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Nursing Home Care during the COVID-19 Pandemic

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: closed (30 October 2023) | Viewed by 14789

Special Issue Editors


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Guest Editor
1. Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
2. Institute for Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
Interests: quality of care; health economic evaluations; dementia

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Guest Editor
1. Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
2. SOCIUM—Research Center on Inequality and Social Policy, University of Bremen, 28359 Bremen, Germany
Interests: long-term care; health economics; health policy; demography; comparative welfare state research; health services research
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Special Issue Information

Dear Colleagues,

Currently, COVID-19 is the biggest challenge for health systems worldwide. Older people are particularly vulnerable to this disease as they face a high risk of severe forms of the disease and a high mortality when infected with SARS-CoV-2. With the worldwide number of people aged 80 years and older having doubled since the 1990s and exceeding 126 million people today, the protection of the elderly has been a priority over the last year. Within the group of the elderly, care-dependent people living in nursing homes have been particularly effected; in 2020, in western countries half of all deceased persons with COVID-19 have been living in long-term care facilities. To make matters worse, nursing staff in nursing homes also have a much higher risk of infection. Measures of social distancing, which until the availability of vaccination have been the primary coping strategy, are not easily applicable for care-dependent people.

The way different countries and organizations met these challenges has varied considerably, among other things being dependent on the availability of protective materials and tests as well as institutional factors, e.g., the qualification of staff. Social distancing often caused new problems and risks for care-dependent persons and even novel promising efforts like vaccination programs still carry lots of open questions, e.g., the duration of acquired immunity, effectiveness regarding virus mutations, or being still infectious to others despite vaccination.

This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the situation of nursing homes during the pandemic. Research papers, reviews, and case reports are welcome. We invite you to submit research on single countries and certain periods, but also papers comparing countries, regions, or different waves of the pandemic. The contributions may be descriptive in nature but also evaluative. Papers dealing with best practice approaches to face the pandemic are also welcome. Other manuscript types accepted include methodological papers, position papers, brief reports, and commentaries. We will accept manuscripts from different disciplines including public health and nursing sciences, epidemiology, health services research, health economics, and social sciences in general.

Here are some examples of topics that could be addressed in this Special Issue:

  • Covid-19-related morbidity and mortality in nursing homes
  • Social distancing in nursing homes: intended and unintended effects
  • Strictness and timeliness of preventive measures in nursing homes
  • Social Distancing, testing, and vaccination – a different answer for each wave?
  • How do measures for nursing homes relate to those for the rest of the population?

Prof. Dr. Karin Wolf-Ostermann
Prof. Dr. Heinz Rothgang
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19
  • caregiver
  • long-term care
  • nursing home care
  • nursing staff

Published Papers (7 papers)

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Research

17 pages, 1451 KiB  
Article
Long-Term Quality of Life after COVID-19 Infection: Cross-Sectional Study of Health Care Workers
by Moussa Antar, Hansjoerg Ullerich, Andreas Zaruchas, Torsten Meier, Ricarda Diller, Ulrich Pannewick and Sameer A. Dhayat
Int. J. Environ. Res. Public Health 2024, 21(2), 235; https://doi.org/10.3390/ijerph21020235 - 17 Feb 2024
Viewed by 1658
Abstract
(1) Background: Post-COVID syndrome is defined as symptoms that occur simultaneously with or after a COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people’s long-term quality of life following a COVID-19 infection. The [...] Read more.
(1) Background: Post-COVID syndrome is defined as symptoms that occur simultaneously with or after a COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people’s long-term quality of life following a COVID-19 infection. The aim of this cross-sectional study was to investigate the long-term quality of life after COVID-19 among employees of a hospital in Germany and to identify risk factors. (2) Methods: A monocentric, cross-sectional study was conducted using the validated and digitized WHOQOL-BREF questionnaire via Netigate® between 10/2022 and 02/2023. Data on the quality of life and global health status were collected in the following four domains: physical health, mental health, social relationships, and the environment. (3) Results: The response rate was 73.8 % (923/1250). Furthermore, 63.4 % of the hospital staff respondents reported at least one persistent symptom after a COVID-19 infection, leading to significant differences in quality of life. Pre-existing conditions, persistent symptoms, and disabilities after a COVID-19 infection as well as a high BMI, no partnership, and a low educational level were found to significantly contribute to a low long-term quality of life. (4) Conclusions: Obesity, a lack of partnership, and a low level of education were independent risk factors for a lower quality of life post-COVID-19 infection in this cohort of hospital staff. Further multicenter studies are required to validate the incidence and their suitability as independent risk factors for post-COVID syndrome. Full article
(This article belongs to the Special Issue Nursing Home Care during the COVID-19 Pandemic)
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9 pages, 324 KiB  
Article
Greatest Risk Factor for Death from COVID-19: Older Age, Chronic Disease Burden, or Place of Residence? Descriptive Analysis of Population-Level Canadian Data
by Susan P. Phillips and Lisa F. Carver
Int. J. Environ. Res. Public Health 2023, 20(24), 7181; https://doi.org/10.3390/ijerph20247181 - 15 Dec 2023
Viewed by 1449
Abstract
During the first wave of COVID-19, three-quarters of Canadian deaths were among those age 80 and older. We examined whether age, chronic disease load, sex, or place was the strongest predictor of such deaths. A cross-sectional analysis of administrative data from 1 January [...] Read more.
During the first wave of COVID-19, three-quarters of Canadian deaths were among those age 80 and older. We examined whether age, chronic disease load, sex, or place was the strongest predictor of such deaths. A cross-sectional analysis of administrative data from 1 January 2020 to 30 October 2020 for the population of Ontario (n = 15,023,174) was performed. Using logistic regression analysis, we determined whether place of residence (community dwelling, community dwelling with formal home care, or long-term care facility), age group, sex, or chronic disease burden was most strongly associated with the outcome of death within 60 days of a positive SARS-CoV-2 PCR test. Overall, there were 2766 deaths attributed to COVID-19. The age-related odds of dying increased from 6.1 (age 65–74) to 13.4 (age 85 or older) relative to those aged <65 years. This age effect was dwarfed by an odds ratio of 117.1 for those living in long-term care versus independently in the community, adjusted for age, sex, and chronic disease burden. The risk of death from COVID-19 aligned much more with social realities than individual risks. The disproportionate mortality arising specifically from institutional residence demands action to identify sources and ameliorate the harms of living in such facilities. Full article
(This article belongs to the Special Issue Nursing Home Care during the COVID-19 Pandemic)
13 pages, 640 KiB  
Article
COVID-19 in German Nursing Homes: The Impact of Facilities’ Structures on the Morbidity and Mortality of Residents—An Analysis of Two Cross-Sectional Surveys
by Benedikt Preuß, Lasse Fischer, Annika Schmidt, Kathrin Seibert, Viktoria Hoel, Dominik Domhoff, Franziska Heinze, Werner Brannath, Karin Wolf-Ostermann and Heinz Rothgang
Int. J. Environ. Res. Public Health 2023, 20(1), 610; https://doi.org/10.3390/ijerph20010610 - 29 Dec 2022
Cited by 1 | Viewed by 1128
Abstract
The COVID-19 pandemic constitutes an exceptional risk to people living and working in nursing homes (NHs). There were numerous cases and deaths among NH residents, especially at the beginning of the pandemic when no vaccines had yet been developed. Besides regional differences, individual [...] Read more.
The COVID-19 pandemic constitutes an exceptional risk to people living and working in nursing homes (NHs). There were numerous cases and deaths among NH residents, especially at the beginning of the pandemic when no vaccines had yet been developed. Besides regional differences, individual NHs showed vast differences in the number of cases and deaths: while in some, nobody was affected, in others, many people were infected or died. We examine the relationship between facility structures and their effect on infections and deaths of NH residents and infections of staff, while considering the influence of COVID-19 prevalence among the general population on the incidence of infection in NHs. Two nationwide German surveys were conducted during the first and second pandemic waves, comprising responses from n = 1067 NHs. Different hurdle models, with an assumed Bernoulli distribution for zero density and a negative binomial distribution for the count density, were fitted. It can be shown that the probability of an outbreak, and the number of cases/deaths among residents and staff, increased with an increasing number of staff and the general spread of the virus. Therefore, reverse isolation of NH residents was an inadequate form of protection, especially at the beginning of the pandemic. Full article
(This article belongs to the Special Issue Nursing Home Care during the COVID-19 Pandemic)
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13 pages, 1023 KiB  
Article
Determination of Workload, Work Stress and Related Factors in Nursing Home Workers during the COVID-19 Pandemic in Turkey
by Şengül Akdeniz, Mustafa Çoban, Orhan Koç, Mehtap Pekesen, Nilufer Korkmaz Yaylagul, Seda Sönmez, Filiz Yetiz, Gülüşan Özgün Başıbüyük, Mehmet Efe, Ayşe Dericioğulları Ergun, Özlem Özgür, Melih Vural, Aslı Gözde Akış and İsmail Tufan
Int. J. Environ. Res. Public Health 2023, 20(1), 160; https://doi.org/10.3390/ijerph20010160 - 22 Dec 2022
Cited by 3 | Viewed by 2280
Abstract
COVID-19 has caused a major crisis all over the world. To manage this crisis, a fixed shift system was applied to nursing home staff in Turkey to protect nursing home residents from the COVID-19 pandemic. Staff were not allowed to leave the institution [...] Read more.
COVID-19 has caused a major crisis all over the world. To manage this crisis, a fixed shift system was applied to nursing home staff in Turkey to protect nursing home residents from the COVID-19 pandemic. Staff were not allowed to leave the institution during fixed shifts. It is thought that this practice for the COVID-19 outbreak, while protecting nursing home residents on the one hand, increased the workload and related stress of nursing home staff on the other hand. To the best of our knowledge, there is no study examining the workload and stress caused by the COVID-19 pandemic for nursing home staff in Turkey. The aim of this study was to examine the level of workload and work stress experienced by staff working in nursing homes during the COVID-19 pandemic in Turkey. Methods: A cross-sectional research design was used in the study. The sample of the study consisted of nursing home personnel working in nursing homes in the provinces of Istanbul, Ankara, Izmir and Antalya between October 2021 and January 2022. A personal information form and a workload and stress scale were used for collecting the data. Cluster analysis was performed with SPSS software. Results: In total, 154 nursing home personnel participated in the study. A statistically significant difference was found between the mean age of the two clusters. The first cluster was described as “old” and the second as “young”. Statistically significant and high values were found in the quantitative workload, qualitative workload, job organization, social work area and fatigue factors in the nursing home staff in the older participant cluster. Conclusion: The results of this study provide new information about the concepts of workload and work stress experienced during the COVID-19 pandemic in Turkey, which will serve as a guide for the management of future pandemics. Therefore, this study will contribute to the strategies to be followed in future pandemics in Turkey. Full article
(This article belongs to the Special Issue Nursing Home Care during the COVID-19 Pandemic)
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12 pages, 465 KiB  
Article
Distancing Measures and Challenges Discussed by COVID-19 Outbreak Teams of Dutch Nursing Homes: The COVID-19 MINUTES Study
by Lisa S. van Tol, Hanneke J. A. Smaling, Wendy Meester, Sarah I. M. Janus, Sytse U. Zuidema, Margot W. M. de Waal, Monique A. A. Caljouw and Wilco P. Achterberg
Int. J. Environ. Res. Public Health 2022, 19(11), 6570; https://doi.org/10.3390/ijerph19116570 - 27 May 2022
Cited by 2 | Viewed by 1932
Abstract
The most severe COVID-19 infections and highest mortality rates are seen among long-term care residents. To reduce the risk of infection, physical distancing is important. This study investigates what physical distancing measures were discussed by COVID-19 outbreak teams of Dutch long-term care organizations [...] Read more.
The most severe COVID-19 infections and highest mortality rates are seen among long-term care residents. To reduce the risk of infection, physical distancing is important. This study investigates what physical distancing measures were discussed by COVID-19 outbreak teams of Dutch long-term care organizations and what challenges they encountered. The COVID-19 MINUTES study is a qualitative multi-center study (n = 41) that collected minutes of COVID-19 outbreak teams from March 2020 to October 2021. Textual units about distancing measures were selected and analyzed using manifest content analysis for the first wave: early March–early May 2020; the intermediate period of 2020: mid-May–mid-September 2020; and the second wave: late September 2020–mid-June 2021. During all periods, COVID-19 outbreak teams often discussed distancing visitors from residents. Moreover, during the first wave they often discussed isolation measures, during the intermediate period they often discussed distancing staff and volunteers from residents, and during both the intermediate period and the second wave they often discussed distancing among residents. During all periods, less often admission measures were discussed. Challenges persisted and included unrest among and conflicts between visitors and staff, visitors violating measures, resident non-adherence to measures, and staffing issues. The discussed distancing measures and corresponding challenges may guide local long-term care and (inter)national policymakers during the further course of the COVID-19 pandemic, outbreaks of other infectious diseases, and long-term care innovations. Full article
(This article belongs to the Special Issue Nursing Home Care during the COVID-19 Pandemic)
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11 pages, 1399 KiB  
Article
Activities for Residents of Dutch Nursing Homes during the COVID-19 Pandemic: A Qualitative Study
by Marlon M. P. Smeitink, Hanneke J. A. Smaling, Lisa S. van Tol, Miriam L. Haaksma, Monique A. A. Caljouw and Wilco P. Achterberg
Int. J. Environ. Res. Public Health 2022, 19(9), 5465; https://doi.org/10.3390/ijerph19095465 - 30 Apr 2022
Cited by 2 | Viewed by 2505
Abstract
To protect nursing home residents from getting infected with COVID-19, several measures have been imposed. The aim of this study was to describe the impact of these measures on activities for Dutch nursing home residents, the conditions under which the activities could take [...] Read more.
To protect nursing home residents from getting infected with COVID-19, several measures have been imposed. The aim of this study was to describe the impact of these measures on activities for Dutch nursing home residents, the conditions under which the activities could take place, and the considerations when making decisions about the (dis)continuation of activities. The study consisted of the data of the qualitative MINUTES-study. Textual units derived from documentation of an outbreak team (OT) meetings on activities, well-being, informal caregivers, and volunteers from 39 long-term care organizations were re-analyzed using a content analysis. The results shows that OTs more often discussed restarting and continuing activities than stopping activities during the COVID-19 pandemic. There were differences between time periods, but activities never completely stopped according to the minutes. Activities were offered in an adapted way, often under certain conditions, such as organizing activities at other locations (e.g., outside), with limited group size, and following specific guidelines. The main focus of the considerations made were the ability to adhere to the guidelines, the well-being of residents, ensuring safety, and balancing benefits versus risks given vaccination availability and coverage. Overall, the study showed that organizing activities for nursing home residents despite COVID-19 measures is possible. Full article
(This article belongs to the Special Issue Nursing Home Care during the COVID-19 Pandemic)
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18 pages, 964 KiB  
Article
Comparing the Clinical Characteristics and Mortality of Residential and Non-Residential Older People with COVID-19: Retrospective Observational Study
by Francesc X. Marin-Gomez, Jacobo Mendioroz-Peña, Miguel-Angel Mayer, Leonardo Méndez-Boo, Núria Mora, Eduardo Hermosilla, Ermengol Coma, Josep-Maria Vilaseca, Angela Leis, Manolo Medina, Queralt Miró Catalina and Josep Vidal-Alaball
Int. J. Environ. Res. Public Health 2022, 19(1), 483; https://doi.org/10.3390/ijerph19010483 - 2 Jan 2022
Cited by 8 | Viewed by 2554
Abstract
Nursing homes have accounted for a significant part of SARS-CoV-2 mortality, causing great social alarm. Using data collected from electronic medical records of 1,319,839 institutionalised and non-institutionalised persons ≥ 65 years, the present study investigated the epidemiology and differential characteristics between these two [...] Read more.
Nursing homes have accounted for a significant part of SARS-CoV-2 mortality, causing great social alarm. Using data collected from electronic medical records of 1,319,839 institutionalised and non-institutionalised persons ≥ 65 years, the present study investigated the epidemiology and differential characteristics between these two population groups. Our results showed that the form of presentation of the epidemic outbreak, as well as some risk factors, are different among the elderly institutionalised population with respect to those who are not. In addition to a twenty-fold increase in the rate of adjusted mortality among institutionalised individuals, the peak incidence was delayed by approximately three weeks. Having dementia was shown to be a risk factor for death, and, unlike the non-institutionalised group, neither obesity nor age were shown to be significantly associated with the risk of death among the institutionalised. These differential characteristics should be able to guide the actions to be taken by the health administration in the event of a similar infectious situation among institutionalised elderly people. Full article
(This article belongs to the Special Issue Nursing Home Care during the COVID-19 Pandemic)
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