Factors Associated With the Quality of Life of Nursing Home Residents During the COVID-19 Pandemic: A Cross-Sectional Study

Objectives: Quality of life (QoL) of nursing home (NH) residents is critical, yet understudied, particularly during the COVID-19 pandemic. Our objective was to examine whether COVID-19 outbreaks, lack of access to geriatric professionals, and care aide burnout were associated with NH residents' QoL. Design: Cross-sectional study (July to December 2021). Setting and Participants: We purposefully selected 9 NHs in Alberta, Canada, based on their COVID-19 exposure (no or minor/short outbreaks vs repeated or extensive outbreaks). We included data for 689 residents from 18 care units. Methods: We used the DEMQOL-CH to assess resident QoL through video-based care aide interviews. Independent variables included a COVID-19 outbreak in the NH in the past 2 weeks (health authority records), care unit-levels of care aide burnout (9-item short-form Maslach Burnout Inventory), and resident access to geriatric professionals (validated facility survey). We ran mixed-effects regression models, adjusted for facility and care unit (validated surveys), and resident covariates (Resident Assessment Instrument-Minimum Data Set 2.0). Results: Recent COVID-19 outbreaks (b = 0.189; 95% CI: 0.058-0.320), higher proportions of emotionally exhausted care aides on a care unit (b = 0.681; 95% CI: 0.246-1.115), and lack of access to geriatric professionals (b = 0.216; 95% CI: 0.003-0.428) were significantly associated with poorer resident QoL. Conclusions and Implications: Policies aimed at reducing infection outbreaks, better supporting staff, and increasing access to specialist providers may help to mitigate how COVID-19 has negatively affected NH resident QoL. & COPY; 2023 The Authors. Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

This study examined the association between COVID-19 outbreaks, access to geriatric professionals, care aide burnout, and the quality of life (QoL) of nursing home residents. The results showed that recent COVID-19 outbreaks, high levels of emotionally exhausted care aides, and lack of access to geriatric professionals were significantly associated with poorer QoL among nursing home residents.