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Friedrich B, Forbes G, Jhass A, Lorencatto F, Shallcross L, Antonopoulou V. Factors influencing staff attitudes to COVID-19 vaccination in care homes in England: a qualitative study. BMC Health Serv Res 2023; 23:1066. [PMID: 37798753 PMCID: PMC10557274 DOI: 10.1186/s12913-023-10031-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic disproportionately affected people living and working in UK care homes causing high mortality rates. Vaccinating staff members and residents is considered the most effective intervention to reduce infection and its transmission rates. However, uptake of the first dose of the COVID-19 vaccine in care homes was variable. We sought to investigate factors influencing uptake of COVID-19 vaccination in care home staff to inform strategies to increase vaccination uptake and inform future preparedness. METHODS Twenty care home staff including managerial and administrative staff, nurses, healthcare practitioners and support staff from nine care homes across England participated in semi-structured telephone interviews (March-June 2021) exploring attitudes towards the COVID-19 vaccine and factors influencing uptake. We used thematic analysis to generate themes which were subsequently deductively mapped to the Capability, Opportunity, Motivation-Behaviour (COM-B) model. The Behavioural Change Wheel (BCW) was used to identify potential intervention strategies to address identified influences. RESULTS Enablers to vaccine uptake included the willingness to protect care home residents, staff and family/friends from infection and the belief that vaccination provided a way back to normality (reflective motivation); convenience of vaccination and access to accurate information (physical opportunity); and a supporting social environment around them favouring vaccination (social opportunity). Barriers included fears about side-effects (automatic motivation); a lack of trust due to the quick release of the vaccine (reflective motivation); and feeling pressurised to accept vaccination if mandatory (automatic motivation). CONCLUSIONS We identified influences on COVID-19 vaccine uptake by care home staff that can inform the implementation of future vaccination programmes. Strategies likely to support uptake include information campaigns and facilitating communication between staff and managers to openly discuss concerns regarding possible vaccination side effects. Freedom of choice played an important role in the decision to be vaccinated suggesting that the decision to mandate vaccination may have unintended behavioural consequences.
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Affiliation(s)
- Bettina Friedrich
- Institute of Health Informatics, Faculty of Population Sciences, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Gillian Forbes
- Centre for Behaviour Change, Department of Clinical, Education and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Arnoupe Jhass
- Institute of Health Informatics, Faculty of Population Sciences, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Fabiana Lorencatto
- Centre for Behaviour Change, Department of Clinical, Education and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- NIHR Policy Research Unit in Behavioural Science, Population Health Sciences Institute, Newcastle University, Newcastle, NE2 4AX, UK
| | - Laura Shallcross
- Institute of Health Informatics, Faculty of Population Sciences, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Vivi Antonopoulou
- Centre for Behaviour Change, Department of Clinical, Education and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- NIHR Policy Research Unit in Behavioural Science, Population Health Sciences Institute, Newcastle University, Newcastle, NE2 4AX, UK.
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Dixon J, Lorenz-Dant K, Stubbs E, Harrison Dening K, Mostaghim M, Casson D. Registered care home managers' experiences of responding to the national care home visiting guidance in England during the Covid-19 pandemic; a multi-method qualitative study. BMC Geriatr 2023; 23:236. [PMID: 37076808 PMCID: PMC10113990 DOI: 10.1186/s12877-023-03935-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/26/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Visiting restrictions in care homes in England and many comparable countries during the Covid-19 pandemic were extensive and prolonged. We examined how care home managers experienced, understood and responded to the national care home visiting guidance in England in developing their visiting policies. METHODS A diverse sample of 121 care home managers across England, recruited through varied sources including the NIHR ENRICH network of care homes, completed a 10-item qualitative survey. Follow-up, in-depth qualitative interviews were conducted with a purposive sub-sample of 40 managers. Data were analysed thematically using Framework, a theoretically and methodologically flexible tool for data analysis in multiple researcher teams. FINDINGS Some viewed the national guidance positively; as supporting the restrictive measures they felt necessary to protect residents and staff from infection, or as setting a broad policy framework while allowing local discretion. More commonly, however, managers experienced challenges. These included the guidance being issued late; the initial document and frequent, media-led updates not being user-friendly; important gaps, particularly in relation to dementia and the risks and harms associated with restrictions; guidance being unhelpfully open to interpretation while restrictive interpretations by regulators limited apparent scope for discretion; fragmented systems of local governance and poor central-local coordination; inconsistent access and quality of support from local regulators wider sources of information, advice and support that, while often valued, were experienced as uncoordinated, duplicative and sometimes confusing; and insufficient account taken of workforce challenges. CONCLUSIONS Underlying many of the challenges experienced were structural issues, for which there have been longstanding calls for investment and strategic reform. For increasing sector resilience, these should be are urgently addressed. Future guidance would also be significantly strengthened by gathering better data, supporting well-facilitated peer exchange, engaging the sector more fully and dynamically in policy-making and learning from care home managers' and staff's experiences, particularly of assessing, managing and mitigating the wider risks and harms associated with visiting restrictions.
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Affiliation(s)
- Josie Dixon
- Care Policy and Evaluation Centre, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - Klara Lorenz-Dant
- University of Augsburg, Universitätsstraße 2, 86159, Augsburg, Germany
| | - Edmund Stubbs
- Care Policy and Evaluation Centre, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Karen Harrison Dening
- De Montfort University, The Gateway, Leicester, LE1 9BH, UK
- Dementia UK, 7th Floor, One Aldgate, London, EC3N 1RE, UK
| | - Manna Mostaghim
- Care Policy and Evaluation Centre, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Daniel Casson
- Care England, 2nd Floor, 2 Devonshire Square, London, EC2M 4UJ, UK
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Dymchuk E, Mirhashemi B, Chamberlain S, Beeber A, Hoben M. The impact of COVID-19 on relationships between family/friend caregivers and care staff in continuing care facilities: a qualitative descriptive analysis. BMC Nurs 2023; 22:121. [PMID: 37059999 PMCID: PMC10102683 DOI: 10.1186/s12912-023-01289-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/04/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and related public health measures added a new dynamic to the relationship between caregivers and care staff in congregate care settings. While both caregivers and staff play an important role in resident quality of life and care, it is common for conflict to exist between them. These issues were amplified by pandemic restrictions, impacting not only caregivers and care staff, but also residents. While research has explored the relationship between caregivers and care staff in long-term care and assisted living homes, much of the research has focused on the caregiver perspective. Our objective was to explore the impact of COVID-19-related public health measures on caregiver-staff relationships from the perspective of staff in long-term care and assisted living homes. METHODS We conducted 9 focus groups and 2 semi-structured interviews via videoconference. RESULTS We identified four themes related to caregiver-staff relationships: (1) pressure from caregivers, (2) caregiver-staff conflict, (3) support from caregivers, and (4) staff supporting caregivers. CONCLUSIONS The COVID-19 pandemic disrupted long-standing relationships between caregivers and care staff, negatively impacting care staff, caregivers, and residents. However, staff also reported encouraging examples of successful collaboration and support from caregivers. Learning from these promising practices will be critical to improving preparedness for future public health crises, as well as quality of resident care and life in general.
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Affiliation(s)
- Emily Dymchuk
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Bita Mirhashemi
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Chamberlain
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Anna Beeber
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthias Hoben
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada.
- School of Health Policy and Management, Faculty of Health, York University, Room 301E Stong College 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
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Chirico I, Pappadà A, Giebel C, Ottoboni G, Valente M, Gabbay M, Chattat R. The impact of COVID-19 restrictions and care home strategies on residents with dementia as experienced by family carers in Italy. Aging Ment Health 2023; 27:512-520. [PMID: 35333142 DOI: 10.1080/13607863.2022.2056137] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES The COVID-19 pandemic and public health measures caused serious consequences for several population cohorts, including people with dementia in care homes and their families. The aim of this study was to explore the impact of COVID-19 on care home residents with dementia as experienced by family carers in Italy. Specifically, strategies implemented to overcome the pandemic's constraints, their influence upon care, and consequences for everyday life of residents with dementia and carers were investigated. METHODS Semi-structured interviews explored participants' experiences of the pandemic, its restrictions and the services' status during lockdown. Transcripts were analysed via thematic analysis. RESULTS 26 family carers were interviewed. Three themes emerged: (1) COVID-19 restrictions negatively affected both residents with dementia and family carers, (2) Changing policies in care homes during COVID-19, and (3) Technology use in care homes during COVID-19. COVID-19 restrictions severely affected care home residents with dementia, disrupted their daily living, and accelerated their cognitive decline. Consequently carers' emotional burdens increased. Care home response strategies (safe visiting and digital solutions) were critical, though they were not enough to compensate for the lack of close in-person contacts. CONCLUSIONS Mixed evidence emerged about the feasibility of care home strategies and their associated benefits. To meet arising needs and possible future pandemic waves, there is a need for updated health strategies. These should prioritise a continuity of therapeutic activities and minimize negative effects on residents' quality of life, whilst incorporating feasible and accessible digital solutions to provide remote communication and psychological support for family carers.
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Affiliation(s)
| | | | - Clarissa Giebel
- Department of Primary Care & Mental Health, University of Liverpool, UK.,NIHR ARC NWC, Liverpool, UK
| | | | - Marco Valente
- Department of Psychology, University of Bologna, Italy
| | - Mark Gabbay
- Department of Primary Care & Mental Health, University of Liverpool, UK.,NIHR ARC NWC, Liverpool, UK
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Italy
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MacLean R, Durepos P, Gibbons C, Morris P, Witherspoon R, Taylor N, Keeping-Burke L, McCloskey R. Education and training for infection prevention and control provided by long-term care homes to family caregivers: a scoping review protocol. JBI Evid Synth 2023:02174543-990000000-00124. [PMID: 36647898 DOI: 10.11124/jbies-22-00308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The objective of this review is to map the infection prevention and control education and training that long-term care homes use with families during a pandemic or infectious outbreak. INTRODUCTION During the COVID-19 pandemic, restrictions were imposed on visits to long-term care homes to decrease the risk of virus transmission. These restrictions had negative consequences for both residents and families. A scoping review of infection prevention and control education and training used with families will inform family visitation practices and policies during future infectious outbreaks. INCLUSION CRITERIA This review will examine literature describing infection prevention and control education and training provided to families in long-term care homes. Research and narrative papers, including experimental, quasi-experimental, descriptive observational quantitative and qualitative studies, reviews, text, policy, and opinion papers, will be considered for inclusion. METHODS A 3-step approach will be followed, in line with the JBI methodology for scoping reviews. Published literature will be searched for in databases including CINAHL, Embase, ERIC, MEDLINE, and AgeLine. Published and unpublished papers will be considered from 1990 to the present, in English or in French. The World Health Organization, Centers for Disease Control, and the Public Health Agency of Canada websites will be searched for unpublished and gray literature. Two authors will independently review and assess studies for inclusion and extract the data. The findings will be charted in a narrative summary and tables.
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Affiliation(s)
- Rachel MacLean
- Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada
| | - Pamela Durepos
- Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada
| | | | - Patricia Morris
- Faculty of Nursing, University of New Brunswick, Fredericton, NB, Canada.,Horizon Health Network, NB, Canada
| | | | - Natasha Taylor
- University of New Brunswick, Department of Nursing & Health Sciences, Saint John, NB, Canada
| | - Lisa Keeping-Burke
- University of New Brunswick, Department of Nursing & Health Sciences, Saint John, NB, Canada.,The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, University of New Brunswick, Saint John, NB, Canada
| | - Rose McCloskey
- University of New Brunswick, Department of Nursing & Health Sciences, Saint John, NB, Canada.,The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, University of New Brunswick, Saint John, NB, Canada
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Zwar L, König HH, Hajek A. Conspiracy mentality among informal caregivers as a risk factor for caregiver burden, mental health, perceived loneliness and social isolation during the COVID-19 pandemic: findings of a representative online study from Germany. Qual Life Res 2022; 31:3139-3151. [PMID: 35789451 PMCID: PMC9255449 DOI: 10.1007/s11136-022-03177-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aims to analyze if and how conspiracy mentality is associated with mental health, burden and perceived social isolation and loneliness of informal caregivers of older individuals with care needs. METHODS A quantitative, cross-sectional study was conducted. Participants had to be at least 40 years of age and were drawn randomly from the German online panel forsa.omninet and questioned between the 4th and 19th of March 2021. A sample of 489 informal caregivers (relatives and non-relatives supporting individuals aged ≥ 60 years) was questioned. Conspiracy mentality, depressive symptoms, loneliness and social exclusion were measured with validated instruments (e.g., The Conspiracy Mentality Questionnaire). Questions referred to the last three months prior to assessment. Multiple linear regression analyses, adjusted for sociodemographic, economic and health factors and indicators of the pandemic, were conducted. RESULTS Findings indicate a significant positive association between conspiracy mentality and caregiver burden, loneliness, social exclusion, and depressive symptoms. No gender differences were found for any outcome. CONCLUSIONS The results indicate that conspiracy mentality could be a risk factor for mental health, perceived social isolation and loneliness, and contribute to increased caregiver burden among informal caregivers of older care recipients during the COVID-19 pandemic. Accordingly, informal caregivers could benefit from actions focused on reducing conspiracy mentality during a health crisis, which could improve psychosocial health and wellbeing in this vulnerable group.
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Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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7
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Lion KM, Moyle W, Cations M, Day S, Pu L, Murfield J, Gabbay M, Giebel C. How Did the COVID-19 Restrictions Impact People Living With Dementia and Their Informal Carers Within Community and Residential Aged Care Settings in Australia? A Qualitative Study. JOURNAL OF FAMILY NURSING 2022; 28:205-218. [PMID: 35674356 DOI: 10.1177/10748407221101638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this study was to explore how formal social support changed after implementation of the COVID-19 public health measures and how these restrictions affected people living with dementia and their informal carers in Australia. Sixteen informal carers and two people living with dementia were interviewed between August and November 2020. Participants were asked about their experiences of the pandemic and the impact that the restrictions had on their lives and care. Thematic analysis identified four overarching themes describing (a) prepandemic limitations of the aged care system, (b) the aged care system's response to the COVID-19 restrictions, (c) changes affecting informal carers, and (d) the challenges faced by people living with dementia. The findings highlighted the challenges faced by the Australian aged care system before the pandemic and the additional burden placed on informal carers who supported people living with dementia across residential and home settings during the pandemic.
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Affiliation(s)
| | - Wendy Moyle
- Griffith University, Brisbane, Queensland, Australia
| | - Monica Cations
- Flinders University, Adelaide, South Australia, Australia
| | - Sally Day
- Flinders University, Adelaide, South Australia, Australia
| | - Lihui Pu
- Griffith University, Brisbane, Queensland, Australia
| | - Jenny Murfield
- Griffith University, Brisbane, Queensland, Australia
- Deakin University, Geelong, Victoria, Australia
| | - Mark Gabbay
- University of Liverpool, Liverpool, UK
- National Institute of Health Research Applied Research Collaboration North West Coast, Liverpool, UK
| | - Clarissa Giebel
- University of Liverpool, Liverpool, UK
- National Institute of Health Research Applied Research Collaboration North West Coast, Liverpool, UK
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8
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Developing a Meaningful Garden Space in a Care Home with Staff and Family Members: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127025. [PMID: 35742271 PMCID: PMC9222630 DOI: 10.3390/ijerph19127025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 02/04/2023]
Abstract
Background: Care home residents are often passive and lack active engagement in meaningful activities. The aim of this qualitative study was to co-develop a plan for a meaningful garden space in an urban care home in the north of England, to inform the subsequent building of such a garden space on the care home premises. Methods: Members of staff participated in focus groups conducted at the care home. Family carers were interviewed by telephone. Both focus groups and interviews were audio-recorded, with transcripts analysed independently using thematic analysis by two researchers, and consensus achieved on final themes. Findings: Two focus groups with staff (n = 17) and seven interviews with family carers were held. Thematic analysis generated seven key themes for the garden about its meaning and environmental features: (1) Current opinions on physical environment; (2) access; (3) adaptation to the environment; (4) staffing; (5) socialising; (6) sensory features; and (7) active meaningful participation. The garden needed to be accessible to residents in wheelchairs, and in all weathers and seasonal conditions, as well as being adapted to the needs of people living with dementia. Areas for social activities, such as picnics, and intergenerational activities, as well as private spaces, were recommended. Throughout the garden, sensory features were suggested, incorporating the use of vision, smell, touch, and sound, such as through water features. Moreover, it was recommended that residents should be able to contribute to the delivery of the activities themselves, including through a café and a vegetable garden. Conclusions: Family carers and staff considered that the garden would benefit from an intensive update to meet the needs of residents. This study therefore has practical implications for care home design, which are of even greater importance since the pandemic, as outdoor spaces were considered safer for care home visiting.
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Cornally N, Kilty C, Buckley C, O’Caoimh R, O’Donovan MR, Monahan MP, O’Connor CD, Fitzgerald S, Hartigan I. The Experience of COVID-19 Visitor Restrictions among Families of People Living in Long-Term Residential Care Facilities during the First Wave of the Pandemic in Ireland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116559. [PMID: 35682143 PMCID: PMC9180630 DOI: 10.3390/ijerph19116559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 01/10/2023]
Abstract
Public health responses to COVID-19 in long-term residential care facilities (LTRCFs) have restricted family engagement with residents. These restrictions impact on quality of care and the psychosocial and emotional well-being of family caregivers. Following a national cross-sectional web-based survey, respondents were invited to provide personal reflections on visitor restrictions. This study aims to describe the consequences of these restrictions for individuals living in LTRCF and their families during the first wave of the COVID-19 pandemic. Data from open-ended questions contained within the survey were analyzed using Braun and Clarke’s (2006) method of thematic analysis. Four themes were identified: 1. Altered Communication and Connection; 2. Emotional and Psychological Impact; 3. Protecting and Caring Role of Staff; 4. Family Role. Throughout the narrative accounts, it is evident that the visitor restrictions impacted on the emotional and mental well-being of families. Some respondents expressed frustration that they could not assist staff in essential care provision, reducing meaning and purpose in their own lives. COVID-19 LTRCF visitor restrictions made little distinction between those providing essential personal care and those who visit for social reasons. A partnership approach to care provision is important and should encompass strategies to maintain the psychosocial and emotional well-being of families and their relatives during times of self-isolating or restrictive measures.
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Affiliation(s)
- Nicola Cornally
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
- Correspondence:
| | - Caroline Kilty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
| | - Catherine Buckley
- Northridge House Education and Research Centre, St. Luke’s Home, T12H970 Cork, Ireland;
| | - Rónán O’Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, T12WE28 Cork, Ireland;
- Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, T12WE28 Cork, Ireland;
| | - Mark R. O’Donovan
- Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, T12WE28 Cork, Ireland;
| | - Margaret P. Monahan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
| | - Caroline Dalton O’Connor
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
| | - Serena Fitzgerald
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
| | - Irene Hartigan
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland; (C.K.); (M.P.M.); (C.D.O.); (S.F.); (I.H.)
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Hollinghurst J, Hollinghurst R, North L, Mizen A, Akbari A, Long S, Lyons RA, Fry R. COVID-19 risk factors amongst 14,786 care home residents: an observational longitudinal analysis including daily community positive test rates of COVID-19, hospital stays and vaccination status in Wales (UK) between 1 September 2020 and 1 May 2021. Age Ageing 2022; 51:6577098. [PMID: 35511729 PMCID: PMC9070807 DOI: 10.1093/ageing/afac084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND COVID-19 vaccinations have been prioritised for high risk individuals. AIM Determine individual-level risk factors for care home residents testing positive for SARS-CoV-2. STUDY DESIGN Longitudinal observational cohort study using individual-level linked data from the Secure Anonymised Information Linkage (SAIL) databank. SETTING Fourteen thousand seven hundred and eighty-six older care home residents (aged 65+) living in Wales between 1 September 2020 and 1 May 2021. Our dataset consisted of 2,613,341 individual-level daily observations within 697 care homes. METHODS We estimated odds ratios (ORs [95% confidence interval]) using multilevel logistic regression models. Our outcome of interest was a positive SARS-CoV-2 PCR test. We included time-dependent covariates for the estimated community positive test rate of COVID-19, hospital inpatient status, vaccination status and frailty. Additional covariates were included for age, sex and specialist care home services. RESULTS The multivariable regression model indicated an increase in age (OR 1.01 [1.00,1.01] per year), community positive test rate (OR 1.13 [1.12,1.13] per percent increase), hospital inpatients (OR 7.40 [6.54,8.36]), and residents in care homes with non-specialist dementia care (OR 1.42 [1.01,1.99]) had an increased odds of a positive test. Having a positive test prior to the observation period (OR 0.58 [0.49,0.68]) and either one or two doses of a vaccine (0.21 [0.17,0.25] and 0.05 [0.02,0.09], respectively) were associated with a decreased odds. CONCLUSIONS Care providers need to remain vigilant despite the vaccination rollout, and extra precautions should be taken when caring for the most vulnerable. Minimising potential COVID-19 infection for care home residents when admitted to hospital should be prioritised.
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Affiliation(s)
| | | | | | | | | | | | - Ronan A Lyons
- Population Data Science, Swansea University, Wales, UK
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