Strict isolation requires a different approach to the family of hospitalised patients with COVID-19: A rapid qualitative study

Maaskant, Jolanda; Jongerden, Irene P.; Bik, J; Joosten, Mala M. H.; Musters, Selma C W; Storm‐Versloot, Marja N.; Wielenga, Joke M.; Eskes, Anne

doi:10.1016/j.ijnurstu.2020.103858

Cited by 39 publications

(76 citation statements)

References 41 publications

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“…Video calling already happened before COVID-19, but was more structural used during the COVID-19 pandemic to replace physical contact between patient and family. Several evaluation studies about video calling with relatives of hospital patients during the COVID-19 pandemic show that relatives are overall positive about this feature, but also experienced barriers, such as technical difficulties and technological literacy (both by relatives and staff), difficult and unstructured communication, difficulty in building rapport, and lack of continuity (no consistent contact person) [23][24][25][26]. These studies also show that relatives stated that video calling cannot replace physical visits of family.…”

Section: Discussionmentioning

confidence: 95%

Family support on intensive care units during the COVID-19 pandemic: a qualitative evaluation study into experiences of relatives

Klop

Nasori

Klinge

et al. 2021

BMC Health Serv Res

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Background During the first peak of the COVID-19 pandemic in the Netherlands, relatives of patients with COVID-19 admitted to Intensive Care Units (ICUs) were severely restricted in visiting their relatives and in communicating with treating physicians. Family communication is a core element of critical care, however, this pandemic forced medical ICU staff to arrange alternative family support for instance by Family Support Teams (FSTs), consisting of non-ICU affiliated staff who telephonically contacted relatives. This study aims to examine relatives’ experiences with FSTs on two ICUs of a Dutch university medical centre, and to evaluate its working strategies. . Methods In a semi-structured interview study, relatives of patients with COVID-19 admitted to ICU’s, who had been supported by the FSTs, were sampled purposively. Twenty-one interviews were conducted telephonically by three researchers. All interviews were topic list guided and audio-recorded. Data was analysed thematically. Results All participants indicated they went through a rough time. Almost all evaluated the FSTs positively. Four major themes were identified. First, three important pillars of the FSTs were providing relatives with transparency about the patients’ situation, providing attention to relatives’ well-being, and providing predictability and certainty by calling on a daily basis in a period characterised by insecurity. Second, relatives appeared to fulfil their information needs by calls of the FSTs, but also by calling the attending ICU nurse. Information provided by the FSTs was associated with details and reliability, information provided by nurses was associated with the patient’s daily care. Third, being a primary family contact was generally experienced as both valuable and as an emotional burden. Last, participants missed proper aftercare. Family support often stopped directly after the patient died or had left the ICU. Relatives expressed a need for extended support after that moment since they had strong emotions after discharge or death of the patient. Conclusions Family support in times of the extreme COVID-19 situation is important, as relatives are restricted in communication and have a strong need for information and support. Relatives feel encouraged by structure, frequency, support and understanding by FSTs. However, remote family support should be tailored to the needs of relatives. A fixed contact person on de ICU and video calling might be good extra options for family support, also in future post COVID-19 care, but cannot replace physical visits.

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Section: Discussionmentioning

confidence: 95%

Family support on intensive care units during the COVID-19 pandemic: a qualitative evaluation study into experiences of relatives

Klop

Nasori

Klinge

et al. 2021

BMC Health Serv Res

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“…It was also important to provide clear definitions of the role to ensure those who were deployed into them were clear what was expected of them. However, to date, there has been limited evaluation of these roles and currently the focus has been on the clinical team’s perspective on how families were supported (18). The feeling of depersonalisation and moral distress nurses expressed at not being able to communicate effectively with families supports the implementation of these roles in times where visiting is restricted (18).…”

Section: Discussionmentioning

confidence: 99%

“…The copyright holder for this preprint this version posted May 19, 2021. ; https://doi.org/10.1101/2021.05. 18.21256801 doi: medRxiv preprint and complaint (8). Families frequently enter a space of liminality and powerlessness when a loved one is admitted to hospital and can feel further marginalised by the approaches taken by healthcare staff (9).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Family Liaison Officer (FLO) role during the COVID-19 Pandemic

Hughes

Anderton

Taylor

2021

Preprint

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Objectives: During the first wave of COVID-19 heavy restrictions were placed on hospital visitations in the United Kingdom. To support communication between families and patients a central London hospital introduced the role of the Family Liaison Officer. Communication within healthcare settings is often the subject of contention, particularly for patients families. During periods of crisis communication can become strained for patients and their families. We aimed to evaluate the rapid implementation of this role to provide guidance if it was required in the future and to explore the potential for this to become a standard role. Design: Service evaluation Setting: Single National Health Service hospital in London. Methods: Semi-structured video interviews with a convenience sample of 12 participants. Data were analysed using Framework Analysis. Participants: Family Liaison Officers (n=5) and colleagues who experienced working alongside them (n=7). Results: Key themes were identified from the interviews pertaining to the role, the team, the impact and the future. Two versions of the role emerged though the process based on the Family Liaison Officers previous background: Clinical Family Liaison Officers (primarily nurses) and Pastoral Family Liaison Officers (primarily play specialists). Both the Family Liaison Officers and their colleagues agreed that the role had a very positive impact on the wards during this time. Negative aspects of the role, such as a lack of induction, boundaries or clear structure were also discussed. Conclusion: The Family Liaison Officer was a key role during the pandemic in facilitating communication between patient, clinical team and family. The challenges associated with the role reflect the speed in which it was implemented but it was evident to those in the role and clinicians who the role was supporting that it has potential to help improve hospital communication, and the work of healthcare staff outside of a pandemic.

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“…Restricted visitation has also been shown to have negative psychologic impacts on family members of critically ill patients ( 11 ), especially during end-of-life ( 27 ). A study on the psychologic impacts of the COVID-19 pandemic reported that critical care clinicians perceived that restricted visitation policies were associated with symptoms of anxiety and depression among patients and families ( 28 ) and moral distress in healthcare professionals ( 29 ). Similarly, in the current study, a panel of stakeholders prioritized items that described psychologic impacts of restricted visitation on patients (e.g., isolation, loneliness), families (e.g., not visiting loved ones before sedated or intubated), and healthcare professionals (e.g., moral distress).…”

Section: Discussionmentioning

confidence: 99%

A Modified Delphi Process to Prioritize Experiences and Guidance Related to ICU Restricted Visitation Policies During the Coronavirus Disease 2019 Pandemic

Fiest

Krewulak

Makuk

et al. 2021

Critical Care Explorations

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Strict isolation requires a different approach to the family of hospitalised patients with COVID-19: A rapid qualitative study

Cited by 39 publications

References 41 publications

Family support on intensive care units during the COVID-19 pandemic: a qualitative evaluation study into experiences of relatives

Family support on intensive care units during the COVID-19 pandemic: a qualitative evaluation study into experiences of relatives

Evaluation of the Family Liaison Officer (FLO) role during the COVID-19 Pandemic

A Modified Delphi Process to Prioritize Experiences and Guidance Related to ICU Restricted Visitation Policies During the Coronavirus Disease 2019 Pandemic

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