Abstract
Objectives: The health-enhancing benefits or regular physical activity (PA) reach into old age. With the emergence of the coronavirus disease of 2019 (COVID-19) pandemic and the associated national lockdowns and restrictions, nursing home residents were restrained from being physically active. In our study, we aimed to assess the impact of the COVID-19-related restrictions on PA promotion in nursing homes from an organizational-sociological lens.Methods: We collected data in eight nursing homes in Germany. Data collection included (i) semistructured interviews focusing on COVID-19-related restrictions and their effects on nursing homes from the home administrators' perspectives; (ii) open-ended surveys with nursing home staff and relatives focusing on daily routines and contact restrictions; and (iii) collection of documents such as care concepts, mission statements, and weekly activity plans. We analyzed all data with a reflexive thematic analysis approach.Results: We identified three stages of COVID-19-related changes in nursing homes that impacted PA promotion, as follows: (1) external closure and search for emergency control, (2) organizational adaptations to create a livable daily life in the internal environment, and (3) slow reintegration of interactions with the external organizational environment. Document analysis revealed that PA promotion was not part of decision programs or internal staff work descriptions. Rather, PA promotion was delegated to external service providers. The assignment of PA promotion to external providers was not structurally anchored in decision programs, which makes PA promotion not sustainable, particularly during unforeseen events that limit access to the organization. During the pandemic, executive staff believed in internal staff to buffer competencies with regard to PA promotion. Thus, executive staff often considered PA promotion relevant, even during the pandemic, but thought that PA promotion is a task that can be fulfilled by unqualified but motivated internal staff.Conclusion: While our study participants showed a high level of coping-capacity belief, it remains unclear which long-term impacts of COVID-19 on PA promotion in nursing homes are to be expected. At the practice level, executive staff in nursing homes that aim to promote PA within their organization should become aware that PA promotion needs to be incorporated into organizational structures to be implemented and continued in challenging times such as in a pandemic.
Highlights
BackgroundPhysical activity (PA) has widely been acknowledged as a decisive behavior to promote health
We aim to address the following main questions: (1) How do nursing homes react to COVID-19related restrictions? With this question, we want to find out to which extent the Corona pandemic leads to an organizational change
We will present data on the question to which extent the impact of COVID19 on PA promotion is manageable against the background of given organizational structures
Summary
BackgroundPhysical activity (PA) has widely been acknowledged as a decisive behavior to promote health. Despite being a substantial contributor to biopsychosocial well-being and healthy aging, PA tends to be limited in institutions for older people: nursing home residents show low levels of PA and a high prevalence of sedentariness (Barber et al, 2015; Lotvonen et al, 2017). With the emergence of the coronavirus disease of 2019 (COVID-19) pandemic in the early spring of 2020 and the associated national lockdowns and restrictions, nursing home residents were restrained from being physically active. Public health authorities established behavioral guidelines for nursing homes on regional, state, and/or federal levels. In order to decrease the risk of infection and to protect residents, social and environmental regulations were implemented in several countries worldwide, including the lockdown of nursing homes for both visitors and residents
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