear of missing out. The preference for solitude showed a negative relation. The motivation to continue using media for communication after the pandemic was strongly related to the quality and quantity of actual use. Low extraversion and high openness were related to higher motivation for future use. Implications such as the importance of providing fast internet and good usability of communication media as well as the relevance of increasing media literacy of people are discussed.
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Affiliation(s)
- Jennifer V Meier
- Department of Psychology, University of Cologne, Cologne, Germany
| | - Josephine A Noel
- Department of Psychology, University of Cologne, Cologne, Germany
| | - Kai Kaspar
- Department of Psychology, University of Cologne, Cologne, Germany
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Lood Q, Haak M, Dahlin-Ivanoff S. Everyday life in a Swedish nursing home during the COVID-19 pandemic: a qualitative interview study with persons 85 to 100 years. BMJ Open 2021; 11:e048503. [PMID: 34145018 PMCID: PMC8214988 DOI: 10.1136/bmjopen-2020-048503] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 06/03/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To understand and report on the impact of the COVID-19 pandemic on the everyday lives of frail older persons living in nursing homes by exploring their experiences of how the pandemic-related restrictions had influenced them and in what way. DESIGN Empirical qualitative interview study. SETTING A publicly run nursing home in an urban area in Sweden in June 2020. The nursing home had visitor restrictions, cancelled activities and physical distancing requirements since March 2020. PARTICIPANTS A total of 10 persons, 85-100 years, living in a Swedish nursing home during the COVID-19 pandemic, were recruited through nursing home management and interviewed in June 2020 using medically approved visors and physical distancing. ANALYSIS Interviews were analysed using thematic analysis, which involves familiarisation, coding and definition of themes. Transcripts were coded into data-driven categories before being organised into categories that described and explained the data. RESULTS The analysis resulted in the main theme 'It is like living in a bubble', that describes everyday life in the nursing home during the pandemic as a world of its own in which the older persons felt both protected and isolated. This is described in four subthemes: living 1 day at a time, without fear of the virus; feeling taken care of; having limited freedom and missing out on the little extras. CONCLUSIONS Contributing to the growing area of COVID-19-related research, our findings provide novel insights into how pandemic-related restrictions in nursing homes represent a risk of isolating older people from the outside world and diminishing their freedom. Put in relation to the previous research, these findings could be applied beyond the pandemic, to develop research and practice that puts focus on how to support older people to decide for themselves how to spend the rest of their lives.
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Affiliation(s)
- Qarin Lood
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health-AgeCap, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
- School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Maria Haak
- Research Platform for Collaboration for Health, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
- Department of Health Sciences, Lund University Faculty of Medicine, Lund, Sweden
| | - Synneve Dahlin-Ivanoff
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health-AgeCap, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
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Schweighart R, Klemmt M, Neuderth S, Teti A. [Experiences and perspectives of nursing home residents with depressive symptoms during the COVID-19 pandemic: a qualitative study]. Z Gerontol Geriatr 2021; 54:353-358. [PMID: 34081187 PMCID: PMC8174127 DOI: 10.1007/s00391-021-01926-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/12/2021] [Indexed: 11/30/2022]
Abstract
Hintergrund Die COVID-19-Pandemie erfordert umfangreiche Maßnahmen in Pflegeheimen mit dem Ziel der Infektionsvermeidung. Diese Maßnahmen wirken sich auf das Leben der Bewohnenden aus und führen u. a. zu einer Zunahme an Depressivität und anderen negativen Begleiterscheinungen. Ziel der Arbeit Die Studie hat die Exploration der Erfahrungen und Sichtweisen von Pflegeheimbewohnenden mit depressiver Symptomatik während der Pandemie zum Ziel. Methoden Es wurden 9 leitfadengestützte Interviews mit Bewohnenden geführt, welche mittels der inhaltlich-strukturierenden Inhaltsanalyse nach Kuckartz ausgewertet wurden. Ergebnisse Es konnten 3 Hauptthemen identifiziert werden: Empfindungen und Emotionen in Bezug auf die Pandemie, Veränderungen und Einschränkungen durch die Maßnahmen sowie Wünsche vor dem Hintergrund der Pandemie. Die befragten Bewohnenden berichten sowohl von emotionalen Belastungen als auch davon, keine Angst vor einer Infektion und deren Folgen zu haben. Zudem äußern die Befragten z. T. unangenehme Einschränkungen wie das Tragen von Masken, deren Nutzen sie bisweilen kritisch hinterfragen. Weiter werden diverse Wünsche der Bewohnenden in Bezug zur Pandemie wie etwa das Verlassen des Pflegeheims identifiziert. Diskussion Die Studie zeigt komplexe Empfindungen, Veränderungen und Wünsche bei Pflegeheimbewohnenden aufgrund der Pandemie und der daraus resultierenden Maßnahmen. Dies erfordert einen individuellen Zugang zu den Bewohnenden mit depressiver Symptomatik, um eine Zunahme psychischer Probleme zu vermeiden. Vor diesem Hintergrund ergibt sich die Notwendigkeit einer partizipativen Umsetzung der Gesundheitsschutzmaßnahmen bei der besonders vulnerablen Gruppe der Pflegeheimbewohnenden.
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Affiliation(s)
- Roxana Schweighart
- Institut für Gerontologie, Universität Vechta, Driverstraße 23, 49377, Vechta, Deutschland.
| | - Malte Klemmt
- Institut für Angewandte Sozialwissenschaften, Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Deutschland
| | - Silke Neuderth
- Institut für Angewandte Sozialwissenschaften, Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Deutschland
| | - Andrea Teti
- Institut für Gerontologie, Universität Vechta, Driverstraße 23, 49377, Vechta, Deutschland
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Paananen J, Rannikko J, Harju M, Pirhonen J. The impact of Covid-19-related distancing on the well-being of nursing home residents and their family members: a qualitative study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2021; 3:100031. [PMID: 34095858 PMCID: PMC8166157 DOI: 10.1016/j.ijnsa.2021.100031] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/04/2021] [Accepted: 05/21/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The aim of this study is to examine the consequences of Covid-19-related isolation and social restrictions on the well-being of nursing home residents and their family members, and to analyze how distancing has affected the relationships of family members with residents and the nursing home staff. DESIGN The data consist of 41 thematic one-on-one interviews conducted during May-December 2020 with family members of nursing home residents. Convenience sampling was utilized by asking several nursing homes in different parts of Finland to relay a contact request from the researchers to the residents' family members. The main themes of the interviews were lockdown and visiting restrictions. Subthemes included the frequency of visits, other means of interaction, changes in the relationships of family members with their loved ones and with nursing home staff, and the feelings aroused by the situation. The interviews were audio recorded and transcribed verbatim, resulting in 794 pages of data. METHOD The qualitative study uses inductive content analysis. NVivo12 software facilitated the systematic coding of the data. RESULTS According to the family members, distancing aggravated the residents' pre-existing conditions: they reported a sudden progression in memory disorders and significant deterioration in physical abilities, for example. Both residents and family members experienced anxiety, grief, and severe stress, and family members expressed concern that residents might die due to a lack of social contact and activity. Family members were also frustrated about not being able to touch their relatives or participate in their care, and therefore sometimes thought that their visits were useless. New forms of interaction with family members, introduced by the nursing homes, were appreciated. However, some family members perceived the interactional protocols as unfair and complained about insufficient information. CONCLUSIONS The findings underline the need for nursing homes to implement a good interactional protocol. Overall, the results show that the measures taken to protect residents' health during the Covid-19 outbreak were short-sighted in terms of the social dimension of well-being. It is therefore important to continue developing safe and humane solutions for interaction when social restrictions are in place. Tweetable abstract: Covid-19-related distancing has caused anxiety, grief, and severe stress for nursing home residents and their family members.
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Affiliation(s)
- Jenny Paananen
- Department of Nursing Science, University of Turku, 20014, Finland
| | - Johanna Rannikko
- Department of Nursing Science, University of Turku, 20014, Finland
| | - Maija Harju
- Faculty of Social Sciences, University of Helsinki, P.O Box 9, 00014, Finland
| | - Jari Pirhonen
- Faculty of Social Sciences, University of Helsinki, P.O Box 9, 00014, Finland
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Corpora M, Kelley M, Kasler K, Heppner A, Van Haitsma K, Abbott KM. "It's Been a Whole New World": Staff Perceptions of Implementing a Person-Centered Communication Intervention During the COVID-19 Pandemic. J Gerontol Nurs 2021; 47:9-13. [PMID: 34039094 DOI: 10.3928/00989134-20210407-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The coronavirus disease 2019 (COVID-19) has challenged the way nursing homes deliver person-centered care (PCC). Preferences for Activity and Leisure (PAL) Cards are a tool to communicate residents' important preferences to staff. Monthly interviews (N = 32) were conducted with champions who were conducting a PAL Card quality improvement project in Tennessee nursing homes (N = 11) between March and August 2020. Three major themes emerged: Structural Changes (e.g., halting admissions, adding an isolation unit), Resident Burden (e.g., physical isolation, loneliness), and Provider Burnout (e.g., increased workload, mental exhaustion). Further, providers expressed the benefits to using PAL Cards, specifically in regard to blunting the negative impact of each theme. Results showed the overall negative impact of COVID-19 on nursing home communities. Nursing staff experienced greater burden than other staff, reflecting their prominent role in providing direct care to residents with COVID-19. Staff reported that PAL Cards helped promote PCC. [Journal of Gerontological Nursing, 47(5), 9-13.].
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Levin-Zamir D, Sorensen K, Su TT, Sentell T, Rowlands G, Messer M, Pleasant A, Saboga Nunes L, Lev-Ari S, Okan O. Health promotion preparedness for health crises - a 'must' or 'nice to have'? Case studies and global lessons learned from the COVID-19 pandemic. Glob Health Promot 2021; 28:27-37. [PMID: 33775167 PMCID: PMC8246413 DOI: 10.1177/1757975921998639] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The current COVID-19 pandemic has exposed missing links between health promotion and national/global health emergency policies. In response, health promotion initiatives were urgently developed and applied around the world. A selection of case studies from five countries, based on the Socio-Ecological Model of Health Promotion, exemplify ‘real-world’ action and challenges for health promotion intervention, research, and policy during the COVID-19 pandemic. Interventions range from a focus on individuals/families, organizations, communities and in healthcare, public health, education and media systems, health-promoting settings, and policy. Lessons learned highlight the need for emphasizing equity, trust, systems approach, and sustained action in future health promotion preparedness strategies. Challenges and opportunities are highlighted regarding the need for rapid response, clear communication based on health literacy, and collaboration across countries, disciplines, and health and education systems for meaningful solutions to global health crises.
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Affiliation(s)
- Diane Levin-Zamir
- Clalit, Tel Aviv, Israel.,School of Public Health, University of Haifa, Haifa, Israel
| | | | - Tin Tin Su
- Monash University, Bandar Sunway, Malaysia
| | - Tetine Sentell
- Office of Public Health Studies, University of Hawai'i at Mānoa, Hawaii, United States
| | | | - Melanie Messer
- APOLLON Hochschule der Gesundheitswirtschaft (University of Applied Sciences), Bremen, Germany
| | | | - Luis Saboga Nunes
- University of Education Freiburg, Freiburg im Breisgau, Baden-Württemberg, Germany
| | - Shahar Lev-Ari
- Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Orkan Okan
- Bielefeld University, Bielefeld, North Rhine-Westphalia, Germany
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Kaelen S, van den Boogaard W, Pellecchia U, Spiers S, De Cramer C, Demaegd G, Fouqueray E, Van den Bergh R, Goublomme S, Decroo T, Quinet M, Van Hoof E, Draguez B. How to bring residents' psychosocial well-being to the heart of the fight against Covid-19 in Belgian nursing homes-A qualitative study. PLoS One 2021; 16:e0249098. [PMID: 33770110 PMCID: PMC7997017 DOI: 10.1371/journal.pone.0249098] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/10/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Nursing homes (NH) for the elderly have been particularly affected by the Covid-19 pandemic mainly due to their hosted vulnerable populations and poor outbreak preparedness. In Belgium, the medical humanitarian organization Médecins Sans Frontières (MSF) implemented a support project for NH including training on infection prevention and control (IPC), (re)-organization of care, and psychosocial support for NH staff. As psychosocial and mental health needs of NH residents in times of Covid-19 are poorly understood and addressed, this study aimed to better understand these needs and how staff could respond accordingly. METHODS A qualitative study adopting thematic content analysis. Eight focus group discussions with direct caring staff and 56 in-depth interviews with residents were conducted in eight purposively and conveniently selected NHs in Brussels, Belgium, June 2020. RESULTS NH residents experienced losses of freedom, social life, autonomy, and recreational activities that deprived them of their basic psychological needs. This had a massive impact on their mental well-being expressed in feeling depressed, anxious, and frustrated as well as decreased meaning and quality of life. Staff felt unprepared for the challenges posed by the pandemic; lacking guidelines, personal protective equipment and clarity around organization of care. They were confronted with professional and ethical dilemmas, feeling 'trapped' between IPC and the residents' wellbeing. They witnessed the detrimental effects of the measures imposed on their residents. CONCLUSION This study revealed the insights of residents' and NH staff at the height of the early Covid-19 pandemic. Clearer outbreak plans, including psychosocial support, could have prevented the aggravated mental health conditions of both residents and staff. A holistic approach is needed in NHs in which tailor-made essential restrictive IPC measures are combined with psychosocial support measures to reduce the impact on residents' mental health impact and to enhance their quality of life.
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Affiliation(s)
- Sanne Kaelen
- Belgium Covid-19 Project, Médecins Sans Frontières, Operational Centre Brussels, Brussels, Belgium
| | - Wilma van den Boogaard
- Médecins Sans Frontières, Operational Centre Brussels, Operational Research Unit (LuxOR), Luxembourg, Luxembourg/Brussels, Belgium
| | - Umberto Pellecchia
- Médecins Sans Frontières, Operational Centre Brussels, Operational Research Unit (LuxOR), Luxembourg, Luxembourg/Brussels, Belgium
| | - Sofie Spiers
- Belgium Covid-19 Project, Médecins Sans Frontières, Operational Centre Brussels, Brussels, Belgium
| | - Caroline De Cramer
- Belgium Covid-19 Project, Médecins Sans Frontières, Operational Centre Brussels, Brussels, Belgium
| | - Gwennin Demaegd
- Belgium Covid-19 Project, Médecins Sans Frontières, Operational Centre Brussels, Brussels, Belgium
| | - Edouard Fouqueray
- Belgium Covid-19 Project, Médecins Sans Frontières, Operational Centre Brussels, Brussels, Belgium
| | - Rafael Van den Bergh
- Belgium Covid-19 Project, Médecins Sans Frontières, Operational Centre Brussels, Brussels, Belgium
| | - Stephanie Goublomme
- Belgium Covid-19 Project, Médecins Sans Frontières, Operational Centre Brussels, Brussels, Belgium
| | - Tom Decroo
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Muriel Quinet
- Iriscare, Public Health Institute, Brussels, Belgium
| | - Elke Van Hoof
- Working Group on the Psychosocial Impact of the COVID-19 Pandemic Within the Superior Health Council, Brussels, Belgium
- Mental Health Sub-working Group, GEES, Brussels, Belgium
- Vrije Universiteit Brussel, Brussels, Belgium
| | - Bertrand Draguez
- Belgium Covid-19 Project, Médecins Sans Frontières, Operational Centre Brussels, Brussels, Belgium
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Affiliation(s)
- Gwendolyn L Gilbert
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW.,Sydney Health Ethics, University of Sydney, Sydney, NSW
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Frahsa A, Altmeier D, John JM, Gropper H, Granz H, Pomiersky R, Haigis D, Eschweiler GW, Nieß AM, Sudeck G, Thiel A. "I Trust in Staff's Creativity"-The Impact of COVID-19 Lockdowns on Physical Activity Promotion in Nursing Homes Through the Lenses of Organizational Sociology. Front Sports Act Living 2020; 2:589214. [PMID: 33345161 PMCID: PMC7739680 DOI: 10.3389/fspor.2020.589214] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/28/2020] [Indexed: 12/26/2022] Open
Abstract
Objectives: The health-enhancing benefits or regular physical activity (PA) reach into old age. With the emergence of the coronavirus disease of 2019 (COVID-19) pandemic and the associated national lockdowns and restrictions, nursing home residents were restrained from being physically active. In our study, we aimed to assess the impact of the COVID-19-related restrictions on PA promotion in nursing homes from an organizational-sociological lens. Methods: We collected data in eight nursing homes in Germany. Data collection included (i) semistructured interviews focusing on COVID-19-related restrictions and their effects on nursing homes from the home administrators' perspectives; (ii) open-ended surveys with nursing home staff and relatives focusing on daily routines and contact restrictions; and (iii) collection of documents such as care concepts, mission statements, and weekly activity plans. We analyzed all data with a reflexive thematic analysis approach. Results: We identified three stages of COVID-19-related changes in nursing homes that impacted PA promotion, as follows: (1) external closure and search for emergency control, (2) organizational adaptations to create a livable daily life in the internal environment, and (3) slow reintegration of interactions with the external organizational environment. Document analysis revealed that PA promotion was not part of decision programs or internal staff work descriptions. Rather, PA promotion was delegated to external service providers. The assignment of PA promotion to external providers was not structurally anchored in decision programs, which makes PA promotion not sustainable, particularly during unforeseen events that limit access to the organization. During the pandemic, executive staff believed in internal staff to buffer competencies with regard to PA promotion. Thus, executive staff often considered PA promotion relevant, even during the pandemic, but thought that PA promotion is a task that can be fulfilled by unqualified but motivated internal staff. Conclusion: While our study participants showed a high level of coping-capacity belief, it remains unclear which long-term impacts of COVID-19 on PA promotion in nursing homes are to be expected. At the practice level, executive staff in nursing homes that aim to promote PA within their organization should become aware that PA promotion needs to be incorporated into organizational structures to be implemented and continued in challenging times such as in a pandemic.
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Affiliation(s)
- Annika Frahsa
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Dorothee Altmeier
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Jannika M. John
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Hannes Gropper
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Hanna Granz
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Rebekka Pomiersky
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Daniel Haigis
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital Tübingen, Tübingen, Germany
| | | | - Andreas M. Nieß
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Gorden Sudeck
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sport Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
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Yu SY, Hung HF. Let's Build a New Normal: Transitioning in Hope. J Gerontol Nurs 2020; 46:3-5. [PMID: 32976619 DOI: 10.3928/00989134-20200909-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Baiyewu O, Elugbadebo O, Oshodi Y. Burden of COVID-19 on mental health of older adults in a fragile healthcare system: the case of Nigeria: dealing with inequalities and inadequacies. Int Psychogeriatr 2020; 32:1181-1185. [PMID: 32782036 PMCID: PMC7468683 DOI: 10.1017/s1041610220001726] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 01/10/2023]
Affiliation(s)
- O. Baiyewu
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - O. Elugbadebo
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Y. Oshodi
- Department of Psychiatry, College of Medicine, University of Lagos, Lagos, Nigeria
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Sense of Coherence and Psychological Distress Among Healthcare Workers During the COVID-19 Pandemic in Spain. SUSTAINABILITY 2020. [DOI: 10.3390/su12176855] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The health crisis triggered by COVID-19 and the preventive measures taken to control it have caused a strong psychological impact on the population, especially on healthcare professionals. Risk exposure, uncertainty about how to approach the disease, care and emotional overburden, lack of resources, or unclear ever-changing protocols are, among others, psychological distress risk factors for the healthcare professionals who have faced this dramatic scenario on the front line. On the other hand, the Sense of Coherence (SOC) is a competence that could help these professionals perceive the situation as understandable, manageable, and meaningful, facilitating the activation of their resilience. This work aims to describe the levels of psychological distress and SOC of healthcare professionals during the crisis caused by COVID-19, the relationship between both variables, and their health status. A cross-sectional descriptive study with a sample of 1459 currently active healthcare workers was developed. GHQ-12 and SOC-13 were used for data collection. Bivariate analyses were performed, including Chi-Squared Test, Student’s T-Test, Analysis of Variance—ANOVA (with Bonferroni test for multiple comparisons), and correlations. Cohen’s d or Cramer’s V effect size measurements were also provided. The results showed that 80.6% of healthcare professionals had psychological distress, and the mean score on the SOC-13 scale was 62.8 points (SD = 12.02). Both psychological distress and SOC were related to the presence of COVID-19 symptoms, as well as with contact history. Professionals with psychological distress showed a lower SOC. Taking care of the mental health of healthcare professionals is essential to effectively cope with the COVID-19 pandemic. Given the psychological impact of working in the current menacing scenario, people on the front line against the disease should be protected, minimizing risks, providing them with resources and support, and fostering their coping skills.
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Verbeek H, Gerritsen DL, Backhaus R, de Boer BS, Koopmans RTCM, Hamers JPH. Allowing Visitors Back in the Nursing Home During the COVID-19 Crisis: A Dutch National Study Into First Experiences and Impact on Well-Being. J Am Med Dir Assoc 2020; 21:900-904. [PMID: 32674816 PMCID: PMC7294280 DOI: 10.1016/j.jamda.2020.06.020] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To prevent and control COVID-19 infections, nursing homes across the world have taken very restrictive measures, including a ban for visitors. These restrictive measures have an enormous impact on residents' well-being and pose dilemmas for staff, although primary data are lacking. A Dutch guideline was developed to cautiously open nursing homes for visitors during the COVID-19 pandemic. This study reports the first findings on how the guideline was applied in the local context; the compliance to local protocols; and the impact on well-being of residents, their family caregivers, and staff. DESIGN A mixed-methods cross-sectional study was conducted. SETTING AND PARTICIPANTS In total, 26 nursing homes were permitted to enlarge their possibilities for allowing visitors in their facility. These nursing homes were proportionally representative of the Netherlands as they were selected by their local Area Health Authority for participation. At each nursing home, a contact person was selected for participation in the current study. METHODS A mixed-methods cross-sectional study was conducted, consisting of questionnaire, telephone interviews, analyses of documentation (ie, local visiting protocols), and a WhatsApp group. RESULTS Variation in local protocols was observed, for example, related to the use of personal protective equipment, location, and supervision of visits. In general, experiences were very positive. All nursing homes recognized the added value of real and personal contact between residents and their loved ones and indicated a positive impact on well-being. Compliance with local guidelines was sufficient to good. No new COVID-19 infections were reported during this time. CONCLUSIONS AND IMPLICATIONS These results indicate the value of family visitation in nursing homes and positive impact of visits. Based on these results, the Dutch government has decided to allow all nursing homes in the Netherlands to cautiously open their homes using the guidelines. More research is needed on impact and long-term compliance.
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Affiliation(s)
- Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands.
| | - Debby L Gerritsen
- Department of primary and community care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ramona Backhaus
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Bram S de Boer
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Raymond T C M Koopmans
- Department of primary and community care, Radboud University Medical Center, Nijmegen, the Netherlands; Joachim and Anna, Center for specialized geriatric care, Nijmegen, the Netherlands
| | - Jan P H Hamers
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
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