1
|
Tabet M, Kirby RS, Boyd R, Xaverius P. Family-Centered Care and Delayed or Missed Pediatric Preventive Care due to the COVID-19 Pandemic. Acad Pediatr 2024; 24:848-855. [PMID: 38432513 DOI: 10.1016/j.acap.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To examine the association between family-centered care and its components with delayed or missed preventive care due to the COVID-9 pandemic among US children. METHODS This is a cross-sectional study using nationally representative data from the 2021 National Survey of Children's Health (NSCH). Children were eligible if they received health care services in the past 12 months (n = 42,649; 79.3%). We excluded children with missing data, for a final sample of 40,511 (93.7% of the eligible sample). Children were deemed to have received family-centered care if caregivers responded "always" or "usually" to all five measures of family-centered care. Poisson regression was used to ascertain weighted prevalence ratios (PRs) and 95% confidence intervals (CIs). Predisposing, enabling, and need factors of health care services use were evaluated as potential confounders. RESULTS Approximately 86.7% of children received family-centered care during the pandemic, with significant racial and ethnic differences, findings consistent with pre-pandemic data. In multivariable analyses adjusted for the child's race and age, family-centered care was associated with a 30% reduced likelihood of delayed or missed preventive care (95% CI: 0.64-0.78). Individual components of family-centered care were associated with a 26%-43% reduced likelihood of delayed or missed preventive care. CONCLUSIONS Family-centered care and its components were associated with a reduced likelihood of delayed or missed pediatric preventive care. Our findings highlight the important role of health care providers in curbing the negative effects of the COVID-19 pandemic on pediatric preventive care utilization and emphasize the need to expand family-centered care among racial and ethnic minority groups.
Collapse
Affiliation(s)
- Maya Tabet
- College of Global Population Health (M Tabet and R Boyd), University of Health Sciences and Pharmacy in St. Louis, St. Louis, Mo.
| | - Russell S Kirby
- Chiles Center (RS Kirby), College of Public Health, University of South Florida, Tampa, Fla
| | - Ri'enna Boyd
- College of Global Population Health (M Tabet and R Boyd), University of Health Sciences and Pharmacy in St. Louis, St. Louis, Mo
| | - Pamela Xaverius
- Parkinson's School of Health Sciences and Public Health (P Xaverius), Loyola University Chicago, Maywood, Ill
| |
Collapse
|
2
|
Zachmann S, Peele C, Santhin K, Alisch A, Mannello M, Emilio C, Whalen M. Reducing Undue Burden on Nurses Related to Limited Care Partner Visitation: Lessons Learned for the Future. J Nurs Adm 2024; 54:367-370. [PMID: 38743806 DOI: 10.1097/nna.0000000000001440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVE The purpose of this article was to report best practices for reducing undue burden on nurses related to limited care partner visitation. BACKGROUND Care partners are beneficial to hospitalized patients. Restricted care partner visitation not only impacts patients and care partners but also affects nurses. METHODS Using the Johns Hopkins Evidence-Based Practice model, best practices for reducing nurse burden during periods of restricted visitation were evaluated. RESULTS Best practices include evidence-based visiting policies, technology to facilitate communication, creation of a communication liaison role or team, and communication skills training for nurses. CONCLUSIONS Nursing leaders should proactively prevent the harmful impact that visitor restrictions have on nurses.
Collapse
Affiliation(s)
- Sara Zachmann
- Author Affiliation: Registered Nurse (Zachmann), Registered Nurse (Peele), Registered Nurse (Santhin), In-House Coordinator for Organ & Tissue Donation (Alisch), Registered Nurse (Mannello), Registered Nurse (Emilio), and Evidence-Based Practice Program Coordinator (Whalen), The Johns Hopkins Hospital, Baltimore, Maryland
| | | | | | | | | | | | | |
Collapse
|
3
|
Sun AH, Ménard A, Farrell E, Filip A, Katz A, Orosz Z, Hsu AT. Perceptions of Palliative and End-Of-Life Care Capacity Among Frontline Staff and Administrators in Long-Term Care Homes During the COVID-19 Pandemic in Ontario, Canada: A Mixed-Methods Evaluation. J Am Med Dir Assoc 2023; 24:1586-1593. [PMID: 37488030 PMCID: PMC10293894 DOI: 10.1016/j.jamda.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 05/18/2023] [Accepted: 06/12/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVES The COVID-19 pandemic has greatly affected the morbidity and mortality of residents in long-term care (LTC) homes. However, not much is known about its impact on staff's perception of their capacity to provide palliative and end-of-life (EOL) care for LTC residents over the course of the pandemic. We investigated changes in self-reported confidence among LTC workers and their experience in providing palliative and EOL care to residents before and during the COVID-19 pandemic. DESIGN Mixed-methods evaluation using a survey (n = 19) and semistructured interviews (n = 28). SETTING AND PARTICIPANTS Frontline workers from 9 LTC homes who participated in Communication at End-of-Life Program in Ontario, Canada, between August 2019 and March 2020. METHODS The survey captured LTC staff's confidence level, including attitudes toward death and dying; relationships with residents and families; and participation in palliative and EOL care. The interviews identified facilitators and barriers to providing palliative and EOL care during the pandemic. RESULTS The COVID-19 pandemic negatively impacted frontline LTC staff's confidence in their role as palliative care providers. Participants also reported notable challenges to providing resident-centered palliative and EOL care. Specifically, visitation restriction has led to increased loneliness and isolation of residents and impeded staff's ability to build supportive relationships with families. Furthermore, staffing shortages due to the single-site work restriction and illness increased workload. Psychological stress caused by a fear of COVID-19 infection and transmission also hindered staff's capacity to provide good palliative and EOL care. CONCLUSIONS AND IMPLICATIONS Frontline LTC staff-even those who felt competent in their knowledge and skills in providing palliative and EOL care after receiving training-reported notable difficulties in providing resident-centered palliative and EOL care during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Annie H Sun
- Bruyère Research Institute, Ottawa, Ontario, Canada; Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada
| | - Alixe Ménard
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Emily Farrell
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada
| | - Angelina Filip
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada
| | - Andrea Katz
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada
| | - Zsofia Orosz
- Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada
| | - Amy T Hsu
- Bruyère Research Institute, Ottawa, Ontario, Canada; Ontario Centres for Learning, Research and Innovation in Long-Term Care at Bruyère, Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| |
Collapse
|
4
|
Strayer AL, King BJ. COVID-19 and Elective Spine Surgery: The Older Persons' Experience of Going It Alone. J Neurosci Nurs 2023; 55:113-118. [PMID: 37318188 PMCID: PMC10332507 DOI: 10.1097/jnn.0000000000000707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
ABSTRACT BACKGROUND: Older people with debilitating degenerative spine disease may benefit from surgery. However, recovery is described as a circuitous process. In general, they describe feeling powerless and receiving depersonalized care during hospitalization. Institution of hospital no-visitor policies to reduce COVID-19 spread may have caused additional negative consequences. The purpose of this secondary analysis was to understand experiences of older people who underwent spine surgery during early COVID-19. METHODS: Grounded theory guided this study of people 65 years or older undergoing elective spine surgery. Fourteen individuals were recruited for 2 in-depth interviews at 2 time points: T1 during hospitalization and T2, 1 to 3 months post discharge. All participants were affected by pandemic-imposed restrictions with 4 interviews at T1 with no visitors, 10 with a 1-visitor policy, and 6 interviews at T2 rehabilitation setting with no visitors. Discriminate sampling of data in which participants described their experiences with COVID-19 visitor restrictions was used. Open and axial coding (consistent with grounded theory) was used for data analysis. RESULTS: Three categories, worry and waiting , being alone , and being isolated , emerged from the data. Participants had delays ( waiting ) in getting their surgery scheduled, which produced worry that they would lose more function, become permanently disabled, have increased pain, and experience more complications such as falls. Participants described being alone during their hospital and rehabilitation recovery, without physical or emotional support from family and limited nursing staff contact. Being isolated often occurred from institution policy, restricting participants to their rooms leading to boredom and, for some, panic. CONCLUSIONS: Restricted access to family after spine surgery and during recovery resulted in emotional and physical burden for participants. Our findings support neuroscience nurses advocating for family/care partner integration into patient care delivery and investigation into the effect of system-level policies on patient care and outcomes.
Collapse
|
5
|
Digby R, Hopper I, Hughes L, McCaskie D, Tuck M, Fallon K, Hunter P, Bucknall T. Exploring staff perspectives on caring for isolated hospitalised patients during the COVID-19 pandemic: a qualitative study. BMC Health Serv Res 2023; 23:208. [PMID: 36859246 PMCID: PMC9977084 DOI: 10.1186/s12913-022-09000-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 12/21/2022] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Strict isolation of COVID-19 patients to prevent cross infection may inadvertently cause serious adverse outcomes including psychological harm, limitations to care, increased incidence of delirium, deconditioning and reduced quality of life. Previous research exploring the staff perspective of the effect of isolation on patients is limited. The aim of this study is to understand staff perceptions and interpretations of their experiences of the care and treatment of isolated patients and the impact of isolation on patients, families, and staff. METHOD This qualitative, exploratory study is set in a major metropolitan, quaternary hospital in Melbourne, Australia. Data was collected in focus groups with clinical and non-clinical staff and analysed using content analysis. The hospital ethics committee granted approval. Each participant gave informed verbal consent. RESULTS Participants included 58 nursing, medical, allied health, and non-clinical staff. Six main themes were identified: 1) Communication challenges during COVID-19; 2) Impact of isolation on family; 3) Challenges to patients' health and safety; 4) Impact on staff; 5) Challenging standards of care; 6) Contextual influences: policy, decision-makers and the environment. CONCLUSION Isolating patients and restricting visitors resulted in good pandemic management, but staff perceived it came at considerable cost to staff and consumers. Innovative communication technology may facilitate improved connection between all parties. Mental health support is needed for patients, families, and staff. Further research using a co-design model with input from patients, families and staff is recommended to determine appropriate interventions to improve care. Preventing the spread of infection is essential for good pandemic management, but the cost to consumers and staff must be mitigated. Preparation for future pandemics must consider workforce preparedness, adapted models of care and workflow.
Collapse
Affiliation(s)
- Robin Digby
- Alfred Health, PO Box 315, Prahran, Melbourne, VIC, 3181, Australia.
| | - Ingrid Hopper
- Alfred Health, PO Box 315, Prahran, Melbourne, VIC, 3181, Australia
| | - Leanne Hughes
- Alfred Health, PO Box 315, Prahran, Melbourne, VIC, 3181, Australia
| | - Doug McCaskie
- Alfred Health, PO Box 315, Prahran, Melbourne, VIC, 3181, Australia
| | - Michelle Tuck
- Alfred Health, PO Box 315, Prahran, Melbourne, VIC, 3181, Australia
| | - Kethly Fallon
- Alfred Health, PO Box 315, Prahran, Melbourne, VIC, 3181, Australia
| | - Peter Hunter
- Alfred Health, PO Box 315, Prahran, Melbourne, VIC, 3181, Australia
| | - Tracey Bucknall
- Alfred Health, PO Box 315, Prahran, Melbourne, VIC, 3181, Australia
- Deakin University, Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Alfred Health Partnership, Melbourne, Victoria, Australia
| |
Collapse
|
6
|
Bartoli D, Trotta F, Pucciarelli G, Simeone S, Miccolis R, Cappitella C, Rotoli D, Rocco M. The lived experiences of family members who visit their relatives in Covid-19 intensive care unit for the first time: A phenomenological study. Heart Lung 2022; 54:49-55. [PMID: 35344685 PMCID: PMC8934716 DOI: 10.1016/j.hrtlng.2022.03.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND COVID-19 patient experiences in the intensive care unit (ICU) are marked by family separation. Families understand the importance of isolation and hospital visiting policies, but they consider it necessary to visit their loved ones and use personal protective equipment. OBJECTIVE To describe the lived experiences of family members in their first contact with a relative in a COVID-ICU. METHODS A phenomenological study was conducted using Cohen's method. The subjects were interviewed using an open-question format to allow them full freedom of expression. Twelve family members were recruited between February and March 2021. RESULTS Analysis of the qualitative data resulted in five major themes: (1) fear of contagion related to donning/doffing procedures, (2) positive emotions related to first contact with the hospitalized relative, (3) concern for the emotional state of the hospitalized relative, (4) impact of the COVID-ICU and comparisons between imagination and reality regarding the severity of the disease, and (5) recognition of and gratitude toward healthcare professionals. CONCLUSIONS It has been confirmed that visits to the ICU reduce anxiety among family members. Our findings constitute an internationally relevant contribution to understanding of the needs of relatives who meet loved ones for the first time while wearing personal protective equipment.
Collapse
Affiliation(s)
- Davide Bartoli
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, 00189 Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Francesca Trotta
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, 00189 Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Silvio Simeone
- Department of Clinical and Experimental Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Rosa Miccolis
- Unit of Anesthesia, Intensive Care and Pain Medicine, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Carmen Cappitella
- Department of Management, Sant'Andrea University Hospital, 00189 Rome, Italy
| | - Daniele Rotoli
- Department of Medicine and Psycology, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Monica Rocco
- Department of Clinical and Surgical Translational Medicine, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| |
Collapse
|
7
|
Greenberg JA, Basapur S, Quinn TV, Bulger JL, Schwartz NH, Oh SK, Shah RC, Glover CM. Challenges faced by families of critically ill patients during the first wave of the COVID-19 pandemic. PATIENT EDUCATION AND COUNSELING 2022; 105:297-303. [PMID: 34507866 PMCID: PMC8393512 DOI: 10.1016/j.pec.2021.08.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/02/2021] [Accepted: 08/24/2021] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To understand how surrogates of critically ill patients adjusted to challenges that resulted from the COVID-19 pandemic. METHODS Participants (N = 62) were surrogates of critically ill adults with COVID-19 in the ICU at an urban, academic medical center from March to June 2020. Participants were recruited using convenience sampling and took part in one-time qualitative individual interviews via telephone. Qualitative data were analyzed using thematic content analysis. RESULTS Qualitative analyses yielded four types of challenges: Communication with the medical team, communication among family members, understanding and tracking medical information, and distress related to visitor restrictions. To adjust to challenges related to communication, participants developed routines for receiving updates from the medical team and providing updates to other family members. To adjust to the challenge related to comprehension, participants sought information from external sources such as family members in healthcare fields. To adjust to the challenge related to visitation, participants found some comfort in video calls with the patient. CONCLUSIONS Surrogates of critically ill patients with COVID-19 faced multiple types of challenges yet adjusted to those challenges. PRACTICAL IMPLICATIONS Future research should focus on ways to support the wellbeing of surrogates during times of restricted hospital visitation. Clinical trial registered at ClinicalTrials.gov (NCT03969810).
Collapse
Affiliation(s)
- Jared A Greenberg
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Rush University Medical Center, 1725 W. Harrison St., Suite 010, Chicago, IL, USA.
| | - Santosh Basapur
- Office of Design, Academic Support Services, Rush University Medical Center, Chicago, IL, USA
| | - Thomas V Quinn
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Rush University Medical Center, 1725 W. Harrison St., Suite 010, Chicago, IL, USA
| | - Jeffrey L Bulger
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | | | | | - Raj C Shah
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Family Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Crystal M Glover
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Rush Medical College, Chicago, IL, USA
| |
Collapse
|
8
|
McCulloch H, Campbell-Yeo M, Richardson B, Dol J, Hundert A, Dorling J, Whitehead L, MacRae G, Bishop T, Afifi J, Earle R, Rose AE, Foye S, Inglis D, Kim T, Leighton C, Melanson A, Simpson DC, Smit M. The Impact of Restrictive Family Presence Policies in Response to COVID-19 on Family Integrated Care in the NICU: A Qualitative Study. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:49-62. [PMID: 34931565 PMCID: PMC9072949 DOI: 10.1177/19375867211065178] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objectives: To conduct a needs assessment with families and their healthcare team to understand the impact of restrictive family presence policies in the neonatal intensive care unit (NICU) in response to COVID-19. Background: In response to the COVID-19 pandemic, significant restrictive family presence policies were instituted in most NICUs globally intended to protect infants, families, and HCPs. However, knowledge on the impact of the stress of the pandemic and policies restricting family presence in the NICU on vulnerable neonates and their families remains limited. Methods: Individuals were eligible to participate if they were a caregiver of an infant requiring NICU care or a healthcare provider (HCP) in the NICU after March 1, 2020. Semi-structured interviews were conducted using a virtual communication platform, and transcripts were analyzed using inductive thematic qualitative content analysis. Results: Twenty-three participants were interviewed (12 families and 11 HCPs). Three themes emerged: (1) successes (family-integrated care, use of technology), (2) challenges (lack of standardized messaging and family engagement, impact on parental wellbeing, institutional barriers, and virtual care), and (3) moving forward (responsive and supportive leadership). Conclusions: Our findings highlight the significant impact of family restrictions on the mental well-being of families, physical closeness with parents, and empathetic stress to HCPs. Further study of potential long-term impact is warranted.
Collapse
Affiliation(s)
| | - Marsha Campbell-Yeo
- IWK Health, Halifax, Nova Scotia, Canada.,Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Brianna Richardson
- Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Justine Dol
- IWK Health, Halifax, Nova Scotia, Canada.,Faculty of Health, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | | | | | | | - Sarah Foye
- IWK Health, Halifax, Nova Scotia, Canada
| | | | | | | | | | | | - Mike Smit
- School of Information Management, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
9
|
“Be Their Advocate”: Families’ Experience with a Relative in LTC during the COVID-19 Pandemic. Can J Aging 2021. [DOI: 10.1017/s0714980821000398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractShortly after the COVID-19 pandemic was declared, strict visitor restrictions were issued for long-term care facilities (LTCFs). A year later, restrictions are still in place and they continue to impact family members who have limited or no in-person contact with their relative in LTCFs. The goal of this qualitative longitudinal focused ethnography was to understand the experience of family members who have a relative in a LTCF where visiting has been restricted during the pandemic. Seventeen family members participated in two interviews that were 6 months apart. Data analysis highlighted five key drivers, defined as the workforce, communication deficits, characteristics of care, public health directives, and autonomy of relative which in turn resulted in three main themes: psychological distress, surveillance, and visiting challenges. This study provides a glimpse into the difficult experiences of families with a relative residing in a LTCF in the province of New Brunswick.
Collapse
|
10
|
Maaskant JM, Jongerden IP, Bik J, Joosten M, Musters S, Storm-Versloot MN, Wielenga J, Eskes AM. Strict isolation requires a different approach to the family of hospitalised patients with COVID-19: A rapid qualitative study. Int J Nurs Stud 2021; 117:103858. [PMID: 33621720 PMCID: PMC7834466 DOI: 10.1016/j.ijnurstu.2020.103858] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The outbreak of the COVID-19 pandemic influenced family-centred care dramatically due to restricting visiting policies. In this new situation, nurses were challenged to develop new approaches to involve family members in patient care. A better understanding of these changes and the experiences of nurses is essential to make an adaptation of procedures, and to secure a family-centred approach in care as much as possible. OBJECTIVES The aim of this study was to investigate how family involvement had taken place, and to explore the experiences of nurses with family involvement during the COVID-19 outbreak. In addition, we aimed to formulate recommendations for the involvement of family. METHODS We conducted a qualitative study using patient record review and focus-group interviews between April and July 2020. We reviewed records of patients with confirmed COVID-19, who were admitted to the COVID-19 wards at two affiliated university hospitals in the Netherlands. All records were searched for notations referring to family involvement. In two focus-groups, nurses who worked at the COVID-19 wards were invited to share their experiences. The Rigorous and Accelerated Data Reduction (RADaR) method was used to collect, reduce and analyse the data. RESULTS In total, 189 patient records were reviewed and nine nurses participated in the focus-group meetings. Patient records revealed infrequent and often unstructured communication with focus on physical condition. Nurses confirmed that communication with family was far less than before and that the physical condition of the patient was predominant. The involvement of family in care was limited to practicalities, although more involvement was described in end-of-life situations. Nurses experienced moral distress due to the visiting restrictions, though some acknowledged that they had experienced the direct patient care so intense and burdensome, that family contact simply felt too much. CONCLUSION The communication with and involvement of family in hospital care changed enormously during the COVID-19 outbreak. Based on the identified themes, we formulated recommendations that may be helpful for family-centered care in hospitals during periods of restricted visiting policy.
Collapse
Affiliation(s)
- J M Maaskant
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - I P Jongerden
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, VU University, Amsterdam, the Netherlands
| | - J Bik
- Department of Internal Medicine, Amsterdam UMC, VU University, Amsterdam, the Netherlands
| | - M Joosten
- Department of Internal Medicine, Amsterdam UMC, VU University, Amsterdam, the Netherlands
| | - S Musters
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - M N Storm-Versloot
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - J Wielenga
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - A M Eskes
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
| |
Collapse
|