Tchouaket Eric Nguemeleu, Kruglova Katya, Létourneau Josiane, Bélanger Emilie, Robins Stephanie, Jubinville Maripier, El-Mousawi Fatima, Shen Shiyang, Beogo Idrissa, Sia Drissa
Department of Nursing, Université du Québec en Outaouais, St-Jérôme Campus, 5, rue Saint-Joseph, Office J-2204, Saint-Jérôme, QC, J7Z 0B7, Canada.
Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de la Montagne, Montréal, QC, H3G 2M1, Canada.
BMC Health Serv Res. 2024 Aug 7;24(1):901. doi: 10.1186/s12913-024-11331-2.
The COVID-19 pandemic wreaked havoc on long-term care facilities (LTCFs). Some LTCFs performed better than others at slowing COVID-19 transmission. Emerging literature has mostly described infection prevention and control strategies implemented by LTCFs during the pandemic. However, there is a need for a comprehensive review of factors that influenced the performance of LTCFs in containing COVID-19 spread to inform public health policy.
To build on the existing literature, we conducted a scoping review of factors that influenced LTCF performance during the COVID-19 pandemic using a multidimensional conceptual framework of performance.
We followed the Joanna Briggs Institute's methodology for scoping reviews. We queried CINAHL, MEDLINE (Ovid), CAIRN, Science Direct, Scopus, and Web of Science for peer-reviewed literature in English or French published between January 1, 2020 and December 31, 2021. Retrieved records were screened for context (COVID-19 pandemic), population (LTCFs), interest (internal and external factors that influenced LTCF performance), and outcomes (dimensions of performance: equity, accessibility, reactivity, safety, continuity, efficacy, viability, efficiency). Descriptive characteristics of included articles were summarized. Dimensions of performance as well as internal (e.g., facility characteristics) and external (e.g., visitors) factors identified to have influenced LTCF performance were presented.
We retained 140 articles of which 68% were classified as research articles, 47% originated in North America, and most covered a period between March and July 2020. The most frequent dimensions of performance were "efficacy" (75.7%) and "safety" (75.7%). The most common internal factors were "organizational context" (72.9%) and "human resources" (62.1%), and the most common external factors were "visitors" (27.1%) and "public health guidelines" (25.7%).
Our review contributes to a global interest in understanding the impact of the COVID-19 pandemic on vulnerable populations residing and working in LTCFs. Though a myriad of factors were reported, a lack of randomized controlled trials makes it impossible to establish causality between the identified factors and LTCF performance. The use of a multidimensional framework can be recommended to evaluate healthcare system performance not merely in terms of efficacy and safety, but alongside other critical dimensions such as efficiency and equity.
Research Registry ID: researchregistry7026.
新冠疫情给长期护理机构（LTCF）带来了巨大破坏。一些长期护理机构在减缓新冠病毒传播方面表现优于其他机构。新兴文献大多描述了长期护理机构在疫情期间实施的感染预防和控制策略。然而，需要对影响长期护理机构控制新冠病毒传播表现的因素进行全面综述，以为公共卫生政策提供信息。
为在现有文献基础上进一步研究，我们使用一个多维绩效概念框架，对影响新冠疫情期间长期护理机构绩效的因素进行了范围综述。
我们遵循乔安娜·布里格斯研究所的范围综述方法。我们在CINAHL、MEDLINE（Ovid）、CAIRN、科学Direct、Scopus和科学网中查询了2020年1月1日至2021年12月31日期间以英文或法文发表的同行评议文献。对检索到的记录进行筛选，以确定其是否符合背景（新冠疫情）、人群（长期护理机构）、关注点（影响长期护理机构绩效的内部和外部因素）以及结果（绩效维度：公平性、可及性、反应性、安全性、连续性、有效性、可行性、效率）等方面的要求。对纳入文章的描述性特征进行了总结。呈现了已确定影响长期护理机构绩效的绩效维度以及内部（如机构特征）和外部（如访客）因素。
我们保留了140篇文章，其中68%被归类为研究文章，47%来自北美，且大多数文章涵盖2020年3月至7月期间。最常出现的绩效维度是“有效性”（75.7%）和“安全性”（75.7%）。最常见的内部因素是“组织背景”（72.9%）和“人力资源”（62.1%），最常见的外部因素是“访客”（27.1%）和“公共卫生指南”（25.7%）。
我们的综述有助于全球关注新冠疫情对居住和工作在长期护理机构中的弱势群体的影响。尽管报告了众多因素，但由于缺乏随机对照试验，无法确定已识别因素与长期护理机构绩效之间的因果关系。建议使用多维框架来评估医疗保健系统的绩效，不仅要从有效性和安全性方面，还要结合效率和公平性等其他关键维度。
研究注册ID：researchregistry7026。
