Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
BMJ Open. 2022 Feb 2;12(2):e059437. doi: 10.1136/bmjopen-2021-059437.
To explore the impact of COVID-19 on postdiagnostic dementia care and support provision in England and Wales.
Qualitative research using semistructured interviews, via video or telephone conferencing.
Services providing postdiagnostic support across health, social care and the third sector.
21 professionals previously recruited to an ongoing research programme on postdiagnostic dementia care (or colleagues, if unavailable).
Key themes identified from the data were: challenges caused by COVID-19; responses to those challenges, including a widespread shift to remote working; and effects of COVID-19 on future postdiagnostic support. Challenges included changing and sometimes conflicting guidelines; a lack of access to support; identifying and responding to emerging needs; emotional and physical impact of COVID-19; and balancing COVID-19 risk with other risks such as deterioration. Some dementia services closed, while others adapted and continued to provide support thus potentially widening existing inequalities. There were also some unintended positive outcomes, including improved cross-sector and multidisciplinary working between professionals.
Delivering postdiagnostic dementia support during COVID-19 required essential adaptations. While some changes were detrimental to service users, others were identified as potentially beneficial and highly likely to become the new 'norm', for example, use of blended approaches, combining virtual and face-to-face work, thus allowing more flexible, integrated care. Our data have implications for policy and practice to improve the response to the lingering effects of COVID-19 as well as creating service provision that is more resilient to future pandemics or other periods of disruption.
探索 COVID-19 对英格兰和威尔士的诊断后痴呆症护理和支持服务的影响。
采用半结构式访谈的定性研究，通过视频或电话会议进行。
在卫生、社会护理和第三部门提供诊断后支持服务的机构。
21 名先前被招募到正在进行的诊断后痴呆症护理研究计划中的专业人员（或同事，如果无法联系到）。
从数据中确定的主要主题包括：COVID-19 带来的挑战；应对这些挑战的措施，包括广泛转向远程工作；以及 COVID-19 对未来诊断后支持的影响。挑战包括不断变化且有时相互冲突的指南；缺乏获得支持的机会；识别和应对新出现的需求；COVID-19 对情绪和身体的影响；以及在 COVID-19 风险与其他风险（如恶化）之间取得平衡。一些痴呆症服务关闭，而其他服务则进行了调整并继续提供支持，从而可能扩大现有的不平等现象。此外，还出现了一些意外的积极结果，包括改善了专业人员之间的跨部门和多学科合作。
在 COVID-19 期间提供诊断后痴呆症支持需要进行必要的调整。虽然一些变化对服务使用者不利，但其他变化被认为具有潜在的益处，并且极有可能成为新的“常态”，例如，采用混合方法，将虚拟和面对面工作相结合，从而提供更灵活、更综合的护理。我们的数据对政策和实践具有启示意义，以改善对 COVID-19 挥之不去的影响的应对，并创建更能抵御未来大流行或其他中断时期的服务提供。
