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Title: Long-term care facilities' response to the COVID-19 pandemic : an international, cross-sectional survey
Authors: Eltaybani, S
Igarashi, A
Cal, A
Lai, CKY 
Carrasco, C
Sari, DW
Cho, E
Haugan, G
Bravo, JD
Abouzeid, NA
Wachholz, PA
Isaramalai, SA
Dawood, SS
Pappas, Y
Abd El Moneam, AAEG
Rodríguez, AB
Alqahtani, BA
Pereira, CLN
Jenssen, CRS
Yu, DSF
Ahmed, FR
Mendes, FRP
Randhawa, G
Ahmed, HAESH
Suzuki, H
Prambudi, H
Avci, IA
Waluyo, I
Nurbaeti, I
Vseteckova, J
Horne, JK
Liu, JY 
Ingstad, K
Kashiwabara, K
Grant, L
Abd El Moniem, MM
Sakka, M
Abdelgawad, ME
Subu, MA
Kentzer, N
Almadani, NA
Tomas‐Carus, P
Rodrigues Garcia, RCM
Indarwati, R
Maneerat, S
Chien, WT
Amamiya, Y
Cavalcanti, YW
Yamamoto-Mitani, N
Issue Date: Jan-2023
Source: Journal of advanced nursing, Jan. 2024, v. 80, no. 1, p. 350-365
Abstract: Aims: To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions.
Design: Cross-sectional survey.
Methods: Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines.
Results: The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work–life imbalance.
Conclusions: Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks.
Impact: This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks.
Patient or public contribution: No Patient or Public Contribution.
Keywords: Adherence
Aged
Compliance
COVID-19
Long-term care
Multilevel analysis
Older adults
Publisher: Wiley-Blackwell
Journal: Journal of advanced nursing 
ISSN: 0309-2402
EISSN: 1365-2648
DOI: 10.1111/jan.15785
Rights: © 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
The following publication Eltaybani, S., Igarashi, A., Cal, A., Lai, C. K. Y., Carrasco, C., Sari, D. W., Cho, E., Haugan, G., Bravo, J. D., Abouzeid, N. A., Wachholz, P. A., Isaramalai, S.-a., Dawood, S. S., Pappas, Y., Abd El Moneam, A. A. E. G., Rodríguez, A. B., Alqahtani, B. A., Pereira, C. L. N., Jenssen, C. R. S. … Yamamoto-Mitani, N. (2024). Long-term care facilities' response to the COVID-19 pandemic: An international, cross-sectional survey. Journal of Advanced Nursing, 80, 350–365 is available at https://doi.org/10.1111/jan.15785.
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