Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Department of Gerontology, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
J Am Med Dir Assoc. 2023 Aug;24(8):1127-1132.e6. doi: 10.1016/j.jamda.2023.05.018. Epub 2023 May 30.
COVID-19-related policies introduced extraordinary social disruption in nursing homes. In response, nursing facilities implemented strategies to alleviate their residents' loneliness. This study sought to describe interventions nursing homes used, document the perceived effectiveness of efforts, and determine barriers to implementing strategies to mitigate social isolation and loneliness.
National survey of nursing homes sampled in strata defined by facility size (beds: 30-99, 100+) and quality ratings (1, 2-4, 5).
US Nursing Home Directors of Nursing/Administrators (n = 1676).
The survey was conducted between February and May 2022 (response rate: 30%; n = 504, weighted n = 14,506). Weighted analyses provided nationally representative results.
One-third were extremely concerned about their home's ability to meet residents' medical and social needs during COVID-19 before vaccines were available and 13% after vaccines. Nearly all reported trying to mitigate residents' social isolation during the pandemic. Efforts tried, and perceived as most useful, included using technology (tablets, phones, emails), assigning staff as a family contact, and more staff time with residents. Most frequently cited barriers to implementation were related to staffing issues.
Despite multiple challenges, nearly all nursing homes tried to implement many different approaches to address residents' social needs, with some (eg, having an assigned family contact, use of tablets and phones) perceived as more useful than others. Staffing issues presented barriers for addressing the social needs of nursing home residents. Many strategies for addressing social isolation placed more demands on a workforce already stretched to the limit. While concerns about resident social isolation reduced after vaccine availability, administrators remained extremely concerned about staff burnout and mental health.
新冠疫情相关政策给养老院带来了极大的社会混乱。作为回应，养老院实施了各种策略来缓解居民的孤独感。本研究旨在描述养老院采用的干预措施，记录这些措施的效果，并确定实施减轻社会隔离和孤独感策略的障碍。
对按设施规模（30-99 床、100+床）和质量评级（1、2-4、5）分层抽样的美国养老院进行全国性调查。
美国养老院注册护士/管理人员（n=1676）。
调查于 2022 年 2 月至 5 月进行（应答率：30%；n=504，加权 n=14506）。加权分析提供了全国代表性结果。
在疫苗可用之前，三分之一的人非常担心他们的养老院在新冠疫情期间能够满足居民的医疗和社会需求，而在疫苗可用之后，这一比例为 13%。几乎所有养老院都报告称，在大流行期间试图减轻居民的社会隔离。尝试过的、被认为最有用的措施包括使用技术（平板电脑、电话、电子邮件）、指定工作人员作为家庭联系人，以及增加工作人员与居民的相处时间。实施过程中最常提到的障碍与人员配备问题有关。
尽管面临诸多挑战，但几乎所有养老院都试图实施多种不同的方法来满足居民的社会需求，其中一些方法（例如，指定家庭联系人、使用平板电脑和电话）比其他方法被认为更有用。人员配备问题成为满足养老院居民社会需求的障碍。许多解决社会隔离问题的策略对已经不堪重负的劳动力提出了更多要求。虽然对居民社会隔离的担忧在疫苗可用后有所减少，但管理人员仍然对员工倦怠和心理健康问题深感担忧。
