Tensions between infection control regulations and the home care working environment: An interview study with health care providers early during the COVID-19 pandemic

Background:
Therefore, the objective of this study was to elucidate caregivers’ experiences of ordinary homes as a working environment in home care and home health care during the COVID-19 pandemic. At the beginning of the pandemic, hospital care was in focus and the care of older adults was criticized around the world.

Design and methods:
Semi-structured qualitative interviews were conducted in two municipalities in Sweden between March 2020 and May 2021. One large municipality (population 155,000) with experience of care recipients with COVID-19, and a smaller municipality (population 32,000) were included; both had a focus on preventing the spread of the infection. A total of 27 participants working in home care were interviewed; these were occupational therapists, physical therapists, nurses, and assistant nurses. The interview material was analyzed using content analysis.

Results:
The interviews provided a comprehensive insight into the complex work environment in municipal home care during the pandemic. The staff had to deal with constantly changing information and new guidelines. They were also given new tasks and work routines that demanded more planning and were time-consuming. The staff experienced higher workload and pressure during the pandemic and did not have enough time to recover.

Conclusions:
During a pandemic situation, the information must be comprehensive and gathered in one place, and the managers must ensure sufficient staffing levels, time for reflection, and support for prioritization. The managers must also ensure the mental health of staff and meet their needs for recovery, both at and outside work.