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Hardy MS, Fanaki C, Savoie C, Wilchesky M, Gagnon MP, Laberge M, Couture V, Côté A, Dallaire C, Voyer P, Gallani MC, Dallaire B, Gagnon É. Long-term care staffs' experience in facilitating the use of videoconferencing by cognitively impaired long-term care residents during the COVID-19 pandemic: a mixed-methods study. BMC Health Serv Res 2024; 24:646. [PMID: 38769512 PMCID: PMC11106931 DOI: 10.1186/s12913-024-11095-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 05/09/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, numerous long-term care (LTC) homes faced restrictions that prevented face-to-face visits. To address this challenge and maintain family connections, many LTC homes facilitated the use of electronic tablets to connect residents with their family caregivers. Our study sought to explore the acceptability of this practice among staff members and managers, focusing on their experiences with facilitating videoconferencing. METHODS A convergent mixed method research was performed. Qualitative and quantitative data collection through semi-structured interviews to assess the acceptability of videoconferencing in long-term care homes and to explore the characteristics of these settings. Quantitative data on the acceptability of the intervention were collected using a questionnaire developed as part of the project. The study included a convenience sample of 17 staff members and four managers. RESULTS Managers described LTC homes' characteristics, and the way videoconferencing was implemented within their institutions. Affective attitude, burden, ethicality, opportunity costs, perceived effectiveness, and self-efficacy are reported as per the constructs of the Theoretical Framework of Acceptability. The results suggest a favorable acceptability and a positive attitude of managers and staff members toward the use of videoconferencing in long-term care to preserve and promote contact between residents and their family caregivers. However, participants reported some challenges related to the burden and the costs regarding the invested time and staff shortage. CONCLUSIONS LTC home staff reported a clear understanding of the acceptability and challenges regarding the facilitation of videoconferencing by residents to preserve their contact with family caregivers.
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Affiliation(s)
- Marie-Soleil Hardy
- Faculty of Nursing Science, Université Laval, Québec, QC, G1V 0A6, Canada.
| | - Chaimaa Fanaki
- Faculty of Nursing Science, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Camille Savoie
- Faculty of Nursing Science, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Machelle Wilchesky
- Department of Family Medicine and Division of Geriatric Medicine, McGill University, Montreal, QC, H3S 1Z1, Canada
| | | | - Maude Laberge
- Faculty of Administration, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Vincent Couture
- Faculty of Nursing Science, Université Laval, Québec, QC, G1V 0A6, Canada
| | - André Côté
- Faculty of Administration, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Clémence Dallaire
- Faculty of Nursing Science, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Philippe Voyer
- Faculty of Nursing Science, Université Laval, Québec, QC, G1V 0A6, Canada
| | | | | | - Éric Gagnon
- Faculty of Social Sciences, Université Laval, Québec, QC, G1V 0A6, Canada
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Dijkstra BM, Felten-Barentsz KM, van der Valk MJM, van der Hoeven JG, Schoonhoven L, Vloet LCM. Exploring patients' and relatives' needs and perceptions regarding family participation in essential care in the intensive care unit: A qualitative study. Intensive Crit Care Nurs 2023; 79:103525. [PMID: 37598505 DOI: 10.1016/j.iccn.2023.103525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVES To examine the needs, perceptions and influencing factors according to former adult intensive care unit patients and relatives with regard to family participation in essential care in the unit. RESEARCH DESIGN A qualitative interpretive descriptive study using inductive thematic analysis. SETTING Twelve pairs of former Dutch patients and their relatives were interviewed within two months after the patient's discharge from the unit between December 2017 and April 2018. FINDINGS Four themes emerged: the family's history, the patient's condition, supporting the patient and supporting the relative. The family's history, in particular the relationship with the patient and former experience with care, determined the level of participation in essential care. The level of participation was also influenced by the patient's condition, more specifically level of consciousness, stability of the patient's situation and length of the patient's stay. The third theme, supporting the patient, related to presence/being able to 'be there' for the patient and a mostly positive attitude towards family participation. The last theme was supporting the relative, with three subthemes associated with relatives' needs and perceptions: (dis)comfort with participation in essential care, need for invitation and support, and concern about the possible strain experienced by relatives. CONCLUSION Supporting the patient and supporting the relative are reflecting the needs and perceptions of patients and relatives regarding family participation in essential care. Both the family's history and the patient's condition influence the relative's level of participation. Intensive care unit nurses and other healthcare providers could take these themes into account when encouraging family participation in essential care. IMPLICATIONS FOR CLINICAL PRACTICE Patients' and relatives' needs and perceptions of family participation in essential care in the intensive care unit vary. Family participation in essential care is influenced by the family's history and the patient's condition. Healthcare providers could take these findings into account when implementing family participation in essential care.
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Affiliation(s)
- Boukje M Dijkstra
- Research Department Emergency and Critical Care, HAN University of Applied Sciences, School of Health Studies, Nijmegen, the Netherlands; Intensive Care Unit, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Karin M Felten-Barentsz
- Research Department Emergency and Critical Care, HAN University of Applied Sciences, School of Health Studies, Nijmegen, the Netherlands; Department of Rehabilitation - Physical Therapy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Margriet J M van der Valk
- Research Department Emergency and Critical Care, HAN University of Applied Sciences, School of Health Studies, Nijmegen, the Netherlands
| | | | - Lisette Schoonhoven
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Lilian C M Vloet
- Research Department Emergency and Critical Care, HAN University of Applied Sciences, School of Health Studies, Nijmegen, the Netherlands; IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Foundation Family and Patient Centered Intensive Care, Alkmaar, the Netherlands
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van Wijngaarden J, de Mul M, Ahaus K. Crisis Management Tasks in Dutch Nursing Homes During the COVID-19 Pandemic: A Longitudinal Interview Study. Med Care Res Rev 2023; 80:318-327. [PMID: 36722351 PMCID: PMC9895278 DOI: 10.1177/10775587221150477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The COVID-19 pandemic hit long-term care, and particularly nursing homes hard. We aimed to explore how crisis management goals and tasks evolve during such a prolonged crisis, using the crisis management tasks as identified by Boin and 't Hart as a starting point. This longitudinal, qualitative study comprises 47 interviews with seven Dutch nursing home directors and a focus group. We identified two phases to the crisis response: an acute phase with a linear, rational perspective of saving lives and compliancy to centralized decision-making and an adaptive phase characterized by more decentralized decision-making, reflection, and competing values and perspectives. This study confirms the usability of Boin and 't Hart's typology of crisis management tasks and shows that these tasks "changed color" in the second phase. We also revealed three types of additional work in managing such a crisis: resilience work, emotion work, and normative work.
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Affiliation(s)
- Jeroen van Wijngaarden
- Erasmus University Rotterdam, The
Netherlands,Jeroen van Wijngaarden, Associate
Professor, Erasmus School of Health Policy and Management, Erasmus University
Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
| | | | - Kees Ahaus
- Erasmus University Rotterdam, The
Netherlands
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Hardie RA, Thomas J, Li J, Pearce C, Georgiou A. General practice perspective on the use of telehealth during the COVID-19 pandemic in Australia using an Action Research approach: a qualitative study. BMJ Open 2022; 12:e063179. [PMID: 36302573 PMCID: PMC9620525 DOI: 10.1136/bmjopen-2022-063179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Telehealth has emerged as a viable and safe mode of care delivery in Australia during the COVID-19 pandemic. However, electronic general practice data reveal differences in uptake and consultation mode, which we hypothesise may be due to potential barriers impacting on quality of care. We aimed to identify the benefits and barriers of telehealth use in general practice, using an 'Action Research' approach involving general practitioners (GPs) and general practice stakeholders. DESIGN Qualitative focus group performed within a broader Action Research methodology. SETTING A focus group was held in August 2021, with general practice participants from Victoria, Australia. PARTICIPANTS The study consisted of a purposive sample of 11 participants, including GPs (n=4), representatives from three primary health networks (n=4) and data custodian representatives (n=3) who were part of a project stakeholder group guided by an Action Research approach. METHODS Semistructured interview questions were used to guide focus group discussions via videoconference, which were recorded and transcribed verbatim for analysis. The transcript was analysed using an inductive thematic approach. RESULTS Emerging themes included evolution of telehealth, barriers to telehealth (privacy, eligibility, technology, quality of care, sociodemographic and residential aged care barriers) and benefits of telehealth (practice, quality of care, sociodemographic and residential aged care benefits). CONCLUSION The findings highlight a range of barriers to telehealth that impact general practice, but also provide justification for the continuation and development of telehealth. These results provide important context to support data-driven population-based findings on telehealth uptake. They also highlight areas of quality improvement for the enhancement of telehealth as a valuable tool for routine general practice patient care.
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Affiliation(s)
- Rae-Anne Hardie
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University Faculty of Medicine Health and Human Sciences, Sydney, New South Wales, Australia
| | - Judith Thomas
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University Faculty of Medicine Health and Human Sciences, Sydney, New South Wales, Australia
| | - Julie Li
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University Faculty of Medicine Health and Human Sciences, Sydney, New South Wales, Australia
| | - Christopher Pearce
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University Faculty of Medicine Health and Human Sciences, Sydney, New South Wales, Australia
- Outcome Health, Blackburn, Victoria, Australia
- General Practice, Monash University, Clayton, Victoria, Australia
| | - A Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University Faculty of Medicine Health and Human Sciences, Sydney, New South Wales, Australia
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This was my Crimean War: COVID-19 Experiences of Nursing Home Leaders. J Am Med Dir Assoc 2022; 23:1827-1832. [PMID: 36084690 PMCID: PMC9371982 DOI: 10.1016/j.jamda.2022.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/02/2022] [Accepted: 08/06/2022] [Indexed: 12/05/2022]
Abstract
Objective To describe professional and personal experiences of nursing home care leaders during early waves of the COVID-19 pandemic. Design Qualitative interpretive description. Setting and Participants Eight sites across 2 Canadian provinces. Sites varied by COVID-19 status (low or high), size (<120 or ≥120 beds), and ownership model (for-profit or not-for-profit). We recruited 21 leaders as participants: 14 managers and 7 directors of care. Methods Remote Zoom-assisted semi-structured interviews conducted from January to April 2021. Concurrent data generation and inductive content analysis occurred throughout. Sampling ceased once we reached sufficient analytic variation and richness to answer research questions. Results Most participants were female, ≥50 years of age, and born in Canada. We found 4 major themes. (1) Responsibility to protect: Extreme precautions were employed to protect residents, staff, and leaders’ families. Leaders experienced profound distress when COVID-19 infiltrated their care homes. (2) Overwhelming workloads: Changing public health orders and redeployment to pandemic-related activities caused administrative chaos. Leaders worked double shifts to cope with pandemic demands and maintain their usual work. (3) Mental and emotional toll: All participants reported symptoms of anxiety, depression, and insomnia, leading to ongoing exhaustion. Shifting staff focus from caring to custodial enforcement of isolation caused considerable distress, guilt, and grief. (4) Moving forward: The pandemic spotlighted deficiencies in the nursing home context that lead to inadequate quality of resident care and staff burnout. Some leaders indicated their pandemic experience signaled an unanticipated end to their careers. Conclusions and Implications Nursing home leaders faced mental distress and inordinate workloads during the pandemic. This is an urgent call for systemic change to improve working conditions for leaders and quality of care and quality of life for residents. Nursing home leaders are at increased risk of burnout, which must be addressed to mitigate attrition in the sector.
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Plagg B, Piccoliori G, Engl A, Wiedermann CJ, Mahlknecht A, Barbieri V, Ausserhofer D, Koler P, Tauber S, Lechner M, Lorenz WA, Conca A, Eisendle K. Disaster Response in Italian Nursing Homes: A Qualitative Study during the COVID-19 Pandemic. Geriatrics (Basel) 2022; 7:geriatrics7020032. [PMID: 35314604 PMCID: PMC8938780 DOI: 10.3390/geriatrics7020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/22/2022] Open
Abstract
Nursing homes (NHs) have been among the care settings most affected by both the virus itself and collateral damage through infection protection and control measures (IPC). However, there is a paucity of research regarding disaster response and preparedness of these institutions. The present study aimed to analyze disaster response and management and to develop prospective strategies for disaster management in NHs. A qualitative survey including (i) residents, (ii) nursing staff, (iii) relatives of residents, and (iv) NHs’ medical leads was performed. Data were collected by 45 in-depth interviews. Our results indicate that the shift from resident-centered care towards collective-protective approaches led through the suspending of established care principles to an emergency vacuum: implementable strategies were lacking and the subsequent development of temporary, immediate, and mostly suboptimal solutions by unprepared staff led to manifold organizational, medical, and ethical conflicts against the background of unclear legislation, changing protocols, and fear of legal consequences. IPC measures had long-lasting effects on the health and wellbeing of residents, relatives, and professionals. Without disaster preparedness protocols and support in decision-making during disasters, professionals in NHs are hardly able to cope with emergency situations.
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Affiliation(s)
- Barbara Plagg
- Institute of General Practice and Public Health, Provincial College for Health Professions Claudiana, 39100 Bolzano, Italy; (G.P.); (A.E.); (C.J.W.); (A.M.); (V.B.); (D.A.); (K.E.)
- Faculty of Education, Free University of Bolzano Bozen, 39100 Bolzano, Italy
- Correspondence: ; Tel.: +39-333-300-6080
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Provincial College for Health Professions Claudiana, 39100 Bolzano, Italy; (G.P.); (A.E.); (C.J.W.); (A.M.); (V.B.); (D.A.); (K.E.)
| | - Adolf Engl
- Institute of General Practice and Public Health, Provincial College for Health Professions Claudiana, 39100 Bolzano, Italy; (G.P.); (A.E.); (C.J.W.); (A.M.); (V.B.); (D.A.); (K.E.)
| | - Christian J. Wiedermann
- Institute of General Practice and Public Health, Provincial College for Health Professions Claudiana, 39100 Bolzano, Italy; (G.P.); (A.E.); (C.J.W.); (A.M.); (V.B.); (D.A.); (K.E.)
- Department of Public Health, Medical Decision Making and HTA, University of Health Sciences, Medical Informatics and Technology, 6060 Hall in Tyrol, Austria
| | - Angelika Mahlknecht
- Institute of General Practice and Public Health, Provincial College for Health Professions Claudiana, 39100 Bolzano, Italy; (G.P.); (A.E.); (C.J.W.); (A.M.); (V.B.); (D.A.); (K.E.)
| | - Verena Barbieri
- Institute of General Practice and Public Health, Provincial College for Health Professions Claudiana, 39100 Bolzano, Italy; (G.P.); (A.E.); (C.J.W.); (A.M.); (V.B.); (D.A.); (K.E.)
| | - Dietmar Ausserhofer
- Institute of General Practice and Public Health, Provincial College for Health Professions Claudiana, 39100 Bolzano, Italy; (G.P.); (A.E.); (C.J.W.); (A.M.); (V.B.); (D.A.); (K.E.)
| | - Peter Koler
- Nonprofit Organization Forum Prevention, 39100 Bolzano, Italy; (P.K.); (S.T.); (M.L.)
| | - Sara Tauber
- Nonprofit Organization Forum Prevention, 39100 Bolzano, Italy; (P.K.); (S.T.); (M.L.)
| | - Manuela Lechner
- Nonprofit Organization Forum Prevention, 39100 Bolzano, Italy; (P.K.); (S.T.); (M.L.)
| | - Walter A. Lorenz
- Department of Applied Social Sciences, Faculty of Humanities, Charles University, 182 00 Prague, Czech Republic;
| | - Andreas Conca
- Department of Psychiatry, Bolzano Central Hospital, 39100 Bolzano, Italy;
| | - Klaus Eisendle
- Institute of General Practice and Public Health, Provincial College for Health Professions Claudiana, 39100 Bolzano, Italy; (G.P.); (A.E.); (C.J.W.); (A.M.); (V.B.); (D.A.); (K.E.)
- Academic Teaching Department of Dermatology, Venereology and Allergology, Bolzano Central Hospital, 39100 Bolzano, Italy
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