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

Emerging infectious diseases pose significant risks to vulnerable populations, particularly older adults with underlying health conditions living in long-term care institutions. Yet, while the experiences of healthcare workers in managing these crises are invaluable, there remains limited research on the specific challenges they faced.

To explore the experiences of long-term care workers-including nurses, nursing assistants, and managers-in preventing emerging infectious diseases, the challenges they faced during the pandemic, and how they addressed them.

Twelve participants from long-term care institutions in Taiwan (including assisted living facilities, residential care homes, and nursing homes) were recruited via purposive sampling. All participants worked in the sector during the COVID-19 pandemic, were actively involved in clinical care or institutional management, and were proficient in Mandarin. In-depth interviews were conducted face-to-face between July and August 2024, and data interpretation was guided by thematic analysis.

Four themes emerged. Two themes depicting challenges illustrate challenges arising from inadequate preparation, including technical, cultural, and communication barriers, noncompliance among family members, resource shortages, and the physical and emotional strain endured by frontline workers balancing duty with feelings of guilt and anxiety. Two other themes representing the possibilities for strengthening long-term care highlight the importance of ongoing education, simulation-based training, and fostering participation, as well as the need for adaptive surveillance and tailored crisis response plans.

Long-term care workers reported systemic vulnerabilities, including inadequate preparation, communication barriers, and emotional strain. They also emphasized the importance of inclusive training, simulation-based practice, and adaptive response strategies.

Long-term care institutions should strengthen preparedness by incorporating multilingual, simulation-based infection prevention training, developing family communication strategies that balance clear rationales with dialog, establishing routine surveillance with adaptive response plans, and ensuring psychosocial support for their workforce.