A Critical Discourse Analysis of Family Presence Restrictions in Long-Term Special Care Homes in Saskatchewan During the 2020/21 COVID-19 Pandemic
Bibliographic record
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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".