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Tchouaket EN, Kruglova K, Létourneau J, Bélanger E, Robins S, Jubinville M, El-Mousawi F, Shen S, Beogo I, Sia D. Factors influencing long-term care facility performance during the COVID-19 pandemic: a scoping review. BMC Health Serv Res 2024; 24:901. [PMID: 39113065 PMCID: PMC11304669 DOI: 10.1186/s12913-024-11331-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 07/19/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic wreaked havoc on long-term care facilities (LTCFs). Some LTCFs performed better than others at slowing COVID-19 transmission. Emerging literature has mostly described infection prevention and control strategies implemented by LTCFs during the pandemic. However, there is a need for a comprehensive review of factors that influenced the performance of LTCFs in containing COVID-19 spread to inform public health policy. OBJECTIVE To build on the existing literature, we conducted a scoping review of factors that influenced LTCF performance during the COVID-19 pandemic using a multidimensional conceptual framework of performance. METHODS We followed the Joanna Briggs Institute's methodology for scoping reviews. We queried CINAHL, MEDLINE (Ovid), CAIRN, Science Direct, Scopus, and Web of Science for peer-reviewed literature in English or French published between January 1st, 2020 and December 31st, 2021. Retrieved records were screened for context (COVID-19 pandemic), population (LTCFs), interest (internal and external factors that influenced LTCF performance), and outcomes (dimensions of performance: equity, accessibility, reactivity, safety, continuity, efficacy, viability, efficiency). Descriptive characteristics of included articles were summarized. Dimensions of performance as well as internal (e.g., facility characteristics) and external (e.g., visitors) factors identified to have influenced LTCF performance were presented. RESULTS We retained 140 articles of which 68% were classified as research articles, 47% originated in North America, and most covered a period between March and July 2020. The most frequent dimensions of performance were "efficacy" (75.7%) and "safety" (75.7%). The most common internal factors were "organizational context" (72.9%) and "human resources" (62.1%), and the most common external factors were "visitors" (27.1%) and "public health guidelines" (25.7%). CONCLUSIONS Our review contributes to a global interest in understanding the impact of the COVID-19 pandemic on vulnerable populations residing and working in LTCFs. Though a myriad of factors were reported, a lack of randomized controlled trials makes it impossible to establish causality between the identified factors and LTCF performance. The use of a multidimensional framework can be recommended to evaluate healthcare system performance not merely in terms of efficacy and safety, but alongside other critical dimensions such as efficiency and equity. TRIAL REGISTRATION Research Registry ID: researchregistry7026.
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Affiliation(s)
- Eric Nguemeleu Tchouaket
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada.
| | - Katya Kruglova
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Josiane Létourneau
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Emilie Bélanger
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Stephanie Robins
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Maripier Jubinville
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Fatima El-Mousawi
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
| | - Shiyang Shen
- Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de la Montagne, Montréal, QC, H3G 2M1, Canada
| | - Idrissa Beogo
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1N 6N5, Canada
| | - Drissa Sia
- Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada
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Fremont D, Roberts RL, Webber C, Clarke AE, Milani C, Isenberg SR, Bush SH, Kobewka D, Turcotte L, Howard M, Boese K, Arya A, Robert B, Sinnarajah A, Simon JE, Lau J, Qureshi D, Downar J, Tanuseputro P. Changes in End-of-Life Symptom Management Prescribing among Long-Term Care Residents during COVID-19. J Am Med Dir Assoc 2024; 25:104955. [PMID: 38438112 DOI: 10.1016/j.jamda.2024.01.024] [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: 10/25/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE To examine changes in the prescribing of end-of-life symptom management medications in long-term care (LTC) homes during the COVID-19 pandemic. DESIGN Retrospective cohort study using routinely collected health administrative data in Ontario, Canada. SETTING AND PARTICIPANTS We included all individuals who died in LTC homes between January 1, 2017, and March 31, 2021. We separated the study into 2 periods: before COVID-19 (January 1, 2017, to March 17, 2020) and during COVID-19 (March 18, 2020, to March 31, 2021). METHODS For each LTC home, we measured the percentage of residents who died before and during COVID-19 who had a subcutaneous symptom management medication prescription in their last 14 days of life. We grouped LTC homes into quintiles based on their mean prescribing rates before COVID-19, and examined changes in prescribing during COVID-19 and COVID-19 outcomes across quintiles. RESULTS We captured 75,438 LTC residents who died in Ontario's 626 LTC homes during the entire study period, with 19,522 (25.9%) dying during COVID-19. The mean prescribing rate during COVID-19 ranged from 46.9% to 79.4% between the lowest and highest prescribing quintiles. During COVID-19, the mean prescribing rate in the lowest prescribing quintile increased by 9.6% compared to before COVID-19. Compared to LTC homes in the highest prescribing quintile, homes in the lowest prescribing quintile experienced the highest proportion of COVID-19 outbreaks (73.4% vs 50.0%), the largest mean outbreak intensity (0.27 vs 0.09 cases/bed), the highest mean total days with a COVID-19 outbreak (72.7 vs 24.2 days), and the greatest proportion of decedents who were transferred and died outside of LTC (22.1% vs 8.6%). CONCLUSIONS AND IMPLICATIONS LTC homes in Ontario had wide variations in the prescribing rates of end-of-life symptom management medications before and during COVID-19. Homes in the lower prescribing quintiles had more COVID-19 cases per bed and days spent in an outbreak.
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Affiliation(s)
- Deena Fremont
- Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada
| | - Rhiannon L Roberts
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Colleen Webber
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Anna E Clarke
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Christina Milani
- Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada
| | - Sarina R Isenberg
- Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Shirley H Bush
- Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada; Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Kobewka
- Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Luke Turcotte
- Department of Health Sciences, Brock University, St Catharines, Ontario, Canada
| | - Michelle Howard
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kaitlyn Boese
- Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada; Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Amit Arya
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Kensington Research Institute, Toronto, Ontario, Canada
| | - Benoit Robert
- Centre of Excellence in Frailty-Informed Care, Perley Health, Ottawa, Ontario, Canada
| | | | - Jessica E Simon
- Department of Oncology, Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jenny Lau
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Palliative Care, University Health Network, Toronto, Ontario, Canada
| | - Danial Qureshi
- Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada
| | - James Downar
- Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada; Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Bruyère Research Institute, Bruyère Continuing Care, Ottawa, Ontario, Canada; Department of Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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Ren LH, Wong KLY, Wong J, Kleiss S, Berndt A, Mann J, Hussein A, Hu G, Wong L, Khong R, Fu J, Ahmed N, Nolte J, Hung L. Working with a robot in hospital and long-term care homes: staff experience. BMC Nurs 2024; 23:317. [PMID: 38720346 PMCID: PMC11080152 DOI: 10.1186/s12912-024-01983-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/28/2024] [Indexed: 05/12/2024] Open
Abstract
Although there is a growing literature on the use of telepresence robots in institutional dementia care settings, limited research focused on the perspectives of frontline staff members who deliver dementia care. Our objective was to understand staff perspectives on using telepresence robots to support residents with dementia and their families. Guided by the Consolidated Framework for Implementation Research, we conducted four focus groups and 11 semi-structured interviews across four long-term care (LTC) homes and one hospital in Canada. We included 22 interdisciplinary staff members (e.g., registered nurses, social workers, occupational therapists, recreational therapists) to understand their experiences with telepresence robots. Thematic analysis identified three key themes: 1) Staff Training and Support; 2) Robot Features; 3) Environmental dynamics for Implementation. Our results underscore the imperative of structural support at micro-, meso- and macro-levels for staff in dementia care settings to effectively implement technology. This study contributes to future research and practice by elucidating factors facilitating staff involvement in technology research, integrating staff voices into technology implementation planning, and devising strategies to provide structural support to staff, care teams, and care homes.
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Affiliation(s)
- Lily Haopu Ren
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
| | - Karen Lok Yi Wong
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Joey Wong
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Sarah Kleiss
- Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Annette Berndt
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Jim Mann
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Ali Hussein
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Grace Hu
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Lily Wong
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Ruth Khong
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Jason Fu
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Nazia Ahmed
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Julia Nolte
- Department of Communication and Cognition, Tilburg University, Warandelaan 2, Tilburg, 5037 AB, The Netherlands
| | - Lillian Hung
- Innovation in Dementia and Aging Lab, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
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Aljadani R, Carnahan R, Culp K, Souza-Talarico JN. COVID-19 Pandemic Impact on the Trajectories of Cognitive Decline and Depression Symptoms in Long-Term Care Facility Residents. J Am Med Dir Assoc 2024; 25:328-334.e6. [PMID: 38195079 DOI: 10.1016/j.jamda.2023.12.003] [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: 08/17/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES To compare the longitudinal rates of change in cognition and depressive symptoms between 2019 (pre-COVID-19 pandemic) and 2020 (COVID-19 pandemic) among long-term care facility (LTCF) residents in Iowa, which ranked among the top 10 US states that suffered from extreme nursing staff shortages during this crisis. DESIGN A longitudinal cohort study analyzing the Long-Term Care Minimum Data Set (MDS) version 3.0 between January 1, 2019, and December 31, 2020. SETTING AND PARTICIPANTS LTCF residents from the state of Iowa, with a first assessment before March 10 for each year (2019 and 2020), LTCF stay period >60 days, and at least 2 documented assessments with a minimum of 45 days in between. LTCF residents with a Brief Interview for Mental Status score (BIMS) <3 were excluded. METHODS We computed doubly robust estimators by combining regression and propensity score models for BIMS (cognitive decline) and Nine-item Patient Health Questionnaire (PHQ-9; depression symptoms) monthly scores for 2020 vs 2019. RESULTS A total of 24,025 residents from 436 LTCFs were included. Our research revealed a marginally accelerated monthly decline in BIMS scores during 2020 as opposed to 2019, with a rate of -0.012 per month (95% CI -0.022, -0.002; P = .016). Simultaneously, we observed a monthly increment of 0.016 in the PHQ-9 scores among LTCF residents in 2020 (95% CI 0.006, 0.028; P = .003). CONCLUSIONS AND IMPLICATIONS Our study identified a notable yet modest increase in cognitive decline and depressive symptoms among NH residents in Iowa during the COVID-19 pandemic. Although statistically significant, the changes were small and may not have clinical relevance over 1 year. Further research is needed to examine risk factors for cognitive decline during pandemic scenarios such as social isolation, loneliness, inappropriate patient-centered care, and the relationship with staff shortage and facility resources.
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Affiliation(s)
- Rawabi Aljadani
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Ryan Carnahan
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Kennith Culp
- College of Nursing, University of Iowa, Iowa City, IA, USA
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Krutikov M, Stirrup O, Fuller C, Adams N, Azmi B, Irwin-Singer A, Sethu N, Hayward A, Altamirano H, Copas A, Shallcross L. Built Environment and SARS-CoV-2 Transmission in Long-Term Care Facilities: Cross-Sectional Survey and Data Linkage. J Am Med Dir Assoc 2024; 25:304-313.e11. [PMID: 38065220 PMCID: PMC11139658 DOI: 10.1016/j.jamda.2023.10.027] [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: 07/20/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES To describe the built environment in long-term care facilities (LTCF) and its association with introduction and transmission of SARS-CoV-2 infection. DESIGN Cross-sectional survey with linkage to routine surveillance data. SETTING AND PARTICIPANTS LTCFs in England caring for adults ≥65 years old, participating in the VIVALDI study (ISRCTN14447421) were eligible. Data were included from residents and staff. METHODS Cross-sectional survey of the LTCF built environment with linkage to routinely collected asymptomatic and symptomatic SARS-CoV-2 testing and vaccination data between September 1, 2020, and March 31, 2022. We used individual and LTCF level Poisson and Negative Binomial regression models to identify risk factors for 4 outcomes: incidence rate of resident infections and outbreaks, outbreak size, and duration. We considered interactions with variant transmissibility (pre vs post Omicron dominance). RESULTS A total of 134 of 151 (88.7%) LTCFs participated in the survey, contributing data for 13,010 residents and 17,766 staff. After adjustment and stratification, outbreak incidence (measuring infection introduction) was only associated with SARS-CoV-2 incidence in the community [incidence rate ratio (IRR) for high vs low incidence, 2.84; 95% CI, 1.85-4.36]. Characteristics of the built environment were associated with transmission outcomes and differed by variant transmissibility. For resident infection incidence, factors included number of storeys (0.64; 0.43-0.97) and bedrooms (1.04; 1.02-1.06), and purpose-built vs converted buildings (1.99; 1.08-3.69). Air quality was associated with outbreak size (dry vs just right 1.46; 1.00-2.13). Funding model (0.99; 0.99-1.00), crowding (0.98; 0.96-0.99), and bedroom temperature (1.15; 1.01-1.32) were associated with outbreak duration. CONCLUSIONS AND IMPLICATIONS We describe previously undocumented diversity in LTCF built environments. LTCFs have limited opportunities to prevent SARS-CoV-2 introduction, which was only driven by community incidence. However, adjusting the built environment, for example by isolating infected residents or improving airflow, may reduce transmission, although data quality was limited by subjectivity. Identifying LTCF built environment modifications that prevent infection transmission should be a research priority.
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Affiliation(s)
- Maria Krutikov
- Institute of Health Informatics, University College London, London, UK.
| | - Oliver Stirrup
- Institute for Global Health, University College London, London, UK
| | - Chris Fuller
- Institute of Health Informatics, University College London, London, UK
| | - Natalie Adams
- Institute of Health Informatics, University College London, London, UK
| | - Borscha Azmi
- Institute of Health Informatics, University College London, London, UK
| | - Aidan Irwin-Singer
- Surveillance Testing and Immunity, UK Health Security Agency, London, UK
| | - Niyathi Sethu
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Hector Altamirano
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Laura Shallcross
- Institute of Health Informatics, University College London, London, UK
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6
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Eltaybani S, Igarashi A, Cal A, Lai CKY, Carrasco C, Sari DW, Cho E, Haugan G, Bravo JD, Abouzeid NA, Wachholz PA, Isaramalai SA, Dawood SS, Pappas Y, Abd El Moneam AAEG, Rodríguez AB, Alqahtani BA, Pereira CLN, Jenssen CRS, Yu DSF, Ahmed FR, Mendes FRP, Randhawa G, Ahmed HAESH, Suzuki H, Prambudi H, Avci IA, Waluyo I, Nurbaeti I, Vseteckova J, Horne JK, Liu JY, Ingstad K, Kashiwabara K, Grant L, Abd El Moniem MM, Sakka M, Abdelgawad ME, Subu MA, Kentzer N, Almadani NA, Tomas-Carus P, Rodrigues Garcia RCM, Indarwati R, Maneerat S, Chien WT, Amamiya Y, Cavalcanti YW, Yamamoto-Mitani N. Long-term care facilities' response to the COVID-19 pandemic: An international, cross-sectional survey. J Adv Nurs 2024; 80:350-365. [PMID: 37452500 DOI: 10.1111/jan.15785] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/01/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023]
Abstract
AIMS To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions. DESIGN Cross-sectional survey. METHODS Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines. RESULTS The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work-life imbalance. CONCLUSIONS Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks. IMPACT This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Sameh Eltaybani
- Global Nursing Research Center, The University of Tokyo, Tokyo, Japan
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Ayse Cal
- Department of Nursing, School of Health Sciences, Ankara Medipol University, Ankara, Turkey
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong SAR
| | - Cristina Carrasco
- Neuroimmunophysiology and Chrononutrition Research Group, Department of Physiology, Faculty of Sciences, University of Extremadura, Badajoz, Spain
| | | | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University, College of Nursing, Seoul, South Korea
| | - Gørill Haugan
- Norwegian University of Science and Technology, Department of Public Health Nursing, Trondheim, Norway
- Nord University, Faculty of Nursing and Health Science, Levanger, Norway
| | - Jorge D Bravo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
- Comprehensive Health Research Centre(CHRC), Universidade de Évora, Évora, Portugal
| | - Nesreen A Abouzeid
- Department of Medical Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
- Department of Medical Surgical Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | | | | | - Shaimaa Samir Dawood
- Gerontological nursing department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Yannis Pappas
- Institute for Health Research, University of Bedfordshire, luton, UK
| | | | - Ana Beatriz Rodríguez
- Neuroimmunophysiology and Chrononutrition Research Group, Department of Physiology, Faculty of Sciences, University of Extremadura, Badajoz, Spain
| | | | - Catarina Lino Neto Pereira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | | | - Doris S F Yu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Fatma Refaat Ahmed
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Felismina Rosa P Mendes
- Departamento de Enfermagem, Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Évora, Portugal
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, luton, UK
| | | | - Haruno Suzuki
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
| | - Hery Prambudi
- An Nasher Institute of Healh Sciences, Cirebon, Cirebon West Java, Indonesia
| | - Ilknur Aydin Avci
- Department of Public Health Nursing, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Imam Waluyo
- Padma Kumara Foundation and Consultant International, Collaboration Physiotherapy School YAB, Jakarta, Indonesia
| | - Irma Nurbaeti
- Faculty of Health Sciences, Universitas Islam Negeri Syarif Hidayatullah, Jakarta, Indonesia
| | - Jitka Vseteckova
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
| | | | - Justina Yw Liu
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, Hong Kong SAR
| | - Kari Ingstad
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | | | - Louise Grant
- Faculty of Health and Social Sciences, University of Bedfordshire, Luton, UK
| | | | - Mariko Sakka
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Muhammad Arsyad Subu
- University of Sharjah, Sharjah, United Arab Emirates
- Universitas Binawan, Jakarta, Indonesia
| | - Nichola Kentzer
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
| | - Noura A Almadani
- Community health nursing department, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Pablo Tomas-Carus
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal
| | | | - Retno Indarwati
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Sonthaya Maneerat
- Prapokklao Nursing College, Faculty of Nursing, Praboromarajchanok Institute, Chantaburi, Thailand
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Yuko Amamiya
- Department of Nursing, Faculty of Healthcare Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
| | | | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, The University of Tokyo, Tokyo, Japan
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7
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Zhang D, Lu Q, Li L, Wang X, Yan H, Sun Z. Loneliness in nursing homes: A qualitative meta-synthesis of older people's experiences. J Clin Nurs 2023; 32:7062-7075. [PMID: 37605069 DOI: 10.1111/jocn.16842] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/09/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Older people in the nursing home environment are much less mobile and capable of taking care of themselves as they age, and most of them face the plight of loneliness, which seriously affects the quality of life of older people in their later years. AIMS A systematic review and synthesis of older people's experiences of loneliness in nursing homes. DESIGN Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. METHODS A search of PubMed, Cochrane Library, Web of Science, Embase, the Chinese biomedical literature service system, the China National Knowledge Infrastructure, the Wanfang Database and the Wipu Database for qualitative studies of older people's experiences of loneliness in nursing homes was conducted with a search time frame of March 2023. Evaluation of the quality of the literature using the Joanna Briggs Institute's Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research, And the data were synthesised using Thomas and Harden's method of thematic and content analysis. RESULTS A total of 13 papers were included, and 36 research findings were distilled and integrated into three themes: causes of loneliness; feelings of loneliness; coping with loneliness; and seven sub-themes: aging and loss; environmental transformation; loneliness is a pain; loneliness is a choice; participation; strengthening social ties; and diverting attention. CONCLUSIONS Older people in nursing homes face varying degrees of loneliness, which is a subjective feeling influenced by the interplay between personal awareness and the external environment, so future care interventions should be developed in a comprehensive manner, taking into account the characteristics of the older people themselves and their external environment. NO PATIENT OR PUBLIC CONTRIBUTION This study is a meta-synthesis and does not require relevant contributions from patients or the public.
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Affiliation(s)
- Deping Zhang
- Day Surgery Room, The First Hospital of China Medical University, Shenyang, China
| | - Qizhen Lu
- Operating room, The First Hospital of China Medical University, Shenyang, China
| | - Li Li
- Central sterile Supply department, The First Hospital of China Medical University, Shenyang, China
| | - Xiaofeng Wang
- Mammography, Liaoning Cancer Hospital, Shenyang, China
| | - Hongqi Yan
- Otolaryngology-Head and Neck Surgery, General Hospital of Northern Theatre command, Shenyang, China
| | - Zijian Sun
- Haemodialysis Unit, The First Hospital of China Medical University, Shenyang, China
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8
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Baumbusch J, Blakey EP, Kagan SH, Melendez-Torres GJ, Montayre J, Munsterman E, Omisore T. Taking the bad news with the good: The climate crisis and care for older people. Int J Older People Nurs 2023; 18:e12543. [PMID: 37084081 DOI: 10.1111/opn.12543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 04/22/2023]
Affiliation(s)
| | | | - Sarah H Kagan
- University of Pennsylvania, Pennsylvania, Philadelphia, USA
| | | | - Jed Montayre
- The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | | | - Tope Omisore
- Health Service Executive West, Castlerea, Roscommon, Ireland
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9
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Hoben M, Dymchuk E, Corbett K, Devkota R, Shrestha S, Lam J, Banerjee S, Chamberlain SA, Cummings GG, Doupe MB, Duan Y, Keefe J, O'Rourke HM, Saeidzadeh S, Song Y, Estabrooks CA. Factors Associated With the Quality of Life of Nursing Home Residents During the COVID-19 Pandemic: A Cross-Sectional Study. J Am Med Dir Assoc 2023:S1525-8610(23)00325-0. [PMID: 37150208 PMCID: PMC10076504 DOI: 10.1016/j.jamda.2023.03.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVES Quality of life (QoL) of nursing home (NH) residents is critical, yet understudied, particularly during the COVID-19 pandemic. Our objective was to examine whether COVID-19 outbreaks, lack of access to geriatric professionals, and care aide burnout were associated with NH residents' QoL. DESIGN Cross-sectional study (July to December 2021). SETTING AND PARTICIPANTS We purposefully selected 9 NHs in Alberta, Canada, based on their COVID-19 exposure (no or minor/short outbreaks vs repeated or extensive outbreaks). We included data for 689 residents from 18 care units. METHODS We used the DEMQOL-CH to assess resident QoL through video-based care aide interviews. Independent variables included a COVID-19 outbreak in the NH in the past 2 weeks (health authority records), care unit-levels of care aide burnout (9-item short-form Maslach Burnout Inventory), and resident access to geriatric professionals (validated facility survey). We ran mixed-effects regression models, adjusted for facility and care unit (validated surveys), and resident covariates (Resident Assessment Instrument-Minimum Data Set 2.0). RESULTS Recent COVID-19 outbreaks (β = 0.189; 95% CI: 0.058-0.320), higher proportions of emotionally exhausted care aides on a care unit (β = 0.681; 95% CI: 0.246-1.115), and lack of access to geriatric professionals (β = 0.216; 95% CI: 0.003-0.428) were significantly associated with poorer resident QoL. CONCLUSIONS AND IMPLICATIONS Policies aimed at reducing infection outbreaks, better supporting staff, and increasing access to specialist providers may help to mitigate how COVID-19 has negatively affected NH resident QoL.
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Affiliation(s)
- Matthias Hoben
- School of Health Policy and Management, Faculty of Health, York University, Toronto, ON, Canada; College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
| | - Emily Dymchuk
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Kyle Corbett
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Rashmi Devkota
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Shovana Shrestha
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Jenny Lam
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sube Banerjee
- Faculty of Health, University of Plymouth, England, UK
| | | | - Greta G Cummings
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Malcolm B Doupe
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Yinfei Duan
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Janice Keefe
- Department of Family Studies and Gerontology, Faculty of Arts, Mount Saint Vincent University, Halifax, NS, Canada
| | - Hannah M O'Rourke
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | | | - Yuting Song
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada; School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Carole A Estabrooks
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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10
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Hung L, Mann J, Wallsworth C, Upreti M, Kan W, Temirova A, Wong KLY, Ren H, To-Miles F, Wong J, Lee C, Kar Lai So D, Hardern S. Facilitators and Barriers to Using Virtual Reality and its Impact on Social Engagement in Aged Care Settings: A Scoping Review. Gerontol Geriatr Med 2023; 9:23337214231166355. [PMID: 37020921 PMCID: PMC10068985 DOI: 10.1177/23337214231166355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 04/03/2023] Open
Abstract
Aim: This scoping review aims to identify the facilitators and barriers to the implementation of VR technology in the aged-care setting. Background: Virtual reality (VR) offers the potential to reduce social isolation and loneliness through increased social engagement in aged-care settings. Methods and Analysis: This scoping review followed the Joanna Briggs Institute scoping review methodology and took place between March and August 2022. The review included a three-step search strategy: (1) identifying keywords from CINHAL, Embase, Medline, PsycInfo, Scopus, and Web of Science (2) conducting a second search using all identified keywords and index terms across selected databases; and (3) searching the reference lists of all included articles and reports for additional studies. Results: The final review included 22 articles. The analysis identified factors affecting the VR technology implementation in aged care settings to reduce isolation and loneliness: (a) key facilitators are local champions and staff training. (b) barriers include technological adaptability, video quality, and organizational culture. Conclusion: Existing evidence points to VR as a promising intervention to decrease loneliness and feelings of isolation and improve social engagement in older people living in aged-care settings.
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Affiliation(s)
- Lillian Hung
- University of British Columbia, Vancouver, Canada
| | - Jim Mann
- University of British Columbia, Vancouver, Canada
| | | | - Mona Upreti
- University of British Columbia, Vancouver, Canada
| | - Winnie Kan
- University of British Columbia, Vancouver, Canada
| | | | | | - Haopu Ren
- University of British Columbia, Vancouver, Canada
| | | | - Joey Wong
- University of British Columbia, Vancouver, Canada
| | - Caitlin Lee
- University of British Columbia, Vancouver, Canada
| | | | - Sonia Hardern
- Vancouver Coastal Health Authority, Regional Practice Lead, Research & Knowledge Translation (LTC-QI)
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