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Cardoso AF, Pires MG, Cioga E, Abalroado I, Santos D, Duque FM, Loureiro R, Felizardo H, Fernandes AM, Silva R, Ventura F, Santana E, Cardoso D, Loureiro L. Experiences with remote communication in adult intensive care units during the COVID-19 pandemic: a systematic review protocol. JBI Evid Synth 2023; 21:2455-2464. [PMID: 37711062 DOI: 10.11124/jbies-23-00002] [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: 09/16/2023]
Abstract
OBJECTIVE The objective of this review is to explore the lived experiences of critically ill adults, their families, or health care professionals with remote communication in intensive care units (ICUs) during the COVID-19 pandemic. INTRODUCTION Family visiting restrictions in ICUs during the COVID-19 pandemic imposed significant challenges to communication between critically ill adults, their families, and the health care team. Evidence shows that several communication strategies were developed and implemented in ICUs during the COVID-19 pandemic to promote family engagement; however, the experiences of critically ill adults, their families, and health care professionals with these strategies are scattered across primary qualitative studies. INCLUSION CRITERIA This review will consider qualitative studies that include critically ill adults, their families, or health care professionals, focusing on their experiences with remote communication strategies in ICUs during the COVID-19 pandemic. METHODS This review will be conducted in accordance with JBI methodology. The search strategy will aim to locate both published and unpublished qualitative studies in English, Spanish, and Portuguese. Studies published after January 2020 will be included. Study selection, critical appraisal, and data extraction will be performed independently by 2 reviewers. Data will be presented in narrative format and synthesized using the JBI meta-aggregation process. A ConQual Summary of Findings will be presented. REVIEW REGISTRATION PROSPERO CRD42022383603.
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Affiliation(s)
- Ana Filipa Cardoso
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Miguel Grilo Pires
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Elisabete Cioga
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Inês Abalroado
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Diana Santos
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - Filipa Margarida Duque
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Ricardo Loureiro
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Helena Felizardo
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - António Manuel Fernandes
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Rosa Silva
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
- Nursing School of Porto (ESEP), Porto, Portugal
| | - Filipa Ventura
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Elaine Santana
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Daniela Cardoso
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Health Sciences Research Unit: Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - Luís Loureiro
- Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
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Li J, Cai S, Mei J, Liu X, Wang X, Pan W, Zhang Y. The beliefs and attitudes of intensive care unit nurses and patient families regarding an open visitation policy in China. Nurs Crit Care 2023; 28:800-807. [PMID: 36585813 DOI: 10.1111/nicc.12870] [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] [Received: 07/08/2022] [Revised: 11/15/2022] [Accepted: 11/28/2022] [Indexed: 01/01/2023]
Abstract
AIMS To investigate the beliefs and attitudes of intensive care unit (ICU) nurses and patients' family members towards an open visitation policy in the ICU in China and to explore the reasons that promote or hinder open visitation to improve visitation policy. BACKGROUND Open visitation policies are widely recommended in many countries. However, there are gaps between evidence and practice. Most ICUs in China still use a restrictive policy for family visits, which raises controversy. There are limited visiting times, and family visitors are not allowed to enter the ICU. STUDY DESIGN A multicentre survey was conducted in seven hospitals in China. The Beliefs and Attitudes towards Visitation in the Intensive Care Unit Questionnaire (BAVIQ) was administered to ICU nurses and patient families from 11 the ICUs of seven hospitals. A total of 275 questionnaires were completed and returned by ICU nurses and 139 by patients' family members. RESULTS Among nurses, the belief scale score was 2.87 ± 0.33 (range 2-4), and the attitude scale score was 5.53 ± 1.12 (range 2.33-7). The belief scale was divided into three subscales: nurses, patients, and patients' families. The subscale score for patients' families was the highest, and the nurses' subscale score was the lowest. Most (84.0%) of the nurses were satisfied with the current ICU visitation policy. The belief and attitude scores were 3.13 ± 0.39 (range 1.96-4) and 6.18 ± 1.20 (range 1.67-7), respectively, for family members. The scores of the three subscales, that is, patients, patients' families and nurses, were 3.13 ± 0.40, 3.26 ± 0.43, and 3.04 ± 0.49, respectively. CONCLUSION Nurses' beliefs and attitudes towards implementing an open visitation policy in China are at a less positive level than those of patient family members. RELEVANCE TO CLINICAL PRACTICE The beliefs and attitudes of nurses towards open visitation policy in China need to be improved. The question of how to mobilize nurses' enthusiasm for an open visitation policy poses a challenge for ICU management.
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Affiliation(s)
- Jingjing Li
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- School of Nursing, Fudan University, Shanghai, People's Republic of China
| | - Shining Cai
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jinghua Mei
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Xiao Liu
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Department of Critical Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Xiaorong Wang
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Wenyan Pan
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yuxia Zhang
- Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- School of Nursing, Fudan University, Shanghai, People's Republic of China
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Danielis M, Zanotti R, Rosset M, Giorgino S, Gentilini S, Molaro D, Qualizza A, Garau A. The Italian Family Satisfaction in the Intensive Care Unit Questionnaire: A Psychometric Evaluation Using the Rasch Model. Healthcare (Basel) 2023; 11:1997. [PMID: 37510438 PMCID: PMC10379138 DOI: 10.3390/healthcare11141997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Quality measurement of the intensive care unit (ICU) should include families' perspectives, their satisfaction with the care process and outcomes, and the evaluation of actions to improve their psychological health and wellbeing. The current study was designed to validate the Italian version of the Family Satisfaction in the Intensive Care Unit (FS-ICU) using the Rasch model. Results included reliability and separation for items and persons, item fit statistics, unidimensionality, and item characteristic curve. The study was conducted between August 2022 and February 2023. A total of 108 family members (mean age 54.9 years) completed the FS-ICU questionnaire. The instrument had a moderate discrimination ability and only five items (#21, #23, #10, #22, and #24) exhibited a misfit. The Rasch dimension explained 52.1% of the variance in the data, while the unexplained variance in the first contrast is 7.2%, which indicates a possible second dimension. FS-ICU was shown to be beneficial as an assessment instrument for family member satisfaction in the ICU, despite some flaws that need to further be addressed to improve the scale.
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Affiliation(s)
- Matteo Danielis
- Laboratory of Studies and Evidence Based Nursing, Department of Medicine, University of Padua, 35131 Padua, Italy;
- Department of Anaesthesia and Intensive Care, Academic Hospital of Udine, 33100 Udine, Italy; (M.R.); (S.G.); (S.G.); (D.M.); (A.Q.); (A.G.)
| | - Renzo Zanotti
- Laboratory of Studies and Evidence Based Nursing, Department of Medicine, University of Padua, 35131 Padua, Italy;
| | - Marika Rosset
- Department of Anaesthesia and Intensive Care, Academic Hospital of Udine, 33100 Udine, Italy; (M.R.); (S.G.); (S.G.); (D.M.); (A.Q.); (A.G.)
| | - Serena Giorgino
- Department of Anaesthesia and Intensive Care, Academic Hospital of Udine, 33100 Udine, Italy; (M.R.); (S.G.); (S.G.); (D.M.); (A.Q.); (A.G.)
| | - Sara Gentilini
- Department of Anaesthesia and Intensive Care, Academic Hospital of Udine, 33100 Udine, Italy; (M.R.); (S.G.); (S.G.); (D.M.); (A.Q.); (A.G.)
| | - Dina Molaro
- Department of Anaesthesia and Intensive Care, Academic Hospital of Udine, 33100 Udine, Italy; (M.R.); (S.G.); (S.G.); (D.M.); (A.Q.); (A.G.)
| | - Anna Qualizza
- Department of Anaesthesia and Intensive Care, Academic Hospital of Udine, 33100 Udine, Italy; (M.R.); (S.G.); (S.G.); (D.M.); (A.Q.); (A.G.)
| | - Alessandro Garau
- Department of Anaesthesia and Intensive Care, Academic Hospital of Udine, 33100 Udine, Italy; (M.R.); (S.G.); (S.G.); (D.M.); (A.Q.); (A.G.)
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Jungestrand L, Holm E, Rose L, Wolf A, Ringdal M. Family member perspectives on intensive care unit in-person visiting restrictions during the COVID-19 pandemic: A qualitative study. Intensive Crit Care Nurs 2023; 75:103347. [PMID: 36470700 PMCID: PMC9637525 DOI: 10.1016/j.iccn.2022.103347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/17/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Family member presence in the intensive care unit is important for patient well-being and recovery. Limitations to visits increase the risk of psychological distress in family members. During the COVID-19 pandemic, in-person visiting restrictions were introduced to prevent the spread of infection. PURPOSE To explore the experience of in-person visiting restrictions imposed during the pandemic on family members of patients with COVID-19 admitted to an intensive care unit. METHOD Qualitative method with thematic analysis. Individual semi-structured telephone interviews were conducted. FINDINGS We interviewed 21 family members. The results are presented in one overall theme with two main themes and five sub-themes. The theme 'Striving for closeness even at a distance describes the experience of being kept at a physical distance when participants needed closeness the most. Even participants who were allowed in-person visits perceived a 'distance' due to personal protective equipment or because they could only view the patient from a window. Participants reported that contact with and information about the patient was of utmost importance. Visits were viewed as essential in providing for the patient's wellbeing. Meaningful contact with the ICU team was vital for getting useful information. Phone calls became a lifeline, with digital aids such as video calls used occasionally to overcome the feeling of distance. CONCLUSION Visiting restrictions imposed during the COVID-19 pandemic made straightforward and comprehensible communication of information from the ICU team more essential to reduce family members' perceptions of distance and exclusion from the intensive care unit.
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Affiliation(s)
- Linda Jungestrand
- Kungälvs hospital, Department of Anesthesiology and Intensive Care, Kungälv, Sweden
| | - Emma Holm
- Sahlgrenska University Hospital, Department of Anesthesiology and Intensive Care, Gothenburg, Sweden
| | - Louise Rose
- Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Axel Wolf
- Sahlgrenska University Hospital, Department of Anesthesiology and Intensive Care, Gothenburg, Sweden; Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mona Ringdal
- Kungälvs hospital, Department of Anesthesiology and Intensive Care, Kungälv, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Simone B, Ippolito M, Iozzo P, Zuccaro F, Giarratano A, Cecconi M, Tabah A, Cortegiani A. Variation in Communication and Family Visiting Policies in Italian Intensive Care Units during the COVID-19 Pandemic: A Secondary Analysis of the COVISIT International Survey. Healthcare (Basel) 2023; 11:healthcare11050669. [PMID: 36900674 PMCID: PMC10001082 DOI: 10.3390/healthcare11050669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND During COVID-19 pandemic, restrictions to in-person visiting of caregivers to patients admitted to intensive care units (ICU) were applied in many countries. Our aim was to describe the variations in communication and family visiting policies in Italian ICUs during the pandemic. METHODS A secondary analysis from the COVISIT international survey was conducted, focusing on data from Italy. RESULTS Italian ICUs provided 118 (18%) responses out of 667 responses collected worldwide. A total of 12 Italian ICUs were at the peak of COVID-19 admissions at the time of the survey and 42/118 had 90% or more of patients admitted to ICU affected by COVID-19. During the COVID-19 peak, 74% of Italian ICUs adopted a no-in-person-visiting policy. This remained the most common strategy (67%) at the time of the survey. Information to families was provided by regular phone calls (81% in Italy versus 47% for the rest of the world). Virtual visiting was available for 69% and most commonly performed using devices provided by the ICU (71% in Italy versus 36% outside Italy). CONCLUSION Our study showed that restrictions to the ICU applied during the COVID-19 pandemic were still in use at the time of the survey. The main means of communication with caregivers were telephone and virtual meetings.
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Affiliation(s)
- Barbara Simone
- Department of Surgical, Oncological and Oral Science, University of Palermo, Via Liborio Giuffrè 5, 90127 Palermo, Italy
| | - Mariachiara Ippolito
- Department of Surgical, Oncological and Oral Science, University of Palermo, Via Liborio Giuffrè 5, 90127 Palermo, Italy
- Department of Anaesthesia, Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, 90127 Palermo, Italy
| | - Pasquale Iozzo
- Department of Anaesthesia, Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, 90127 Palermo, Italy
| | - Francesco Zuccaro
- Department of Anesthesia and Intensive Care, Ospedale Madonna delle Grazie, Azienda Sanitaria Matera, 75100 Matera, Italy
| | - Antonino Giarratano
- Department of Surgical, Oncological and Oral Science, University of Palermo, Via Liborio Giuffrè 5, 90127 Palermo, Italy
- Department of Anaesthesia, Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, 90127 Palermo, Italy
| | - Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Alexis Tabah
- Intensive Care Unit, Redcliffe Hospital, Metro North Hospital and Health Services, Redcliffe, QLD 4020, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia
- Antimicrobial Optimisation Group, UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD 4029, Australia
| | - Andrea Cortegiani
- Department of Surgical, Oncological and Oral Science, University of Palermo, Via Liborio Giuffrè 5, 90127 Palermo, Italy
- Department of Anaesthesia, Intensive Care and Emergency, University Hospital Policlinico Paolo Giaccone, 90127 Palermo, Italy
- Correspondence: ; Tel.: +39-0916552751
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Langer T, Depalo FC, Forlini C, Landini S, Mezzetti A, Previtali P, Monti G, de Toma C, Biscardi D, Giannini A, Fumagalli R, Mistraletti G. Correction: Communication and visiting policies in Italian intensive care units during the frst COVID-19 pandemic wave and lockdown: a nationwide survey. BMC Anesthesiol 2022; 22:278. [PMID: 36050641 PMCID: PMC9434503 DOI: 10.1186/s12871-022-01813-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Thomas Langer
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.,Department of Anesthesia and Intensive Care Medicine, Niguarda Ca' Granda, Milan, Italy
| | - Francesca Carmela Depalo
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.,Department of Anesthesia and Intensive Care Medicine, Niguarda Ca' Granda, Milan, Italy
| | - Clarissa Forlini
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.,Department of Anesthesia and Intensive Care Medicine, Niguarda Ca' Granda, Milan, Italy
| | - Silvia Landini
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | | | - Paola Previtali
- Department of Anesthesia and Intensive Care Medicine, Niguarda Ca' Granda, Milan, Italy
| | - Gianpaola Monti
- Department of Anesthesia and Intensive Care Medicine, Niguarda Ca' Granda, Milan, Italy
| | - Carolina de Toma
- Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Davide Biscardi
- Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Alberto Giannini
- Unit of Pediatric Anesthesia and Intensive Care, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Roberto Fumagalli
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy. .,Department of Anesthesia and Intensive Care Medicine, Niguarda Ca' Granda, Milan, Italy.
| | - Giovanni Mistraletti
- Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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