Challenges and Prospects for Preventing the COVID-19 Pandemic in Nursing Homes in Taiwan: A Mixed-Methods Study

Area of Science:

• Gerontology and Long-Term Care
• Infectious Disease Prevention
• Public Health Policy

Background:

• Nursing home residents in Taiwan were highly vulnerable to COVID-19 due to chronic illnesses and congregate living.
• Lack of clear pandemic prevention strategies hampered institutional risk-reduction planning during the COVID-19 crisis.

Purpose of the Study:

• To explore COVID-19 prevention challenges and prospects in Taiwanese nursing homes.
• To evaluate the effectiveness of implemented prevention strategies across different facility types and sizes.
• To assess the need for institutional training on pandemic preparedness.

Main Methods:

• Exploratory sequential mixed-methods study combining focus groups and quantitative surveys.
• Focus groups identified key challenges and recommendations for pandemic prevention.
• Surveys utilized stratified random sampling, analyzed with thematic analysis and descriptive statistics.

Main Results:

• Focus groups revealed themes of role adaptation, frontline exhaustion, care competence gaps, and the need for systematic approaches.
• Surveys showed generally positive self-assessments of prevention effectiveness (average 28.1/36), but 6.8% lacked COVID-19 training.
• Effectiveness did not significantly differ by institution type or scale; training effectiveness was rated highly (average 16.2/20).

Conclusions:

• Despite positive self-assessments, nursing homes face critical challenges in role clarity, staff well-being, and training.
• These issues remain vital for institutional preparedness, even after the WHO declared COVID-19 no longer a global health emergency.
• Findings offer transferable insights for improving pandemic response planning in long-term care settings against future infectious threats.