{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:28:25Z","timestamp":1787020105905,"version":"build-2736575974"},"reference-count":86,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Government of Canada\u2019s New Frontiers in Research Fund","award":["NFRFR-2019-00005"],"award-info":[{"award-number":["NFRFR-2019-00005"]}]},{"name":"Government of Canada\u2019s New Frontiers in Research Fund","award":["NFRFR-2019-00005"],"award-info":[{"award-number":["NFRFR-2019-00005"]}]},{"name":"Government of Canada\u2019s New Frontiers in Research Fund","award":["NFRFR-2019-00005"],"award-info":[{"award-number":["NFRFR-2019-00005"]}]},{"name":"Government of Canada\u2019s New Frontiers in Research Fund","award":["NFRFR-2019-00005"],"award-info":[{"award-number":["NFRFR-2019-00005"]}]},{"DOI":"10.13039\/501100020170","name":"Research Nova Scotia","doi-asserted-by":"crossref","award":["RNS-RRG-004"],"award-info":[{"award-number":["RNS-RRG-004"]}],"id":[{"id":"10.13039\/501100020170","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100020170","name":"Research Nova Scotia","doi-asserted-by":"crossref","award":["RNS-RRG-004"],"award-info":[{"award-number":["RNS-RRG-004"]}],"id":[{"id":"10.13039\/501100020170","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Scotia Scholars Award","award":["file number 24837"],"award-info":[{"award-number":["file number 24837"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>During the COVID-19 pandemic, long-term care (LTC) facilities in Canada were confronted with many rapidly changing public health safety guidelines. Based on the guidelines, LTC facilities had to implement a series of virus containment and mitigation measures, presenting significant challenges for both workers and residents. This research aims to provide insights that could be used to guide improvements in the experiences of LTC workers, and of residents, in future pandemic crises.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative multi-case study was used to explore the pandemic experiences of a demographically diverse group of LTC workers in Canada, focusing on how public health safety guidelines impacted them, and their perceptions of challenges faced by residents. Fourteen workers were engaged from facilities in Nova Scotia and British Columbia, which are regions distinct geographically and with differences in safety guidelines and implementation. Semi-structured interviews were conducted between April to October 2021. Using thematic analysis, we identified patterns within and across the interview transcripts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The thematic analysis provided an understanding of the experiences and perspectives of LTC workers. There were four key themes: (1)\n                      <jats:italic>Tangling with Uncertainty<\/jats:italic>\n                      , that describes the effects of ambiguous messaging and shifting COVID-19 safety guidance on workers; (2)\n                      <jats:italic>Finding Voice<\/jats:italic>\n                      , that highlights how workers coped with feelings of helplessness during the healthcare crisis; (3)\n                      <jats:italic>Ripple Effects<\/jats:italic>\n                      , of pandemic pressures on workers beyond resident care, that included strengthening of inter-colleague support as well as financial challenges, and; (4)\n                      <jats:italic>Loss of Home<\/jats:italic>\n                      , where workers perceived that protection of residents led to a loss of the residents\u2019 home environment, personal freedom, and autonomy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings suggest that LTC workers\u2019 experiences during future pandemics may be improved by their inclusion in the development of public health safety guidelines, facilitating inter-colleague support systems, and ensuring worker financial stability. A balance should be found between preventing infection in LTC facilities and retaining the principles of holistic and resident-centered care for workers\u2019 and residents\u2019 mental health benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12877-024-05656-0","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T19:58:36Z","timestamp":1739822316000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Unveiling the impact: understanding long-term care workers\u2019 experiences and their perceptions of resident challenges amidst the COVID-19 pandemic"],"prefix":"10.1186","volume":"25","author":[{"given":"Donna M.","family":"Halperin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista","family":"Whitfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Bettinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Orhierhor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"Salter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailey M.","family":"Selig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Mack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian R.","family":"Condran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camryn","family":"Salyzyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet A.","family":"Parsons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Kervin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Halperin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"5656_CR1","doi-asserted-by":"publisher","first-page":"912336","DOI":"10.3389\/fimmu.2022.912336","volume":"13","author":"R Rovito","year":"2022","unstructured":"Rovito R, Augello M, Ben-Haim A, Bono V, d\u2019Arminio Monforte A, Marchetti G. Hallmarks of severe COVID-19 pathogenesis: a pas de deux between viral and host factors. Front Immunol. 2022;13:912336.","journal-title":"Front Immunol"},{"issue":"4","key":"5656_CR2","doi-asserted-by":"publisher","first-page":"146","DOI":"10.23937\/2474-3658\/1510146","volume":"6","author":"B Mohan","year":"2020","unstructured":"Mohan B, Nambiar V. COVID-19: an insight into SARS-CoV-2 pandemic originated at Wuhan City in Hubei Province of China. J Infect Dis Epidemiol. 2020;6(4):146.","journal-title":"J Infect Dis Epidemiol"},{"issue":"13","key":"5656_CR3","first-page":"12493","volume":"12","author":"X Fang","year":"2020","unstructured":"Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z et al. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging. 2020;12(13):12493.","journal-title":"Aging (Albany N Y)"},{"key":"5656_CR4","doi-asserted-by":"publisher","DOI":"10.1556\/2060.2022.00206","author":"A P\u00e9terfi","year":"2022","unstructured":"P\u00e9terfi A, M\u00e9sz\u00e1ros \u00c1, Szarvas Z, P\u00e9nzes M, Fekete M, Feh\u00e9r \u00c1 et al. Comorbidities and increased mortality of COVID-19 among the elderly: a systematic review. Physiol Int. 2022. https:\/\/doi.org\/10.1556\/2060.2022.00206","journal-title":"Physiol Int"},{"issue":"5","key":"5656_CR5","doi-asserted-by":"publisher","first-page":"105951","DOI":"10.1016\/j.ijantimicag.2020.105951","volume":"55","author":"H Li","year":"2020","unstructured":"Li H, Liu S-M, Yu X-H, Tang S-L, Tang C-K. Coronavirus disease 2019 (COVID-19): current status and future perspectives. Int J Antimicrob Agents. 2020;55(5):105951.","journal-title":"Int J Antimicrob Agents"},{"key":"5656_CR6","doi-asserted-by":"crossref","unstructured":"Pang L, Liu Y, Shen M, Ye J, Chen R, Lan Z et al. Influence of aging on deterioration of patients with COVID-19. Aging. 2020;12(24):26248.","DOI":"10.18632\/aging.202136"},{"key":"5656_CR7","unstructured":"WHO. COVID-19: symptoms and severity. WHO. https:\/\/www.who.int\/westernpacific\/emergencies\/covid-19\/information\/asymptomatic-covid-19. 2022."},{"key":"5656_CR8","unstructured":"Government of Canada. From risk to resilience: an equity approach to COVID-19. https:\/\/www.canada.ca\/en\/public-health\/corporate\/publications\/chief-public-health-officer-reports-state-public-health-canada\/from-risk-resilience-equity-approach-covid-19.html. 2020."},{"issue":"5","key":"5656_CR9","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1016\/j.jamda.2021.02.021","volume":"22","author":"A Vipperman","year":"2021","unstructured":"Vipperman A, Zimmerman S, Sloane PD. COVID-19 recommendations for assisted living: implications for the future. J Am Med Dir Assoc. 2021;22(5):933\u20138. e935.","journal-title":"J Am Med Dir Assoc"},{"key":"5656_CR10","doi-asserted-by":"publisher","first-page":"e075148","DOI":"10.1136\/bmj-2023-075148","volume":"382","author":"CA Estabrooks","year":"2023","unstructured":"Estabrooks CA, Ewa V, Keefe J, Straus SE. The predictable crisis of covid-19 in Canada\u2019s long term care homes. BMJ. 2023;382:e075148.","journal-title":"BMJ"},{"issue":"10270","key":"5656_CR11","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/S0140-6736(21)00083-0","volume":"397","author":"P Webster","year":"2021","unstructured":"Webster P. COVID-19 highlights Canada\u2019s care home crisis. Lancet. 2021;397(10270):183.","journal-title":"Lancet"},{"key":"5656_CR12","unstructured":"CIHI. Pandemic experience in the long-term care sector. https:\/\/www.cihi.ca\/sites\/default\/files\/document\/covid-19-rapid-response-long-term-care-snapshot-en.pdf. 2020."},{"key":"5656_CR13","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.2105\/AJPH.2020.305936","volume":"110","author":"M Silverman","year":"2020","unstructured":"Silverman M, Clarke M, Stranges S. Did lessons from SARS help Canada\u2019s response to COVID-19?. Am J Public Health. 2020;110:1797\u20139.","journal-title":"Am Public Health Ass"},{"key":"5656_CR14","doi-asserted-by":"crossref","unstructured":"Estabrooks CA, Straus SE, Flood CM, Keefe J, Armstrong P, Donner GJ, et al. Restoring trust: COVID-19 and the future of long-term care in Canada. FACETS. 2020;5:651\u201391.","DOI":"10.1139\/facets-2020-0056"},{"key":"5656_CR15","unstructured":"CIHI. Long-term care homes in Canada: how many and who owns them?. https:\/\/www.cihi.ca\/en\/long-term-care-homes-in-canada-how-many-and-who-owns-them. 2021."},{"issue":"7","key":"5656_CR16","doi-asserted-by":"publisher","first-page":"e2015957","DOI":"10.1001\/jamanetworkopen.2020.15957","volume":"3","author":"DN Fisman","year":"2020","unstructured":"Fisman DN, Bogoch I, Lapointe-Shaw L, McCready J, Tuite AR. Risk factors associated with mortality among residents with coronavirus disease 2019 (COVID-19) in long-term care facilities in Ontario, Canada. JAMA Netw open. 2020;3(7):e2015957\u20132015957.","journal-title":"JAMA Netw open"},{"key":"5656_CR17","doi-asserted-by":"publisher","first-page":"708903","DOI":"10.3389\/fpubh.2021.708903","volume":"9","author":"A Cyr","year":"2021","unstructured":"Cyr A, Mondal P, Hansen G. An inconsistent Canadian provincial and territorial response during the early COVID-19 pandemic. Front Public Health. 2021;9:708903.","journal-title":"Front Public Health"},{"issue":"1","key":"5656_CR18","doi-asserted-by":"publisher","first-page":"e053894","DOI":"10.1136\/bmjopen-2021-053894","volume":"12","author":"I Beogo","year":"2022","unstructured":"Beogo I, Tchouaket EN, Sia D, Bationo NJ-C, Collin S, Tapp D, et al. Promising best practices implemented in long-term care homes during COVID-19 pandemic to address social isolation and loneliness: a scoping review protocol. BMJ Open. 2022;12(1):e053894.","journal-title":"BMJ Open"},{"issue":"1","key":"5656_CR19","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/s12912-022-00823-3","volume":"21","author":"L Hung","year":"2022","unstructured":"Hung L, Yang SC, Guo E, Sakamoto M, Mann J, Dunn S, et al. Staff experience of a Canadian long-term care home during a COVID-19 outbreak: a qualitative study. BMC Nurs. 2022;21(1):45.","journal-title":"BMC Nurs"},{"key":"5656_CR20","unstructured":"WHO. WHO strategic communications framework for effective communications. https:\/\/www.who.int\/docs\/default-source\/documents\/communicating-for-health\/communication-framework.pdf. 2024."},{"issue":"1","key":"5656_CR21","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1186\/s12877-022-03419-3","volume":"22","author":"I Beogo","year":"2022","unstructured":"Beogo I, Bationo NJ-C, Sia D, Collin S, Kinkumba Ramazani B, L\u00e9tourneau A-A et al. COVID-19 pandemic or chaos time management: first-line worker shortage\u2013a qualitative study in three Canadian provinces. BMC Geriatr. 2022;22(1):727.","journal-title":"BMC Geriatr"},{"issue":"10","key":"5656_CR22","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1111\/jan.14467","volume":"76","author":"CH Chu","year":"2020","unstructured":"Chu CH, Donato-Woodger S, Dainton CJ. Competing crises: COVID\u201019 countermeasures and social isolation among older adults in long\u2010term care. J Adv Nurs. 2020;76(10):2456.","journal-title":"J Adv Nurs"},{"key":"5656_CR23","doi-asserted-by":"crossref","unstructured":"Chu CH, Wang J, Fukui C, Staudacher S, Wachholz PA, Wu B. The impact of COVID-19 on social isolation in long-term care homes: perspectives of policies and strategies from six countries. J Aging Soc Policy.  2021;33:459\u201373.","DOI":"10.1080\/08959420.2021.1924346"},{"issue":"1","key":"5656_CR24","doi-asserted-by":"publisher","first-page":"2075532","DOI":"10.1080\/17482631.2022.2075532","volume":"17","author":"CH Chu","year":"2022","unstructured":"Chu CH, Yee AV, Stamatopoulos V. It\u2019s the worst thing I\u2019ve ever been put through in my life: the trauma experienced by essential family caregivers of loved ones in long-term care during the COVID-19 pandemic in Canada. Int J Qual Stud Health Well-being (QHW). 2022;17(1):2075532.","journal-title":"Int J Qual Stud Health Well-being (QHW)"},{"issue":"6","key":"5656_CR25","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1016\/j.gerinurse.2021.10.012","volume":"42","author":"C Ickert","year":"2021","unstructured":"Ickert C, Stefaniuk R, Leask J. Experiences of long-term care and supportive living residents and families during the COVID-19 pandemic:it\u2019s a lot different for us than it is for the average Joe. Geriatr Nurs. 2021;42(6):1547\u201355.","journal-title":"Geriatr Nurs"},{"issue":"5","key":"5656_CR26","doi-asserted-by":"publisher","first-page":"igac036","DOI":"10.1093\/geroni\/igac036","volume":"6","author":"S Staempfli","year":"2022","unstructured":"Staempfli S, Havaei F, Phinney A, MacPhee M. Unintended consequences of pandemic management strategies on residents and family in one long-term care home in British Columbia: a patient-supported qualitative study. Innov Aging. 2022;6(5):igac036.","journal-title":"Innov Aging"},{"issue":"1","key":"5656_CR27","doi-asserted-by":"publisher","first-page":"e12509","DOI":"10.1111\/opn.12509","volume":"18","author":"CB Smith","year":"2023","unstructured":"Smith CB, Wong KLY, To-Miles F, Dunn S, Gregorio M, Wong L, et al. Exploring experiences of loneliness among Canadian long\u2010term care residents during the COVID\u201019 pandemic: a qualitative study. Int J Older People Nurs. 2023;18(1):e12509.","journal-title":"Int J Older People Nurs"},{"key":"5656_CR28","doi-asserted-by":"publisher","unstructured":"Sims-Gould J, Franke T, Staempfli S, Hung L, Havaei F. Implementation of the single site order in long-term care:: what we can learn from using the consolidated framework for implementation research. J Long-Term Care. 2023:153\u201365. https:\/\/doi.org\/10.31389\/jltc.145","DOI":"10.31389\/jltc.145"},{"key":"5656_CR29","volume-title":"Multiple case study analysis","author":"RE Stake","year":"2013","unstructured":"Stake RE. Multiple case study analysis. New York: Guilford Press; 2013."},{"issue":"1","key":"5656_CR30","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1002\/nur.21768","volume":"40","author":"H Kim","year":"2017","unstructured":"Kim H, Sefcik JS, Bradway C. Characteristics of qualitative descriptive studies: a systematic review. Res Nurs Health. 2017;40(1):23\u201342.","journal-title":"Res Nurs Health"},{"issue":"1","key":"5656_CR31","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1186\/s12913-023-09670-7","volume":"23","author":"F Havaei","year":"2023","unstructured":"Havaei F, Sims-Gould J, Staempfli S, Franke T, Park M, Ma A, et al. Impact of the single site order in LTC: exacerbation of an overburdened system. BMC Health Serv Res. 2023;23(1):666.","journal-title":"BMC Health Serv Res"},{"key":"5656_CR32","unstructured":"Statistics Canada. Demographic estimates by age and gender, provinces and territories: Interactive dashboard. https:\/\/www150.statcan.gc.ca\/n1\/pub\/71-607-x\/71-607-x2020018-eng.htm (accessed March 25,2024). 2023."},{"key":"5656_CR33","unstructured":"BC Provincial Health Office. https:\/\/www2.gov.bc.ca\/gov\/content\/health\/about-bc-s-health-care-system\/office-of-the-provincial-health-officer. 2023."},{"key":"5656_CR34","unstructured":"Nova Scotia DHW. https:\/\/library.nshealth.ca\/covid19patient\/ltc. Accessed 25 March 2024."},{"key":"5656_CR35","volume-title":"The art of case study research","author":"RE Stake","year":"1995","unstructured":"Stake RE. The art of case study research. Thousand Oaks. California: SAGE; 1995."},{"issue":"2","key":"5656_CR36","first-page":"134","volume":"20","author":"B Yazan","year":"2015","unstructured":"Yazan B. Three approaches to case study methods in education: Yin, Merriam, and Stake. Qualitative Rep. 2015;20(2):134\u201352.","journal-title":"Qualitative Rep"},{"key":"5656_CR37","unstructured":"Merriam SB, Tisdell EJ. Qualitative research: a guide to design and implementation. Wiley; 2015."},{"key":"5656_CR38","unstructured":"Merriam SB. Qualitative Research and case study applications in Education. Revised and expanded from Case Study Research in Education. ERIC; 1998."},{"issue":"3","key":"5656_CR39","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1007\/s11135-021-01182-y","volume":"56","author":"D Byrne","year":"2022","unstructured":"Byrne D. A worked example of Braun and Clarke\u2019s approach to reflexive thematic analysis. Qual Quant. 2022;56(3):1391\u2013412.","journal-title":"Qual Quant"},{"issue":"2","key":"5656_CR40","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77\u2013101.","journal-title":"Qual Res Psychol"},{"key":"5656_CR41","unstructured":"Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. SAGE Publications; 2006."},{"issue":"10","key":"5656_CR42","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1177\/1077800410383121","volume":"16","author":"SJ Tracy","year":"2010","unstructured":"Tracy SJ. Qualitative quality: eight big-tent criteria for excellent qualitative research. Qualitative Inq. 2010;16(10):837\u201351.","journal-title":"Qualitative Inq"},{"key":"5656_CR43","unstructured":"Woo K. Essentials of nursing research. 4th ed. Wolters Kluwer Health; 2019."},{"issue":"6","key":"5656_CR44","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","volume":"19","author":"A Tong","year":"2007","unstructured":"Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349\u201357.","journal-title":"Int J Qual Health Care"},{"issue":"3","key":"5656_CR45","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1080\/0142159X.2022.2057287","volume":"45","author":"FM Olmos-Vega","year":"2023","unstructured":"Olmos-Vega FM, Stalmeijer RE, Varpio L, Kahlke R. A practical guide to reflexivity in qualitative research: AMEE Guide 149. Med Teach. 2023;45(3):241\u201351.","journal-title":"Med Teach"},{"key":"5656_CR46","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2288-13-117","volume":"13","author":"NK Gale","year":"2013","unstructured":"Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13:1\u20138.","journal-title":"BMC Med Res Methodol"},{"key":"5656_CR47","doi-asserted-by":"publisher","first-page":"233339361774228","DOI":"10.1177\/2333393617742282","volume":"4","author":"C Bradshaw","year":"2017","unstructured":"Bradshaw C, Atkinson S, Doody O. Employing a qualitative description approach in health care research. Glob Qual Nurs Res. 2017;4:2333393617742282.","journal-title":"Glob Qual Nurs Res"},{"key":"5656_CR48","doi-asserted-by":"publisher","unstructured":"Thorne S. On the use and abuse of verbatim quotations in qualitative research reports. Nurse Author Editor. 2020.  https:\/\/doi.org\/10.1111\/nae2.2","DOI":"10.1111\/nae2.2"},{"key":"5656_CR49","doi-asserted-by":"crossref","unstructured":"Lincoln YS, Guba EG. Naturalistic inquiry: SAGE; 1985.","DOI":"10.1016\/0147-1767(85)90062-8"},{"issue":"8","key":"5656_CR50","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1080\/21645515.2018.1460296","volume":"14","author":"CM McPherson","year":"2018","unstructured":"McPherson CM, Halperin DM, Henry B, Di Castri AM, Kwong JC. Examination of the British Columbia influenza prevention policy for healthcare workers: phase 1 qualitative case study. Hum Vaccin Immunother. 2018;14(8):1883\u20139.","journal-title":"Hum Vaccin Immunother"},{"issue":"1","key":"5656_CR51","doi-asserted-by":"publisher","first-page":"1074","DOI":"10.1186\/s12913-023-10062-0","volume":"23","author":"M Orhierhor","year":"2023","unstructured":"Orhierhor M, Pringle W, Halperin D, Parsons J, Halperin SA, Bettinger JA. Lessons learned from the experiences and perspectives of frontline healthcare workers on the COVID-19 response: a qualitative descriptive study. BMC Health Serv Res. 2023;23(1):1074.","journal-title":"BMC Health Serv Res"},{"key":"5656_CR52","unstructured":"BC Gov. Changes to long-term care visitation on the way. https:\/\/news.gov.bc.ca\/releases\/2021HLTH0022-000551. 2021."},{"issue":"10","key":"5656_CR53","doi-asserted-by":"publisher","first-page":"6782","DOI":"10.1002\/nop2.1955","volume":"10","author":"TH Azizi","year":"2023","unstructured":"Azizi TH, Begjani J, Arman A, Hoseini ASS. The concept analysis of helplessness in nurses during the COVID-19 pandemic: a hybrid model. Nurs Open. 2023;10(10):6782\u201393.","journal-title":"Nurs Open"},{"issue":"8","key":"5656_CR54","doi-asserted-by":"publisher","first-page":"e022498","DOI":"10.1136\/bmjopen-2018-022498","volume":"8","author":"G Thompson","year":"2018","unstructured":"Thompson G, Shindruk CL, Adekoya AA, Demczuk L, McClement S. Meanings of \u2018centredness\u2019 in long-term care facilities: a scoping review protocol. BMJ Open. 2018;8(8):e022498.","journal-title":"BMJ Open"},{"issue":"2","key":"5656_CR55","doi-asserted-by":"publisher","first-page":"184","DOI":"10.33790\/jphip1100184","volume":"5","author":"J Yee","year":"2021","unstructured":"Yee J, Souza M, Horta N, Kartoz C. Person-centered care for older adults living in long-term care facilities: a systematic literature review. J Pub Health Issue Pract. 2021;5(2):184.","journal-title":"J Pub Health Issue Pract"},{"key":"5656_CR56","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-021-06917-z","volume":"21","author":"J Billings","year":"2021","unstructured":"Billings J, Ching BCF, Gkofa V, Greene T, Bloomfield M. Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis. BMC Health Serv Res. 2021;21:1\u201317.","journal-title":"BMC Health Serv Res"},{"key":"5656_CR57","unstructured":"The Eden Alternative. https:\/\/www.edenalt.org\/organizations. 2023."},{"key":"5656_CR58","volume-title":"Asylums: essays on the social situation of mental patients and other inmates","author":"E Goffman","year":"1990","unstructured":"Goffman E. Asylums: essays on the social situation of mental patients and other inmates. New York: Doubleday; 1990."},{"key":"5656_CR59","doi-asserted-by":"publisher","first-page":"e20200560","DOI":"10.1590\/1980-220x-reeusp-2020-0560","volume":"55","author":"JL Bruinsma","year":"2021","unstructured":"Bruinsma JL, Beuter M, Borges ZN, Jacobi CS, Benetti ERR, Backes C. Institutional routines and interpersonal conflicts among elderly in a long-term care facility. Rev Esc Enferm USP. 2021;55:e20200560.","journal-title":"Rev Esc Enferm USP"},{"key":"5656_CR60","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.socscimed.2017.03.024","volume":"180","author":"MA Hillen","year":"2017","unstructured":"Hillen MA, Gutheil CM, Strout TD, Smets EM, Han PK. Tolerance of uncertainty: conceptual analysis, integrative model, and implications for healthcare. Soc Sci Med. 2017;180:62\u201375.","journal-title":"Soc Sci Med"},{"key":"5656_CR61","doi-asserted-by":"publisher","first-page":"102454","DOI":"10.1016\/j.janxdis.2021.102454","volume":"83","author":"P Millroth","year":"2021","unstructured":"Millroth P, Frey R. Fear and anxiety in the face of COVID-19: negative dispositions towards risk and uncertainty as vulnerability factors. J Anxiety Disord. 2021;83:102454.","journal-title":"J Anxiety Disord"},{"issue":"5","key":"5656_CR62","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1177\/07334648221146252","volume":"42","author":"SA Boamah","year":"2023","unstructured":"Boamah SA, Weldrick R, Havaei F, Irshad A, Hutchinson A. Experiences of healthcare workers in long-term care during COVID-19: a scoping review. J Appl Gerontol. 2023;42(5):1118\u201336.","journal-title":"J Appl Gerontol"},{"issue":"2","key":"5656_CR63","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1111\/1468-0009.12500","volume":"99","author":"WD Dawson","year":"2021","unstructured":"Dawson WD, Boucher NA, Stone R, Van Houtven CH. COVID-19: the time for collaboration between long\u2010term services and supports, health care systems, and public health is now. Milbank Q. 2021;99(2):565\u201394.","journal-title":"Milbank Q"},{"key":"5656_CR64","doi-asserted-by":"crossref","unstructured":"Patey AM, Soong C. Top-down and bottom-up approaches to low-value care. BMJ Qual Saf. 2023;32:65\u201368.","DOI":"10.1136\/bmjqs-2022-014977"},{"issue":"10","key":"5656_CR65","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1016\/j.ijnurstu.2014.04.003","volume":"51","author":"J Li","year":"2014","unstructured":"Li J, Porock D. Resident outcomes of person-centered care in long-term care: a narrative review of interventional research. Int J Nurs Stud. 2014;51(10):1395\u2013415.","journal-title":"Int J Nurs Stud"},{"key":"5656_CR66","unstructured":"Government of Canada. Long-term care and COVID-19: report of a special task force prepared for the chief science advisor of Canada. https:\/\/science.gc.ca\/site\/science\/sites\/default\/files\/attachments\/2022\/Long-Term-Care-and-Covid19_2020.pdf. 2020."},{"key":"5656_CR67","doi-asserted-by":"crossref","unstructured":"Prasad K, McLoughlin C, Stillman M, Poplau S, Goelz E, Taylor S, et al. Prevalence and correlates of stress and burnout among US healthcare workers during the COVID-19 pandemic: a national cross-sectional survey study. EClinicalMedicine. 2021;16:35.","DOI":"10.1016\/j.eclinm.2021.100879"},{"issue":"3","key":"5656_CR68","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1097\/JOM.0000000000001235","volume":"60","author":"SK Brooks","year":"2018","unstructured":"Brooks SK, Dunn R, Aml\u00f4t R, Rubin GJ, Greenberg N. A systematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. J Occup Environ Med. 2018;60(3):248\u201357.","journal-title":"J Occup Environ Med"},{"key":"5656_CR69","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1478-4491-6-18","volume":"6","author":"LN Henderson","year":"2008","unstructured":"Henderson LN, Tulloch J. Incentives for retaining and motivating health workers in Pacific and Asian countries. Hum Resour Health. 2008;6:1\u201320.","journal-title":"Hum Resour Health"},{"key":"5656_CR70","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12888-021-03637-w","volume":"22","author":"EG Spilg","year":"2022","unstructured":"Spilg EG, Rushton CH, Phillips JL, Kendzerska T, Saad M, Gifford W et al. The new frontline: exploring the links between moral distress, moral resilience and mental health in healthcare workers during the COVID-19 pandemic. BMC Psychiatry. 2022;22:1\u201312.","journal-title":"BMC Psychiatry"},{"issue":"1","key":"5656_CR71","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1097\/00004010-200601000-00005","volume":"31","author":"K-h Chang","year":"2006","unstructured":"Chang K-h, Gotcher DF, Chan M-y. Does social capital matter when medical professionals encounter the SARS crisis in a hospital setting. Health Care Manage Rev. 2006;31(1):26\u201333.","journal-title":"Health Care Manage Rev"},{"key":"5656_CR72","doi-asserted-by":"crossref","unstructured":"Pollock AC, Cheyne P, Cowie J, Davis J, McCallum B, McGill J, et al. Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. Cochrane Database Syst Rev. 2020;11(11):CD013779.","DOI":"10.1002\/14651858.CD013779"},{"issue":"3","key":"5656_CR73","first-page":"24","volume":"2","author":"H Gordon","year":"2020","unstructured":"Gordon H, Styra R, Bloomberg N. Staff respite units for healthcare providers during COVID-19. J Concur Disorders (JCD). 2020;2(3):24.","journal-title":"J Concur Disorders (JCD)"},{"issue":"2","key":"5656_CR74","doi-asserted-by":"publisher","first-page":"195","DOI":"10.2752\/175174212X13325123562304","volume":"9","author":"I Van Steenwinkel","year":"2012","unstructured":"Van Steenwinkel I, Baumers S, Heylighen A. Home in later life: a framework for the architecture of home environments. Home Cultures. 2012;9(2):195\u2013217.","journal-title":"Home Cultures"},{"key":"5656_CR75","doi-asserted-by":"crossref","unstructured":"Rijnaard MD, Van Hoof J, Janssen B, Verbeek H, Pocornie W, Eijkelenboom A, Beerens H, Molony S, Wouters E. The factors influencing the sense of home in nursing homes: a systematic review from the perspective of residents. J Aging Res. 2016; 2016.","DOI":"10.1155\/2016\/6143645"},{"key":"5656_CR76","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12877-021-02530-1","volume":"21","author":"R Backhaus","year":"2021","unstructured":"Backhaus R, Verbeek H, De Boer B, Urlings JH, Gerritsen DL, Koopmans RT, et al. 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. BMC Geriatr. 2021;21:1\u20137.","journal-title":"BMC Geriatr"},{"issue":"8","key":"5656_CR77","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1097\/NMD.0b013e3181e9dc76","volume":"198","author":"J Cohen-Mansfield","year":"2010","unstructured":"Cohen-Mansfield J, Thein K, Dakheel-Ali M, Regier NG, Marx MS. The value of social attributes of stimuli for promoting engagement in persons with dementia. J Nerv Ment. 2010;198(8):586\u201392.","journal-title":"J Nerv Ment"},{"issue":"5","key":"5656_CR78","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1111\/jgs.16478","volume":"68","author":"M Eghtesadi","year":"2020","unstructured":"Eghtesadi M. Breaking social isolation amidst COVID-19: a viewpoint on improving access to technology in long\u2010term care facilities. J Am Geriatr Soc. 2020;68(5):949.","journal-title":"J Am Geriatr Soc"},{"key":"5656_CR79","first-page":"702","volume":"15","author":"T-P Apostolidi","year":"2022","unstructured":"Apostolidi T-P, Apostolidi N, Malliarou M. How nurses perceive care and their relationship with their compassion: a literature review. Int J Caring Sci. 2022;15:702.","journal-title":"Int J Caring Sci"},{"key":"5656_CR80","volume-title":"The compassionate mind: a new approach to life\u2019s challenges","author":"P Gilbert","year":"2013","unstructured":"Gilbert P. The compassionate mind: a new approach to life\u2019s challenges. London: Robinson; 2013."},{"key":"5656_CR81","doi-asserted-by":"crossref","unstructured":"Watson WH. The meanings of touch: geriatric nursing. J Commun. 1975;25:104\u201312.","DOI":"10.1111\/j.1460-2466.1975.tb00611.x"},{"issue":"7","key":"5656_CR82","doi-asserted-by":"publisher","first-page":"2470","DOI":"10.1111\/jonm.13667","volume":"30","author":"J Cohen-Mansfield","year":"2022","unstructured":"Cohen-Mansfield J. The impact of COVID\u201019 on long\u2010term care facilities and their staff in Israel: results from a mixed methods study. J Nurs Manag. 2022;30(7):2470\u20138.","journal-title":"J Nurs Manag"},{"issue":"1","key":"5656_CR83","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1017\/S0144686X20000896","volume":"42","author":"K Johansson","year":"2022","unstructured":"Johansson K, Borell L, Rosenberg L. Qualities of the environment that support a sense of home and belonging in nursing homes for older people. Ageing Soc. 2022;42(1):157\u201378.","journal-title":"Ageing Soc"},{"issue":"4","key":"5656_CR84","doi-asserted-by":"publisher","first-page":"239","DOI":"10.34172\/jcs.2022.24","volume":"11","author":"S Babaei","year":"2022","unstructured":"Babaei S, Taleghani F, Farzi S. Components of compassionate care in nurses working in the Cardiac wards: a descriptive qualitative study. J Caring Sci. 2022;11(4):239\u201345.","journal-title":"J Caring Sci"},{"key":"5656_CR85","doi-asserted-by":"publisher","first-page":"004695802110051","DOI":"10.1177\/00469580211005191","volume":"58","author":"C Henning-Smith","year":"2021","unstructured":"Henning-Smith C, Cross D, Rahman A. Challenges to admitting residents: perspectives from rural nursing home administrators and staff. INQUIRY: J Health Care Organ Provis Financing. 2021;58:00469580211005191.","journal-title":"INQUIRY: J Health Care Organ Provis Financing"},{"issue":"1","key":"5656_CR86","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1111\/jgs.18024","volume":"71","author":"HK Titley","year":"2023","unstructured":"Titley HK, Young S, Savage A, Thorne T, Spiers J, Estabrooks CA. Cracks in the foundation: the experience of care aides in long-term care homes during the COVID\u201019 pandemic. J Am Geriatr Soc. 2023;71(1):198\u2013205.","journal-title":"J Am Geriatr Soc"}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-024-05656-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-024-05656-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-024-05656-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T19:59:04Z","timestamp":1739822344000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgeriatr.biomedcentral.com\/articles\/10.1186\/s12877-024-05656-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,17]]},"references-count":86,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["5656"],"URL":"https:\/\/doi.org\/10.1186\/s12877-024-05656-0","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,17]]},"assertion":[{"value":"10 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki. This study was approved by the IWK Health Research Ethics Board (1025871), St. Francis Xavier University Research Ethics Board (24833), and The University of British Columbia Children\u2019s and Women\u2019s Health Centre of British Columbia Research Ethics Board (H20-02296). All participants provided verbal consent during their interview. All participants also provided their consent to take part in the interviews. Based on participants\u2019 preference, written or verbal informed consent was obtained before each interview.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"108"}}