Mulla Reem T, Hirdes John P, Kroetsch Brittany, McAiney Carrie, Heckman George A
School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
BMJ Open. 2025 Mar 26;15(3):e090522. doi: 10.1136/bmjopen-2024-090522.
Mental health disorders are common among residents of long-term care (LTC). Despite depression being the most common type of mental illness, it is often undiagnosed in LTC. Due to its prevalence, chronicity and associated morbidity, depression poses a considerable service use burden. The COVID-19 pandemic has brought needed attention to the mental health challenges faced by older adults in LTC.
To explore the effects of isolation on the mood of LTC residents and compare between both the pre-COVID-19 and COVID-19 periods.
A scoping review.
PubMed, CINAHL, PsycINFO, SCOPUS, Google Scholar and medRxiv were searched for studies that met the eligibility criteria: (1) articles assessing mood or mental health status of LTC residents; (2) mood disturbance resulting from visitation restrictions/isolation or loneliness; (3) residents were without severe dementia or moderate/severe cognitive impairment and (4) studies were available in English. Studies were excluded if their entire sample was residents with severe cognitive impairment or severe dementia. A total of 31 studies were included in this review. The total number of articles retrieved from the databases searched was 3652 articles, of which 409 duplicates were removed. 3242 article titles and abstracts were screened for eligibility, of which 3063 were excluded. The remaining 180 full-text studies were reviewed for eligibility, where an additional 149 studies were excluded. Data were then extracted from all full-length pieces for analysis, and findings were summarised.
The review identified contradictory views with a diversity of findings highlighting the complexity of factors influencing residents' mood during a global health crisis such as that of COVID-19. Studies highlighted the importance of quality interactions with others for the well-being of LTC residents. Significant correlations were found between social isolation, loneliness and depression. During COVID-19, visitation restrictions led to increased loneliness, depression and mood problems, especially among residents without cognitive impairment. However, some studies reported no significant adverse effects or even a decrease in depression symptoms during COVID-19 restrictions, possibly due to implemented strategies to maintain social engagement.
The COVID-19 pandemic had a substantial impact on LTC homes, influencing the physical and mental well-being of residents. This highlighted pre-existing challenges in the LTC system, emphasising the importance of comprehensive strategies to safeguard resident mental health. It is important to combine measures to ensure both physical safety and mental well-being.
心理健康障碍在长期护理（LTC）机构的居民中很常见。尽管抑郁症是最常见的精神疾病类型，但在长期护理机构中往往未被诊断出来。由于其患病率、慢性病程及相关发病率，抑郁症带来了相当大的服务使用负担。2019冠状病毒病大流行使人们开始关注长期护理机构中老年人面临的心理健康挑战。
探讨隔离对长期护理机构居民情绪的影响，并比较2019冠状病毒病之前和期间的情况。
一项范围综述。
在PubMed、CINAHL、PsycINFO、SCOPUS、谷歌学术和medRxiv上检索符合以下纳入标准的研究：（1）评估长期护理机构居民情绪或心理健康状况的文章；（2）探视限制/隔离或孤独导致的情绪障碍；（3）居民无严重痴呆或中度/重度认知障碍；（4）研究为英文。如果整个样本均为患有严重认知障碍或严重痴呆的居民，则排除该研究。本综述共纳入31项研究。从检索的数据库中检索到的文章总数为3652篇，其中删除了409篇重复文章。对3242篇文章的标题和摘要进行了纳入资格筛选，其中3063篇被排除。对其余180项全文研究进行了纳入资格审查，又排除了149项研究。然后从所有全文中提取数据进行分析，并总结研究结果。
该综述发现了相互矛盾的观点，各种研究结果突出了在2019冠状病毒病这样的全球健康危机期间影响居民情绪的因素的复杂性。研究强调了与他人进行高质量互动对长期护理机构居民福祉的重要性。社交隔离、孤独感与抑郁症之间存在显著相关性。在2019冠状病毒病期间，探视限制导致孤独感、抑郁和情绪问题增加，尤其是在无认知障碍的居民中。然而，一些研究报告称在2019冠状病毒病限制措施实施期间没有显著的不良影响，甚至抑郁症状有所减轻，这可能是由于实施了维持社交参与的策略。
2019冠状病毒病大流行对长期护理机构产生了重大影响，影响了居民的身心健康。这凸显了长期护理系统中先前存在的挑战，强调了保障居民心理健康的综合策略的重要性。将确保身体安全和心理健康的措施结合起来很重要。
