Nurses’ Experiences of Care in Portuguese Nursing Homes during the COVID-19 Pandemic: A Focus Group Study

Abstract

The COVID-19 pandemic has had a considerable influence on long-term care facilities, exposing the shortcomings of nursing homes in implementing recommendations by health authorities. It also emphasizes the need for a nursing management model customized to the vulnerable status of residents, organizational demands, and occupational nursing requirements. We aimed to characterize the perspectives of nurses who have experienced COVID-19 in nursing homes regarding measures implemented to avoid or manage outbreaks in that environment. An interview was conducted with a focus group following the consolidated Criteria for Reporting Qualitative research guidelines. Data analysis was performed using WebQDA software following a thematic category orientation. Eight Portuguese nurses working in nursing homes from the country’s central area participated in this study. We identified three major significant areas for long-term care respiratory outbreak management: strategic (policy, staffing, and resources); tactical (training, organization, engagement, and supervision); and operational planning (vigilance, prevention of disease spread, and family involvement). From the participants’ view, the management of COVID-19 in nursing homes must be highly supportive and responsive, offering resources to control risks, supporting residents’ care, and ensuring the safety and well-being of residents and staff members. Saturation was not reached; thus, further research is needed in this area.

Family Involvement Training for Staff and Family Caregivers: Case Report on Program Design and Mixed Methods Evaluation

“…Restrictions hastened residents’ physical and cognitive decline [ 21 , 22 ]. Family caregivers experienced loneliness [ 21 , 23 ], guilt, and anxiety at the irreplaceable lost time together [ 1 , 24 ]. As these impacts of COVID-19 restrictions emerged, one or two essential family caregivers were allowed into residents’ rooms to provide some care [ 20 , 21 ].…”

“…Coe and Werner’s analysis of population health survey data found that family caregivers of long-term care residents contributed 37.4 h of care per month on average, which is roughly equivalent to an extra full-time shift of paid providers per month [ 16 ]. The long-term care staffing shortages that existed prior to the pandemic [ 8 , 24 ] were exacerbated by restrictions on what family caregivers could do [ 17 ], leading to increased work to follow COVID-19 policies [ 23 , 25 ] and trying to meet residents’ increased care and socioemotional needs [ 16 , 17 ] while supporting family visitations through window visits or with technology such as iPads or ZOOM [ 6 , 26 , 27 ]. The pandemic reinforced that family involvement in long-term care is essential for promoting person-centered care, improving the well-being of residents, and fostering a collaborative approach to caregiving [ 5 , 10 , 14 ].…”

“…Hayward and colleagues [ 10 ] suggest that policy change is not sufficient to improve family involvement. They advise that interventions specially designed to improve family involvement are required [ 10 , 14 , 23 ]. Further, interventions need to be planned with an understanding of the system policies and organizational processes that enhance or impede meaningful family involvement [ 5 , 29 ].…”