Taking the 'care' out of care homes: The moral dilemma of institutional long-term care provision during COVID-19
Taking the 'care' out of care homes: The moral dilemma of institutional long-term care provision during COVID-19
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DOI：
10.1111/hsc.13651
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发表时间：
2021-11-21
影响因子：
2.4
通讯作者：
Gabbay, Mark
中科院分区：
文献类型：
--
作者：
Giebel, Clarissa;Hanna, Kerry;Gabbay, Mark
关于大流行如何改变了护理之家的护理服务，人们知之甚少。本研究旨在从员工及家属的角度探讨COVID-19对护理院的护理服务及探访的影响。为此，我们进行了一项基于电话和缩放的定性半结构化访谈研究。护理之家的工作人员和家庭照顾者的人生活与痴呆症（PLWD）在英国通过方便抽样招募，并通过电话或在线参与。参与者参加了一个半结构化的远程访谈。数据收集于2020年10月至11月期间。研究小组的两名成员分别使用专题分析法对匿名记录进行了分析，在研究小组投入的支持下，共同讨论了编码和主题。42名参加者（26名家庭照顾者和16名护理院工作人员）参加了培训。产生了五个主题：（a）护理之家的声誉和所涉经费问题;（B）缺乏护理;（c）沟通或缺乏沟通;（d）探视权/根据住院者的需要作出改变;（e）住院者的情况恶化。由于在整个大流行期间缺乏明确的指导，护理院提供的护理各不相同，允许家庭成员探视的程度和类型也各不相同。护理院和家庭成员之间缺乏沟通，政府和护理院也缺乏沟通，导致家庭护理人员感到被排斥，并担心亲属的福祉。我们需要改善与护理院和公众的沟通和明确的指导，以消除COVID-19限制对居民、他们的家人和支持他们的护理人员的潜在破坏性影响。
Little is known on how the pandemic has changed care home care delivery. The aim of this study was to explore the impact of COVID-19 on care provision and visits in care homes from staff and family members' perspectives. For this purpose, we conducted a telephone- and zoom-based qualitative semi-structured interview study. Care home staff and family carers of people living with dementia (PLWD) across the UK were recruited via convenience sampling and participated via telephone or online. Participants took part in a semi-structured remote interview. Data were collected between October and November 2020. Anonymised transcripts were analysed separately by two research team members using thematic analysis, with codes discussed and themes generated jointly, supported by research team input. 42 participants (26 family carers and 16 care home staff) took part. Five themes were generated: (a) Care home reputation and financial implications; (b) Lack of care; (c) Communication or lack thereof; (d) Visiting rights/changes based on residents' needs; (e) Deterioration of residents. With a lack of clear guidance throughout the pandemic, care homes delivered care differently with disparities in the levels and types of visiting allowed for family members. Lack of communication between care homes and family members, but also government and care homes, led to family carers feeling excluded and concerned about the well-being of their relative. Improved communication and clear guidance for care homes and the public are required to negate the potentially damaging effects of COVID-19 restrictions upon residents, their families and the carers who support them.