Search

The COVID-19 pandemic has had a major impact on long-term care facilities (LTCFs). While much attention has been paid to the impact of the pandemic on residents, less attention has been given to the experiences of staff and factors impacting their resilience in facing challenges working in LTCF. This research describes the factors contributing to the resiliency of LTCF staff during the COVID-19 pandemic in northern British Columbia (BC). Transcripts from 53 participants who completed one-hour semi-structured interviews were included and thematic analysis was conducted. All participants had experience working in a LTCF facility in northern BC during the pandemic. The LTCF staff described resilience as the ability to adapt to changing circumstances and protocols, while also maintaining a positive attitude and uplifting spirits during times of adversity. The analysis revealed five key themes influencing staff resilience: (1) availability and provision of resources for staff, (2) leadership and management within LTCFs, (3) social support available to staff, (4) impact of residents’ morale on staff resilience, and (5) personal attributes and characteristics of the staff. Understanding and addressing the five themes can guide the development of targeted strategies and interventions aimed at enhancing staff resilience and well-being during challenging circumstances. By recognizing and addressing the specific needs of LTCF staff, it is possible to improve the overall quality of care provided in LTCF and promote the well-being of both residents and staff. The findings shed light on the interplay of these themes and their profound influence on LTCF staff. Identifying staff’s needs and factors that contribute to their resilience may lower staff turnover, leading to a stronger and more resilient healthcare system, capable of safeguarding vulnerable populations, particularly during times of crisis such as the COVID-19 pandemic.

The COVID-19 pandemic has had a major impact on long-term care facilities (LTCFs). While much attention has been paid to the impact of the pandemic on residents, less attention has been given to the experiences of staff and factors impacting their resilience in facing challenges working in LTCF. This research describes the factors contributing to the resiliency of LTCF staff during the COVID-19 pandemic in northern British Columbia (BC). Transcripts from 53 participants who completed one-hour semi-structured interviews were included and thematic analysis was conducted. All participants had experience working in a LTCF facility in northern BC during the pandemic. The LTCF staff described resilience as the ability to adapt to changing circumstances and protocols, while also maintaining a positive attitude and uplifting spirits during times of adversity. The analysis revealed five key themes influencing staff resilience: (1) availability and provision of resources for staff, (2) leadership and management within LTCFs, (3) social support available to staff, (4) impact of residents' morale on staff resilience, and (5) personal attributes and characteristics of the staff. Understanding and addressing the five themes can guide the development of targeted strategies and interventions aimed at enhancing staff resilience and well-being during challenging circumstances. By recognizing and addressing the specific needs of LTCF staff, it is possible to improve the overall quality of care provided in LTCF and promote the well-being of both residents and staff. The findings shed light on the interplay of these themes and their profound influence on LTCF staff. Identifying staff's needs and factors that contribute to their resilience may lower staff turnover, leading to a stronger and more resilient healthcare system, capable of safeguarding vulnerable populations, particularly during times of crisis such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Abstract Background Malnutrition is a prevalent issue among older adults in long-term care facilities and is associated with adverse health outcomes and increased healthcare costs. Identifying the predictors of malnutrition in this population is crucial for developing effective intervention strategies. This study aimed to explore the factors contributing to malnourishment among older individuals living in long-term care facilities in Qatar. Methods This cross-sectional study included 75 older adults from two long-term care facilities (Rumailah Hospital and Enaya Specialized Care Center) in Qatar. Baseline characteristics, including age, sex, length of stay, mortality, weight, body mass index, co-morbidities, and laboratory parameters, were assessed. Data were analyzed using the most recent version of the SPSS software, version 29. Predictors of malnutrition and mortality were identified using logistic regression analysis. Results Of the 75 older individuals included in the study, 85% (64) were malnourished. The average age of the participants was 74.89 years, with a standard deviation of 10.21. Of all participants, approximately 61% (46) were males, and 39% (29) were females. Most malnourished older adults were classified as either at “moderate (29.69%)” or “severe risk (37.50%),” according to the Geriatric Nutritional Risk Index. Malnourished participants experienced a significant percentage of weight change within 3 months (14.01 ± 7.89); the only statistically significant predictor of malnutrition was the percentage of weight change within 3 months with an odds ratio (OR) of 4.8 (confidence interval [CI] 1.56–14.75) and p-value of 0.006. Statistically significant predictors of mortality were malnutrition (OR 24.84, CI 1.09–564) and age (OR 1.07, CI 1.00–1.14). Conclusions A significant predictor of malnutrition in older adults identified in this study was the sudden and recent change in weight, which can be employed to detect individuals at risk early and guide tailored interventions. Malnutrition is a significant predictor of mortality. Employing a multidimensional strategy to tackle malnutrition can improve outcomes for the older individuals.

BackgroundNeglect is a common form of abuse, and long-term care facilities record higher incidences of this abuse. Given that older adult care workers are the main workforce in these facilities, their neglectful behavior requires public health attention. Internal individual characteristics can lead to older adult abuse, and managing workers who abuse older adults may require various methods. This study aimed to identify the profiles of neglect among older adult care workers in long-term care facilities and explore the influencing factors of neglect.MethodsIn this cross-sectional study, a convenience sample of older adult care workers from 15 long-term care facilities in Shandong Province (N = 421) completed a questionnaire on the characteristics associated with neglect. Latent profile analysis was used to identify distinct neglect profiles and promote the understanding of individual characteristics associated with varying levels of neglect. One-way analysis of variance and multivariate logistic regression analyses were used to examine the population characteristic differences.ResultsOlder adult care workers exhibited three neglect profiles, namely, the “low-risk group,” “medium-risk group,” and “high-risk group.” Males, participants with no employment qualification certificate, and those who did not attend regular training represented the majority of those in the “high-risk group.” Participants with a monthly income of more than ¥ 4,000 and nursing 1–2 older adults simultaneously represented the majority of those in the “low-risk group.”ConclusionLong-term care facility administrators should tailor interventions to individual care worker profiles to reduce neglect behaviors and improve care levels.

The present research study focuses on exploring the effects of horticultural activities on the health outcomes of residents of long-term care facilities (LTCFs). The study utilizes evidence-based nursing and a systematic literature review. A search for relevant articles was conducted on databases such as PubMed, EMBASE, CINAHL, PsycINFO, and Cochrane. Randomized controlled trials in English and Chinese were included in the analysis, with two researchers independently evaluating the selected articles. The synthesis of results revealed that horticultural activities for residents of LTCFs had positive effects on physical aspects, such as increasing physical agility and aerobic endurance. Moreover, they had positive influences including happiness, positive mental health. In terms of social aspects, horticultural activities for older adults helped reduce aggressive behaviors, promoted goal-oriented living, and enhanced quality of life. Evidence of the impact of horticultural activities on the positive mental health of residents of LTCFs is relatively scarce compared to community-dwelling older adults, where psychological states are often studied in negative contexts. It has been suggested that LTCFs should integrate horticultural activities into their regular programs to foster positive mental health outcomes. Horticultural activities show promise in promoting positive mental health among residents of LTCFs and warrant further exploration. [ABSTRACT FROM AUTHOR]

The present research study focuses on exploring the effects of horticultural activities on the health outcomes of residents of long-term care facilities (LTCFs). The study utilizes evidence-based nursing and a systematic literature review. A search for relevant articles was conducted on databases such as PubMed, EMBASE, CINAHL, PsycINFO, and Cochrane. Randomized controlled trials in English and Chinese were included in the analysis, with two researchers independently evaluating the selected articles. The synthesis of results revealed that horticultural activities for residents of LTCFs had positive effects on physical aspects, such as increasing physical agility and aerobic endurance. Moreover, they had positive influences including happiness, positive mental health. In terms of social aspects, horticultural activities for older adults helped reduce aggressive behaviors, promoted goal-oriented living, and enhanced quality of life. Evidence of the impact of horticultural activities on the positive mental health of residents of LTCFs is relatively scarce compared to community-dwelling older adults, where psychological states are often studied in negative contexts. It has been suggested that LTCFs should integrate horticultural activities into their regular programs to foster positive mental health outcomes. Horticultural activities show promise in promoting positive mental health among residents of LTCFs and warrant further exploration.

Background: Neglect is a common form of abuse, and long-term care facilities record higher incidences of this abuse. Given that older adult care workers are the main workforce in these facilities, their neglectful behavior requires public health attention. Internal individual characteristics can lead to older adult abuse, and managing workers who abuse older adults may require various methods. This study aimed to identify the profiles of neglect among older adult care workers in long-term care facilities and explore the influencing factors of neglect., Methods: In this cross-sectional study, a convenience sample of older adult care workers from 15 long-term care facilities in Shandong Province ( N = 421) completed a questionnaire on the characteristics associated with neglect. Latent profile analysis was used to identify distinct neglect profiles and promote the understanding of individual characteristics associated with varying levels of neglect. One-way analysis of variance and multivariate logistic regression analyses were used to examine the population characteristic differences., Results: Older adult care workers exhibited three neglect profiles, namely, the "low-risk group," "medium-risk group," and "high-risk group." Males, participants with no employment qualification certificate, and those who did not attend regular training represented the majority of those in the "high-risk group." Participants with a monthly income of more than ¥ 4,000 and nursing 1-2 older adults simultaneously represented the majority of those in the "low-risk group.", Conclusion: Long-term care facility administrators should tailor interventions to individual care worker profiles to reduce neglect behaviors and improve care levels., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yan, Wang, Ding, Sun, Gao and Liu.)

Healthcare workers (HCWs) in long-term care facilities (LTCFs) can represent a source of influenza infection for the elderly. While flu vaccination coverage (VC) is satisfactory in the elderly, HCWs are less likely to be vaccinated. There is no definitive evidence on which types of healthcare system-based interventions at LTCFs would be more useful in improving the vaccination uptake among HCWs. We performed a systematic review in different databases (Pubmed, Cochrane Database of Systematic Reviews, Health Evidence, Web of Science, Cinahl) to provide a synthesis of the available studies on this topic. Among the 1177 articles screened by their titles and abstracts, 27 were included in this review. Most of the studies reported multiple interventions addressed to improve access to vaccination, eliminate individual barriers, or introduce policy interventions. As expected, mandatory vaccinations seem to be the most useful intervention to increase the vaccination uptake in HCWs. However, our study suggests that better results in the vaccination uptake in HCWs were obtained by combining interventions in different areas. Educational campaigns alone could not have an impact on vaccination coverage. LTCFs represent an ideal setting to perform preventive multi-approach interventions for the epidemiological transition toward aging and chronicity.

Background: Population aging has caused a rise in the institutionalization, disability, and mortality rates of older adults worldwide. Older adults are able to engage in muscle training. Elastic band exercises can safely and effectively improve the upper and lower muscle strength and balance of older adults. Purpose: This study was developed to examine the effects of a 3-month elastic band exercise program on the activities of daily living (ADLs), hand muscle strength, balance, and lower limb muscle strength of older adults living in institutional settings. Methods: This was a randomized controlled trial. Sixty-one participants were randomly sampled from two long-term care facilities (LTCFs) in northern Taiwan (31 participants in the experimental group and 30 participants in the control group). Both groups underwent pretesting concurrently. The experimental group participated in 3 months of elastic band exercises, whereas the control group participated in the routine exercise program in their LTCFs. All of the participants were tested 1 and 3 months after the intervention. Results: The average ADL, hand muscle strength, balance, and lower limb muscle strength scores of participants in the experimental group had improved significantly more than those of the control group at posttest (all p s <.05). Conclusions/Implications for Practice: Elastic band exercises positively affect ADLs, hand muscle strength, balance, and lower limb muscle strength in older adults living in LTCFs. Moreover, the high benefit-to-cost ratio of these exercises helps lower the threshold of health promotion. We recommend including elastic band exercises in routine activities and designing different elastic band exercises for older adults at different proficiency levels. Furthermore, an elastic band exercise network should be established to improve the policy and implementation aspects of elastic band activities, raise awareness among community-dwelling and institutionalized older adults, and promote elastic band exercises to LTCFs nationwide. [ABSTRACT FROM AUTHOR]

Background: Due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE), infections among residents are increasing in long-term care facilities (LTCFs), resulting in a high rate of morbidity and healthcare costs. A designated infection control team is unavailable to control the disease., Methods: A systematic review and meta-analysis were conducted to characterize the causes of ESBL-PE and evaluate the infection control strategies within LTCFs. Multiple regression analysis (MRA) was included as supplementary statistical analysis to identify relationships between LTCFs, geographical locations, infection control measures (ICMs), and ESBL-PE. A systematic search was conducted for studies from January 2008 to December 2018. Twenty-two of the 3106 studies met the inclusion criteria., Results: The pooled prevalence for ESBL-PE among LTCFs residents was a mean difference (MD) of 15.78 (95% CI: 0.04, 31.53). Risk factors included the influence of regional areas was a standardized mean difference (SMD) of 0.61(95% CI: 0.32, 0.91) in Europe, SMD was 14.92 (95% CI: 9.17, 20.68) in Asia, and SMD was 0.51(95% CI: 0.35, 0.67) in other regions (North America and Australia). Nine of 22 studies reported ICMs were MD of 13.59 (95% CI: 5.32, 21.86)., Conclusions: Meta-analysis and MRA revealed a statistically significant association between LTCF and ESBL-PE among residents ( p  = .05). Strict adherence to infection control measures in LTCFs is needed to address this ESBL-PE prevalence among residents. The potential positive social change is promoting knowledge about vulnerable residents in LTCFs and the community factors responsible for ESBL infection., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Coronavirus disease 2019 (COVID-19) has posed severe threats to human safety in the healthcare sector, particularly in residents in long-term care facilities (LTCFs) at a higher risk of morbidity and mortality. This study aims to draw on cumulative prospect theory (CPT) to develop a decision model to explore LTCF administrators' risk perceptions and management decisions toward this pandemic. This study employed the policy Delphi method and survey data to examine managers' perceptions and attitudes and explore the effects of sociodemographic characteristics on healthcare decisions. The findings show that participants exhibited risk aversion for small losses but became risk-neutral when considering devastating damages. LTCF managers exhibited perception bias that led to over- and under-estimation of the occurrence of infection risk. The contextual determinants, including LTCF type, scale, and strategy, simultaneously affect leaders' risk perception toward consequences and probabilities. Specifically, cost-leadership facilities behave in a loss-averse way, whereas hybrid-strategy LTCFs appear biased in measuring probabilities. This study is the first research that proposes a CPT model to predict administrators' risk perception under varying mixed gain–loss circumstances involving considerations of healthcare and society in the pandemic context. This study extends the application of CPT into organizational-level decisions. The results highlight that managers counteract their perception bias and subjective estimation to avoid inappropriate decisions in healthcare operations and risk governance for a future health emergency. [ABSTRACT FROM AUTHOR]

Promoting positive mental health is crucial for the elderly living in long-term care facilities (LTCFs). This study aims to examine the effectiveness of horticultural therapy on the level of sense of coherence (SOC) among older LTCF residents with relatively normal mental function. With convenient sampling, a total of 86 participants were recruited from 12 LTCFs in northeastern Taiwan. In the experimental group (n = 49), the mean (±standard deviation) score of SOC was 50.45 ± 6.07 at baseline and increased to 56.37 ± 7.20 (p < 0.001) after 12-week horticultural intervention. In contrast, the mean SOC score did not change significantly in the control group (n = 37) during the study period. Generalized estimating equation analysis showed that a significant interaction effect between group and time on the SOC score (p < 0.001). Our findings indicate that horticultural therapy is effective to strengthen the SOC level of older LTCF residents without dementia.

Healthcare workers (HCWs) in long-term care facilities (LTCFs) can represent a source of influenza infection for the elderly. While flu vaccination coverage (VC) is satisfactory in the elderly, HCWs are less likely to be vaccinated. There is no definitive evidence on which types of healthcare system-based interventions at LTCFs would be more useful in improving the vaccination uptake among HCWs. We performed a systematic review in different databases (Pubmed, Cochrane Database of Systematic Reviews, Health Evidence, Web of Science, Cinahl) to provide a synthesis of the available studies on this topic. Among the 1177 articles screened by their titles and abstracts, 27 were included in this review. Most of the studies reported multiple interventions addressed to improve access to vaccination, eliminate individual barriers, or introduce policy interventions. As expected, mandatory vaccinations seem to be the most useful intervention to increase the vaccination uptake in HCWs. However, our study suggests that better results in the vaccination uptake in HCWs were obtained by combining interventions in different areas. Educational campaigns alone could not have an impact on vaccination coverage. LTCFs represent an ideal setting to perform preventive multi-approach interventions for the epidemiological transition toward aging and chronicity. [ABSTRACT FROM AUTHOR]