Long Term Care & Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada.
Long Term Care & Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada
BMJ Open. 2023 Dec 20;13(12):e076186. doi: 10.1136/bmjopen-2023-076186.
The goals of this rapid realist review were to ask: (a) what are the key mechanisms that drive successful interventions for long COVID in long-term care (LTC) and (b) what are the critical contexts that determine whether the mechanisms produce the intended outcomes?
Rapid realist review.
Medline, CINAHL, Embase, PsycINFO and Web of Science for peer-reviewed literature and Google for grey literature were searched up to 23 February 2023.
We included sources focused on interventions, persons in LTC, long COVID or post-acute phase at least 4 weeks following initial COVID-19 infection and ones that had a connection with source materials.
Three independent reviewers searched, screened and coded studies. Two independent moderators resolved conflicts. A data extraction tool organised relevant data into context-mechanism-outcome configurations using realist methodology. Twenty-one sources provided 51 intervention data excerpts used to develop our programme theory. Synthesised findings were presented to a reference group and expert panel for confirmatory purposes.
Fifteen peer-reviewed articles and six grey literature sources were eligible for inclusion. Eleven context-mechanism-outcome configurations identify those contextual factors and underlying mechanisms associated with desired outcomes, such as clinical care processes and policies that ensure timely access to requisite resources for quality care delivery, and resident-centred assessments and care planning to address resident preferences and needs. The underlying mechanisms associated with enhanced outcomes for LTC long COVID survivors were: awareness, accountability, vigilance and empathetic listening.
Although the LTC sector struggles with organisational capacity issues, they should be aware that comprehensively assessing and monitoring COVID-19 survivors and providing timely interventions to those with long COVID is imperative. This is due to the greater care needs of residents with long COVID, and coordinated efficient care is required to optimise their quality of life.
本快速现实主义综述旨在探讨：（a）在长期护理（LTC）中，哪些是推动长新冠干预成功的关键机制；（b）哪些是决定这些机制是否产生预期结果的关键背景？
快速现实主义综述。
截至 2023 年 2 月 23 日，通过 Medline、CINAHL、Embase、PsycINFO 和 Web of Science 检索同行评议文献，通过 Google 检索灰色文献。
我们纳入了专注于干预措施、LTC 中的人、长新冠或急性后阶段至少 4 周以上的新冠感染患者以及与原始材料有联系的研究。
三位独立评审员搜索、筛选和编码研究。两位独立的调和员解决了冲突。使用现实主义方法，数据提取工具将相关数据组织到情景-机制-结果配置中。21 个来源提供了 51 个干预措施数据摘录，用于制定我们的计划理论。综合结果被提交给参考小组和专家小组进行确认。
15 篇同行评议文章和 6 篇灰色文献来源符合纳入标准。11 个情景-机制-结果配置确定了与预期结果相关的背景因素和潜在机制，例如确保及时获得必要资源以提供高质量护理的临床护理流程和政策，以及针对居民偏好和需求进行居民为中心的评估和护理计划。与 LTC 长新冠幸存者改善结果相关的潜在机制包括：意识、问责制、警惕和同理心倾听。
尽管长期护理部门面临组织能力问题，但他们应该意识到，全面评估和监测新冠幸存者并及时为长新冠患者提供干预措施至关重要。这是因为长新冠患者的护理需求更大，需要协调高效的护理以优化他们的生活质量。
