Belgium Covid-19 Project, Médecins Sans Frontières, Operational Centre Brussels, Brussels, Belgium.
Médecins Sans Frontières, Operational Centre Brussels, Operational Research Unit (LuxOR), Luxembourg, Luxembourg/Brussels, Belgium.
PLoS One. 2021 Mar 26;16(3):e0249098. doi: 10.1371/journal.pone.0249098. eCollection 2021.
Nursing homes (NH) for the elderly have been particularly affected by the Covid-19 pandemic mainly due to their hosted vulnerable populations and poor outbreak preparedness. In Belgium, the medical humanitarian organization Médecins Sans Frontières (MSF) implemented a support project for NH including training on infection prevention and control (IPC), (re)-organization of care, and psychosocial support for NH staff. As psychosocial and mental health needs of NH residents in times of Covid-19 are poorly understood and addressed, this study aimed to better understand these needs and how staff could respond accordingly.
A qualitative study adopting thematic content analysis. Eight focus group discussions with direct caring staff and 56 in-depth interviews with residents were conducted in eight purposively and conveniently selected NHs in Brussels, Belgium, June 2020.
NH residents experienced losses of freedom, social life, autonomy, and recreational activities that deprived them of their basic psychological needs. This had a massive impact on their mental well-being expressed in feeling depressed, anxious, and frustrated as well as decreased meaning and quality of life. Staff felt unprepared for the challenges posed by the pandemic; lacking guidelines, personal protective equipment and clarity around organization of care. They were confronted with professional and ethical dilemmas, feeling 'trapped' between IPC and the residents' wellbeing. They witnessed the detrimental effects of the measures imposed on their residents.
This study revealed the insights of residents' and NH staff at the height of the early Covid-19 pandemic. Clearer outbreak plans, including psychosocial support, could have prevented the aggravated mental health conditions of both residents and staff. A holistic approach is needed in NHs in which tailor-made essential restrictive IPC measures are combined with psychosocial support measures to reduce the impact on residents' mental health impact and to enhance their quality of life.
养老院（NH）受到新冠疫情的严重影响，主要原因是其入住的是脆弱人群，且疫情防控准备工作较差。在比利时，无国界医生组织（MSF）开展了一个支持 NH 的项目，包括感染预防和控制（IPC）培训、（重新）组织护理以及 NH 工作人员的心理社会支持。由于 NH 居民在新冠疫情期间的心理社会和心理健康需求了解甚少，本研究旨在更好地了解这些需求以及工作人员如何相应地做出回应。
采用主题内容分析法的定性研究。2020 年 6 月，在比利时布鲁塞尔的 8 家 NH 中，通过有针对性和方便的选择，共进行了 8 次直接护理人员焦点小组讨论和 56 次居民深入访谈。
NH 居民经历了自由、社交生活、自主性和娱乐活动的丧失，这剥夺了他们的基本心理需求。这对他们的心理健康产生了巨大影响，表现为抑郁、焦虑和沮丧，以及意义和生活质量下降。工作人员对疫情带来的挑战感到准备不足；缺乏指南、个人防护设备以及护理组织的明确性。他们面临着专业和道德困境，感到“被困”在 IPC 和居民的福祉之间。他们目睹了对其居民实施的措施产生的不利影响。
本研究揭示了疫情早期居民和 NH 工作人员的见解。更明确的疫情计划，包括心理社会支持，可以防止居民和工作人员的心理健康状况恶化。NH 需要采取整体方法，将定制的基本限制 IPC 措施与心理社会支持措施相结合，以减轻对居民心理健康的影响，提高他们的生活质量。
