{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:50:23Z","timestamp":1791946223966,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Caring Sciences"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>During the early phase of the COVID\u201019 pandemic, nursing homes faced rapid changes in national guidelines and significant uncertainty in daily practice. Healthcare personnel and leaders were required to make immediate decisions regarding isolation and infection control, often involving complex ethical challenges. This study explores how nursing home staff and leaders experienced these challenges, particularly in relation to isolation practices, and interprets them through central ethical principles and values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study is based on qualitative data from one Norwegian nursing home that experienced confirmed COVID\u201019 infection early in the pandemic. Data were collected through one focus group interview with nursing staff, and individual interviews with two leaders and two physicians. Clarke and Braun's thematic analysis was used, and an ethical framework was applied in the interpretive phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analysis identified three interconnected themes:\n                      <jats:italic>Efforts in Making Isolation as Gentle as Possible<\/jats:italic>\n                      \u2014healthcare personnel aimed to protect residents from infection while maintaining familiarity, empathy, and emotional presence, reflecting values linked to virtue ethics.\n                      <jats:italic>Balancing Safety and Relational Care<\/jats:italic>\n                      \u2014healthcare personnel faced moral tensions when trying to protect residents while preserving dignity and communication with relatives under strict restrictions.\n                      <jats:italic>Challenges Related to Interpretation and Application of Isolation Guidelines\u2014<\/jats:italic>\n                      healthcare personnel navigated uncertainty in rapidly changing recommendations, highlighting ethical challenges related to autonomy, informed consent, proportionality, and quality of life.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study demonstrates the complex interplay of ethical values when isolating nursing home residents during the early phase of the pandemic. Pandemic\u2010related restrictions substantially limited autonomy and raised questions of proportionality, dignity, and informed consent. These findings highlight the need for ethical reflection and support to balance protection with humane care in future crises.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/scs.70192","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T10:20:23Z","timestamp":1770718823000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ethical Challenges in Care for Nursing Home Residents During COVID\u201019: Insights From a Qualitative Study"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1060-6095","authenticated-orcid":false,"given":"Irene","family":"Aasmul","sequence":"first","affiliation":[{"name":"The Dignity Centre  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frode F.","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Centre for Care Research West Western Norway University of Applied Sciences  Bergen Norway"},{"name":"VID Specialized University  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_2_12_2_1","article-title":"Mortality Associated With COVID\u201019 in Care Homes: International Evidence","volume":"14","author":"Comas\u2010Herrera A.","year":"2020","journal-title":"Article in LTCcovid.Org, International Long\u2010Term Care Policy Network, CPEC\u2010LSE"},{"key":"e_1_2_12_3_1","volume-title":"Nasjonal Faglig Retningslinje for Demens","author":"Helsedirektoratet","year":"2017"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904\u2010018\u20100323\u20103"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/scs.12213"},{"key":"e_1_2_12_6_1","volume-title":"Beslutningsprosesser for Begrensning av. Livsforlengende Behandling Hos Alvorlige Syke og D\u00f8ende. Nasjonal Veileder","author":"Helsedirektoratet","year":"2013"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph181910099"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969733020976194"},{"key":"e_1_2_12_9_1","volume-title":"Principles of Biomedical Ethics","author":"Beauchamp T. L.","year":"2019"},{"key":"e_1_2_12_10_1","first-page":"216","volume-title":"Geriatrisk Sykepleie, God Omsorg Til Den Gamle Pasienten","author":"Sletteb\u00f8 \u00c5.","year":"2021"},{"key":"e_1_2_12_11_1","unstructured":"F. F.Jacobsen C.Arntzen S. A.Devik et\u00a0al. \u201cErfaringer Med COVID\u201019 i Norske Sykehjem. Underlagsrapport for Koronakommisjonen [Experiences of COVID\u201019 in Norwegian Nursing Homes. A Report for the Norwegian Corona Commission] \u201dReport. 1 (2021)."},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-69909-7_3470-2"},{"key":"e_1_2_12_13_1","volume-title":"Sykepleie og Etikk","author":"Sletteb\u00f8 \u00c5.","year":"2013"},{"key":"e_1_2_12_14_1","volume-title":"Samtalen, Skj\u00f8nnet og Evidensen","author":"Martinsen K.","year":"2005"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.4220\/Sykepleienf.2022.88651"},{"key":"e_1_2_12_16_1","unstructured":"M. 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