Factors influencing long-term care facility performance during the COVID-19 pandemic: a scoping review.

BACKGROUND: The COVID-19 pandemic wreaked havoc on long-term care facilities (LTCFs). Some LTCFs performed better than others at slowing COVID-19 transmission. Emerging literature has mostly described infection prevention and control strategies implemented by LTCFs during the pandemic. However, there is a need for a comprehensive review of factors that influenced the performance of LTCFs in containing COVID-19 spread to inform public health policy. OBJECTIVE: To build on the existing literature, we conducted a scoping review of factors that influenced LTCF performance during the COVID-19 pandemic using a multidimensional conceptual framework of performance. METHODS: We followed the Joanna Briggs Institute's methodology for scoping reviews. We queried CINAHL, MEDLINE (Ovid), CAIRN, Science Direct, Scopus, and Web of Science for peer-reviewed literature in English or French published between January 1st, 2020 and December 31st, 2021. Retrieved records were screened for context (COVID-19 pandemic), population (LTCFs), interest (internal and external factors that influenced LTCF performance), and outcomes (dimensions of performance: equity, accessibility, reactivity, safety, continuity, efficacy, viability, efficiency). Descriptive characteristics of included articles were summarized. Dimensions of performance as well as internal (e.g., facility characteristics) and external (e.g., visitors) factors identified to have influenced LTCF performance were presented. RESULTS: We retained 140 articles of which 68% were classified as research articles, 47% originated in North America, and most covered a period between March and July 2020. The most frequent dimensions of performance were "efficacy" (75.7%) and "safety" (75.7%). The most common internal factors were "organizational context" (72.9%) and "human resources" (62.1%), and the most common external factors were "visitors" (27.1%) and "public health guidelines" (25.7%). CONCLUSIONS: Our review contributes to a global interest in understanding the impact of the COVID-19 pandemic on vulnerable populations residing and working in LTCFs. Though a myriad of factors were reported, a lack of randomized controlled trials makes it impossible to establish causality between the identified factors and LTCF performance. The use of a multidimensional framework can be recommended to evaluate healthcare system performance not merely in terms of efficacy and safety, but alongside other critical dimensions such as efficiency and equity. TRIAL REGISTRATION: Research Registry ID: researchregistry7026.

The Impact of "Soft" and "Hard" Flood Adaptation Measures on Affected Population's Mental Health: A Mixed Method Scoping Review.

BACKGROUND: The frequency and severity of floods has increased in different regions of the world due to climate change. It is important to examine how adaptation measures impact the mental health of individuals affected by these disasters. OBJECTIVE: The goal of this scoping review was to document the existing studies on the impact of flood adaptation measures in affected populations to identify the best preventive strategies and limitations that deserve further exploration. METHODS: This study followed the PRISMA-ScR guidelines. Inclusion criteria focused on studies in English or French available in MEDLINE and Web of Science that examined the impact of adaptation measures on the mental health of flood victims. Literature reviews or non-study records were excluded from the analysis. RESULTS: A total of 857 records were obtained from the examined databases. After 2 rounds of screening, 9 studies were included for full-text analysis. Six studies sought to identify the factors that drive resilience in flood victims, whereas 3 studies analyzed the impact of external interventions on their mental health. CONCLUSIONS: The limited number of studies demonstrates the need for public health policies to develop flood adaptation measures that can be used to support the mental health of flood victims.