The psychological well-being of people in a COVID-19 supervised quarantine facility: A mixed methods study.

WHAT IS KNOWN ON THE SUBJECT?: Supervised Quarantine has been shown to impact the psychological well-being of those in quarantine both during the COVID-19 pandemic and in previous pandemics. There are few studies regarding the psychological impact of supervised quarantine for the purpose of COVID-19 mitigation. There is little research regarding the psychological well-being of professionals maintaining quarantine, despite the fact they risk potential psychological distress. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper addresses the paucity of knowledge regarding the psychological well-being of those undergoing quarantine in a purpose-built facility. The quarantined study population involved uniquely domestic arrivals and also professionals maintaining quarantine. Lack of control, isolation and miscommunication were perceived as challenging mental well-being. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Although psychological distress in Domestic arrivals appeared low, there are still identifiable stresses on mental well-being. Mental health workers need to be cognizant that point entry to COVID-19 quarantine (Domestic vs. International as well as specific regions) may influence risk of psychological distress. Mental Health nurses supporting those in quarantine should afford quarantined individuals a degree of choice, establish regular clear communication and consider how to establish peer support mechanisms within the quarantine environment. ABSTRACT: INTRODUCTION: Supervised quarantine may compromise psychological well-being. There is equivocal evidence regarding psychological distress in compulsory supervised quarantine facilities. AIMS: To evaluate the mental well-being of people undergoing and working in a supervised COVID-19 quarantine facility. METHOD: Mixed methodology was used, including a cross-sectional analysis of psychological distress (DASS-21) and individual semi-structured interviews (10 professionals maintaining quarantine and 10 quarantined persons). RESULTS: Overall levels of psychological distress were low. Those quarantining from Victoria had significantly lower depression scores compared to all other departure points. Qualitative analysis identified distress being linked to a lack of control, isolation and miscommunication. DISCUSSION: Quarantine was associated with low levels of psychological distress. This was lower in people travelling from Victoria, a state where there were higher rates of infections and restrictions. Interviews showed that psychological distress was conceptualized as being associated with supervised quarantine, but participants recognized the overall importance of quarantine. IMPLICATIONS FOR PRACTICE: Mental health professionals supporting quarantined people should consider original departure points may predict levels of psychological distress. Implementing ways of gaining control through affording choice, improving communication channels and establishing peer support networks within quarantine settings may help maintain mental well-being.

Examining the development and utilization of infection control policies to safely support adults with intellectual and developmental disabilities in congregate living settings during COVID-19.

OBJECTIVE: Congregate living settings supporting individuals with intellectual and developmental disabilities (IDD) have experienced unprecedented challenges during the COVID-19 pandemic. This study aimed to explore the development and utilization of infection control policies in congregate living settings supporting individuals with IDD during the COVID-19 pandemic. METHODS: This qualitative study employed an interpretive description using semi-structured interviews involving administrative personnel from agencies assisting those with IDD residing in Developmental Services congregate living settings in Ontario, Canada. RESULTS: Twenty-two semi-structured interviews were conducted with individuals from 22 agencies. Thematic analysis revealed three categories: Development of infection control policies, Implementation of infection control policies, and Impact of infection control policies. Each category yielded subsequent themes. Themes from the Development of infection control policies category included New responsibilities and interpreting the grey areas, and Feeling disconnected and forgotten. Four themes within the Implementation of infection control policies category included, "It's their home" (i.e. difficulty balancing public health guidance and organizational values), Finding equipment and resources (e.g. supports and barriers), Information overload (i.e. challenges agencies faced when implementing policies), and Emerging vaccination (i.e. perspective of agencies as they navigate vaccination for clients and staff). The category of Impact of infection control policies had one theme-Fatigue and burnout, capturing the impact of policies on stakeholders in congregate living settings. CONCLUSION: Agencies experienced difficulties developing and implementing infection control policies, impacting the clients they serve and their families and staff. Public health guidance should be tailored to each congregate living setting rather than generally applied.

RéSUMé: OBJECTIF: Les lieux d'hébergement collectif pour les personnes ayant une déficience intellectuelle ou de développement (DID) ont affronté des défis sans précédent durant la pandémie de la COVID-19. La présente étude vise à explorer l'élaboration et l'utilisation des politiques de prévention des infections dans les lieux d'hébergement collectif pour les personnes ayant une DID durant la pandémie de la COVID-19. MéTHODES: Cette étude qualitative repose sur la description interprétative lors d'entrevues semi-structurées auprès du personnel administratif des organismes qui viennent en aide aux personnes ayant une DID et résidant dans des lieux d'hébergement collectif en Ontario, au Canada. RéSULTATS: Au total, 22 entrevues semi-structurées ont été effectuées auprès de personnes provenant de 22 organismes. L'analyse thématique a révélé trois catégories : Élaboration des politiques de prévention des infections, mise en œuvre des politiques de prévention des infections, et impacts des politiques de prévention des infections. Chaque catégorie a généré des thèmes subséquents. Les thèmes liés à l'élaboration des politiques de prévention des infections comprenaient les nouvelles responsabilités et l'interprétation des zones grises, et le sentiment de détachement et d'avoir été oublié. Quatre thèmes découlant de la mise en œuvre des politiques de prévention des infections comprenaient « c'est leur maison ¼ (c'est-à-dire difficulté d'équilibrer les mesures de santé publique et les valeurs organisationnelles), trouver de l'équipement et des ressources (p. ex., mesures de soutien et obstacles), surcharge d'information (c'est-à-dire les défis qu'ont dû affronter les organismes lors de la mise en œuvre des politiques) et la vaccination émergente (notamment la perspective des organismes lorsqu'ils ont dû composer avec le processus de vaccination pour la clientèle et le personnel). La catégorie des impacts des politiques de prévention des infections avait un thème : la fatigue et l'épuisement professionnel, saisissant les impacts des politiques de prévention des infections dans les lieux d'hébergement collectif sur ses intervenants. CONCLUSION: Les organismes ont éprouvé des difficultés lors de l'élaboration et la mise en œuvre de politiques de prévention des infections, touchant ainsi leurs clients, leurs familles et leurs employés. Les mesures de santé publique devraient plutôt être adaptées à chaque lieu d'hébergement collectif, et non pas appliquées de façon générale.