Care‐home Nurses' responses to the COVID‐19 pandemic: Managing ethical conundrums at personal cost: A qualitative study

Journal of Nursing Scholarship, Journal Year: 2022, Volume and Issue: 55(1), P. 226 - 238

Published: Dec. 4, 2022

Abstract Introduction The COVID‐19 pandemic had an unprecedented effect on those living and working in care‐homes for older people, as residents were particularly vulnerable to contracting the SARS‐CoV‐2 virus, associated with high morbidity mortality. Often undervalued, care‐home nurses (RNs) are leaders, managing complex care while isolation from their professional peers. made this more apparent, when treatments initially unknown, increased due withdrawal of many health services, accompanied by staff shortages. Objective To explore RNs' experiences people's during pandemic. Design Qualitative interview study. Setting Care‐homes people England Scotland, UK. Methods Recruitment via direct contact care‐homes, social media, links provided national partners, then purposive sampling age, gender, type care‐home, location. Data collected through one‐to‐one online interviews using topic guide developed collaboratively nurses, focusing how impacted nurses' resilience mental wellbeing. analyzed thematically Tronto's ethics framework development interpretative themes. Results Eighteen (16 female; 16 adult, two nurses) interviewed March–June 2021; majority aged 46–55 years; mean time registered Nursing Midwifery Council: 19 17 nursed COVID‐19. resonated five tenets ethical care: attentiveness, responsibility, competence, responsiveness, solidarity. All described being attentive needs others, but less own needs, which came at personal cost. RNs aware leadership responsibilities, responsive they could be resident processing sharing rapidly changing guidance implementing appropriate infection control measures, felt that relatives regulatory bodies not always appreciative. enhanced clinical skills, increasing standing, reported having compromise care, leading moral distress. Broadly, participants a sense solidarity across together cope crisis. Conclusion Care‐home unprepared pandemic, experienced Supporting recover is essential maintain healthy, stable workforce specific RNs, recognizing unique experiences. Support will likely benefit other workers either directly wider roll‐out, or indirectly improved wellbeing nurse leaders. Clinical relevance international public emergency, created challenges Registered Nurses long‐term facilities impact virus. faced distinct hospital‐based nursing peers non‐nursing colleagues isolation, roles, legal obligations, psychological distress one hand, also newly found confidence existing recognition community specialisms.

Language: Английский

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Barriers to accessing and receiving mental health care for paid and unpaid carers of older adults

Health Expectations, Journal Year: 2024, Volume and Issue: 27(2)

Published: March 25, 2024

Abstract Aim The aim of this qualitative study was to explore the barriers and facilitators accessing receiving mental health care for paid unpaid carers older adults. Methods Unpaid adults in England were interviewed remotely between May December 2022. Participants asked about their experiences needs support. Reflexive thematic analysis used analyse data. Results Thirty‐seven participated ( n = 9; 28), with majority caring a parent dementia. Thematic generated four themes: lack healthcare support, social system failing enable time off, personal unsupportive work culture. Healthcare professionals failed provide any link services, including when dementia diagnosis received. Structural organisational evidenced by being unable take off from duties or role, due an absence support relative. Conclusions This is first have explored suggests that structural, cause severe difficulties required relatives, services users residents. Public Involvement Two aided development topic guides, data analysis, interpretation dissemination. Both supported trained code anonymised transcripts.

Language: Английский

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A service mapping exercise of four health and social care staff mental health and wellbeing services, Resilience Hubs, to describe health service provision and interventions

BMC Health Services Research, Journal Year: 2024, Volume and Issue: 24(1)

Published: April 4, 2024

Abstract Background NHS England funded 40 Mental Health and Wellbeing Hubs to support health social care staff affected by the COVID-19 pandemic. We aimed document variations in how national guidance was adapted local contexts of four North England. Methods used a modified version Price’s (2019) service mapping methodology. Service level data were inform analysis. A template from range tools, including European Mapping Schedule, reviewed Hub leads. Key included model; staffing; interventions. Data collected between March 2021 – 2022 site research assistants. Findings accuracy-checked leads, logic model developed theorise may effect change. Results goals models closely reflected guidance; offering: proactive outreach; team-based support; clinical assessment; onward referral, rapid access mental (in-house external). Implementation context client group with high need, waiting times at external services. predominantly staffed experienced clinicians, manage these presentations organisational working. Formulation-based psychological assessment provision direct therapy not core functions model, however all incorporated adaptations into their response contexts, such as extensive lists within services, and/or falling gaps existing provision. Finally, standalone records system seen important reassure users confidentiality. Other more nuanced variation depended on localised contexts. Conclusion This study provides map for setting up emphasising early understandings new services will integrate systems. Local regional led configuration. Whilst additional are supported available literature, further is needed determine whether should comprise essential components wellbeing moving forward. Future also comparative effectiveness components, limits permissible variation. Study registration researchregistry6303.

Language: Английский

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Nurses’ ethical challenges when providing care in nursing homes during the COVID-19 pandemic

Nursing Ethics, Journal Year: 2022, Volume and Issue: 30(1), P. 32 - 45

Published: Oct. 17, 2022

Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging the residents, their relatives, care staff. While these clearly impacted daily life in Norwegian nursing homes, knowledge about how pandemic influenced practice is sparse. Aim: aim of study was to illuminate ethical difficult situations experienced by nurses working homes during COVID-19 pandemic. Research design participants: research involved semistructured individual interviews conducted 15 8 3 health regions Norway, within both urban rural areas. Ethical considerations: Oral written information provided before participants gave consent. transcribed were de-identified. approved Centre Data. Findings: Four identified: (a) turning home into a prison; (b) using medication maintain peace order; (c) being left alone responsibility; (d) s. impact on decision-making. Conclusions: nurses' challenges intertwined external factors, such as national local guidelines, own internalized which connected subjective professionality. This duality inflicted emotional distress few opportunities perform professionally sound safe manner.

Language: Английский

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Implementation, uptake and use of a digital COVID-19 symptom tracker in English care homes in the coronavirus pandemic: a mixed-methods, multi-locality case study

Implementation Science Communications, Journal Year: 2023, Volume and Issue: 4(1)

Published: Jan. 17, 2023

Abstract Background COVID-19 spread rapidly in UK care homes for older people the early pandemic. National infection control recommendations included remote resident assessment. A region North-West England introduced a digital symptom tracker to identify signs of deterioration facilitate responses. We examined implementation, uptake and use across four geographical case study localities first year Methods This was rapid, mixed-methods, multi-locality study. Tracker calculated using number taking up as proportion total locality. Mean summarised at locality level compared. Semi-structured interviews were conducted with professionals involved implementation used explore factors localities. Template Analysis Consolidated Framework Implementation Research (CFIR) guided interpretation qualitative data. Results Uptake varied ranging between 13.8 77.8%. decreased all over time different rates, average 18 58%. The context differed process deviated from initially planned strategy, stakeholder engagement homes’ training. Four interpretative themes reflected most influential appearing affect use: (1) (2) readiness, (3) clarity purpose/perceived value (4) relative priority wider system pressures. Conclusions Our findings resonate solutions evidence base prior pandemic, suggesting three key that can inform future development rapid responses home settings even times crisis: an incremental approach testing organisational readiness attention climate, particularly innovation’s fit local contexts (i.e. systems, infrastructure, work processes practices); involvement end-users innovation design development; enabling users’ easy access sustained, high-quality, appropriate training support enable staff adapt solutions.

Language: Английский

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Nursing home staff perceptions of well‐being during the COVID‐19 pandemic: A qualitative study

Journal of Advanced Nursing, Journal Year: 2023, Volume and Issue: 79(10), P. 3866 - 3875

Published: June 12, 2023

To explore how nursing home staff perceived their work environment during the COVID-19 pandemic and this impacted well-being.A qualitative interview study.Interviews were held with twenty-two registered nurses assistant from five homes in Netherlands between April 2021 July 2021. The interviews analysed using content analysis. Standards for Reporting Qualitative Research (SRQR) followed.Five themes emerged indicated that working well-being of staff. Three concerned experiences at work: eroding care, additional roles workplace support. Specifically, increased workload tasks, constant stream new guidelines constrictive personal protective equipment caused discomfort anxiety. Two other outside work-life interference social interactions status. reported when they returned after work, tired worried about spreading virus while facing limited support.The distancing measures due to negatively by increasing demands absence adequate resources.The needs should receive continued attention ensure sustainability healthcare future crises.The managers participated recommending topics be covered interviews.What problem did study address? pressure stressful conditions on pandemic. What main findings? Nurses created strategies cope declining well-being. However, available resources not alleviate Where whom will research have an impact? This is important organizations understand affected so may better prepare crises.

Language: Английский

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Post-traumatic stress disorder, anxiety, depression and burnout in nursing home staff in South France during the COVID-19 pandemic

Translational Psychiatry, Journal Year: 2023, Volume and Issue: 13(1)

Published: June 15, 2023

Abstract The high mortality rate in nursing homes during the COVID-19 pandemic may be linked to psychological disorders staff. Hence, we assessed prevalence and associated factors of probable post-traumatic stress disorder (PTSD), anxiety, depression, burnout home staff a cross-sectional study including 66 randomly selected southern France. 537 contacted 3 821 workers (14.0%) responded between April October 2021. We collected information on center organization, severity exposure, socio-demographic an online survey. PTSD (PCL-5), anxiety depressive (Hospital Anxiety Depression Scale) sub-scores syndrome (Maslach Burnout Inventory Human Services Survey for Medical Personnel) were assessed. Probable was reported 115/537 responders (21.4% (95% CI [18.0%–24.9%])). After adjustment, low-level exposure residents (AOR, 0.5; 95% [0.3–0.9]), fear managing 3.5; [1.9–6.4]), conflicts with 2.3; CI, [1.2–4.4]), colleagues 3.6; [1.7–8.6]), cancellation leave 4.8; [2.0–11.7]) temporary worker employment 3.4; [1.7–6.9]) higher PTSD. depression 28.8% [24.9%–32.7%]) 10.4% [7.8%–13.1%]), respectively. Psychological observed nearly one third pandemic. continuous surveys preventive measures are needed this particularly at-risk population.

Language: Английский

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Mental health and self-rated health of older carers during the COVID-19 pandemic: evidence from England

Aging & Mental Health, Journal Year: 2023, Volume and Issue: 28(1), P. 103 - 111

Published: July 23, 2023

Objectives Older carers play a vital role supporting population health and protecting social care systems, yet there has been little research on understanding the effect of pandemic this group. In paper, we investigate caring as factor contributing to mental self-rated health.Methods We cross-sectional longitudinal associations between provision family wellbeing using data from 5,149 members English Longitudinal Study Ageing who responded Wave 9 (2018/2019) two COVID-19 sub-studies (June/July 2020; November/December 2020). use logistic or linear regression models depending outcome measures, controlling for pre-pandemic socioeconomic, demographic, health-related variables.Results Before pandemic, 21% respondents cared friends. people someone inside household mostly continued provide during with more than quarter reporting an increase in amount provided. Co-resident were disproportionately female, older, lowest wealth quintile, likely report disability chronic conditions. Both analyses suggest that, compared those living outside household, co-resident significantly poorer health.Conclusion The older worsened first year period also characterised by disruptions support closure respite services. Support carers' physical requires greater policy attention, especially

Language: Английский

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Being used for the greater good while fighting on the frontline: care staff’s experiences of working with older people during the COVID-19 pandemic in Sweden

BMC Geriatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: Feb. 6, 2024

Abstract Bakground Worldwide, older people were more severely affected during the COVID-19 pandemic than others. In Sweden, those living in residential care facilities had highest mortality rate, followed by receiving home services. The Swedish and international literature on working environment for assistant nurses aides shows an increase stress, anxiety, depression post-traumatic stress syndromes. Care organisations badly prepared to prevent virus from spreading protect staff stress. order be better possible future pandemics, health well-being of staff, experiences both after a are important aspects take into account. Therefore, this study aims describe their conditions impact all lives. Methodology has qualitative, descriptive design. data was collected four focus group interviews with 21 participants analysed using qualitative content analysis. Results results revealed theme, Being used greater good while fighting frontline , which then divided three categories: portrayed as risk people, not being valued burnt out. worsening that contributed resulted high degree burnout, members wanting actually leaving employment. After they felt forgotten again left cope even worse situation before. Conclusions major effect terms private To pandemics or disasters, responsibility will need ensure have necessary competencies there is adequate staffing place. This also means government funding multiple interventions needed.

Language: Английский

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Impact of COVID-19 on the Residential Aged Care Workforce, and Workers From Culturally and Linguistically Diverse Backgrounds: A Rapid Literature Review

Ageing International, Journal Year: 2024, Volume and Issue: 49(4), P. 836 - 871

Published: Feb. 21, 2024

Abstract This literature review explores the impact of COVID-19 upon residential aged care (RAC) workforce during coronavirus (COVID-19) pandemic, including from culturally and linguistically diverse (CALD) backgrounds. It also considers related interventions for RAC workforce. The databases ProQuest, PubMed, Cumulated Index to Nursing Allied Health Literature (CINAHL), Google Scholar Cochrane Central were searched in April May 2022. Twenty-six studies identified which on workforce, four CALD Many highlighted shortages, workplace demands, worker wellbeing, intention quit profession. importance communication support strategies pandemic underlined. Issues pertinent included understanding dementia, vaccine hesitancy care, migration labour market policies Workforce factors, poor working conditions (and lack paid leave) had a significant morbidity mortality. Conversely, responding impacted mental health. There is need research consider organisational communication, work-life balance, specific training needs workers backgrounds, who comprise proportion Australia many other countries.

Language: Английский

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