Determinants of nurse's and personal support worker's adherence to facial protective equipment in a community setting during the COVID-19 pandemic: A pilot study

Introduction: Facial protective equipment (FPE) is a critical barrier to COVID-19 transmission, but compliance with FPE recommendations has historically been low, even amongst health care workers. This study analyzes factors influencing home care worker FPE compliance during the COVID-19 pandemic. Materials and Methods: Nurses and PSWs employed by VHA Home HealthCare (N=199) completed an online survey adapted from a Facial Protection Questionnaire used in previous studies from January 27 – February 10, 2021. Descriptive statistics, tests of significance, and logistic regression were conducted for each variable separated by FPE compliance. Results: This study found higher rates of FPE compliance (71%) than previously reported. Regression results suggest that participants who were not always FPE compliant (29%) were significantly more likely to have lower perceived FPE efficacy, lower knowledge of recommended FPE use, lower perception of risk at work, and higher personal barriers for face shields. Fogging of glasses or face shields from wearing a mask (74%) or face shield (71%) increased job difficulty for many participants. Conclusions: Policies and initiatives addressing perceived FPE efficacy, knowledge of recommended FPE use, perception of at-work risk, and personal barriers to FPE would be expected to significantly affect FPE compliance in the home care sector. Additionally, interventions that reduce visibility issues while wearing FPE would decrease personal barriers to FPE use.

Homecare personal support worker experiences working during the COVID-19 pandemic: A qualitative study

Introduction: Personal support workers (PSWs) are considered the backbone of homecare however their working conditions remain precarious and unregulated suggesting increased vulnerability in the face of a pandemic. The purpose of this study is to better understand the experiences of PSWs working in homecare during the COVID-19 pandemic. Methods: This qualitative descriptive study used a social constructivist approach to understand the experiences of Toronto-based PSWs working at a local homecare agency during the COVID-19 pandemic. Semi-structured virtual interviews were conducted. All transcribed interviews were coded and analyzed using the DEPICT framework. Results: 19 interviews were completed. PSWs shared a strong belief in duty to work during a health crisis and responsibility to support their vulnerable clients despite feeling vulnerable themselves to transmission and infection;the weight of pandemic anxiety was felt daily and intensely for most. PSWs described existing system challenges exacerbated by the pandemic that tested the limits of their motivations to work, emotional wellbeing and perception of organizational support. Conclusions: The COVID-19 pandemic contributed to increased occupational stress among PSWs. Longstanding system-level issues coupled with increased emotional labour has positioned this workforce at- risk for burnout indicating that health human resource issues may persist if unaddressed. Homecare organizations can implement strategies that promote and protect the mental wellbeing of PSWs while aggressively lobbying for system changes such as higher wages and better labour protections.