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Improving the Quality of Long-Term Care

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: 30 April 2026 | Viewed by 1762

Special Issue Editor


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Guest Editor
School of Nursing, University of British Columbia, T225-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
Interests: health services research; long-term care; staffing and workload; quality and safety of health care; healthy work environments; occupational health and safety; workplace violence
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Special Issue Information

Dear Colleagues,

The long-term care (LTC) sector is an overlooked, under-resourced, and understudied healthcare sector. The COVID-19 pandemic brought to the surface systemic, long-standing, and pervasive deficiencies within the sector, resulting in significant human suffering and tragic loss of life. The LTC deficiencies have led to serious difficulties with the provision of high-quality person-centered care for LTC residents, further marginalizing LTC residents and their providers, who are known to be adversely impacted at the intersection of many diversity factors such as age, race, gender, immigration, and disability. The questions are: What can we do to address LTC deficiencies that compromise high-quality, person-centered care for LTC residents? What policies and practices improve the provision of quality, safe, and equitable care in LTC? This Special Issue invites researchers to share new research and perspectives on care delivery in LTC, especially evidence-informed strategies at different system levels (e.g., socioecological levels).

Dr. Farinaz Havaei
Guest Editor

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Keywords

  • long-term care
  • quality of care
  • quality of life
  • working conditions
  • person-centered care
  • cognitive impairment
  • staffing and workload

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Published Papers (2 papers)

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Research

20 pages, 2130 KiB  
Article
The Impact of Telepresence Robots on Family Caregivers and Residents in Long-Term Care
by Lillian Hung, Joey Oi Yee Wong, Haopu (Lily) Ren, Yong Zhao, Jason Jincheng Fu, Jim Mann and Lun Li
Int. J. Environ. Res. Public Health 2025, 22(5), 713; https://doi.org/10.3390/ijerph22050713 - 1 May 2025
Viewed by 465
Abstract
Telepresence robots can enhance social connection and support person-centered care in long-term care (LTC) homes. This study evaluates their impact in facilitating virtual visits between family caregivers and older residents in Canadian LTC homes. Telepresence robots were placed in residents’ rooms, allowing virtual [...] Read more.
Telepresence robots can enhance social connection and support person-centered care in long-term care (LTC) homes. This study evaluates their impact in facilitating virtual visits between family caregivers and older residents in Canadian LTC homes. Telepresence robots were placed in residents’ rooms, allowing virtual visits at mutual convenience. A total of 18 residents and 17 family caregivers participated. Quantitative assessments included the Zarit Burden Interview, the De Jong Gierveld Loneliness Scale, and the Quality of Life in Alzheimer’s Disease scale, while qualitative data were collected through interviews, field notes, and observations. Repeated ANOVA showed that using telepresence robots significantly reduced caregiver burden (p = 0.008), improved residents’ quality of life (p = 0.028), and decreased resident loneliness (p = 0.038). Older caregivers experienced the greatest burden reduction, with scores dropping from a mean of 25.0 at baseline to 16.1 at two months. Qualitative findings provided further context, revealing that residents felt more connected, close, and engaged, while families found the robots facilitated continuity of care, complemented in-person visits, reduced stress and guilt, and provided reassurance. These findings suggest that telepresence robots can enhance the well-being of both residents and caregivers in LTC homes, though future research should explore their long-term impact and technological limitations. Full article
(This article belongs to the Special Issue Improving the Quality of Long-Term Care)
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19 pages, 737 KiB  
Article
Navigating Workforce Challenges in Long-Term Care: A Co-Design Approach to Solutions
by Sheila A. Boamah, Farzana Akter, Bahar Karimi and Farinaz Havaei
Int. J. Environ. Res. Public Health 2025, 22(4), 520; https://doi.org/10.3390/ijerph22040520 - 28 Mar 2025
Viewed by 691
Abstract
(1) Background: The enduring impact of COVID-19 on the long-term care (LTC) sector remains uncertain, necessitating targeted efforts to address current and emerging challenges. This study aims to identify the key stressors faced by healthcare workers (HCWs) in LTC and to co-develop innovative, [...] Read more.
(1) Background: The enduring impact of COVID-19 on the long-term care (LTC) sector remains uncertain, necessitating targeted efforts to address current and emerging challenges. This study aims to identify the key stressors faced by healthcare workers (HCWs) in LTC and to co-develop innovative, actionable strategies that mitigate these stressors, foster resilience, and promote workforce retention. (2) Methods: This study utilized a qualitative co-design methodology within a mixed-methods, multi-phase framework conducted between July 2023 and October 2024. This article focuses on Phase 1, which involved 11 semi-structured focus groups and steering group discussions with 24 HCWs, including personal support workers (PSWs), nurses, and LTC administrators across Ontario to explore workplace-related distress and foster a shared understanding of challenges in the LTC sector. Data were audio-recorded, transcribed verbatim, and analyzed using thematic analysis to derive key themes and actionable insights. (3) Results: Key themes emerging from co-design sessions included the need for (i) effective workload management tools, (ii) the prioritization of psychological safety and mental health services, (iii) reducing regulatory and bureaucratic burdens, (iv) strengthening management practices, and (v) fostering recognition and a positive sector image. Co-design sessions with HCWs and leaders facilitated the identification of priority issues and high-level solutions, including addressing workload issues, implementing mental health and support programs, enhancing work–life integration, improving management training, and promoting psychological safety in LTC settings. (4) Conclusions: This study deepens our understanding of workplace challenges in the LTC sector and the factors contributing to HCWs’ mental distress. Leveraging a co-design approach offers valuable insights into the lived experiences of HCWs and leaders. The findings provide actionable guidance for LTC leaders and policymakers to create effective, tailored interventions that actively engage HCWs in addressing workplace stressors and mitigating recurrent challenges. Full article
(This article belongs to the Special Issue Improving the Quality of Long-Term Care)
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