Halperin Donna M, Whitfield Krista, Bettinger Julie A, Orhierhor Marian, Salter Katherine L, Selig Bailey M, Mack Anna, Condran Brian R, Davis Alexa, Salyzyn Camryn, Parsons Janet A, Kervin Melissa, Halperin Scott A
Canadian Center for Vaccinology, Dalhousie University, IWK Health, Nova Scotia Health, Halifax, NS, Canada.
Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS, Canada.
BMC Geriatr. 2025 Feb 17;25(1):108. doi: 10.1186/s12877-024-05656-0.
During the COVID-19 pandemic, long-term care (LTC) facilities in Canada were confronted with many rapidly changing public health safety guidelines. Based on the guidelines, LTC facilities had to implement a series of virus containment and mitigation measures, presenting significant challenges for both workers and residents. This research aims to provide insights that could be used to guide improvements in the experiences of LTC workers, and of residents, in future pandemic crises.
A qualitative multi-case study was used to explore the pandemic experiences of a demographically diverse group of LTC workers in Canada, focusing on how public health safety guidelines impacted them, and their perceptions of challenges faced by residents. Fourteen workers were engaged from facilities in Nova Scotia and British Columbia, which are regions distinct geographically and with differences in safety guidelines and implementation. Semi-structured interviews were conducted between April to October 2021. Using thematic analysis, we identified patterns within and across the interview transcripts.
The thematic analysis provided an understanding of the experiences and perspectives of LTC workers. There were four key themes: (1) Tangling with Uncertainty, that describes the effects of ambiguous messaging and shifting COVID-19 safety guidance on workers; (2) Finding Voice, that highlights how workers coped with feelings of helplessness during the healthcare crisis; (3) Ripple Effects, of pandemic pressures on workers beyond resident care, that included strengthening of inter-colleague support as well as financial challenges, and; (4) Loss of Home, where workers perceived that protection of residents led to a loss of the residents' home environment, personal freedom, and autonomy.
The findings suggest that LTC workers' experiences during future pandemics may be improved by their inclusion in the development of public health safety guidelines, facilitating inter-colleague support systems, and ensuring worker financial stability. A balance should be found between preventing infection in LTC facilities and retaining the principles of holistic and resident-centered care for workers' and residents' mental health benefits.
在新冠疫情期间,加拿大的长期护理机构面临着许多迅速变化的公共卫生安全指南。根据这些指南,长期护理机构必须实施一系列病毒控制和缓解措施,给工作人员和居民都带来了重大挑战。本研究旨在提供见解,以指导未来疫情危机中改善长期护理工作人员和居民的体验。
采用定性多案例研究方法,探讨加拿大不同人口统计学特征的长期护理工作人员的疫情经历,重点关注公共卫生安全指南如何影响他们,以及他们对居民所面临挑战的看法。从新斯科舍省和不列颠哥伦比亚省的机构中招募了14名工作人员,这两个地区地理位置不同,安全指南和实施情况也存在差异。2021年4月至10月进行了半结构化访谈。通过主题分析,我们在访谈记录中识别出了模式。
主题分析提供了对长期护理工作人员经历和观点的理解。有四个关键主题:(1)与不确定性纠缠,描述了信息模糊和不断变化的新冠安全指南对工作人员的影响;(2)找到发声渠道,强调工作人员在医疗危机期间如何应对无助感;(3)连锁反应,疫情压力对工作人员的影响超出了居民护理范围,包括同事间支持的加强以及经济挑战;(4)失去家园感,工作人员认为对居民的保护导致居民失去了家庭环境、个人自由和自主权。
研究结果表明,通过让长期护理工作人员参与公共卫生安全指南的制定、促进同事间支持系统以及确保工作人员的经济稳定,未来疫情期间长期护理工作人员的体验可能会得到改善。应在防止长期护理机构感染与为工作人员和居民的心理健康利益保留整体和以居民为中心的护理原则之间找到平衡。