Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
J Am Geriatr Soc. 2023 Jan;71(1):198-205. doi: 10.1111/jgs.18024. Epub 2022 Sep 9.
Care aides (certified nursing assistants, personal support workers) are the largest workforce in long-term care (LTC) homes (nursing homes). They provide as much as 90% of direct care to residents. Their health and well-being directly affect both quality of care and quality of life for residents. The aim of this study was to understand the impact of COVID-19 on care aides working in LTC homes during the first year of the pandemic.
We conducted semi-structured interviews with a convenience sample of 52 care aides from 8 LTC homes in Alberta and one in British Columbia, Canada, between January and April 2021. Nursing homes were purposively selected across: (1) ownership model and (2) COVID impact (the rate of COVID infections reported from March to December 2020). Interviews were recorded and analyzed using inductive content analysis.
Care aides were mainly female (94%) and older (74% aged 40 years or older). Most spoke English as an additional language (76%), 54% worked full-time in LTC homes, and 37% worked multiple positions before "one worksite policies" were implemented. Two themes emerged from our analysis: (1) Care aides experienced mental and emotional distress from enforcing resident isolation, grief related to resident deaths, fear of contracting and spreading COVID-19, increased workload combined with staffing shortages, and rapidly changing policies. (2) Care aides' resilience was supported by their strong relationships, faith and community, and capacity to maintain positive attitudes.
These findings suggest significant, ongoing adverse effects for care aides in LTC homes from working through the COVID-19 pandemic. Our data demonstrate the considerable strength of this occupational group. Our results emphasize the urgent need to appropriately and meaningfully support care aides' mental health and well-being and adequately resource this workforce. We recommend improved policy guidelines and interventions.
在长期护理（LTC）机构（养老院）中，护理助手（注册护士助理、个人支持工作者）是最大的劳动力。他们为居民提供高达 90%的直接护理。他们的健康和福祉直接影响居民的护理质量和生活质量。本研究旨在了解在大流行的第一年，护理助手在 LTC 机构工作时，新冠疫情对他们的影响。
我们于 2021 年 1 月至 4 月期间，对来自加拿大阿尔伯塔省的 8 个 LTC 机构和不列颠哥伦比亚省的 1 个机构的 52 名护理助手进行了方便样本的半结构式访谈。养老院是根据以下标准进行有针对性选择的：（1）所有权模式；（2）新冠疫情的影响（2020 年 3 月至 12 月报告的 COVID 感染率）。访谈内容通过归纳内容分析进行记录和分析。
护理助手主要是女性（94%）和老年人（74%年龄在 40 岁或以上）。大多数人会说英语以外的其他语言（76%），54%全职在 LTC 机构工作，37%在“一个工作场所政策”实施前从事多个职位。我们的分析得出了两个主题：（1）护理助手在执行居民隔离措施时经历了精神和情绪困扰、与居民死亡相关的悲痛、对感染和传播 COVID-19 的恐惧、工作量增加与人员短缺以及快速变化的政策。（2）护理助手的韧性得到了他们之间的牢固关系、信仰和社区以及保持积极态度的能力的支持。
这些发现表明，在新冠疫情期间，LTC 机构的护理助手面临着持续的严重不利影响。我们的数据表明了这个职业群体的巨大力量。我们的结果强调了迫切需要适当地、有意义地支持护理助手的心理健康和福祉，并充分为这个劳动力提供资源。我们建议改进政策指导方针和干预措施。
