Other Titles
The Forgotten Vulnerable: Advocating for Emerging Infectious Disease Prevention in Long-Term Care [Symposium Title]
Abstract
Aim: To explore the experiences of long-term care workers in preventing emerging infectious diseases, the challenges they faced during the pandemic, and how they were addressed.
Design: This study used an exploratory qualitative research design.
Methods: The study involved various long-term care institutions across Taiwan. Twelve interviewees, including four nurses, four nursing assistants, and four managers, were recruited via purposive sampling. All interviewees worked in the sector during the COVID-19 pandemic, were actively involved in clinical care or institutional management, and were proficient in Mandarin. In-depth interviews were conducted face-to-face between July and August 2024, and data interpretation was guided by thematic analysis.
Results: Four themes emerged. Two themes depicting dilemmas, “Islands Amid the Storm” and “Cracks in the Armor – Frontline Fragility”, illustrate the challenges of inadequate preparation, including technical, cultural, and communication barriers, noncompliance of family members, and resource shortages, and the physical and emotional strain endured by the frontline workers balancing duty with feelings of guilt and anxiety, respectively. The two forward-looking themes representing prospects of long-term care, “Enhancing Stability Through Preparedness and Participation” and “Building a Shield in Uncertain Times”, highlight the importance of continuous education, simulation-based training, and fostering participation, alongside the need for adaptive surveillance and tailored crisis response plans.
Conclusion: This study highlights the pivotal role played by long-term care institutions during outbreaks of emerging infectious diseases and the significant challenges they faced during the COVID-19 pandemic. The findings offer actionable recommendations based on the firsthand experiences of workers and serve to inform routine practices, enhance emergency response strategies, and support the development of more effective pandemic prevention policies within these institutions.
Notes
References:
Birt, L., Lane, K., Corner, J., Sanderson, K., & Bunn, D. (2023). Care-home Nurses' responses to the COVID-19 pandemic: Managing ethical conundrums at personal cost: A qualitative study. Journal of Nursing Scholarship, 55(1), 226–238.
Centers for Disease Control and Prevention. (2020). Nursing Homes and Assisted Living (Long-term Care Facilities [LTCFs]). U.S. Department of Health & Human Services. https:// www.cdc.gov/longtermcare/index.html.
Estabrooks, C. A., Straus, S. E., Flood, C. M., Keefe, J., Armstrong, P., Donner, G. J., Boscart, V., Ducharme, F., Silvius, J. L., & Wolfson, M. C. (2020). Restoring trust: COVID-19 and the future of long-term care in Canada. Facets, 5(1), 651–691.
Fisher, E., Cárdenas, L., Kieffer, E., & Larson, E. (2021). Reflections from the "Forgotten Front Line": A qualitative study of factors affecting wellbeing among long-term care workers in New York City during the COVID-19 pandemic. Geriatric nursing, 42(6), 1408–1414.
Gao, Y. D., Ding, M., Dong, X., Zhang, J. J., Kursat Azkur, A., Azkur, D., Gan, H., Sun, Y. L., Fu, W., Li, W., Liang, H. L., Cao, Y. Y., Yan, Q., Cao, C., Gao, H. Y., Brüggen, M. C., van de Veen, W., Sokolowska, M., Akdis, M., & Akdis, C. A. (2021). Risk factors for severe and critically ill COVID-19 patients: A review. Allergy, 76(2), 428–455.
Szczerbinska, K. (2020). Could we have done better with COVID-19 in nursing homes? European Geriatric Medicine, 11(4), 639-643.
Sigma Membership
Lambda Beta at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Qualitative Research
Keywords:
Long-term Care, Public and Community Health, Policy and Advocacy, Infectious Disease Prevention, COVID-19, Pandemic
Recommended Citation
Kung, Po-Jen; Chen, Ching-Min; and Reynolds, Nancy, "Dilemmas and Prospects of Infectious Disease Prevention in Long-Term Care: A Qualitative Study" (2025). International Nursing Research Congress (INRC). 296.
https://www.sigmarepository.org/inrc/2025/presentations_2025/296
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Dilemmas and Prospects of Infectious Disease Prevention in Long-Term Care: A Qualitative Study
Seattle, Washington, USA
Aim: To explore the experiences of long-term care workers in preventing emerging infectious diseases, the challenges they faced during the pandemic, and how they were addressed.
Design: This study used an exploratory qualitative research design.
Methods: The study involved various long-term care institutions across Taiwan. Twelve interviewees, including four nurses, four nursing assistants, and four managers, were recruited via purposive sampling. All interviewees worked in the sector during the COVID-19 pandemic, were actively involved in clinical care or institutional management, and were proficient in Mandarin. In-depth interviews were conducted face-to-face between July and August 2024, and data interpretation was guided by thematic analysis.
Results: Four themes emerged. Two themes depicting dilemmas, “Islands Amid the Storm” and “Cracks in the Armor – Frontline Fragility”, illustrate the challenges of inadequate preparation, including technical, cultural, and communication barriers, noncompliance of family members, and resource shortages, and the physical and emotional strain endured by the frontline workers balancing duty with feelings of guilt and anxiety, respectively. The two forward-looking themes representing prospects of long-term care, “Enhancing Stability Through Preparedness and Participation” and “Building a Shield in Uncertain Times”, highlight the importance of continuous education, simulation-based training, and fostering participation, alongside the need for adaptive surveillance and tailored crisis response plans.
Conclusion: This study highlights the pivotal role played by long-term care institutions during outbreaks of emerging infectious diseases and the significant challenges they faced during the COVID-19 pandemic. The findings offer actionable recommendations based on the firsthand experiences of workers and serve to inform routine practices, enhance emergency response strategies, and support the development of more effective pandemic prevention policies within these institutions.
Description
Overall Symposium Summary: Emerging infectious diseases pose severe risks to long-term care institutions due to resource constraints and resident vulnerabilities. This national four-phase study addresses these risks: Phase One defines key roles in infection prevention; Phase Two develops a competency instrument for frontline workers; and Phases Three and Four explore barriers and facilitators in infection control. This research urges policy action, presenting a globally adaptable model to strengthen care institutions.
Note: The attached slide deck is a combined symposium presentation containing the slides of all featured symposium speakers. It does not contain individual title slides for each session presented within the symposium.
To locate the other presentations in this symposium, search the repository by the Symposium Title shown in the Other Title field of this item record.