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Kearsley SL, Walker L, Johnson MJ, Bravington A. Ancillary hospital workers experience during COVID-19: systematic review and narrative synthesis. BMJ Support Palliat Care 2024:spcare-2024-004855. [PMID: 39084691 DOI: 10.1136/spcare-2024-004855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND COVID-19 overwhelmed healthcare systems worldwide. Its impact on clinical staff is well documented, but little is known about the effects on ancillary staff (cleaners, porters and caterers). AIM To identify the evidence of the impact of COVID-19 on ancillary staff at National Health Service (NHS) hospitals in England. DESIGN Systematic review and narrative synthesis. DATA SOURCES Databases (MEDLINE, CINAHL Ultimate, APA PsycINFO, APA PsycArticles and Academic Search Ultimate). Reference lists were searched. Four independent reviewers screened titles and abstracts against inclusion criteria. Data were extracted from included papers and studies were critically assessed using relevant critical appraisal tools. RESULTS 8/178 studies were included, of which 5 quantitative, 2 qualitative and 1 mixed methods. Ancillary staff had higher rates of past and present COVID-19 infection. Participants felt that the work of ancillary staff had been insufficiently recognised by managers and that they had little voice within the NHS. They also experienced inequity regarding available support and safe working practices due to largely digital modes of communication which they rarely, if ever, used. In an evaluation of a personal protective equipment support 'helper' programme, ancillary workers were more positive about it than nurses, allied health practitioners, and doctors. CONCLUSION Few studies included ancillary staff. As reported, ancillary staff at NHS hospitals had a higher prevalence of COVID-19 infection but felt marginalised and poorly supported. They valued training when offered. Additional research is needed to understand better the impact of COVID-19 on ancillary key workers, and how best to support them in future similar circumstances.
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Affiliation(s)
| | - Liz Walker
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
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Gadbois EA, Brazier JF, Turner J, Hawes C, Florence LC, Belazis L. "It Made Me Feel Like a Person Again": Benefits of Meals on Wheels-Based Social Connection Programs. J Appl Gerontol 2024:7334648241257798. [PMID: 39023859 DOI: 10.1177/07334648241257798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Social isolation and loneliness are associated with negative health outcomes, and these outcomes are exacerbated among older adults who are homebound. To address this issue, Meals on Wheels programs increasingly provide social connection services to clients in addition to home-delivered meals. This descriptive qualitative study examines the impact of three types of social connection programs on the well-being of homebound older adult clients, as well as on the volunteers and staff members who deliver the programs. Thematic analysis of semi-structured interviews conducted with 117 clients, volunteers, and staff in six Meals on Wheels social connection programs across the United States indicated that program participation was associated with substantial benefits. Benefits included the development of supportive friendships, reduced feelings of loneliness, and an improved overall sense of well-being. Insights from this study may inform the development, expansion, and sustainability of social connection programs provided by community-based organizations.
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Affiliation(s)
- Emily A Gadbois
- Health Services, Policy, & Practice, Brown University School of Public Health, Providence, RI, USA
| | - Joan F Brazier
- Health Services, Policy, & Practice, Brown University School of Public Health, Providence, RI, USA
| | - Jeffrey Turner
- Health Services, Policy, & Practice, Brown University School of Public Health, Providence, RI, USA
| | - Courtney Hawes
- Health Services, Policy, & Practice, Brown University School of Public Health, Providence, RI, USA
| | | | - Laura Belazis
- Strategy & Impact, Meals on Wheels America, Arlington, VA, USA
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Nilsen A, Eriksen S, Lichtwarck B, Hillestad AH, Julnes SG, Tretteteig S, Rokstad AMM. Treatment and Care for Nursing Home Residents with COVID-19: A Qualitative Study. J Multidiscip Healthc 2024; 17:2935-2946. [PMID: 38933696 PMCID: PMC11199164 DOI: 10.2147/jmdh.s467459] [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: 03/06/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Purpose Coronavirus disease 2019 (COVID-19) placed a significant strain on nursing homes, leading to numerous outbreaks and high mortality rates. This situation created considerable stress and challenges for residents, their physicians and nurses, as well as family caregivers. By understanding these challenges, we can gain new insights and learn valuable lessons. Thus, the purpose of this study is to examine the treatment and care provided to nursing home residents with COVID-19, as experienced by physicians, nurses, and family caregivers. Participants and Methods This study is a secondary analysis of 35 interviews with physicians, nurses, and family caregivers, each with personal experience caring for nursing home residents diagnosed with COVID-19. The interviews took place from December 2020 to April 2021. We analyzed the transcriptions based on Braun and Clarke's reflexive thematic analysis model and followed a qualitative descriptive design as outlined by Sandelowski. Findings The analysis produced three themes: 1) Balancing medical treatment, 2) The need for increased systematic monitoring of vital functions, and 3) Determining the treatment level for nursing home residents. These themes were explored through the unique perspectives of the three participant groups: physicians, nurses, and family caregivers. The findings revealed several challenges related to treatment and care for nursing home residents diagnosed with COVID-19. This applied both to relief of symptoms, monitoring of vital functions, assessment of treatment level and use of advance care planning. Conclusion Drawing from the experiences of physicians, nurses, and family caregivers, there should be a unified plan at the municipal or national level for competency development in nursing homes to prepare for future crises like pandemics or epidemics. Additionally, the safe engagement of family caregivers and relatives should be given priority.
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Affiliation(s)
- Anita Nilsen
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Siren Eriksen
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Bjørn Lichtwarck
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | | | - Signe Gunn Julnes
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Signe Tretteteig
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne Marie Mork Rokstad
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Bergman BP, Mackay DF, Pell JP. Impact of COVID-19 on the veteran population: evidence from the Trends in Scottish Veterans Health study. BMJ Mil Health 2024:e002677. [PMID: 38697753 DOI: 10.1136/military-2024-002677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/30/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION There have been few epidemiological studies on the impact of the SARS-CoV-2 (COVID-19) pandemic on the veteran population, other than on specific aspects such as mental health, and none in the UK. We used data from the Trends in Scottish Veterans Health cohort to explore the risk of hospitalisation and death associated with COVID-19 in veterans resident in Scotland in comparison with matched non-veterans. METHODS Retrospective cohort study of 71 000 veterans and a comparison group of 230 000 non-veterans matched for age, sex and geography, using Cox proportional hazard analysis to explore the risk of hospitalisation with COVID-19 and COVID-19-associated death overall and by birth cohort, sex and length of military service. RESULTS Between 1 January 2020 and 31 December 2021, 564 (0.79%) veterans had been hospitalised with COVID-19 compared with 1728 (0.75%) non-veterans. The Cox model showed no significant difference overall, HR 0.99, 95% CIs 0.90 to 1.11, p=0.800. Subgroup analysis showed increased risk in older, short-serving (<20 weeks) Early Service Leavers (ESL). There was no overall difference in COVID-19-associated deaths, HR 0.99, 95% CI 0.79 to 1.23, p=0.993, but subgroup analysis showed a non-significant reduced risk of death in veterans aged 61-70 years, and a 38% higher risk in veterans aged over 70 years which almost reached statistical significance, p=0.054. This was only partially explained by socioeconomic factors and common comorbidities, although we had no data on domestic circumstances or care home residence. CONCLUSIONS Overall, military service was not a risk factor for either hospitalisation or death associated with COVID-19. Older ESLs were at increased risk compared with non-veterans, but military service is unlikely to have been causal. The risk of death was increased in the oldest veterans and further studies are needed to explain this once census data become available for linkage.
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Affiliation(s)
| | - D F Mackay
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - J P Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Kunkle R, Xu H, Thomas LE, Webb LE, O'Brien EC, Geary CR. Nursing Home Workers' Experience During the COVID-19 Pandemic. Res Gerontol Nurs 2024; 17:131-140. [PMID: 38815218 DOI: 10.3928/19404921-20240423-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
PURPOSE To understand nursing home workers' experience during the coronavirus disease 2019 (COVID-19) pandemic and investigate the prevalence of health-related quality of life, emotional distress, job satisfaction, and the impact of the pandemic. METHOD The Healthcare Worker Exposure Response and Outcomes (HERO) Registry served as the data source for this descriptive cross-sectional analysis. Recruitment was conducted nationally. Eligible nursing home workers (N = 1,409) enrolled in the study online, self-reported demographic and employment characteristics, and completed electronic surveys. RESULTS Nursing home workers reported overall good physical health, frequent depressive symptoms, burnout, and a high prevalence of feeling tired, stressed, having trouble sleeping, and feeling worried. Age and race were found to be positively associated with the impact of the pandemic. CONCLUSION Findings demonstrate the difficulties and challenges nursing home workers faced during the COVID-19 pandemic. Future research needs to evaluate the relationships among nursing home workers' roles, mental health, depressive symptoms, and prevalence of burnout with a larger, more diverse sample. [Research in Gerontological Nursing, 17(3), 131-140.].
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Allsopp K, Varese F, French P, Young E, White H, Chung P, Davey J, Hassan AA, Wright SA, Barrett A, Bhutani G, McGuirk K, Shields G, Huntley F, Jordan J, Rowlandson A, Sarsam M, Ten Cate H, Walker H, Watson R, Willbourn J, Hind D. A service mapping exercise of four health and social care staff mental health and wellbeing services, Resilience Hubs, to describe health service provision and interventions. BMC Health Serv Res 2024; 24:430. [PMID: 38575960 PMCID: PMC10996192 DOI: 10.1186/s12913-024-10835-1] [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: 09/15/2023] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND NHS England funded 40 Mental Health and Wellbeing Hubs to support health and social care staff affected by the COVID-19 pandemic. We aimed to document variations in how national guidance was adapted to the local contexts of four Hubs in the North of England. METHODS We used a modified version of Price's (2019) service mapping methodology. Service level data were used to inform the analysis. A mapping template was adapted from a range of tools, including the European Service Mapping Schedule, and reviewed by Hub leads. Key data included service model; staffing; and interventions. Data were collected between March 2021 - March 2022 by site research assistants. Findings were accuracy-checked by Hub leads, and a logic model developed to theorise how the Hubs may effect change. RESULTS Hub goals and service models closely reflected guidance; offering: proactive outreach; team-based support; clinical assessment; onward referral, and rapid access to mental health support (in-house and external). Implementation reflected a service context of a client group with high mental health need, and high waiting times at external mental health services. Hubs were predominantly staffed by experienced clinicians, to manage these mental health presentations and organisational working. Formulation-based psychological assessment and the provision of direct therapy were not core functions of the NHS England model, however all Hubs incorporated these adaptations into their service models in response to local contexts, such as extensive waiting lists within external services, and/or client presentations falling between gaps in existing service provision. Finally, a standalone clinical records system was seen as important to reassure Hub users of confidentiality. Other more nuanced variation depended on localised contexts. CONCLUSION This study provides a map for setting up services, emphasising early understandings of how new services will integrate within existing systems. Local and regional contexts led to variation in service configuration. Whilst additional Hub functions are supported by available literature, further research is needed to determine whether these functions should comprise essential components of staff wellbeing services moving forward. Future research should also determine the comparative effectiveness of service components, and the limits of permissible variation. STUDY REGISTRATION researchregistry6303.
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Affiliation(s)
- Kate Allsopp
- Complex Trauma & Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Research and Innovation, 3rd Floor Rawnsley Building, Hathersage Road, Manchester, UK.
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK.
| | - Filippo Varese
- Complex Trauma & Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Research and Innovation, 3rd Floor Rawnsley Building, Hathersage Road, Manchester, UK
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
| | - Paul French
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Brooks Building, Bonsall Street, Manchester, UK
- Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
| | - Ellie Young
- Greater Manchester Resilience Hub, Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
| | - Hannah White
- Complex Trauma & Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Research and Innovation, 3rd Floor Rawnsley Building, Hathersage Road, Manchester, UK
| | - Priscilla Chung
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Jessica Davey
- Humber and North Yorkshire Resilience Hub, Tees Esk and Wear Valleys NHS Foundation Trust, West Park Hospital, Edward Pease Way, Darlington, UK
| | - Alysha A Hassan
- Cheshire and Merseyside Resilience Hub, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, UK
| | - Sally-Anne Wright
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Alan Barrett
- Greater Manchester Resilience Hub, Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
- School of Health Science, University of Salford, Mary Seacole Building, Frederick Road Campus, Broad St, Salford, UK
| | - Gita Bhutani
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Katherine McGuirk
- Greater Manchester Health and Social Care Partnership, 4th Floor, 3 Piccadilly Place, Manchester, UK
| | - Gemma Shields
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
| | - Fay Huntley
- Cheshire and Merseyside Resilience Hub, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, UK
- Doctorate of Clinical Psychology, School of Health in Social Science, Old Medical School, University of Edinburgh, Teviot Place, Room 2.2, Doorway 6, Edinburgh, UK
| | - Joanne Jordan
- Humber and North Yorkshire Resilience Hub, Tees Esk and Wear Valleys NHS Foundation Trust, West Park Hospital, Edward Pease Way, Darlington, UK
| | - Aleix Rowlandson
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, UK
| | - May Sarsam
- Cheshire and Merseyside Resilience Hub, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, UK
| | - Hein Ten Cate
- Lancashire and South Cumbria Resilience Hub, Lancashire and South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, UK
| | - Holly Walker
- Humber and North Yorkshire Resilience Hub, Tees Esk and Wear Valleys NHS Foundation Trust, West Park Hospital, Edward Pease Way, Darlington, UK
| | - Ruth Watson
- Greater Manchester Mental Health NHS Foundation Trust, Trust Headquarters, Bury New Road, Prestwich, Manchester, M25 3BL, UK
| | - Jenni Willbourn
- Greater Manchester Resilience Hub, Pennine Care NHS Foundation Trust, Trust Headquarters, 225 Old Street, Ashton-Under-Lyne, Greater Manchester, UK
| | - Daniel Hind
- School of Health and Related Research, The Innovation Centre, University of Sheffield, 217 Portobello, Sheffield, UK
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Giebel C, Prato L, Metcalfe S, Barrow H. Barriers to accessing and receiving mental health care for paid and unpaid carers of older adults. Health Expect 2024; 27:e14029. [PMID: 38528675 DOI: 10.1111/hex.14029] [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: 10/23/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024] Open
Abstract
AIM The aim of this qualitative study was to explore the barriers and facilitators to accessing and receiving mental health care for paid and unpaid carers of older adults. METHODS Unpaid and paid carers for older adults in England were interviewed remotely between May and December 2022. Participants were asked about their experiences of mental health needs and support. Reflexive thematic analysis was used to analyse the data. RESULTS Thirty-seven carers participated (npaid = 9; nunpaid = 28), with the majority caring for a parent with dementia. Thematic analysis generated four themes: lack of healthcare support, social care system failing to enable time off, personal barriers and unsupportive work culture. Healthcare professionals failed to provide any link to mental health services, including when a dementia diagnosis was received. Structural and organisational barriers were evidenced by carers being unable to take time off from their unpaid caring duties or paid caring role, due to an absence of social care support for their relative. CONCLUSIONS This is the first study to have explored the barriers to mental health care and support for paid and unpaid carers for older adults and suggests that structural, organisational and personal barriers cause severe difficulties in accessing required support to care for older relatives, services users and residents. PUBLIC INVOLVEMENT Two unpaid carers aided with the development of topic guides, data analysis, interpretation and dissemination. Both were supported and trained to code anonymised transcripts.
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Affiliation(s)
- Clarissa Giebel
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Laura Prato
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Sue Metcalfe
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
| | - Hazel Barrow
- NIHR Applied Research Collaboration North West Coast, Liverpool, UK
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Petersen J, Müller H, Melzer M. [Perceived changes in the workload of home care nurses during the COVID-19 pandemic: Results of an online survey]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2024; 184:26-33. [PMID: 38143226 DOI: 10.1016/j.zefq.2023.10.005] [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: 03/31/2023] [Revised: 09/25/2023] [Accepted: 10/24/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND The COVID-19 pandemic posed major challenges to the health care system, particularly to nursing. Intensive care was often the focus of attention. However, home care nursing was also confronted with drastic changes, while it is largely unknown how the work situation changed for employees as a result of the pandemic - also depending on the sponsorship of home care nursing services. METHODS A nationwide online survey of home-care nurses was conducted in May and June 2022. The Intensification of Job Demands Scale (IDS) and an open question regarding changes in the work situation due to the pandemic were used among other instruments. RESULTS More than two-thirds of the 976 home-care nurses surveyed agreed with the respective statements regarding work intensification (e.g., taking fewer breaks, doing work activities at the same time, not having enough time). Additional factors for psychological workload during the pandemic primarily fell within the scope of work organization (e.g., staff absences due to illness and quarantine, vaccination related leaves and terminations, additional workload due to handling protective clothing). Employees of privately run care services experienced fewer COVID-19-related changes than home care nurses employed by non-profit providers. CONCLUSION In future crisis situations, good information management (e.g., uniform, consistent and comprehensible guidelines and recommendations for action) and ways to compensate for staff shortages should be created.
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Affiliation(s)
- Julia Petersen
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dresden, Deutschland.
| | - Helene Müller
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dresden, Deutschland
| | - Marlen Melzer
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dresden, Deutschland
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Lövenmark A, Hammar LM. Being used for the greater good while fighting on the frontline: care staff's experiences of working with older people during the COVID-19 pandemic in Sweden. BMC Geriatr 2024; 24:135. [PMID: 38321402 PMCID: PMC10848549 DOI: 10.1186/s12877-023-04644-0] [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: 05/26/2023] [Accepted: 12/27/2023] [Indexed: 02/08/2024] Open
Abstract
BAKGROUND Worldwide, older people were more severely affected during the COVID-19 pandemic than others. In Sweden, those living in residential care facilities had the highest mortality rate, followed by those receiving home care services. The Swedish and international literature on the working environment for assistant nurses and care aides during the pandemic shows an increase in stress, anxiety, depression and post-traumatic stress syndromes. Care organisations were badly prepared to prevent the virus from spreading and to protect the staff from stress. In order to be better prepared for possible future pandemics, the health and well-being of the staff, the care of older people and the experiences of the staff both during and after a pandemic are important aspects to take into account. Therefore, this study aims to describe the experiences of assistant nurses and care aides working in the care of older people during the COVID-19 pandemic in Sweden, their working conditions and the impact all this had on their lives. METHODOLOGY The study has a qualitative, descriptive design. The data was collected in four focus group interviews with 21 participants and analysed using qualitative content analysis. RESULTS The results revealed the theme, Being used for the greater good while fighting on the frontline, which was then divided into three categories: portrayed as a risk for older people, not being valued and being burnt out. The worsening working conditions that the pandemic contributed to resulted in a high degree of stress and risk of burnout, with staff members both wanting to and actually leaving their employment. After the pandemic they felt forgotten again and left to cope in an even worse situation than before. CONCLUSIONS The pandemic had a major effect on assistant nurses and care aides in terms of their working environment and their private lives. To be better prepared for future pandemics or disasters, organisations with responsibility for the care of older people will need to ensure that their staff have the necessary competencies and that there is adequate staffing in place. This also means that adequate government funding and multiple interventions will be needed.
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Affiliation(s)
- Annica Lövenmark
- The School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
| | - Lena Marmstål Hammar
- The School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- The School of Health and Welfare, Dalarna University, Falun, Sweden
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Swall A, Hammar LM, Boström AM. Listen to the voices of nurses: the role of community chief nurses and registered nurses in the provision of care for older people in Sweden during the COVID-19 pandemic - a cross-sectional study. BMC Geriatr 2024; 24:127. [PMID: 38308241 PMCID: PMC10835959 DOI: 10.1186/s12877-023-04652-0] [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: 06/21/2023] [Accepted: 12/31/2023] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND During the pandemic in Sweden, the aim was to protect older people, especially those among them who were sick, frail and vulnerable in residential care facilities. A ban was put on visits at all residential care facilities in March 2020 to prevent the spread of infection among the older people. This study aims to describe the experiences of Community Chief Nurses and Registered Nurses who provided medical and nursing care for older people in residential care facilities and home care during the first wave of the COVID-19 pandemic, and to examine factors associated with the quality of care. METHODS The study has a mixed method cross-sectional design (STROBE). Data were collected using a web-based survey that comprised two questionnaires, for Community Chief Nurses and Registered Nurses developed for the study. Data were analysed using descriptive statistics and logistic regression models, as well as qualitative content analyses. RESULTS The majority of Community Chief Nurses reported adequate opportunities to work with management to handle the COVID-19 pandemic. The Registered Nurses reported that the quality of care, as well as the person's safety, was negatively affected during the pandemic. Factors associated with good care were as follows: information-sharing; ability to comply with hygiene practices; competence in how to care for older persons with COVID-19; a physician at bedside assessing their health; and support from frontline managers. CONCLUSION The study highlights crucial facets that care organizations must address to enhance their readiness for future pandemics or disasters, ensuring the security and well-being of the older people.
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Affiliation(s)
- Anna Swall
- School of Health and Welfare, Dalarna University, Högskolan Dalarna, 791 88, Falun, Sweden.
| | - Lena Marmstål Hammar
- School of Health and Welfare, Dalarna University, Högskolan Dalarna, 791 88, Falun, Sweden
- School of Health, Care and Social Welfare, Mälardalen University, Box 833, 721 23, Eskilstuna/Västerås, Sweden
| | - Anne-Marie Boström
- Division of Nursing, Department of Neurobiology, Care Science and Society Karolinska Institute, Alfred Nobels Allé 23, 141 83, Stockholm, Huddinge, Sweden
- Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- R&D Unit, Stockholms Sjukhem, Stockholm, Sweden
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Navarro-Prados AB, Rodríguez-Ramírez Y, Satorres E, Meléndez JC. Stress and burnout in nursing home and égida workers during COVID-19. J Adv Nurs 2024; 80:733-744. [PMID: 37675948 DOI: 10.1111/jan.15849] [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: 04/07/2023] [Revised: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
AIMS Finding out whether there are differences in the levels of stress and burnout between workers providing care to dependent adults and those caring for independent older adults would provide comparative information about two different models of care. During the COVID-19 pandemic, workers caring for older adults were subjected to maladaptive situations that produced stress and burnout. DESIGN A cross-sectional survey design using the STROBE checklist. METHODS A total of 900 nursing home and égidas workers were assessed for stress and burnout. Data were collected online from October 2020 to February 2021, when Puerto Rico was experiencing the peak of the third wave of COVID-19. MANOVAs were performed to study the interactions between the workplace and having had COVID, the workplace and the size of institution and the workplace and position held. DATA SOURCES October 2020 to February 2021. RESULTS All interactions were significant. Nursing homes showed higher levels of stress and burnout when workers had undergone COVID, when the size of the institution was larger and for technical staff other services; in égidas, having undergone COVID did not influence stress or burnout, which increased when the institution was smaller and for executive staff. CONCLUSIONS This study showed that the effects of the COVID-19 pandemic affected nursing home workers more significantly than those working in other types of residential models with independent older adults. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Applying preventive interventions aimed at reducing stress and burnout would facilitate the adaptation of workers caring for older adults and help to improve the quality of care. IMPACT This study analysed the impact of COVID-19 on the stress and burnout of workers providing services to older adults. Nursing home workers who have had COVID-19 have higher stress and burnout. The size of the institution has a different effect depending on whether older adults are dependent or independent. Workers in institutions dedicated to the care of the older adults. REPORTING METHOD This study has adhered to the relevant EQUATOR guidelines: STROBE. PATIENT OR PUBLIC CONTRIBUTION During the different waves of the COVID-19 pandemic, it was difficult to establish direct contact with workers providing care to older adults; this reason made it necessary to apply online systems to obtain information. The workers appreciated the fact that the implications for stress and burnout of the situation experienced during this difficult process were investigated.
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Affiliation(s)
- Ana-Belén Navarro-Prados
- Department of Developmental Psychology, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | | | - Encarnacion Satorres
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Juan C Meléndez
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
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PRICE D, DI GESSA G. Mental health and self-rated health of older carers during the COVID-19 pandemic: evidence from England. Aging Ment Health 2024; 28:103-111. [PMID: 37482075 PMCID: PMC10803633 DOI: 10.1080/13607863.2023.2236569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/11/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES Older carers play a vital role supporting population health and protecting health and social care systems, yet there has been little research on understanding the effect of the pandemic on this group. In this paper, we investigate caring as a factor contributing to mental and self-rated health. METHODS We investigate cross-sectional and longitudinal associations between provision of family care and mental health and wellbeing using longitudinal data from 5,149 members of the English Longitudinal Study of Ageing who responded to Wave 9 (2018/2019) and two COVID-19 sub-studies (June/July 2020; November/December 2020). We use logistic or linear regression models depending on outcome measures, controlling for pre-pandemic socioeconomic, demographic, and health-related variables. RESULTS Before the pandemic, 21% of respondents cared for family or friends. Older people caring for someone inside the household mostly continued to provide care during the pandemic, with more than a quarter reporting an increase in the amount of care provided. Co-resident carers were disproportionately female, older, in the lowest wealth quintile, and more likely to report disability and chronic conditions. Both cross-sectional and longitudinal analyses suggest that, compared to those caring for people living outside the household, co-resident carers were significantly more likely to report poorer mental health and self-rated health. CONCLUSION The health of older carers worsened disproportionately in the first year of the pandemic, a period also characterised by disruptions to support and closure of respite services. Support for carers' mental and physical health requires greater policy attention, especially in pandemic conditions.
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Affiliation(s)
- Debora PRICE
- Department of Sociology, School of Social Sciences, University of Manchester, Manchester, UK
| | - Giorgio DI GESSA
- Institute of Epidemiology & Health Care, Department of Epidemiology & Public Health, University College London, London, UK
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Hammar LM, Alam M, Eklund C, Boström AM, Lövenmark A. Clarity and adaptability of instructions preventing the spread of the COVID-19 virus and its association with individual and organisational factors regarding the psychosocial work environment: a cross-sectional study. BMC Health Serv Res 2023; 23:1312. [PMID: 38017458 PMCID: PMC10683104 DOI: 10.1186/s12913-023-10320-1] [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: 05/25/2023] [Accepted: 11/14/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND In Sweden, older people in residential care had the highest mortality rates, followed by those who received home care, during the coronavirus disease 2019 (COVID-19) pandemic. Staff working in the care of older people assumed responsibility for preventing the spread of the virus despite lacking the prerequisites and training. This study aimed to investigate the psychosocial work environment during the COVID-19 pandemic among staff in the care of older people and examine the factors associated with staff's perceptions of the clarity of instructions and the ability to follow them. METHODS A cross-sectional study design was employed using a web survey. The staff's perceptions of their psychosocial environment were analysed using descriptive statistics. The association between organisational and individual factors, as well as the degree of clarity of the instructions and the staff's ability to follow them, were assessed using multivariate (ordinal) regression analysis. RESULTS The main findings show that perceptions of the clarity and adaptability of the instructions were primarily correlated with organisational factors, as higher responses (positive) for the subscales focusing on role clarity, support and encouragement in leadership at work were associated with the belief that the instructions were clear. Similarly, those indicating high job demands and high individual learning demands were less likely to report that the instructions were clear. Regarding adaptability, high scores for demands on learning and psychological demands were correlated with lower adaptability, while high scores for role clarity, encouraging leadership and social support, were associated with higher adaptability. CONCLUSIONS High job demands and individual learning demands were demonstrated to decrease the staff's understanding and adoption of instructions. These findings are significant on an organisational level since the work environment must be prepared for potential future pandemics to promote quality improvement and generally increase patient safety and staff health.
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Affiliation(s)
- Lena Marmstål Hammar
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
- Division of Nursing, Department of Neurobiology, Care Science and Society Karolinska Institute, Stockholm, Sweden.
- School of Health and Welfare, Dalarna University, Falun, Sweden.
| | - Moudud Alam
- School of Information and Engineering/Statistics, Dalarna University, Falun, Sweden
| | - Caroline Eklund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Anne-Marie Boström
- Division of Nursing, Department of Neurobiology, Care Science and Society Karolinska Institute, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden
- R&D unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Annica Lövenmark
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Leung CLK, Wei WI, Li KK, McNeil EB, Tang A, Wong SYS, Kwok KO. Revisiting Vaccine Hesitancy in Residential Care Homes for the Elderly for Pandemic Preparedness: A Lesson from COVID-19. Vaccines (Basel) 2023; 11:1700. [PMID: 38006032 PMCID: PMC10675220 DOI: 10.3390/vaccines11111700] [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: 09/29/2023] [Revised: 10/28/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
Residents in residential care homes for the elderly (RCHEs) are at high risk of severe illnesses and mortality, while staff have high exposure to intimate care activities. Addressing vaccine hesitancy is crucial to safeguard vaccine uptake in this vulnerable setting, especially amid a pandemic. In response to this, we conducted a cross-sectional survey to measure the level of vaccine hesitancy and to examine its associated factors among residents and staff in RCHEs in Hong Kong. We recruited residents and staff from 31 RCHEs in July-November 2022. Of 204 residents, 9.8% had a higher level of vaccine hesitancy (scored ≥ 4 out of 7, mean = 2.44). Around 7% of the staff (n = 168) showed higher vaccine hesitancy (mean = 2.45). From multi-level regression analyses, higher social loneliness, higher anxiety, poorer cognitive ability, being vaccinated with fewer doses, and lower institutional vaccination rates predicted residents' vaccine hesitancy. Similarly, higher emotional loneliness, higher anxiety, being vaccinated with fewer doses, and working in larger RCHEs predicted staff's vaccine hesitancy. Although the reliance on self-report data and convenience sampling may hamper the generalizability of the results, this study highlighted the importance of addressing the loneliness of residents and staff in RCHEs to combat vaccine hesitancy. Innovative and technology-aided interventions are needed to build social support and ensure social interactions among the residents and staff, especially amid outbreaks.
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Affiliation(s)
- Cyrus Lap Kwan Leung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Wan In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Kin-Kit Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China;
| | - Edward B. McNeil
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Arthur Tang
- School of Science, Engineering and Technology, RMIT University, Ho Chi Minh City 700000, Vietnam;
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
| | - Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; (C.L.K.L.); (W.I.W.); (E.B.M.); (S.Y.S.W.)
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong, Hong Kong, China
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15
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Henriques HR, Sousa D, Faria J, Pinto J, Costa A, Henriques MA, Durão MC. Learning from the covid-19 outbreaks in long-term care facilities: a systematic review. BMC Geriatr 2023; 23:618. [PMID: 37784017 PMCID: PMC10546730 DOI: 10.1186/s12877-023-04319-w] [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: 01/10/2023] [Accepted: 09/14/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has devastatingly affected Long-Term Care Facilities (LTCF), exposing aging people, staff members, and visitors. The world has learned through the pandemic and lessons can be taken to adopt effective measures to deal with COVID-19 outbreaks in LTCF. We aimed to systematically review the available evidence on the effect of measures to minimize the risk of transmission of COVID-19 in LTCs during outbreaks since 2021. METHODS The search method was guided by the preferred reporting items for systematic reviews (PRISMA) and the reporting guideline synthesis without meta-analysis (SWiM) in systematic reviews. The search was performed in April 2023. Observational and interventional studies from the databases of PubMed, Web of Science, Scopus, Cochrane Systematic Reviews, CINAHL, and Academic Search were systematically reviewed. We included studies conducted in the LTCF with outbreaks that quantitatively assess the effect of non-pharmacological measures on cases of COVID-19. Two review authors independently reviewed titles for inclusion, extracted data, and undertook the risk of bias according to pre-specified criteria. The quality of studies was analyzed using the Joanna Briggs Institute Critical Appraisal. RESULTS Thirteen studies were included, with 8442 LTCF experiencing COVID-19 outbreaks and 598 thousand participants (residents and staff members). Prevention and control of COVID-19 infection interventions were grouped into three themes: strategic, tactical, and operational measures. The strategic measures reveal the importance of COVID-19 prevention and control as LTCF structural characteristics, namely the LTCF size, new admissions, infection control surveillance, and architectural structure. At the tactical level, the lack of personal and long staff shifts is related to COVID-19's spread. Operational measures with a favorable effect on preventing COVID-19 transmission are sufficient. Personal protective equipment stock, correct mask use, signaling, social distancing, and resident cohorting. CONCLUSIONS Operational, tactical, and strategic approaches may have a favorable effect on preventing the spread of COVID-19 in LTCFs experiencing outbreaks. Given the heterogeneous nature of the measures, performing a meta-analysis was not possible. Future research should use more robust study designs to explore similar infection control measures in LTCFs during endemic situations with comparable outbreaks. TRIAL REGISTRATION The protocol of this systematic review was registered in PROSPERO (CRD42020214566).
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Affiliation(s)
- Helga Rafael Henriques
- Escola Superior de Enfermagem de Lisboa, CIDNUR - Nursing Research, Innovation and Development Centre of Lisbon, Avenida Prof Egas Moniz, 1600-190, Lisbon, Portugal.
| | - Diana Sousa
- Escola Superior de Enfermagem de Lisboa, CIDNUR - Nursing Research, Innovation and Development Centre of Lisbon, Avenida Prof Egas Moniz, 1600-190, Lisbon, Portugal
| | - José Faria
- Escola Superior de Enfermagem de Lisboa, CIDNUR - Nursing Research, Innovation and Development Centre of Lisbon, Avenida Prof Egas Moniz, 1600-190, Lisbon, Portugal
| | - Joana Pinto
- Escola Superior de Enfermagem de Lisboa, CIDNUR - Nursing Research, Innovation and Development Centre of Lisbon, Avenida Prof Egas Moniz, 1600-190, Lisbon, Portugal
| | - Andreia Costa
- Escola Superior de Enfermagem de Lisboa, CIDNUR - Nursing Research, Innovation and Development Centre of Lisbon, Avenida Prof Egas Moniz, 1600-190, Lisbon, Portugal
- Instituto de Saúde Ambiental - ISAMB, Lisbon Medical School - Avenida Professor Egas Moniz MB, 1649-028, Lisbon, Portugal
| | - Maria Adriana Henriques
- Escola Superior de Enfermagem de Lisboa, CIDNUR - Nursing Research, Innovation and Development Centre of Lisbon, Avenida Prof Egas Moniz, 1600-190, Lisbon, Portugal
- Instituto de Saúde Ambiental - ISAMB, Lisbon Medical School - Avenida Professor Egas Moniz MB, 1649-028, Lisbon, Portugal
| | - Maria Cândida Durão
- Escola Superior de Enfermagem de Lisboa, CIDNUR - Nursing Research, Innovation and Development Centre of Lisbon, Avenida Prof Egas Moniz, 1600-190, Lisbon, Portugal
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16
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van Diepen C, Vestjens L, Nieboer AP, Scheepers R. Nursing home staff perceptions of well-being during the COVID-19 pandemic: A qualitative study. J Adv Nurs 2023; 79:3866-3875. [PMID: 37309050 DOI: 10.1111/jan.15730] [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: 01/13/2023] [Revised: 04/25/2023] [Accepted: 05/30/2023] [Indexed: 06/14/2023]
Abstract
AIMS To explore how nursing home staff perceived their work environment during the COVID-19 pandemic and how this impacted their well-being. DESIGN A qualitative interview study. METHODS Interviews were held with twenty-two registered nurses and assistant nurses from five nursing homes in the Netherlands between April 2021 and July 2021. The interviews were analysed using qualitative content analysis. The Standards for Reporting Qualitative Research (SRQR) were followed. RESULTS Five themes emerged from the interviews and indicated that working during the COVID-19 pandemic impacted perceived well-being of nursing home staff. Three themes concerned experiences at work: eroding care, additional roles and workplace support. Specifically, the increased workload with additional tasks, the constant stream of new guidelines and constrictive personal protective equipment caused discomfort and anxiety. Two other themes concerned experiences outside of work: work-life interference and social interactions and status. The nurses reported that when they returned home after work, they were tired and worried about spreading the virus while facing limited social interactions and support. CONCLUSION The social distancing measures due to the COVID-19 pandemic negatively impacted nursing home staff well-being by increasing demands in the absence of adequate resources. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The well-being needs of nurses should receive continued attention to ensure the sustainability of healthcare during future crises. PATIENT OR PUBLIC CONTRIBUTION The nursing home managers participated in recommending the topics to be covered during interviews. IMPACT What problem did the study address? The pressure of stressful working conditions on the well-being of nurses during the pandemic. What were the main findings? Nurses created strategies to cope with declining well-being. However, the available resources did not alleviate the increased demands caused by the pandemic. Where and on whom will the research have an impact? This study is important for healthcare organizations to understand how the COVID-19 pandemic affected nurses so that they may better prepare for future crises.
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Affiliation(s)
- Cornelia van Diepen
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Lotte Vestjens
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
- De Zorggroep Noord- en Midden-Limburg, Venlo-Blerick, the Netherlands
| | - Anna P Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Renée Scheepers
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
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17
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Berning MJ, Zhong Z, White EM, Niznik JD, Berry SD. Retention and Resilience of Nursing Home Staff During the COVID-19 Pandemic: Voices from the Frontline. J Am Med Dir Assoc 2023; 24:1606-1608. [PMID: 37582480 PMCID: PMC10543619 DOI: 10.1016/j.jamda.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 08/17/2023]
Affiliation(s)
- Michelle J Berning
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; University of Minnesota Medical School, Minneapolis, MN, USA
| | - Zada Zhong
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA; Center for Aging and Health, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA
| | - Elizabeth M White
- Brown University School of Public Health, Department of Health Services, Policy, & Practice, Providence, RI, USA
| | - Joshua D Niznik
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA; Center for Aging and Health, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA; Division of Pharmaceutical Outcomes and Policy, University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Sarah D Berry
- Hinda and Arthur Marcus Institute for Aging Research and Department of Medicine, Hebrew SeniorLife, Boston, MA, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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Arellano-Alvarez P, Muñoz-Guerrero B, Ruiz-Barranco A, Garibay-Nieto N, Hernandez-Lopez AM, Aguilar-Cuarto K, Pedraza-Escudero K, Fuentes-Corona Z, Villanueva-Ortega E. Barriers in the Management of Obesity in Mexican Children and Adolescents through the COVID-19 Lockdown-Lessons Learned and Perspectives for the Future. Nutrients 2023; 15:4238. [PMID: 37836521 PMCID: PMC10574799 DOI: 10.3390/nu15194238] [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: 09/04/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023] Open
Abstract
The COVID-19 lockdown caused health system issues, including the need for long-term care for patients with conditions like childhood obesity. We wanted to know how the lockdown had changed our patients' health and which variables had greater influence in preventing and managing overweight and obesity in kids and teens during and after the lockdown. METHODS Our study comprised two phases. The initial descriptive cross-sectional phase included surveys of children who are overweight or obese and their parents/guardians from the Pediatric Obesity Clinic at the Child Welfare Unit (UBI, acronym in Spanish) in the Hospital General de México "Dr. Eduardo Liceaga" (n = 129). The participants were studied to explore changes in lifestyle, physical activity, sleep patterns, eating behaviors, food consumption, anxiety, and depression. In the second phase, the biochemical, body composition, and anthropometric parameters of 29 pre-COVID-19 patients were compared before and after the lockdown. RESULTS The survey showed more moderate anxiety and depression, alterations in sleep, physical inactivity, and an increase in the consumption of animal products, fruits, cereals, tubers, sugary drinks, and ultra-processed food. In the study's comparative phase, we observed a substantial increase in BMI z-score (p = 0.01), waist circumference (p < 0.001), fat mass (p < 0.001), percentage of adiposity (p = 0.002), and basal glucose (p = 0.047) and a drop in lean mass (p = 0.008). CONCLUSIONS The pandemic led to a loss of routines and socioeconomic changes that made it difficult to address weight and obesity in young people. The results show that managing obesity in our patients involves considering both lifestyle and the social environment. This encourages us to consider a comprehensive and personalized approach.
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Affiliation(s)
- Paulina Arellano-Alvarez
- Pediatric Obesity Clinic at Child Welfare Unit (UBI, Acronym in Spanish) of The Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (P.A.-A.); (B.M.-G.); (A.R.-B.); (N.G.-N.); (A.M.H.-L.); (K.A.-C.); (K.P.-E.); (Z.F.-C.)
- Master’s and Doctorate Program in Medical, Dental and Health Sciences, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Brenda Muñoz-Guerrero
- Pediatric Obesity Clinic at Child Welfare Unit (UBI, Acronym in Spanish) of The Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (P.A.-A.); (B.M.-G.); (A.R.-B.); (N.G.-N.); (A.M.H.-L.); (K.A.-C.); (K.P.-E.); (Z.F.-C.)
| | - Alejandra Ruiz-Barranco
- Pediatric Obesity Clinic at Child Welfare Unit (UBI, Acronym in Spanish) of The Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (P.A.-A.); (B.M.-G.); (A.R.-B.); (N.G.-N.); (A.M.H.-L.); (K.A.-C.); (K.P.-E.); (Z.F.-C.)
| | - Nayely Garibay-Nieto
- Pediatric Obesity Clinic at Child Welfare Unit (UBI, Acronym in Spanish) of The Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (P.A.-A.); (B.M.-G.); (A.R.-B.); (N.G.-N.); (A.M.H.-L.); (K.A.-C.); (K.P.-E.); (Z.F.-C.)
| | - Ana María Hernandez-Lopez
- Pediatric Obesity Clinic at Child Welfare Unit (UBI, Acronym in Spanish) of The Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (P.A.-A.); (B.M.-G.); (A.R.-B.); (N.G.-N.); (A.M.H.-L.); (K.A.-C.); (K.P.-E.); (Z.F.-C.)
| | - Karina Aguilar-Cuarto
- Pediatric Obesity Clinic at Child Welfare Unit (UBI, Acronym in Spanish) of The Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (P.A.-A.); (B.M.-G.); (A.R.-B.); (N.G.-N.); (A.M.H.-L.); (K.A.-C.); (K.P.-E.); (Z.F.-C.)
| | - Karen Pedraza-Escudero
- Pediatric Obesity Clinic at Child Welfare Unit (UBI, Acronym in Spanish) of The Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (P.A.-A.); (B.M.-G.); (A.R.-B.); (N.G.-N.); (A.M.H.-L.); (K.A.-C.); (K.P.-E.); (Z.F.-C.)
| | - Zendy Fuentes-Corona
- Pediatric Obesity Clinic at Child Welfare Unit (UBI, Acronym in Spanish) of The Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (P.A.-A.); (B.M.-G.); (A.R.-B.); (N.G.-N.); (A.M.H.-L.); (K.A.-C.); (K.P.-E.); (Z.F.-C.)
| | - Erendira Villanueva-Ortega
- Pediatric Obesity Clinic at Child Welfare Unit (UBI, Acronym in Spanish) of The Hospital General de México “Dr. Eduardo Liceaga”, Mexico City 06720, Mexico; (P.A.-A.); (B.M.-G.); (A.R.-B.); (N.G.-N.); (A.M.H.-L.); (K.A.-C.); (K.P.-E.); (Z.F.-C.)
- Master’s and Doctorate Program in Medical, Dental and Health Sciences, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
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Scheepers RA, van den Broek T, Cramm JM, Finkenflügel H, Nieboer AP. Changes in work conditions and well-being among healthcare professionals in long-term care settings in the Netherlands during the COVID-19 pandemic: a longitudinal study. HUMAN RESOURCES FOR HEALTH 2023; 21:59. [PMID: 37507814 PMCID: PMC10385940 DOI: 10.1186/s12960-023-00847-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Healthcare professionals working in long-term care facilities reported heavy job demands and a lack of job resources during the 2019 coronavirus disease (COVID-19) pandemic. However, how job demands and resources in these facilities changed during the pandemic, and how possible changes affected professionals' work-related well-being, remains unclear. Thus, we explored changes in job demands and resources in the face of surging COVID-19 infection rates, and investigated associations of these changes with changes in burnout and work engagement, among healthcare professionals working in long-term care facilities in the Netherlands. METHODS This longitudinal study was conducted with healthcare professionals working in five long-term care facilities in the Netherlands. Data were collected in early and late 2021, when infection rates in long-term care facilities were low and high (mean, 29.1 and 275.4 infections/day), respectively. In total, 173 healthcare professionals completed the validated Job Demands and Resources Questionnaire, Copenhagen Burnout Inventory, and Utrecht Work Engagement Scale at both timepoints. We performed paired-samples t tests to examine changes in job demands and resources, and fixed-effects linear regression analyses to examine associations of within-person changes in job demands and resources with those in burnout and work engagement. RESULTS Healthcare professionals perceived increased workloads, associated with increased burnout and decreased work engagement during the study period. Within-person increases in perceived collegial support were associated positively with work engagement and negatively with burnout symptoms. CONCLUSIONS Healthcare professionals in long-term care facilities perceived increased workloads in the wake of surging infection rates during the COVID-19 pandemic, resulting in increased burnout and decreased work engagement. These changes in burnout and work engagement were also perceived in response to declining collegial support. Efforts to protect the work-related well-being of healthcare professionals working in long-term care facilities in the pandemic context that focus on workload reduction and the promotion of collegial support may be most beneficial.
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Affiliation(s)
- Renée A Scheepers
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3062 PA, Rotterdam, The Netherlands.
| | - Thijs van den Broek
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3062 PA, Rotterdam, The Netherlands
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3062 PA, Rotterdam, The Netherlands
| | - Harry Finkenflügel
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3062 PA, Rotterdam, The Netherlands
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, PO Box 1738, 3062 PA, Rotterdam, The Netherlands
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Affiliation(s)
| | - Vivian Ewa
- Department of Family Medicine, University of Calgary, Alberta, Canada
| | - Janice Keefe
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Nova Scotia, Canada
| | - Sharon E Straus
- KT Program, Li Ka Shing Knowledge Institute, St Michael's Hospital-Unity Health Toronto, Toronto, Ontario Canada
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21
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Conejero I, Petrier M, Fabbro Peray P, Voisin C, Courtet P, Potier H, Elotmani L, Lafont B, Lefrant JY, Lopez Castroman J, Arbus C, Blain H. Post-traumatic stress disorder, anxiety, depression and burnout in nursing home staff in South France during the COVID-19 pandemic. Transl Psychiatry 2023; 13:205. [PMID: 37322006 DOI: 10.1038/s41398-023-02488-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/15/2023] [Accepted: 05/26/2023] [Indexed: 06/17/2023] Open
Abstract
The high mortality rate in nursing homes during the COVID-19 pandemic may be linked to psychological disorders in staff. Hence, we assessed the prevalence and associated factors of probable post-traumatic stress disorder (PTSD), anxiety, depression, and burnout of nursing home staff during the COVID-19 pandemic in a cross-sectional study including 66 randomly selected nursing homes in southern France. 537 of the contacted 3 821 nursing home workers (14.0%) responded between April and October 2021. We collected information on center organization, severity of COVID-19 exposure, and socio-demographic information in an online survey. The prevalence of probable PTSD (PCL-5), anxiety and depressive disorders (Hospital Anxiety Depression Scale) and the sub-scores of burnout syndrome (Maslach Burnout Inventory Human Services Survey for Medical Personnel) were assessed. Probable PTSD was reported in 115/537 responders (21.4% (95% CI [18.0%-24.9%])). After adjustment, low-level exposure to COVID-19 in nursing home residents (AOR, 0.5; 95% CI [0.3-0.9]), fear of managing COVID-19 residents (AOR, 3.5; 95% CI [1.9-6.4]), conflicts with residents (AOR, 2.3; 95% CI, [1.2-4.4]), conflicts with colleagues (AOR, 3.6; 95% CI [1.7-8.6]), cancellation of leave (AOR, 4.8; 95% CI [2.0-11.7]) and temporary worker employment (AOR, 3.4; 95% CI [1.7-6.9]) were associated with higher prevalence of probable PTSD. The prevalence of probable anxiety and depression were 28.8% (95% CI [24.9%-32.7%]) and 10.4% (95% CI [7.8%-13.1%]), respectively. Psychological disorders were observed in nearly one third of nursing home workers during the COVID-19 pandemic. Hence, continuous surveys and preventive measures are needed in this particularly at-risk population.
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Affiliation(s)
- Ismael Conejero
- Department of Psychiatry, CHU Nîmes, PSNREC, INSERM, University of Montpellier, Nîmes, France.
| | - Melissa Petrier
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU Nimes, IDESP, INSERM, University of Montpellier, Nîmes, France
| | - Pascale Fabbro Peray
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU Nimes, IDESP, INSERM, University of Montpellier, Nîmes, France
| | - Christelle Voisin
- Agence Régionale de Santé Occitanie, Services régionaux de Toulouse, Direction de l'offre de soins et de l'autonomie, Pôle médico-social, Unité politique du vieillissement, Toulouse, France
| | - Philippe Courtet
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Hugo Potier
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU Nimes, IDESP, INSERM, University of Montpellier, Nîmes, France
| | - Loubna Elotmani
- UR-UM103, IMAGINE, Department of Anesthesia Critical Care Emergency and Pain Medicine, CHU Nimes, University of Montpellier, Nîmes, France
| | | | - Jean-Yves Lefrant
- UR-UM103, IMAGINE, Department of Anesthesia Critical Care Emergency and Pain Medicine, CHU Nimes, University of Montpellier, Nîmes, France
| | - Jorge Lopez Castroman
- Department of Psychiatry, Nimes University Hospital, Institut de Génomique Fonctionnelle, University of Montpellier, CNRS-INSERM, Montpellier, France
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Christophe Arbus
- Toulouse University Hospital, Toulouse, France
- Inserm U1214, University of Toulouse III, Toulouse, France
| | - Hubert Blain
- Department of Internal Medicine and Geriatrics, University Hospital of Montpellier, Montpellier University, Centre Antonin Balmes, Montpellier, France
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22
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Mavragani A, Duan Y, Slubik S, Estabrooks CA. Impact of the COVID-19 Pandemic on Health, Well-being, and Quality of Work-Life Outcomes Among Direct Care Nursing Staff Working in Nursing Home Settings: Protocol for a Systematic Review. JMIR Res Protoc 2023; 12:e40390. [PMID: 36853752 PMCID: PMC9976775 DOI: 10.2196/40390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Increased workload, lack of resources, fear of infection, and the suffering and loss of residents have placed a significant emotional burden on regulated and unregulated direct care nursing staff (eg, registered nurses, licensed practical nurses, and care aides) in nursing homes (residential long-term care homes). Psychological distress and burnout related to COVID-19 have been cited among direct care staff within nursing homes. Studies have also emphasized the resilience of direct care staff, who, despite the significant challenges created by the pandemic, remained committed to providing quality care. To date, only one nursing home-specific review has synthesized evidence from 15 studies conducted early in the pandemic, which reported anxiety, posttraumatic stress disorder, and depression among direct care staff. OBJECTIVE The objectives of this systematic review are to (1) synthesize all empirical evidence on the impact of the COVID-19 pandemic on direct care staffs' mental health, physical health, and work-life outcomes; (2) identify specific risks and protective factors; and (3) examine the effect of strategies or interventions that have been developed to improve these outcomes. METHODS We will include all study designs reporting objective or subjective measurements of direct care staffs' mental health, physical health, and quality of work-life in nursing home settings during the COVID-19 pandemic (January 2020 onward). We will search multiple databases (MEDLINE, CINAHL, Embase, Scopus, and PsycINFO) and gray literature sources with no language restrictions. Two authors will independently screen, assess data quality, and extract data for synthesis. Given the heterogeneity in research designs, we will use multiple data synthesis methods that are suitable for quantitative and qualitative studies. RESULTS As of December 2022, full text screening has been completed and data extraction is underway. The expected completion date is June 30, 2023. CONCLUSIONS This systematic review will uncover gaps in current knowledge, increase our understanding of the disparate findings to date, identify risks and factors that protect against the sustained effects of the pandemic, and elucidate the feasibility and effects of interventions to support the mental health, physical health, and quality of work-life of frontline nursing staff. This study will inform future research exploring how the health care system can be more proactive in improving quality of work-life and supporting the health and psychological needs of frontline staff amid extreme stressors such as the pandemic and within the wider context of prepandemic conditions. TRIAL REGISTRATION PROSPERO CRD42021248420; https://tinyurl.com/4djk7rpm. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40390.
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Affiliation(s)
| | - Yinfei Duan
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sydney Slubik
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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23
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Abstract
Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses' ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses' own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner.
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Affiliation(s)
- Hillestad AH
- Lovisenberg Diaconal University College, Oslo, Norway
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24
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Nelson PA, Bradley F, Ullah A, Whittaker W, Brunton L, Calovski V, Money A, Dowding D, Cullum N, Wilson P. Implementation, uptake and use of a digital COVID-19 symptom tracker in English care homes in the coronavirus pandemic: a mixed-methods, multi-locality case study. Implement Sci Commun 2023; 4:7. [PMID: 36650559 PMCID: PMC9843982 DOI: 10.1186/s43058-022-00387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/19/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND COVID-19 spread rapidly in UK care homes for older people in the early pandemic. National infection control recommendations included remote resident assessment. A region in North-West England introduced a digital COVID-19 symptom tracker for homes to identify early signs of resident deterioration to facilitate care responses. We examined the implementation, uptake and use of the tracker in care homes across four geographical case study localities in the first year of the pandemic. METHODS This was a rapid, mixed-methods, multi-locality case study. Tracker uptake was calculated using the number of care homes taking up the tracker as a proportion of the total number of care homes in a locality. Mean tracker use was summarised at locality level and compared. Semi-structured interviews were conducted with professionals involved in tracker implementation and used to explore implementation factors across localities. Template Analysis with the Consolidated Framework for Implementation Research (CFIR) guided the interpretation of qualitative data. RESULTS Uptake varied across the four case study localities ranging between 13.8 and 77.8%. Tracker use decreased in all localities over time at different rates, with average use ranging between 18 and 58%. The implementation context differed between localities and the process of implementation deviated over time from the initially planned strategy, for stakeholder engagement and care homes' training. Four interpretative themes reflected the most influential factors appearing to affect tracker uptake and use: (1) the process of implementation, (2) implementation readiness, (3) clarity of purpose/perceived value and (4) relative priority in the context of wider system pressures. CONCLUSIONS Our study findings resonate with the digital solutions evidence base prior to the COVID-19 pandemic, suggesting three key factors that can inform future development and implementation of rapid digital responses in care home settings even in times of crisis: an incremental approach to implementation with testing of organisational readiness and attention to implementation climate, particularly the innovation's fit with local contexts (i.e. systems, infrastructure, work processes and practices); involvement of end-users in innovation design and development; and enabling users' easy access to sustained, high-quality, appropriate training and support to enable staff to adapt to digital solutions.
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Affiliation(s)
- Pauline A. Nelson
- grid.5379.80000000121662407Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Room 6.312, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Fay Bradley
- grid.5379.80000000121662407Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Room 6.312, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Akbar Ullah
- grid.5379.80000000121662407Manchester Centre for Health Economics, Faculty of Biology Medicine and Health, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Will Whittaker
- grid.5379.80000000121662407Manchester Centre for Health Economics, Faculty of Biology Medicine and Health, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Lisa Brunton
- grid.5379.80000000121662407Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL UK
| | - Vid Calovski
- grid.5379.80000000121662407Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Room 6.312, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Annemarie Money
- grid.5379.80000000121662407Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Room 6.312, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Dawn Dowding
- grid.5379.80000000121662407Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Room 6.312, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Nicky Cullum
- grid.5379.80000000121662407Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Room 6.312, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Paul Wilson
- grid.5379.80000000121662407Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL UK
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25
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Birt L, Lane K, Corner J, Sanderson K, Bunn D. Care-home Nurses' responses to the COVID-19 pandemic: Managing ethical conundrums at personal cost: A qualitative study. J Nurs Scholarsh 2023; 55:226-238. [PMID: 36464814 PMCID: PMC9878168 DOI: 10.1111/jnu.12855] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The COVID-19 pandemic had an unprecedented effect on those living and working in care-homes for older people, as residents were particularly vulnerable to contracting the SARS-CoV-2 virus, associated with high morbidity and mortality. Often undervalued, care-home nurses (RNs) are leaders, managing complex care while working in isolation from their professional peers. The pandemic made this more apparent, when care and treatments for COVID-19 were initially unknown, isolation increased due to withdrawal of many professional health services, accompanied by staff shortages. OBJECTIVE To explore RNs' experiences of working in older people's care-homes during the COVID-19 pandemic. DESIGN Qualitative interview study. SETTING Care-homes for older people in England and Scotland, UK. METHODS Recruitment via direct contact with care-homes, social media, and links provided by national partners, then purposive sampling for age, gender, type of care-home, and location. Data collected through one-to-one online interviews using topic guide developed collaboratively with care-home nurses, focusing on how COVID-19 impacted on nurses' resilience and mental wellbeing. Data analyzed thematically using Tronto's ethics of care framework to guide development of interpretative themes. RESULTS Eighteen nurses (16 female; 16 adult, and two mental health nurses) were interviewed March-June 2021; majority aged 46-55 years; mean time registered with Nursing and Midwifery Council: 19 years; 17 had nursed residents with COVID-19. RNs' experiences resonated with Tronto's five tenets of ethical care: attentiveness, responsibility, competence, responsiveness, and solidarity. All nurses described being attentive to needs of others, but were less attentive to their own needs, which came at personal cost. RNs were aware of their professional and leadership responsibilities, being as responsive as they could be to resident needs, processing and sharing rapidly changing guidance and implementing appropriate infection control measures, but felt that relatives and regulatory bodies were not always appreciative. RNs developed enhanced clinical skills, increasing their professional standing, but reported having to compromise care, leading to moral distress. Broadly, participants reported a sense of solidarity across care-home staff and working together to cope with the crisis. CONCLUSION Care-home nurses felt unprepared for managing the COVID-19 pandemic, many experienced moral distress. Supporting care-home nurses to recover from the pandemic is essential to maintain a healthy, stable workforce and needs to be specific to care-home RNs, recognizing their unique pandemic experiences. Support for RNs will likely benefit other care-home workers either directly through wider roll-out, or indirectly through improved wellbeing of nurse leaders. CLINICAL RELEVANCE The COVID-19 pandemic, an international public health emergency, created many challenges for Registered Nurses (RNs) working in long-term care facilities for older people, as residents were particularly vulnerable to the impact of the SARS-CoV-2 virus. Care-home RNs faced challenges distinct from their hospital-based nursing peers and non-nursing social care colleagues due to their isolation, leadership roles, professional legal obligations, and ethical responsibilities, leading to psychological distress on the one hand, but also a newly found confidence in their existing and newly developed skills, and increased recognition by the wider health community of their specialisms.
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Affiliation(s)
- Linda Birt
- School of Health SciencesUniversity of East AngliaNorfolkUK,Present address:
School of HealthcareUniversity of LeicesterLeicesterUK
| | - Kathleen Lane
- School of Health SciencesUniversity of East AngliaNorfolkUK
| | - Jason Corner
- School of Health SciencesUniversity of East AngliaNorfolkUK
| | | | - Diane Bunn
- School of Health SciencesUniversity of East AngliaNorfolkUK
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26
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Zhang H, Wu Y, Wang N, Sun X, Wang Y, Zhang Y. Caregivers' experiences and perspectives on caring for the elderly during the COVID-19 pandemic: A qualitative systematic review. J Nurs Manag 2022; 30:3972-3995. [PMID: 36208194 PMCID: PMC9874760 DOI: 10.1111/jonm.13859] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/19/2022] [Accepted: 10/02/2022] [Indexed: 01/27/2023]
Abstract
AIMS The goal of this study was to explore caregivers' experiences, perspectives, emotions, knowledge and needs in caring for older people during the COVID-19 pandemic. These included, but were not limited to, experiences in hospital care, home care and nursing home care. BACKGROUND Because of the high mortality rate associated with the COVID-19 pandemic, senior care is critical. During the COVID-19 pandemic, caregivers caring for older people have had unique experiences potentially affecting the quality of care provided. This topic has received substantial attention since the start of the pandemic and has been studied by numerous researchers. However, experiences may differ among countries and time periods. In addition, no qualitative systematic reviews on this topic appear to have been published. EVALUATION In this systematic review of qualitative studies, data were collected from the following electronic databases: PubMed, Web of Science, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Science Direct and PsycINFO. Titles and abstracts were screened according to the inclusion and exclusion criteria, full texts were screened and the methodological quality of included studies was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research by two independent reviewers. KEY ISSUE(S) A total of 141 findings were extracted and aggregated into 20 categories; 6 synthesized findings were identified. CONCLUSION This review indicates caregivers' experiences and perceptions regarding caring for older people during the COVID-19 pandemic. The results of a qualitative systematic review show that caregivers' emotions, cognitions and knowledge have affected the quality of caregivers' senior care services during the pandemic. Caregivers caring for older adults should practise self-awareness, understanding their knowledge and attitudes to improve the quality of senior care. Moreover, health care administrators and policymakers should make concerted efforts to cultivate a better working environment. IMPLICATIONS FOR NURSING MANAGEMENT Managers should formulate timely and effective management strategies. During the COVID-19 pandemic, the workload of caregivers has increased, thus requiring better scheduling by managers. Furthermore, managers should consider the negative emotions of caregivers and prevent negative emotions from affecting their work. Besides, virtual technology should be applied to senior care and psychological support be provided for caregivers in this special care setting.
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Affiliation(s)
- Huichao Zhang
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Yuan Wu
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Nannan Wang
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Xuhan Sun
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Yuqing Wang
- School of NursingNanjing University of Chinese MedicineNanjingJiangsuChina
| | - Yuxi Zhang
- Geriatric Hematology/Radiotherapy Wardthe First Affiliated Hospital of Nanjing Medical University300 Guangzhou RoadNanjingJiangsuChina
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27
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Titley HK, Young S, Savage A, Thorne T, Spiers J, Estabrooks CA. Cracks in the foundation: The experience of care aides in long-term care homes during the COVID-19 pandemic. J Am Geriatr Soc 2022; 71:198-205. [PMID: 36082802 PMCID: PMC9538008 DOI: 10.1111/jgs.18024] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/28/2022] [Accepted: 08/14/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Care aides (certified nursing assistants, personal support workers) are the largest workforce in long-term care (LTC) homes (nursing homes). They provide as much as 90% of direct care to residents. Their health and well-being directly affect both quality of care and quality of life for residents. The aim of this study was to understand the impact of COVID-19 on care aides working in LTC homes during the first year of the pandemic. METHODS We conducted semi-structured interviews with a convenience sample of 52 care aides from 8 LTC homes in Alberta and one in British Columbia, Canada, between January and April 2021. Nursing homes were purposively selected across: (1) ownership model and (2) COVID impact (the rate of COVID infections reported from March to December 2020). Interviews were recorded and analyzed using inductive content analysis. RESULTS Care aides were mainly female (94%) and older (74% aged 40 years or older). Most spoke English as an additional language (76%), 54% worked full-time in LTC homes, and 37% worked multiple positions before "one worksite policies" were implemented. Two themes emerged from our analysis: (1) Care aides experienced mental and emotional distress from enforcing resident isolation, grief related to resident deaths, fear of contracting and spreading COVID-19, increased workload combined with staffing shortages, and rapidly changing policies. (2) Care aides' resilience was supported by their strong relationships, faith and community, and capacity to maintain positive attitudes. CONCLUSIONS These findings suggest significant, ongoing adverse effects for care aides in LTC homes from working through the COVID-19 pandemic. Our data demonstrate the considerable strength of this occupational group. Our results emphasize the urgent need to appropriately and meaningfully support care aides' mental health and well-being and adequately resource this workforce. We recommend improved policy guidelines and interventions.
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Affiliation(s)
| | - Sandra Young
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
| | - Amber Savage
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
| | - Trina Thorne
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
| | - Jude Spiers
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
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