Psychosocial changes during COVID-19 lockdown on nursing home residents, their relatives and clinical staf: a prospective observational study

Abstract

Background Previous works have observed an increase of depression and other psychological disorders on nursing home residents as a consequence of coronavirus disease 2019 (COVID-19) lockdown; however, there are few studies that have performed a comprehensive evaluation of all people involved in nursing homes environment. The objective of the work was to analyse the impact of lockdown on psychosocial factors of nursing home residents, relatives and clinical staf and how these variables have infuenced residents’ survival. Methods A prospective study was designed. Evaluations were performed at three diferent times: a) at the beginning of Spanish confnement, in March 2020; b) just before the second wave of the pandemic, with relaxation of security measures but in lockdown, and c) in January–February 2021, at the end of the second wave, when visits were already allowed. The study was conducted on three diferent nursing homes. Three hundred and one residents, 119 clinical staf and 51 relatives took part in the study. Anxiety and depression were evaluated in all participants. A scale on the meaning of sufering was also performed. In addition, burnout status was also determined in the clinical staf. Results All participants showed lower depression during lockdown, while at the beginning and at the end of the confnement, these values were signifcantly increased. In residents, these changes were dependent of cognitive status (p=0.012). Anxiety was signifcantly higher in residents. The evolution of anxiety was similar than with depres sion, with lower values during confnement, although clinical staf showed higher anxiety levels at the beginning. The feeling of sufering was signifcantly lower in the clinical staf than in resident and relative groups. Residents’ survival was dependent of cognitive status (p=0.018) and voluntary confnement (p<0.001). Conclusions During the frst COVID-19 lockdown, psychological wellbeing of residents cared in nursing homes, their relatives and staf did not seem to be seriously afected. Previous mental health in relatives and staf together with a resilient approach to the adversity might partly be protecting factors. The lack of consequences on residents’ anxiety, depression and perception of social support may refect the special attention and care they received. Finally, as in the current study only data of the frst two COVID-19 waves were analysed, its fndings might be partly generalized to all the pandemic.