International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Bailrigg, Lancaster, UK.
Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
BMC Geriatr. 2024 Mar 27;24(1):286. doi: 10.1186/s12877-024-04804-w.
Care homes (long-term care facilities) were profoundly impacted early in the COVID-19 pandemic, both in terms of resident mortality and restrictions for infection control. This study investigated the impact on the emotional well-being of care home staff of challenges faced at this time, and the strategies used to manage them.
Semi-structured interviews conducted October 2020-June 2021 with care home staff and health service staff working with them explored the impact of the early waves of the COVID-19 pandemic (March 2020-June 2021). Interview data were analysed using reflexive thematic analysis.
Interview participants were 16 care home staff and 10 health service staff. Analysis generated four key themes: 1)Anxiety and distress, 2)Overwhelming workload, 3)Pulling through; and 4)Resilience in a time of crisis. Care home staff experienced Anxiety and distress due to uncertainty of what to expect; witnessing illness and deaths of residents; concerns regarding their own health, and sometimes feeling their work was under-recognised. They also experienced an Overwhelming workload due to infection control measures, caring for sick residents and reduction in external healthcare support. Our theme of Pulling through reflects the peer support and problem-solving strategies with which care home staff managed the impact of the pandemic, along with a sense of responsibility and meaning towards their work. An overarching theme of Resilience in a time of crisis drew on the other three themes and describes how many staff managed, maintained, and often increased their work despite the challenges of the pandemic. Participants also described increasing emotional fatigue as the pandemic continued.
This paper builds on literature on the emotional impact of the pandemic on care home staff, also exploring ways that staff responded to this impact. These findings can help inform planning for future crises including disease outbreaks, and raise important questions for further work to develop pandemic preparedness in care homes and beyond. They also raise wider questions about the current cultural status of care work, which may have exposed care home staff to greater risk of distress, and which contrasts with the professionalism and responsibility shown by staff in response to pandemic challenges.
在 COVID-19 大流行早期，养老院（长期护理机构）受到了深远的影响，无论是在居民死亡率方面，还是在感染控制方面。本研究调查了此时面临的挑战对养老院工作人员情绪健康的影响，以及用于管理这些挑战的策略。
2020 年 10 月至 2021 年 6 月，对养老院工作人员和与之合作的卫生服务人员进行了半结构化访谈，探讨了 COVID-19 大流行早期（2020 年 3 月至 2021 年 6 月）的影响。使用反思性主题分析对访谈数据进行了分析。
参与访谈的有 16 名养老院工作人员和 10 名卫生服务工作人员。分析产生了四个主要主题：1）焦虑和困扰；2）不堪重负的工作量；3）挺过来；4）危机中的韧性。养老院工作人员因对未来情况的不确定性而感到焦虑和困扰；目睹居民患病和死亡；对自己的健康感到担忧，有时觉得自己的工作没有得到足够的认可。他们还因感染控制措施、照顾患病居民以及外部医疗支持减少而面临不堪重负的工作量。我们的主题“挺过来”反映了养老院工作人员在大流行期间通过同伴支持和解决问题的策略来应对影响，以及对工作的责任感和意义。一个贯穿始终的主题是“危机中的韧性”，它借鉴了其他三个主题，描述了许多工作人员如何在大流行的挑战下管理、维持，并且常常增加他们的工作。参与者还描述了随着大流行的持续，他们的情绪疲劳感不断增加。
本文在关于大流行对养老院工作人员情绪影响的文献基础上，进一步探讨了工作人员对此类影响的应对方式。这些发现有助于为未来的危机（包括疾病爆发）规划提供信息，并提出了进一步的工作的重要问题，以在养老院和其他地方加强大流行准备。它们还提出了关于护理工作当前文化地位的更广泛问题，这可能使养老院工作人员面临更大的困扰风险，而与工作人员应对大流行挑战时表现出的专业精神和责任感形成对比。
