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Master Thesis

Étude de l’impact du confinement et des mesures de distanciation sociale en lien avec l'épidémie de Covid-19 sur l’autonomie, la locomotion, la nutrition, la psychologie, la mortalité et les comorbidités des résidents d’EHPAD de Haute-Savoie

Abstract : Background: Quantitative retrospective cohort study in medical records over a 6-month period surrounding the containment that lasted from March to May 2020. Material and methods: The population of interest was that of residents of EHPADs in Haute-Savoie who had not contracted a Covid-19 infection during the period evaluated. The sample was thus composed of 475 residents, from 19 different establishments drawn equally in each Groupement Hospitalier Territorial de Haute-Savoie. The main exclusion criterion was Covid-19 infection, whether confirmed by PCR or strongly suspected with negative PCR. The non-inclusion criteria were refusal of participation by the resident, as well as admission to the EHPAD after the start of the containment (14 March 2020). In each institution that agreed to participate, data were collected by analysing the patient files on the various software packages, using the Epi-Info software and the Microsoft Access database. The various statistical analyses were carried out for the different search criteria using the R++ software. The main objective of the study was to find a link between the physical and social distancing measures implemented and the autonomy, locomotion, nutrition, psychology, mortality and co-morbidities of EHPAD residents in Haute-Savoie. The secondary objective is to examine the difference in mortality outside of Covid in EHPAD between 2019 and 2020. Results: The study highlights a decrease in the average GIR score from 2.55 at the beginning of the study to 2.21 at the end of the confinement. There was also a significant weight loss among the residents, on average minus 2.02 kg per resident between the beginning of the confinement and six months after the confinement. There was also an increase in the prescription of psychotropic treatments. The average number of falls per resident is increased in 2020 compared to 2019 and correlated with the increase in psychotropic treatment. These factors encourage the entry into a spiral of undernutrition, which leads to weight loss, muscle wasting, falls and bedsores and contributes to the loss of autonomy of EHPAD residents. This could also be explained by the lack of availability of carers, to the detriment of residents' autonomy during nursing care. Or by the decrease in visits which usually contribute to maintaining physical activity. Conclusion: Strict confinement in EHPAD during exceptional epidemic periods, despite its epidemiological interest, leads to a significant decrease in the autonomy of residents and a deterioration of their nutritional status. These elements must be taken into account in the benefit-risk balance.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03547143
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Friday, January 28, 2022 - 12:10:23 PM
Last modification on : Saturday, January 29, 2022 - 3:39:10 AM
Long-term archiving on: : Friday, April 29, 2022 - 8:18:30 PM

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  • HAL Id : dumas-03547143, version 1

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Rémi Joiris, Quentin Lapierre. Étude de l’impact du confinement et des mesures de distanciation sociale en lien avec l'épidémie de Covid-19 sur l’autonomie, la locomotion, la nutrition, la psychologie, la mortalité et les comorbidités des résidents d’EHPAD de Haute-Savoie. Médecine humaine et pathologie. 2022. ⟨dumas-03547143⟩

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