A Critical Discourse Analysis of Family Presence Restrictions in Long-Term Special Care Homes in Saskatchewan During the 2020/21 COVID-19 Pandemic
Date
2023-06-05
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
0009-0001-5148-9454
Type
Thesis
Degree Level
Masters
Abstract
Purpose: This study explored the language of the pandemic family presence restrictions in Saskatchewan long-term care by examining the health orders, policies, and policy implementation discourses that shaped the restrictions. A better understanding of how these discourses were enacted throughout the pandemic provides evidence about how these policies were lived. Methodology: Fairclough’s three-dimensional approach to critical discourse analysis was employed using a patient-oriented research approach. The highest most specific restriction discourses through to the enactment communications were analyzed for language, organization, meaning, and actions that were eventually lived and experienced in the community. These were the Saskatchewan public health orders, Saskatchewan Health Authority policies, and the implementation communications to long-term care communities and families from March 2020 to July 2021. Using a patient-oriented research approach, resident-family partners co-developed the study, co-analyzed the data, and co-developed meaningful recommendations and knowledge translation plans. The patient-oriented research approach situates well in critical social studies. Conclusions: The consistent use of the term “visitor” and the class system that developed around visitors in describing family presence indicates family presence is not well understood and not well lived in patient-and-family-centered care, especially in long-term care. Disempowerment occurred at the practice level because of public health order and policy language. A higher value was placed on safety than quality of life, which is opposite to what long-term care residents and families report to want. This study has informed the impetus for trauma-informed practice, collaboration, empowerment, evidence-based practice in health policy development, improved family presence in patient-and-family-centered care, and access and equity for long-term care family caregivers, particularly during current and future public health emergencies.
Description
Keywords
Family presence, family presence restrictions, safe family presence, family, visitor, patient-and-family centered care, safety, older adults, long-term care, long-term special care homes, patient-oriented research, critical social theory, linguistics, Systemic Functional Linguistics, critical discourse analysis, Fairclough, policy, public health order, health care governance, power, empowerment, disempowerment, health inequity, legitimization, hegemony, status-quo, social order, social practice, social events, trauma, trauma-informed care, choice, collaboration, nursing, COVID-19, pandemic
Citation
Degree
Master of Nursing (M.N.)
Department
Nursing
Program
Nursing