Facilitators to models of care.

Long-term care homes (LTCHs) implemented various models of care during the COVID-19 pandemic. The purpose of this study was to identify these models of care and provide suggestions on best practices that could be integrated into LTCHs in efforts to improve resident care. The project included a quantitative survey and semi-structured key informant interviews with LTCH managers across Canada. Our objectives were to 1) identify models of care that were used to support resident care in Canadian LTCHs during the COVID-19 pandemic and to describe their intervention components, processes of implementation, and perceived impact; 2) determine whether LTCHs planned to sustain models of care implemented during the COVID-19 pandemic. Our results show that the most frequently reported models of care were related to healthy food options, exercise, music and art programs, and planned social activities for residents. Five barriers were identified in relation to implementing these models of care, which included: lack of funding, resources, or staffing; staff not being familiar with/reluctant to use the model; lack of resident buy-in; fear of COVID-19; and pandemic regulations. Common facilitators to implementation were also identified and included: staff support; resident/family buy-in; funding, legislation and/or resources provided; familiarity with model prior to COVID-19; and collaboration with other LTCHs. LTCHs perceived the models to be effective and planned to sustain most implemented models. LTCH managers discussed the need for funding and legislation to improve LTCHs and support the implementation of promising models of care. This study provides insight into the models of care implemented during the pandemic crisis period in Canadian LTCHs, how effective they were perceived to be, and plans for sustainment beyond the pandemic period.新冠疫情期间，长期护理院（Long-term care homes, LTCH）推行了多种照护模式。本研究旨在识别此类照护模式，并为可整合至长期护理院的最佳实践提供建议，以改善入住者的照护质量。本项目涵盖了针对加拿大境内长期护理院管理者的定量问卷调查与半结构化关键知情人访谈。我们的研究目标为：1）识别新冠疫情期间加拿大长期护理院中用于支持入住者照护的各类照护模式，并描述其干预组件、实施流程及感知效果；2）明确长期护理院是否计划延续疫情期间推行的照护模式。研究结果显示，报告频次最高的照护模式涵盖健康饮食选项、运动、音乐与艺术项目，以及为入住者规划的社交活动。本研究共识别出5项推行此类照护模式的阻碍因素，具体包括：资金、资源或人员配备不足；医护人员对相关模式不熟悉/不愿使用；入住者缺乏配合意愿；对新冠病毒的恐惧；以及疫情防控法规。同时，本研究也明确了常见的推行促进因素，包括：医护人员支持；入住者/家属的配合意愿；获得的资金、立法支持及/或资源；疫情前已熟悉相关模式；以及与其他长期护理院开展协作。长期护理院认为此类照护模式效果良好，并计划延续大部分已推行的模式。护理院管理者指出，亟需获得资金与立法支持，以改善长期护理院的运营条件，并助力推广具有前景的照护模式。本研究深入解析了新冠疫情危机期间加拿大长期护理院所推行的照护模式、其被感知的有效性，以及疫情后延续此类模式的相关规划。