Impact of isolation on the biopsychosocial functioning of older people with COVID-19.

INTRODUCTION: COVID-19 is a highly contagious coronavirus disease that has had a significant impact on the functioning of society. On 11 March 2020, due to the rapid spread of the virus, the WHO declared a global pandemic. By the end of 2021, 5 variants of SARS-CoV-2 had been identified since the beginning of the pandemic. The course of the disease varied depending on the age of the patients and the presence of possible comorbidities. Most patients were asymptomatic or sparsely symptomatic of the infection; however, in about 6% of cases, the course of the disease was critical. Typical symptoms of COVID-19 include: fever, muscle pain and headache, lack of smell and taste, cough, dyspnea, diarrhoea and nausea. According to epidemic guidelines, infected patients were subjected to isolation, which harmed their mental state, especially the elderly. OBJECTIVE: The aim of the study was to assess the impact of isolation on the biopsychosocial functioning of elderly patients with COVID-19. MATERIAL AND METHODS: The study was conducted among 360 elderly patients in hospital wards operating as a unit in a hospital complex dedicated to patients infected with the SARS-CoV-2 virus. Data were collected using standardized questionnaires: ADL Scale, IADL, GDS, SF-36 Quality of Life Scale, Multidimensional Scale of Perceived Social Support, and supplementary questions about, among others, the oxygen therapy provided, length of stay in the unit, and the support received from relatives. RESULTS: Almost half (48%) of the subjects received oxygen therapy, and 36% had a length of disease of 7-14 days. A correlation was observed between the quality of life and the above-mentioned factors. Correlations of quality of life indicators with the length of illness were moderate (except for the level of pain) and positive, meaning that the longer the patients were ill, the lower their quality of life. Correlations of disease severity were moderate for pain, vitality, and emotional limitations, while vital for physical functioning and limitations and general and mental health. The intensity of oxygen therapy was moderately correlated with physical and emotional limitations and general health and strongly correlated with physical functioning, vitality and mental health. Correlations between functional status and mental status of elderly patients were also studied. Analysis of variance showed that the constructed model was an excellent fit to the data, F = 37.14; p < 0.001, explaining 42% of the variance in the dependent variable (R2= 0.42). As many as 80% of the respondents felt that isolation harmed their well-being. Examining the impact of quality of life on their well-being showed that most of the associations tested were statistically significant, and all were positive. Associations of moderate strength were shown for physical functioning, physical limitations and general health, while strong associations were shown for vitality, emotional limitations and mental health. Pain complaints were associated with changes in well-being at the level of statistical trend (p = 0.055). This means that the lower the patients' quality of life, especially in terms of vitality and mental health, the more significant the impact of isolation on their well-being. The study also investigated the effect of social support on mental state. The model proved to be an excellent fit to the data, F = 5.91, p = 0.002, and explained 23% of the variance in the dependent variable (Adjusted R² = 0.23). At the same time, support from friends turned out to be the only significant predictor (Beta = 0.53), and this means that the more support the subjects received from them, the lower the level of depression they manifested. CONCLUSIONS: 1) The better the functional state of a senior and the support received from relatives, the lower the severity of depression. 2) The lower the quality of a senior's life, especially in terms of mental state, the greater the negative impact on his/her well-being in isolation. 3) The low quality of life of a senior increased the likelihood of depression. 4) The quality of life of older Covid-19 patients was higher in those without chronic disease. 5) The quality-of-life level was lower in patients with a more severe course of COVID-19, and longer duration of disease and oxygen therapy.

Ageing policy in Poland during the COVID-19 pandemic.

INTRODUCTION AND OBJECTIVE: Poland is engaged in the implementation of activation programmes for seniors at governmental as well as non-governmental levels. Among these programmes may be mentioned, 'Active+', 'Senior+', 'Care 75+', and 'Senior Caritas'. The COVID-19 pandemic highlighted the need for the inclusion of seniors into social life, and concern about their health. An important challenge for social and ageing policy is the provision of proper standards of care and health protection, especially during an increased sanitary regime. The aim of the study was analysis of the ageing policy strategy and the quality of life of seniors before and during the COVID-19 pandemic. REVIEW METHODS: The study was conducted by the method of analysis of data in the area of national initiatives concerning activation programmes for seniors implemented during 2020-2021. The starting point was the well-established definition of the quality of life by the WHO. ABBREVIATED DESCRIPTION OF THE STATE OF KNOWLEDGE: The analysis performed showed a multitude of factors determining the needs of seniors at the time of the pandemic, which often differed from those observed earlier. The latest studies of the quality of life of the elderly in Poland demonstrated that nearly 60% of respondents assessed their psychological condition as worse than before the pandemic. Another problem was the issue of physical activity, which was limited by more than 62% of seniors, and difficulties with access to health care system services. SUMMARY: It seems necessary to implement forms of assistance which could be adjusted to the changing epidemiological conditions, in order to improve the quality of life of persons who, in the near future, will constitute a considerable percentage of Polish society.