[Psychosocial effects of the pandemic on staff and residents of nursing homes as well as their relatives-A systematic review].
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ABSTRACT: Background
Following the COVID-19 pandemic residents of nursing homes, their visitors and families as well as employees are faced with new challenges. Protective measures have a strong impact on the well-being of all these groups of persons.Material and methods
A systematic search was carried out for studies investigating the psychosocial consequences of the COVID-19 pandemic for residents, their visitors and families as well as nursing home staff. Results were analyzed by narrative synthesis.Results
A total of 756 studies were screened and 15 studies were included. These studies were conducted between February and June 2020 with participants from 14 countries. Participants reported loneliness, grief and depressive symptoms among residents. Some gave an account of fear as a reaction of residents to social distancing. Residents with cognitive impairment suffered more although there are conflicting reports. The well-being of visitors and friends was compromised and their feeling of loneliness increased. Nursing home personnel reported fear of getting infected and of infecting residents or their own families. Infected workers in the USA expressed anger about a lack of protection. Furthermore, an increase in workload was reported.Conclusion
Studies conducted during the first months of the pandemic reported negative consequences for the psychosocial well-being of residents, their visitors and nursing home staff. Individual needs for future support of these groups are distinct and need further evaluation during the on-going pandemic.
SUBMITTER: Benzinger P
PROVIDER: S-EPMC7901511 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe Covid-19 pandemic and associated visiting restrictions have challenged communication with others for older people residing in nursing homes.AimThe aim of this study was to explore residents' experiences of encounters and communication with staff and relatives and friends during the Covid-19 pandemic.DesignAn exploratory study with an inductive approach.MethodsSemi-structured telephone interviews with 16 Swedish nursing home residents were conducted. Data were analyzed using qualitative content analysis; the study reports according to the COREQ checklist.ResultsThree main categories emerged: (1) Mixed feelings and experiences of encounters with nursing staff, (2) Adapting to hampered communication and finding strategies to overcome language barriers, and (3) Facing pandemic restrictions and living an adjusted life. Nine subcategories are reported within these categories. Residents mainly reported good encounters with staff and receiving the care they needed, but unhelpful encounters were also reported. To manage communication with staff with limited Swedish language skills, residents developed several strategies. During the visiting ban, residents felt secure but also lonely. Staying connected with the outside world required residents to use the phone and handle other digital aids, such as video calls, but lack of technical skills among staff hindered frequent use of video calls.ConclusionThis study highlights how residents can feel safe in extreme situations, but increased competence, including digital literacy and language skills, among staff is required. Care providers should provide relevant information to residents and staff and employ competent staff. Findings indicate that communication plans need to include enabling communication for residents both within and outside nursing homes, taking staff language skills into consideration.
| S-EPMC9744594 | biostudies-literature
Project description:ImportanceCoronavirus disease 2019 (COVID-19) is a major threat to nursing homes. During the COVID-19 pandemic wave that hit France in March and April 2020, staff members of some French nursing homes decided to confine themselves with their residents on a voluntary basis to reduce the risk of entry of the severe acute respiratory syndrome coronavirus 2 into the facility.ObjectiveTo investigate COVID-19-related outcomes in French nursing homes that implemented voluntary staff confinement with residents.Design, setting, and participantsThis retrospective cohort study was conducted in French nursing homes from March 1 to May 11, 2020. Participants included residents and staff members of the nursing homes where staff participated in voluntary self-confinement as well as those of the facilities for elderly people where staff did not practice self-confinement. Rates of COVID-19 cases and mortality in the cohort of nursing homes with self confinement were compared with those derived from a population-based survey of nursing homes conducted by French health authorities.ExposuresNursing homes with staff who self-confined were identified from the media and included if the confinement period of staff with residents was longer than 7 days.Main outcomes and measuresMortality related to COVID-19 among residents and COVID-19 cases among residents and staff members. COVID-19 was diagnosed by primary care or hospital physicians on the basis of fever and respiratory signs (eg, cough, dyspnea) or a clinical illness compatible with COVID-19; COVID-19 diagnoses were considered confirmed if real-time reverse transcriptase-polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 on nasopharyngeal swab was positive and considered possible if the test had not been performed or results were negative. Cases of COVID-19 were recorded by a telephone interview with the directors of nursing homes with staff who self-confined and by a nationwide declaration survey to health authorities for all facilities.ResultsThis study included 17 nursing homes in which 794 staff members confined themselves to the facility with their 1250 residents. The national survey included 9513 facilities with 385 290 staff members and 695 060 residents. Only 1 nursing home with staff who self-confined (5.8%) had cases of COVID-19 among residents, compared with 4599 facilities in the national survey (48.3%) (P < .001). Five residents (0.4%) in the nursing homes with staff who self-confined had confirmed COVID-19, compared with 30 569 residents (4.4%) with confirmed COVID-19 in the national survey (P < .001); no residents of facilities with self-confinement had possible COVID-19, compared with 31 799 residents (4.6%) with possible COVID-19 in the national survey (P < .001). Five residents (0.4%) in the nursing homes with staff who self-confined died of COVID-19, compared with 12 516 (1.8%) in the national survey (odds ratio, 0.22; 95% CI, 0.09-0.53; P < .001). Twelve staff members (1.6%) from the facilties with self-confinement had confirmed or possible COVID-19, compared with 29 463 staff members (7.6%) in the national survey (P < .001).Conclusions and relevanceIn this cohort study of French nursing homes during the COVID-19 pandemic, mortality rates related to COVID-19 were lower among nursing homes that implemented staff confinement with residents compared with those in a national survey. These findings suggest that self-confinement of staff members with residents may help protect nursing home residents from mortality related to COVID-19 and residents and staff from COVID-19 infection.
| S-EPMC7426749 | biostudies-literature
Project description: Not available
| S-EPMC9088376 | biostudies-literature
Project description:To describe the levels of insomnia, fatigue and intershift recovery, and psychological well-being (burnout, post-traumatic stress and psychological distress), and to examine differences in these measures based on work-related characteristics among nursing staff during COVID-19 pandemic in the United States. The COVID-19 pandemic has created a major physical and psychological burden on nursing staff in the United States and worldwide. A better understanding of these conditions will lead to tailored support and resources for nursing staff during and after the pandemic. Cross-sectional study. Hospital nurses and nursing assistants (N = 587) were recruited online between May-June 2020. The survey included measures on insomnia (Insomnia Severity Index) fatigue and intershift recovery (Occupational Fatigue and Exhaustion Recovery-15), burnout (Maslach Burnout Inventory-Human Services Survey), post-traumatic stress (Short Post-Traumatic Stress Disorder Rating Interview) and psychological distress (Patient Health Questionnaire-4), and questions on work and demographics. The STROBE checklist was followed for reporting. The sample had subthreshold insomnia, moderate-to-high chronic fatigue, high acute fatigue and low-to-moderate intershift recovery. The sample experienced increased emotional exhaustion and depersonalisation, increased personal accomplishment, moderate psychological distress and high post-traumatic stress. Nurses who cared for COVID-19 patients had significantly scored worse on almost all measures than their co-workers. Certain factors such as working hours per week and the frequency of 30-min breaks were significant. Nursing staff experienced poor sleep, fatigue and multiple psychological problems during the COVID-19 pandemic. Moreover, staff who were involved in the care of COVID-19 patients, worked more than 40 h per week and skipped 30-min breaks showed generally worse self-reported outcomes. Nursing administration is recommended to monitor for fatigue and distress on nursing units, re-visit current scheduling practices, reinforce rest breaks and provide access to mental health and sleep wellness resources with additional support for their front-line nursing groups.
| S-EPMC7753687 | biostudies-literature
Project description:Background and objectivesNursing staff turnover is a substantial concern for nursing homes that care for millions of older individuals, especially during the coronavirus disease 2019 pandemic. Low pay is considered as one of the key reasons for high turnover. However, we do not know whether increasing wages can lead to lower turnover. In this study, we fill this gap in our understanding by analyzing the relationship between wages and nursing staff turnover.Research design and methodsWe obtained data on hourly wages (Medicare Cost Reports), turnover (Iowa Department of Human Services), and nursing home and resident characteristics (Nursing Home Compare and LTCFocus) from 2013 to 2017. We summarized the characteristics of nursing homes as well as turnover trends over time. Next, we used pooled ordinary least squares (OLS) and facility fixed effects regressions to examine the relationship between wages and turnover adjusting for nursing home and resident characteristics.ResultsAmong the 396 nursing homes in Iowa, average hourly wage was $27.0 for registered nurses (RNs), $21.6 for licensed practical nurses (LPNs), and $14.1 for certified nurse aides (CNAs) during 2013-2017. Average turnover rates were increasing over time for all staff types and in 2017, turnover rates were 46.0% for RNs, 44.4% for LPNs, and 64.7% for CNAs. In both pooled OLS and facility fixed effects regressions, higher wages were associated with lower turnover of CNAs but not LPNs or RNs. The magnitude of the effect of wages on turnover for CNAs was lower in facility fixed effects regressions.Discussion and implicationsWe found a significant relationship between hourly wages and turnover for CNAs but not for LPNs or RNs. Focusing on higher wages alone may not lead to lower turnover of all types of nursing staff in nursing homes. We should also focus on nonwage factors related to turnover.
| S-EPMC9233199 | biostudies-literature
Project description: Not available
| S-EPMC10576215 | biostudies-literature
Project description:Introduction Soundscapes in nursing homes are often suboptimal for residents. This can cause them feeling anxious and unsafe, or develop behavioral and psychological problems. Residents with dementia cannot adapt nursing home environments to their needs due to cognitive and physical limitations. It is up to the staff of psycho-geriatric wards to improve the soundscape. We evaluated the effect of the sound awareness intervention Mobile Soundscape Appraisal and Recording Technology (MoSART+) on soundscapes in nursing homes. Methods The MoSART+ intervention was carried out in four nursing homes and took three months in each home. The MoSART+ intervention involved training ambassadors, assessing the soundscape with the MoSART application by the nursing staff to raise their sound awareness on random time points, discussing the measurements, and implementing micro-interventions. Soundscapes were assessed from 0 to 100 on four attributes: pleasantness, eventfulness, complexity, and range of affordances. Based on these scores, soundscapes were classified in four dimensions: calm, lively, boring, and chaotic. Nursing staff graded the environment on a scale of 0 to 10. T-test and Z-tests were used to analyze data. Results Staff recorded 1882 measurements with the MoSART app. “People,” “music, TV, and radio,” and “machines and appliances” were the most prevalent sound sources before and after the implementation of micro-interventions. Post-implementation of micro-interventions, soundscapes were pleasant (median 69.0; IQR 54.0–81.0), of low complexity (33.0; 18.0–47.0), uneventful (27.0; 14.0–46.5), and gave moderate affordances (50.0; 35.0–67.0). Changes in attributes were statistically significant (p < 0.01). The proportion of the dimension calm increased (z = 12.7, p < 0.01), the proportion of chaotic decreased (z = 15.0, p < 0.01), and the proportion of lively decreased not statically significant (z = 0.68, p = 0.79). The proportion of boring was unchanged. The proportion of grades ≥6 increased after implementation of the micro-interventions (z = 15.3, p < 0.01). The micro-interventions focused on removing or reducing disturbing sounds and were unique for each nursing home. Discussion The MoSART+ intervention resulted in a statistically significantly improvement of soundscapes, and more favorable evaluations of the nursing staff. The intervention empowered staff to adapt soundscapes. Nursing homes can improve soundscapes by raising sound awareness among staff. Trial Registration Netherlands National Trial Register (NL6831).
| S-EPMC9199855 | biostudies-literature
Project description:Background and objectivesWhen staff experience responsive behaviors from residents, this can lead to decreased quality of work life and lower quality of care in long-term care homes. We synthesized research on factors associated with resident responsive behaviors directed toward care staff and characteristics of interventions to reduce the behaviors.Research design and methodsWe conducted a mixed-methods systematic review with quantitative and qualitative research. We searched 12 bibliographic databases and "gray" literature, using 2 keywords (long-term care, responsive behaviors) and their synonyms. Pairs of reviewers independently completed screening, data extraction, and risk of bias assessment. We developed a coding scheme using the ecological model as an organizing structure and prepared narrative summaries for each factor.ResultsFrom 86 included studies (57 quantitative, 28 qualitative, 1 mixed methods), multiple factors emerged, such as staff training background (individual level), staff approaches to care (interpersonal level), leadership and staffing resources (institutional level), and racism and patriarchy (societal level). Quantitative and qualitative results each provided key insights, such as qualitative results pertaining to leadership responses to reports of behaviors, and quantitative findings on the impact of staff approaches to care on behaviors. Effects of interventions (n = 14) to reduce the behaviors were inconclusive.Discussion and implicationsWe identified the need for an enhanced understanding of the interrelationships among factors associated with resident responsive behaviors toward staff and processes leading to the behaviors. To address these gaps and to inform theory-based effective interventions for preventing or mitigating responsive behaviors, we suggest intervention studies with systematic process evaluations.
| S-EPMC10167766 | biostudies-literature
Project description:BackgroundElder abuse in long-term care is an important public health concern with social, health-related, and economic implications. Staff-to-resident abuse is of particular interest since institutions should protect residents' rights and prevent harm. To provide an up-to date comprehensive overview of staff-to-resident abuse in nursing homes, we performed a scoping review considering types of abuse, their prevalence and associated factors, descriptions, experiences, and preventive interventions.MethodsWe performed a scoping review following the framework provided by Arksey and O'Malley. We searched MEDLINE (via PubMed), CINAHL, PsycINFO via Ovid, and Cochrane Library. Additionally, we performed free web searching using Google Scholar and checked relevant reviews. Two reviewers independently selected studies. We narratively synthesised the results.ResultsOut of 3876 references retrieved by our search, we included 46 studies in 47 reports. The prevalence rates of abuse varied widely, ranging from 0 to 93% depending on the type of abuse. Associated factors of abuse at the staff, resident, and nursing home level were evaluated inconsistently. Abuse was perceived ambiguous: even though it was considered unacceptable, it was underreported. We found only four studies addressing preventive interventions. Of these, four made recommendations for intervention development. Only one study with an experimental design examined a multi-component intervention including education and mutual support.ConclusionsThe review yielded heterogenous evidence not allowing a concrete conclusion on prevalence and associated factors. However, the results show the significance of the problem and indicate that there are associate factors of abuse that can be influenced by appropriate interventions. These are amongst other staff education, organisational culture, and conditions. Further research should investigate the composition and content of preventive interventions and their potential to reduce abusive behaviours.
| S-EPMC9261065 | biostudies-literature
Project description:During the COVID-19 pandemic and compared to other population groups, older people were at a heightened risk of developing lethal disease symptoms. Thus, many countries put in place protective measures to protect this "at-risk" population, especially in nursing homes, to limit the number of infections. These measures consisted mostly in the absence of social gatherings, the impossibility for relatives to enter the nursing homes, limitations in group activities, and the ban of group-eating. Although these measures were helpful to mitigate the spread of the disease, they also induced long periods of social isolation for the residents of nursing homes. This could have impacted the wellbeing and quality of life of residents and their relatives, with a possible impact on the overall health of residents. We designed this rapid review to investigate the literature on the impact of COVID-19 protective measures in nursing homes on the quality of life, wellbeing and physical health of residents and their relatives. Our results showed that most of the articles included in the review, either using qualitative or quantitative methods, evidenced a detrimental impact of protective measures on resident's and their relatives' wellbeing. We argue that, in the event of a new pandemic similar to the COVID-19, protective measures should also take into account their psychological impact, and not only their physical impact.
| S-EPMC10568910 | biostudies-literature