Enablers and Barriers to Implement COVID-19 Measures in Long-Term Care Facilities: A Mixed Methods Implementation Science Assessment in Chile

Abstract BackgroundThe COVID-19 affected disproportionately older people, and particularly people living in long-term care facilities. Considering this problem, the Chilean government issued a series of guidelines and protocols to prevent and manage COVID-19 outbreaks in these facilities. MethodsThis study aims to identify barriers and enablers that affect the implementation of these prevention and management measures. For the analysis, we used an implementation science approach and a mixed-method strategy—survey to facilities’ managers and interviews to carers—, classifying enablers and barriers into four categories: agreement with the intervention’s goals, financial resources to implement the measures, technical needs of the intervention, and cultural factors in the facilities.ResultsResults highlight the importance of the four aforementioned factors in the implementation of COVID-19 guidelines and protocols. Managers and caregivers differ in their view of the main enablers and barriers for implementation. However, they both identify the knowledge about the measures and availability of personal protective equipment as enablers and human resources as a potential barrier. ConclusionsThe identification of several factors related to goals and culture highlights the need to adopt a broad implementation approach when designing intervention for long-term care facilities, avoiding restricting the discussion to resources availability.

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Mapping Research Conducted on Long-Term Care Facilities for Older People in Brazil: A Scoping Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041522 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1522

Author(s):

Patrick Alexander Wachholz ◽

Deborah Cristina De Oliveira ◽

Kathryn Hinsliff-Smith ◽

Reena Devi ◽

Paulo José Fortes Villas Boas ◽

...

Keyword(s):

Mixed Methods ◽

Older People ◽

Study Design ◽

Scoping Review ◽

Long Term Care ◽

Assessment Tools ◽

Small Scale ◽

Term Care ◽

Care Facilities

This scoping review aimed to explore the characteristics, strengths, and gaps in research conducted in Brazilian long-term care facilities (LTCFs) for older adults. Electronic searches investigating the residents (≥60 years old), their families, and the LTCF workforce in Brazil were conducted in Medline, EMBASE, LILACS, and Google Scholar, within the timescale of 1999 to 2018, limited to English, Portuguese, or Spanish. The reference lists were hand searched for additional papers. The Mixed Methods Appraisal Tool (MMAT) was used for critical appraisal of evidence. Data were reported descriptively considering the study design, using content analysis: 327 studies were included (n = 159 quantitative non-randomized, n = 82 quantitative descriptive, n = 67 qualitative, n = 11 mixed methods, n = 6 randomized controlled trials, and n = 2 translation of assessment tools). Regardless of the study design, most were conducted in a single LTCF (45.8%), in urban locations (84.3%), and in non-profit settings (38.7%). The randomized trials and descriptive studies presented the lowest methodological quality based on the MMAT. This is the first review to provide an overview of research on LTCFs for older people in Brazil. It illustrates an excess of small-scale, predominantly qualitative papers, many of which are reported in ways that do not allow the quality of the work to be assured.

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