The experiences of family members of persons with intellectual disabilities who used residential care homes during the COVID-19 pandemic.

BACKGROUND: The global COVID-19 pandemic has shown the vulnerability of some population groups, including persons with intellectual and developmental disabilities (IDD). AIM: The present paper will provide more clarity and understanding of the experiences of family members of persons with IDD housed in residential facilities in Catalonia within the period of maximum restrictions during the COVID-19 pandemic. METHODS AND PROCEDURES: Semi-structured interviews were conducted using an interpretive phenomenological qualitative approach. Study participants consisted of 14 relatives of IDD individuals who were institutionalized in residence facilities or homes. The guiding questions emerged from group discussions with relatives of those with IDD who did not participate in the subsequent interviews. Drawing from this group, the factors that were identified to have had the greatest impact on their lives were later used to guide the interviews. Data collection was carried out in face-to-face individual interviews that were recorded together with the observations of two researchers between February and October 2022. RESULTS: Our analysis identified 4 main themes that developed into additional factors: the decision to stay at home or in the residence, fear, illness, and protocol. Individuals with IDD lost their daily routines, suffered from social isolation, and did not understand the situation. CONCLUSION: The results of this study allow for a better understanding of the experiences of families of persons with IDD in residential centres during the lockdown by identifying their needs and how to better support them in the future. OUTCOMES AND RESULTS: Knowledge and understanding of these events should allow for better management of similar situations in the future.

This study contributes to a growing body of research that examines the experiences of IDD individuals and their families during the early months of the COVID-19 pandemic. A qualitative phenomenological interpretative approach was used following the recommendations of qualitative research practices in health care. Our findings reveal that relatives of persons with IDD who lived in residential care homes felt that the residents were not adequately cared for by the staff, who applied measures for containment and contagion prevention that were disproportionate, resulting in their needs not being considered; these recommended measures had been developed for elderly care homes. Individuals with IDD lost their daily routines, suffered from social isolation, and did not understand the situation. The present findings show that residential care homes for persons with IDD require specific action protocols in crisis situations that are adapted to the needs and characteristics of each centre,thus adopting a model of care based on human rights.

[Assessing the implementation of a nutritional screening protocol in patients admitted to the Medicine Department of a local hospital]. / Evaluación de la aplicación de un protocolo de cribado nutricional en pacientes ingresados en el Servicio de Medicina de un hospital comarcal.

INTRODUCTION: Background: the techniques for screening and nutritional intervention in hospitalized patients are a cost-effective measure. In clinical practice the problem lies in their administration. Objective: to evaluate the implementation of a nutritional screening tool in patients admitted to our Medicine Ward (M). Material and methods: a single-center, prospective, observational study in patients admitted to M. Exclusion criteria: end-stage cancer patients, inpatient stay less than 72 h, and hospital readmission of previously included patients. One out of every 2 hospital admissions was selected. We assessed the following: whether nurses performed the screening test, the Short Nutritional Assessment Questionnaire (SNAQ); the score obtained; consultations with dieticians (ICD); prescribed nutritional support; and coding of malnutrition in the discharge report. Dieticians repeated the SNAQ for one in every 3 patients. Results: during the study period 726 patients were admitted, 377 were selected, and 315 were included. The nursing staff administered the SNAQ to 93.6% of patients and malnutrition was present in 19%. Dieticians detected malnutrition in 37.8%. In 41.9% of patients with severe malnutrition an ICD was performed, whereas in 40% of them no nutritional intervention was implemented. The diagnosis of malnutrition was recorded in the discharge report of 42.1% of our cases. Conclusion: Compliance with screening test administration was good, but there is disagreement with the assessment made by dieticians. For most malnourished patients nutritional support fals to be prescribed, no ICDs are performed, and a malnutrition diagnosis is not included in the discharge report.

INTRODUCCIÓN: Antecedentes: las técnicas de cribado e intervención nutricional en pacientes hospitalizados son una medida coste-efectiva. En la práctica clínica, el problema radica en cómo aplicarlas. Objetivo: evaluar la aplicación de un protocolo de cribado nutricional en pacientes hospitalizados en la Planta de Medicina (M). Material y métodos: estudio unicéntrico, prospectivo y observacional realizado a pacientes que ingresan en M. Los criterios de exclusión fueron: pacientes oncológicos en fase terminal, ingresos inferiores a 72 h y reingresos de pacientes previamente incluidos. Se seleccionaron 1 de cada 2 ingresos. Se evaluaron: si Enfermería había realizado el test de cribado, el Short Nutritional Assessment Questionnaire (SNAQ); la puntuación obtenida; las interconsultas a dietistas (ICD); el soporte nutricional prescrito, y el diagnóstico de desnutrición en el informe de alta. Los dietistas volvieron a administrar el SNAQ a 1 de cada 3 pacientes incluidos. Resultados: durante el periodo de estudio ingresaron 726 pacientes, se seleccionaron 377 y se incluyeron 315. Enfermería administró el SNAQ al 93,6% de los pacientes; presentaban desnutrición el 19%. La determinación realizada por los dietistas detectó un 37,8% de desnutrición. En el 41,9% de los que presentaban desnutrición severa se realizaron ICD; al 40% de ellos no se les realizó ninguna intervención nutricional, y el diagnóstico de desnutrición constaba en el informe de alta del 42,1% de los pacientes. Conclusión: existe un buen cumplimiento en la realización del test de cribado, pero existe también discordancia con la valoración de los dietistas. En la mayoría de los pacientes con desnutrición no se realizan ICD, no se prescribe soporte nutricional y no se hace constar el diagnóstico en el informe de alta.