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Gotlib Conn L, Coburn NG, Di Prospero L, Hallet J, Legere L, MacCharles T, Slutsker J, Tagger R, Wright FC, Haas B. Restricted family presence for hospitalized surgical patients during the COVID-19 pandemic: How hospital care providers and families navigated ethical tensions and experiences of institutional betrayal. SSM. QUALITATIVE RESEARCH IN HEALTH 2022; 2:100147. [PMID: 35937964 PMCID: PMC9344808 DOI: 10.1016/j.ssmqr.2022.100147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/13/2022] [Accepted: 07/29/2022] [Indexed: 01/12/2023]
Abstract
Early in the COVID-19 pandemic restricted family presence in hospitals was a widespread public health intervention to preserve critical resources and mitigate the virus's spread. In this study, we explore the experiences of surgical care providers and family members of hospitalized surgical patients during the period of highly restricted visiting (March 2020 to April 2021) in a large Canadian academic hospital. Thirty-four interviews were completed with hospital providers, family members and members of the hospital's visitor task force. To understand hospital providers' experiences, we highlight the ethical tensions produced by the biomedical and public health ethics frameworks that converged during COVID-19 in hospital providers' bedside practice. Providers grappled with mixed feelings in support of and against restricted visiting, while simultaneously experiencing gaps in resources and care and acting as patient gatekeepers. To understand family members' experiences of communication and care, we use the theory of institutional betrayal to interpret the negative impacts of episodic and systemic communication failures during restricted visiting. Family members of the most vulnerable patients (and patients) experienced short- and long-term effects including anxiety, fear, and refusal of further care. Our analysis draws attention to the complex ways that hospital care providers and families of hospitalized surgical patients sought to establish and reconfigure how trust and patient-centeredness could be achieved under these unprecedented conditions. Practical learnings from this study suggest that if family presence in hospitals must be limited in the future, dedicated personnel for communication and emotional support for patients, families and staff must be prioritized.
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Affiliation(s)
- Lesley Gotlib Conn
- Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada,Division of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada,Corresponding author. Sunnybrook Research Institute, 2075 Bayview Avenue, Suite K3W-13, Toronto, ON, M4N3M5, Canada
| | - Natalie G. Coburn
- Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada,Division of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Lisa Di Prospero
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Julie Hallet
- Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada,Division of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Laurie Legere
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Tracy MacCharles
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Jessica Slutsker
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Ru Tagger
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Frances C. Wright
- Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada,Division of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
| | - Barbara Haas
- Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada,Division of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada
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Bovero A, Pidinchedda A, Clovis F, Berchialla P, Carletto S. Psychosocial factors associated with complicated grief in caregivers during COVID-19: Results from a preliminary cross-sectional study. DEATH STUDIES 2021; 46:1433-1442. [PMID: 34957925 DOI: 10.1080/07481187.2021.2019144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic has changed how end-of-life ceremonies are performed, affecting grief processing and bereavement experiences. In this study, caregivers of patients who died with COVID-19 during the first wave of the pandemic were asked to complete an online survey designed to detect psychosocial factors associated with the presence of complicated grief (CG). The results show CG present in 48.4% of caregivers. The marital and cohabitant status during lockdown, the perceived sense of guilt and depression levels were significantly associated with the presence of CG, whereas attendance at the funeral and social support were found to be significant protective factors.
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Affiliation(s)
- Andrea Bovero
- Clinical Psychology Unit, University Hospital sA.O.U. Città della Salute e della Scienza di Torino", Torino, Italy
| | - Alexa Pidinchedda
- Clinical Psychology Unit, University Hospital sA.O.U. Città della Salute e della Scienza di Torino", Torino, Italy
| | - Federica Clovis
- Clinical Psychology Unit, University Hospital sA.O.U. Città della Salute e della Scienza di Torino", Torino, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Sara Carletto
- Clinical Psychology Unit, University Hospital sA.O.U. Città della Salute e della Scienza di Torino", Torino, Italy
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
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