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Challenges and Possibilities in Preventing Emerging Infectious Diseases in Long-Term Care: A Qualitative Descriptive

Po-Jen Kung1,2, Ching-Min Chen1, Katherine A Ornstein2,3,4

  • 1Department of Nursing, National Cheng Kung University, Tainan, Taiwan.

Journal of Nursing Management
|October 23, 2025
PubMed
Summary

Long-term care workers faced significant challenges during infectious disease outbreaks due to poor preparation and resource shortages. Enhancing training, communication, and support systems is crucial for strengthening pandemic preparedness in these facilities.

Keywords:
COVID-19infectious diseaselong-term carepandemicpreventionqualitative studythematic analysis

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Area of Science:

  • Infectious disease management in healthcare settings.
  • Geriatric care and public health.
  • Healthcare workforce challenges during pandemics.

Background:

  • Emerging infectious diseases pose substantial risks to vulnerable populations, especially older adults in long-term care (LTC).
  • Limited research exists on the specific challenges faced by LTC healthcare workers during infectious disease crises.
  • Healthcare workers' experiences are crucial for understanding and managing public health emergencies.

Purpose of the Study:

  • To explore the experiences of LTC workers in preventing emerging infectious diseases.
  • To identify challenges faced by LTC staff during the COVID-19 pandemic.
  • To understand how LTC workers addressed these challenges.

Main Methods:

  • Purposive sampling of 12 participants from Taiwanese LTC institutions (assisted living, residential care, nursing homes).
  • Participants had experience during the COVID-19 pandemic and were involved in clinical care or management.
  • In-depth, face-to-face interviews conducted July-August 2024, analyzed thematically.

Main Results:

  • Key challenges included inadequate preparation, technical/cultural/communication barriers, noncompliance, resource shortages, and frontline worker strain (guilt, anxiety).
  • Opportunities for improvement involve ongoing education, simulation-based training, and fostering participation.
  • Need for adaptive surveillance and tailored crisis response plans was highlighted.

Conclusions:

  • LTC workers reported systemic vulnerabilities like poor preparation, communication issues, and emotional strain.
  • Inclusive training, simulation practice, and adaptive strategies are vital for future preparedness.
  • Strengthening LTC requires better training, communication, surveillance, and psychosocial support.