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Wound-Specific Oral Nutritional Supplementation Can Reduce the Economic Burden of Pressure Injuries for Nursing Homes: Results from an Economic Model 伤口特异性口服营养补充可以减轻疗养院压力伤害的经济负担:来自经济模型的结果
Q2 Health Professions Pub Date : 2023-01-01 DOI: 10.31389/jltc.173
J. Shafrin, Shanshan Wang, K. Kerr
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引用次数: 0
No Visitors Allowed! The Impact of COVID-19 Restrictions on the Psychosocial Well-Being of Nursing Home Residents 禁止访客入内!COVID-19限制对养老院居民心理社会健康的影响
Q2 Health Professions Pub Date : 2023-01-01 DOI: 10.31389/jltc.135
Shanae Logan Shaw, Ellen Csikai
Context: The COVID-19 pandemic changed life for everyone, but especially for nursing home residents. In March 2020, the Centers for Medicare and Medicaid Services in the United States enacted nursing home restrictions regarding visitation from outside family/friends and changes to facility activity programmes. Objective: This study explored the nursing home policies and practices that preserved relationships among nursing home residents with spouses/partners. Nursing home social workers shared the effects of COVID-19 restrictions on residents’ relationships with spouses/partners and how they sought to maintain these essential social connections to minimise the detrimental effect on the psychosocial well-being of residents. Methods: The study utilised both an online survey and 10 telephone interviews with nursing home social workers in four southern states. Findings: Twenty-eight percent of participants reported that no visitors were allowed, while 25% allowed couples to visit with one another as usual. The most noted practices to maintain social connections were phone calls, video calls, and ‘window’ visits between residents and family/friends; however, as one respondent noted, ‘It’s just not the same. It’s affected them greatly.’ Interviews revealed further details about the detrimental effects of the COVID-19 restrictions on nursing home residents’ overall mental health and attachment relationships with spouses/partners. Limitations: Study limitations exist in the focus on practices in four south-eastern states, with no inclusion of northern US states. An additional limitation of sampling is discussed. Implications: These results highlight the importance of maintaining social connections between residents and spouses/partners. Policies and practices that enhance relationships and connections under all circumstances should be formalised and all health care team members trained to ensure implementation.
背景:2019冠状病毒病大流行改变了每个人的生活,尤其是疗养院居民。2020年3月,美国医疗保险和医疗补助服务中心颁布了限制外来家庭/朋友探视养老院和改变养老院活动方案的规定。目的:本研究探讨疗养院政策与实务,以维持疗养院住客与配偶/伴侣的关系。养老院社工分享了COVID-19限制对居民生活的影响;与配偶/伴侣的关系,以及他们如何维持这些重要的社会关系,以尽量减少对居民心理健康的不利影响。方法:该研究采用了在线调查和10个电话访谈的养老院社会工作者在四个南部州。调查结果:28%的参与者报告说不允许访客,而25%的人允许夫妇像往常一样互相拜访。最著名的保持社会联系的方法是打电话、视频通话和“窗口”。住户与家人/朋友的探访;然而,正如一位受访者所指出的那样,“这是不一样的。”这对他们影响很大。采访揭示了COVID-19限制对养老院居民不利影响的更多细节;整体心理健康和与配偶/伴侣的依恋关系。局限性:研究局限于四个东南部州的实践,不包括美国北部州。讨论了抽样的另一个限制。启示:这些结果强调了维持居民与配偶/伴侣之间的社会联系的重要性。应将在任何情况下加强关系和联系的政策和做法正式化,并对所有卫生保健小组成员进行培训,以确保执行。
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引用次数: 1
Family Physicians’ Roles in Long-Term Care Homes and Other Congregate Residential Care Settings during the COVID-19 Pandemic: A Qualitative Study 在COVID-19大流行期间,家庭医生在长期护理院和其他集中住宿护理机构中的作用:一项定性研究
Q2 Health Professions Pub Date : 2023-01-01 DOI: 10.31389/jltc.229
Maria Mathews, Jennifer Xiao, Lindsay Hedden, Julia Lukewich, Emily Gard Marshall, Richard Buote, Leslie Meredith, Lauren Moritz, Dana Ryan, Sarah Spencer, Shabnam Asghari, Paul S. Gill, Jamie Wickett, Eric Wong
Context: The COVID-19 pandemic disproportionally affected long-term care (LTC) homes and other community-based congregate residential care settings. Although family physicians (FPs) play important roles in the care of residents in LTC homes, provincial pandemic plans make few references to their specific roles in LTC. Objective: To examine the experiences of FPs providing care in LTC homes and other congregate care settings in Canada during the first year of the COVID-19 pandemic (2020–2021). Methods: As part of a multiple case study, we conducted semi-structured qualitative interviews with FPs across four Canadian regions. Interviews were transcribed, and a thematic analysis approach was employed. Findings: Twenty-one of the 68 FPs interviewed discussed providing care in congregate residential settings, including LTC. We identified three major themes: 1) the roles of FPs in community-based congregate residential care settings during a pandemic, 2) modification of the delivery of routine care, and 3) special workforce considerations in pandemic response for community-based congregate residential care settings. Limitations: We interviewed FPs in four Canadian jurisdictions between October 2020 and June 2021; findings may not be generalisable to later pandemic stages or to other provinces. Our recruitment strategy did not specifically target FPs who worked in different types of congregate residential care facilities; further research is needed to examine these settings in greater depth. Implications: FPs have a unique understanding of the populations they serve and are well suited to plan and implement community-adaptive procedures. Future pandemic plans should implement LTC-related FP roles during the pre-pandemic stage of a pandemic response.
背景:2019冠状病毒病大流行对长期护理之家和其他社区聚集性寄宿护理机构的影响尤为严重。尽管家庭医生在LTC住院者的护理中发挥着重要作用,但省级大流行计划很少提及他们在LTC中的具体作用。目的:研究2019冠状病毒病大流行第一年(2020–2021)在加拿大LTC家庭和其他聚集性护理机构提供护理的FPs的经验。方法:作为多案例研究的一部分,我们对加拿大四个地区的FPs进行了半结构化定性访谈。访谈记录下来,并采用专题分析方法。调查结果:68名接受采访的家庭护理人员中有21人讨论了在包括LTC在内的集中居住环境中提供护理。我们确定了三个主要主题:1)大流行期间社区综合寄宿护理机构中FPs的作用,2)常规护理提供的修改,以及3)社区综合寄宿护理机构应对大流行时对劳动力的特殊考虑。限制:我们在2020年10月至2021年6月期间在四个加拿大司法管辖区采访了FPs;调查结果可能无法推广到大流行后期或其他省份。我们的招聘策略并没有专门针对在不同类型的综合住宿护理机构工作的FPs;需要进一步的研究来更深入地检查这些设置。启示:FPs对他们所服务的人群有独特的理解,非常适合计划和实施社区适应程序。未来的大流行计划应在大流行应对的大流行前阶段实施与长期合作有关的计划生育角色。
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引用次数: 0
Navigating Mealtimes to Meet Public Health Mandates in Long-Term Care During COVID-19: Staff Perspectives 在2019冠状病毒病期间调整用餐时间以满足长期护理中的公共卫生要求:工作人员的观点
Q2 Health Professions Pub Date : 2023-01-01 DOI: 10.31389/jltc.217
Hana Dakkak, Sarah A. Wu, Vanessa Trinca, Allison Cammer, Ruth Harvie, Christina Lengyel, Hannah M. O’Rourke, Susan E. Slaughter, Natalie Carrier, Heather Keller
Context: Mealtimes in long-term care (LTC) settings play a pivotal role in the daily lives of residents. The COVID-19 pandemic and the required precautionary infection control mandates influenced many aspects of resident care within LTC homes, including mealtimes. Limited research has been conducted on how mealtimes in LTC were affected during the pandemic from staff perspectives. Objective: To understand the experiences of LTC staff on providing mealtimes during the pandemic. Methods: Semi-structured telephone interviews were conducted with 22 staff involved with mealtimes between February and April 2021. Transcripts were analysed using interpretive description. Findings: Three themes emerged from the analysis: (1) recognizing the influence of homes’ contextual factors. Home size, availability of resources, staffing levels and resident care needs influenced mealtime practices during the pandemic; (2) perceiving a compromised mealtime experience for residents and staff. Staff were frustrated and described residents as being dissatisfied with mealtime and pandemic-initiated practices as they were task-focused and socially isolating and (3) prioritizing mealtimes while trying to stay afloat. An ‘all hands-on deck’ approach, maintaining connections and being adaptive were strategies identified to mitigate the negative impact of the mandates on mealtimes during the pandemic. Limitations: Perspectives were primarily from nutrition and food service personnel. Implications: Overly restrictive public health measures resulted in mealtime practices that prioritized tasks and safety over residents’ quality of life. Learning from this pandemic experience, homes can protect the relational mealtime experience for residents by fostering teamwork, open and frequent communication and being flexible and adaptive.
背景:长期护理(LTC)环境中的用餐时间在居民的日常生活中起着关键作用。COVID-19大流行和所需的预防性感染控制任务影响了长期护理中心住客护理的许多方面,包括用餐时间。从工作人员的角度,对疫情期间LTC的用餐时间如何受到影响进行了有限的研究。目的:了解疫情期间LTC工作人员提供用餐时间的经验。方法:于2021年2月至4月对22名涉及用餐时间的工作人员进行半结构化电话访谈。使用解释性描述分析转录本。研究发现:从分析中得出三个主题:(1)认识到家庭的影响;语境因素。大流行期间,家庭规模、资源可用性、人员配备水平和居民护理需求影响了用餐时间的做法;(2)居民和工作人员的用餐体验受到损害。工作人员感到沮丧,并描述居民对用餐时间和流行病引发的做法不满意,因为他们以任务为中心,孤立社会,(3)优先考虑用餐时间,同时试图维持生计。一个全操作甲板;为减轻疫情期间任务对用餐时间的负面影响,确定了办法、保持联系和适应的战略。局限性:观点主要来自营养和食品服务人员。影响:过度限制的公共卫生措施导致用餐时间优先考虑任务和安全,而不是居民的健康;生活质量。从这次大流行的经验中吸取教训,家庭可以通过培养团队合作、开放和频繁的沟通以及灵活性和适应性来保护居民的用餐时间体验。
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引用次数: 0
Exploring the Challenges Faced by Health Care Professionals Working with People Living with Dementia Amid COVID-19 Pandemic in the English West Midlands Region 探索在英国西米德兰兹地区COVID-19大流行期间与痴呆症患者一起工作的医疗保健专业人员所面临的挑战
Q2 Health Professions Pub Date : 2023-01-01 DOI: 10.31389/jltc.180
M. Ekpenyong, Farai Pfende, M. Nyashanu
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引用次数: 0
The Effectiveness of Advance Care Planning (ACP) Training for Care Home Staff: An Updated Systematic Review 安老院员工预先护理计划(ACP)培训的成效:最新的系统检讨
Q2 Health Professions Pub Date : 2023-01-01 DOI: 10.31389/jltc.225
Victoria Barber-Fleming, Mala Mann, Gillian Mead, Aoife Gleeson
Context: Population ageing and projections that more people will die in care homes demand that care home staff are prepared for advance care planning (ACP). This is an update of a prior review, published in 2021, of ACP education interventions for healthcare professionals in care homes. Objective: We sought to address the questions: (1) What ACP education interventions exist for care home staff? and (2) How effective are these interventions? Method: The review adheres to PRISMA; PROSPERO (ID: CRD42022337865). Original research evaluating ACP education for care home staff, reporting any measurable outcome of effectiveness, was included. Extensive literature searches were performed from March 2018 to June 2022. The results were reported by narrative synthesis. Findings: We identified 10 studies (310 care homes), from the UK, Belgium, Norway and Canada. Major sources of heterogeneity between studies include intervention design, target population and outcome measure. More recent interventions target the wider multi-disciplinary team. There is a trend towards the adoption of more resident/family and staff-related outcomes. There was insufficient evidence to draw conclusions about the effectiveness of ACP education interventions. Limitations: Heterogeneity of the primary studies did not allow for meta-analysis. Implications: There is still insufficient data to determine the effectiveness of ACP education interventions for care home staff. Future researchers should aim to agree on outcomes that are specific to ACP education interventions for care home staff and develop standardised, validated outcome measures. Study design should consider an intervention’s ‘theory of change’ when considering outcomes.
背景:人口老龄化和越来越多的人将死于养老院的预测要求养老院的工作人员做好提前护理计划(ACP)的准备。这是对2021年发表的一篇关于养老院医护人员ACP教育干预措施的先前综述的更新。目的:我们试图解决以下问题:(1)对养老院工作人员有哪些ACP教育干预措施?(2)这些干预措施的效果如何?方法:采用PRISMA检查;普洛斯彼罗(id: crd42022337865)。评估养老院工作人员ACP教育的原始研究,报告了任何可测量的有效性结果。从2018年3月至2022年6月进行了广泛的文献检索。结果用叙事综合法报道。研究结果:我们确定了来自英国、比利时、挪威和加拿大的10项研究(310家养老院)。研究间异质性的主要来源包括干预设计、目标人群和结果测量。最近的干预措施针对的是更广泛的多学科团队。有一种趋势是采用更多与居民/家庭和工作人员有关的成果。没有足够的证据来得出关于ACP教育干预措施有效性的结论。局限性:主要研究的异质性不允许进行meta分析。结论:目前还没有足够的数据来确定ACP教育干预对护理院工作人员的有效性。未来的研究者应该致力于对养老院工作人员的ACP教育干预的具体结果达成一致,并开发标准化的、有效的结果测量方法。研究设计应考虑干预和改变理论。当考虑结果时。
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引用次数: 0
Researchers’ Experiences of the Challenges of Conducting Two Randomised Controlled Trials in Care Homes 研究人员在护理院进行两项随机对照试验的挑战经验
Q2 Health Professions Pub Date : 2023-01-01 DOI: 10.31389/jltc.187
I. Patel, Liz Graham, A. Forster, Ikhlaq Jacob, A. Ellwood
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引用次数: 0
Canadian Long-Term Residential Care Staff Recommendations for Pandemic Preparedness and Workforce Mental Health 加拿大长期住宿护理人员关于流行病防范和劳动力心理健康的建议
Q2 Health Professions Pub Date : 2023-01-01 DOI: 10.31389/jltc.177
Nick Boettcher, Sofia Celis, Bonnie Lashewicz
Context: The impacts of Covid-19 pandemic conditions in Canada’s long-term residential care (LTRC) sector have demonstrated that future pandemic preparedness necessitates not only recovery but deeper sectoral transformation of longstanding vulnerabilities. Improving workforce mental health and resilience is central to these transformative efforts. Objective: This study presents a content analysis of staff recommendations for pandemic preparedness and employee mental health in LTRC. Methods: Qualitative data were gathered through semi-structured interviews conducted with 50 LTRC staff members from 12 organizations. The interviews aimed to gain insights into supporting worker mental health in the first wave of the Covid-19 pandemic. Participant responses to a question seeking recommendations for future pandemic preparedness were extracted and analyzed using qualitative content analysis. Findings: Our findings encompass staff recommendations organized into seven categories: 1) Risk reduction and compensation, 2) Staffing reappraisal, 3) Opportunities for relief, 4) Spaces to be heard, 5) Improved communication, 6) Cultivating responsive leadership, and 7) Redefining public accountability. Limitations: The data primarily relied on interviews with LTRC workers from western Canada. Implications: Recommendations are situated within existing policy and research for worker mental health and staffing. We discuss how supporting and listening to LTRC workers can strengthen pandemic preparedness, workforce mental health, and delivery of quality person-centered care. We position the increased presence of worker voices in knowledge generation and policymaking as vital for realizing the sectoral transformations needed in LTRC.
背景:2019冠状病毒病大流行对加拿大长期寄宿护理(LTRC)行业的影响表明,未来的大流行防范不仅需要恢复,还需要对长期存在的脆弱性进行更深层次的行业转型。改善劳动力的心理健康和复原力是这些变革努力的核心。目的:本研究对LTRC员工对大流行防范和员工心理健康的建议进行内容分析。方法:对来自12个组织的50名LTRC工作人员进行半结构化访谈,收集定性数据。这些访谈旨在深入了解在Covid-19大流行的第一波中如何支持工人的心理健康。与会者对寻求对未来大流行病防范提出建议的问题的答复被提取出来,并使用定性内容分析进行了分析。研究结果:我们的研究结果包括员工建议,分为7类:1)风险降低和补偿,2)人员重新评估,3)救济机会,4)倾听空间,5)改善沟通,6)培养响应型领导,7)重新定义公共责任。局限性:数据主要依赖于对加拿大西部LTRC工人的采访。影响:建议位于现有的工人心理健康和人员配备政策和研究范围内。我们讨论了支持和倾听ltc工作者如何加强大流行防范、劳动力心理健康和提供高质量的以人为本的护理。我们认为,在知识产生和政策制定过程中,工人的声音越来越多,这对于实现低碳经济所需的部门转型至关重要。
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引用次数: 0
A Confluence of Cultures: Advance Care Planning in Long-Term Care Settings 文化的融合:长期护理环境中的预先护理计划
Q2 Health Professions Pub Date : 2023-01-01 DOI: 10.31389/jltc.203
S. Soheilipour, Katrina Jang, B. de Vries, Helen Kwan, G. Gutman
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引用次数: 0
Applying Outcomes in Community-Based Social Care Practice in England 应用结果在基于社区的社会护理实践在英格兰
Q2 Health Professions Pub Date : 2023-01-01 DOI: 10.31389/jltc.169
Stacey E Rand, Grace Collins, Wenjing Zhang, A. Milne, B. Silarova
Context: Social care outcomes (the effect of services on the quality of life of people with support needs and unpaid carers) have been proposed as a way of improving the quality and effectiveness of care. Outcomes have also been proposed as a way of reconceptualising ‘needs’ that have applications in needs assessment, care planning, evaluation and care practice. Objectives: The study aimed to provide insights into social care professionals’ experiences and views on the collection and application of outcomes data in practice and what they believe are the benefits, challenges and barriers to implementation. Methods: Interviews were conducted with 25 social care professionals in England and analysed using a framework approach. Findings: Participants reported perceived benefits of using outcomes data, especially to focus effort on improving the well-being of people with support needs and carers. Perceived challenges include requirements for data collection set by funders/ commissioners, the volume of data collected, difficulties in separating non-service-related influences on outcomes and the format of collection. Participants felt a more flexible approach might facilitate more meaningful conversations, rather than a ‘tick-box’ exercise. Limitations: The study sample was purposive, based on established connections. It only included professionals from London and South East and Central England. Implications: Although outcomes are perceived as important in helping to improve people’s lives, social care professionals identified a number of challenges. Further
背景:社会护理结果(服务对有支持需求的人和无报酬照顾者的生活质量的影响)已被提议作为提高护理质量和有效性的一种方式。结果也被提议作为重新定义“需求”的一种方式,在需求评估、护理计划、评估和护理实践中有应用。目的:本研究旨在了解社会护理专业人员在实践中收集和应用结果数据的经验和观点,以及他们认为实施结果数据的好处、挑战和障碍。方法:对英国25名社会护理专业人员进行访谈,并使用框架方法进行分析。研究结果:参与者报告了使用结果数据的好处,特别是将精力集中在改善有支持需求的人和照顾者的福祉上。感知到的挑战包括供资人/专员制定的数据收集要求、收集的数据量、在区分与服务无关的影响对结果的影响方面的困难以及收集的格式。参与者认为,更灵活的方法可能会促进更有意义的对话,而不是“打勾”式的练习。局限性:研究样本是有目的的,基于已建立的联系。它只包括来自伦敦、英格兰东南部和中部的专业人士。启示:尽管结果被认为对帮助改善人们的生活很重要,但社会护理专业人员发现了一些挑战。进一步
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引用次数: 0
期刊
Journal of long-term care
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