{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T09:21:06Z","timestamp":1776849666291,"version":"3.51.2"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T00:00:00Z","timestamp":1670025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["SL1-174027"],"award-info":[{"award-number":["SL1-174027"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,21]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Coronavirus disease 2019 (COVID-19) pandemic visitor restrictions to long-term care facilities have demonstrated that eliminating opportunities for family-resident contact has devastating consequences for residents\u2019 quality of life. Our study aimed to understand how public health directives to support family visitations during the pandemic were navigated, managed, and implemented by staff.<\/jats:p><\/jats:sec><jats:sec><jats:title>Research Design and Methods<\/jats:title><jats:p>Guided by the Consolidated Framework for Implementation Research, we conducted video\/telephone interviews with 54 direct care and implementation staff in six long-term care homes in two Canadian provinces to assess implementation barriers and facilitators of visitation programs. Equity and inclusion issues were examined in the program\u2019s implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Despite similar public health directives, implementation varied by facility, largely influenced by the existing culture and processes of the facility and the staff understanding of the program; differences resulted in how designated family members were chosen and restrictions around visitations (e.g., scheduling and location). Facilitators of implementation were good communication networks, leadership, and intentional planning to develop the visitor designation processes. However, the lack of consultation with direct care staff led to logistical challenges around visitation and ignited conflict around visitation rules and procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Implications<\/jats:title><jats:p>Insights into the complexities of implementing family visitation programs during a pandemic are discussed, and opportunities for improvement are identified. Our results reveal the importance of proactively including direct care staff and family in planning for future outbreaks.<\/jats:p><\/jats:sec>","DOI":"10.1093\/geront\/gnac175","type":"journal-article","created":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T18:03:36Z","timestamp":1670090616000},"page":"490-500","source":"Crossref","is-referenced-by-count":4,"title":["With COVID Comes Complexity: Assessing the Implementation of Family Visitation Programs in Long-Term Care"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9602-3060","authenticated-orcid":false,"given":"Stephanie A","family":"Chamberlain","sequence":"first","affiliation":[{"name":"Faculty of Nursing, College of Health Sciences, University of Alberta , Edmonton, Alberta , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Warner","sequence":"additional","affiliation":[{"name":"School of Occupational Therapy, Faculty of Health, Dalhousie University , Halifax, Nova Scotia , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa K","family":"Andrew","sequence":"additional","affiliation":[{"name":"Department of Medicine (Geriatrics), Dalhousie University , Halifax, Nova Scotia , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Jean","family":"Hande","sequence":"additional","affiliation":[{"name":"Department of Sociology, Trent University , Peterborough, Ontario , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Hubley","sequence":"additional","affiliation":[{"name":"Nova Scotia Centre on Aging, Mount Saint Vincent University , Halifax, Nova Scotia , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lori E","family":"Weeks","sequence":"additional","affiliation":[{"name":"School of Nursing, Faculty of Health, Dalhousie University , Halifax, Nova Scotia , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3073-8535","authenticated-orcid":false,"given":"Janice M","family":"Keefe","sequence":"additional","affiliation":[{"name":"Nova Scotia Centre on Aging, Mount Saint Vincent University , Halifax, Nova Scotia , Canada"},{"name":"Department of Family Studies and Gerontology, Mount Saint Vincent University , Halifax , Nova Scotia , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,12,3]]},"reference":[{"issue":"1","key":"2023032106164087500_","doi-asserted-by":"crossref","first-page":"Article 588","DOI":"10.1186\/s12877-021-02530-1","article-title":"From wave to wave: A Dutch national study on the long-term impact of COVID-19 on well-being and family visitation in nursing homes","volume":"21","author":"Backhaus","year":"2021","journal-title":"BMC Geriatrics"},{"issue":"4","key":"2023032106164087500_","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1177\/0020731421997088","article-title":"Health systems and services during COVID-19: Lessons and evidence from previous crises: A rapid coping review to inform the United Nations Research Roadmap for the COVID-19 recovery","volume":"51","author":"Baral","year":"2021","journal-title":"International Journal of Health Services"},{"issue":"2","key":"2023032106164087500_","doi-asserted-by":"crossref","first-page":"321","DOI":"10.3138\/jcs.50.2.321","article-title":"Family matters: The work and skills of family\/friend carers in long-term residential care","volume":"50","author":"Barken","year":"2017","journal-title":"Journal of Canadian Studies"},{"issue":"1","key":"2023032106164087500_","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1177\/1049732317730568","article-title":"Supporting family involvement in long-term residential care: Promising practices for relational care","volume":"28","author":"Barken","year":"2018","journal-title":"Qualitative Health Research"},{"issue":"1","key":"2023032106164087500_","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1177\/1074840713507777","article-title":"Invisible hands: The role of highly involved families in long-term residential care","volume":"20","author":"Baumbusch","year":"2014","journal-title":"Journal of Family Nursing"},{"key":"2023032106164087500_","volume-title":"Rapid assessment process: An introduction","author":"Beebe","year":"2001"},{"issue":"1","key":"2023032106164087500_","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1017\/S0714980818000338","article-title":"Who is (still) looking after mom and dad? 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