Führer Amand, Pacolli-Tabaku Latife, Kompa Paula, Yılmaz-Aslan Yüce, Brzoska Patrick
Institut für Medizinische Epidemiologie, Biometrie und Informatik, Profilzentrum Gesundheitswissenschaften, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Germany.
Lehrstuhl für Versorgungsforschung, Fakultät für Gesundheit, Department für Humanmedizin, Universität Witten/Herdecke, Witten, Germany.
Gesundheitswesen. 2024 Apr;86(4):315-321. doi: 10.1055/a-2144-5841. Epub 2023 Oct 10.
Refugees in Germany are often housed in shelters, where their influence on the organization of everyday life is severely limited. During the COVID-19 pandemic, these shelters therefore had a special responsibility to take measures to protect the health of their residents. The aim of this research project was to examine how this task was managed and how the pandemic affected daily life in refugee shelters, with the aim to formulate recommendations for practice.
Using a mixed-methods study, the first step was a scoping review of the literature on the management of infectious disease outbreaks in refugee shelters. Building on the findings of the review, management of the pandemic was then explored in an online survey and in interviews with experts and residents of shelters. In a third step, the results of the preceding steps were summarized and discussed with a panel of experts. Recommendations for practice were developed with the expert panel in two discussion rounds two months apart.
The refugee shelters included in the study were inadequately prepared for the pandemic and often did not develop contingency plans until the pandemic was underway. In many cases, the contingency plans included the establishment of crisis teams, but the interests and perspectives of facility residents were generally not represented by these teams. This subsequently led to problems: Pandemic measures were often not communicated in a timely or sufficiently understandable manner, gaps in care resulting from measures were not identified or addressed, and psychosocial stresses associated with the pandemic and quarantine measures were not adequately mitigated.
• Refugee shelters should establish mechanisms to integrate residents' interests and perspectives into decision-making processes in a structured manner, regardless of the pandemic.• Depending on the type of shelter, this should be realized through resident involvement in decision-making bodies or other appropriate representation of interests. • Measures introduced during the pandemic that may have a negative impact on the psychosocial situation of residents should be terminated as soon as the epidemic justification for the measures no longer applies.
德国的难民通常被安置在收容所，他们对日常生活安排的影响力极为有限。在新冠疫情期间，这些收容所因而肩负特殊责任，需采取措施保护居民健康。本研究项目旨在探讨这项任务是如何开展的，以及疫情如何影响难民收容所的日常生活，以期制定实践建议。
采用混合研究方法，第一步是对难民收容所传染病暴发管理的文献进行范围综述。基于综述结果，随后通过在线调查以及对收容所专家和居民的访谈来探究疫情管理情况。第三步，总结前几步的结果并与专家小组进行讨论。在相隔两个月的两轮讨论中，与专家小组共同制定实践建议。
纳入研究的难民收容所对疫情准备不足，往往直到疫情已经发生才制定应急预案。在许多情况下，应急预案包括设立危机应对小组，但这些小组通常未体现设施居民的利益和观点。这随后引发了一些问题：疫情防控措施往往未及时、充分清晰地传达，措施导致的护理缺口未被识别或解决，与疫情及隔离措施相关的心理社会压力未得到充分缓解。
• 无论是否处于疫情期间，难民收容所都应建立机制，将居民的利益和观点以结构化方式纳入决策过程。• 根据收容所类型，这应通过居民参与决策机构或其他适当的利益代表形式来实现。• 一旦措施的疫情防控依据不再适用，应立即终止疫情期间实施的可能对居民心理社会状况产生负面影响的措施。
