Family experiences and perceptions of intensive care unit care and communication during the COVID-19 pandemic. 2023

R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety, Research, Institute for Health Transformation, Faculty of Health, Geelong, VIC, 3220, Australia; Alfred Health, 55 Commercial Rd, Melbourne, VIC, 3004, Australia. Electronic address: r.digby@deakin.edu.au.

In 2020, during the first wave of the COVID-19 pandemic in Melbourne, visitor access to acute hospitals including intensive care units (ICUs) was initially barred, followed by a limit of one person per patient for one hour per day. This study explores the care and communication experienced by family members of ICU patients during this time. This qualitative descriptive study was conducted at an Australian quaternary hospital. Semistructured phone interviews were conducted using an aide-memoire designed to understand participants' experiences as family of a patient during this time. Interviews were recorded, transcribed, and thematically analysed. Twenty family members of patients in the ICU participated. Three major themes were identified: 'impact of restricting visiting procedures', 'family experiences of communication', and 'care and support'. Inflexible visiting restrictions had a momentous impact on families. Participants objected to having to nominate only two people to visit during the admission and the short visiting time limit. Some family members suffered extreme stress and anxiety during their absence from the bedside. Additional challenges were experienced by rural families, visitors with disabilities, and the young children of patients who were excluded. Communication with clinicians varied. Telehealth was valued by some but not universally embraced. The relationship between staff members and families and involvement in decision-making were unaffected. Families experienced significant psychological distress from being separated from their critically ill relatives. Patient care and involvement in decision-making appeared to be unchanged, but communication with staff felt to be lacking. Better alternatives to face-to-face communication must be sought to limit the impact of family separation on mental health. Families are a key link between the patient and clinicians and often play a major role in patient support and recovery after discharge. There is an urgent need to support them and facilitate meaningful engagement despite the obstacles.

UI MeSH Term Description Entries
D007362 Intensive Care Units Hospital units providing continuous surveillance and care to acutely ill patients. ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D003422 Critical Care Health care provided to a critically ill patient during a medical emergency or crisis. Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D005190 Family A social group consisting of parents or parent substitutes and children. Family Life Cycles,Family Members,Family Life Cycle,Family Research,Filiation,Kinship Networks,Relatives,Families,Family Member,Kinship Network,Life Cycle, Family,Life Cycles, Family,Network, Kinship,Networks, Kinship,Research, Family
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000066491 Clinical Decision-Making Process of formulating a diagnosis based on medical history and physical or mental examinations, and/or choosing an appropriate intervention. Medical Decision-Making,Clinical Decision Making,Decision-Making, Clinical,Decision-Making, Medical,Medical Decision Making
D000086382 COVID-19 A viral disorder generally characterized by high FEVER; COUGH; DYSPNEA; CHILLS; PERSISTENT TREMOR; MUSCLE PAIN; HEADACHE; SORE THROAT; a new loss of taste and/or smell (see AGEUSIA and ANOSMIA) and other symptoms of a VIRAL PNEUMONIA. In severe cases, a myriad of coagulopathy associated symptoms often correlating with COVID-19 severity is seen (e.g., BLOOD COAGULATION; THROMBOSIS; ACUTE RESPIRATORY DISTRESS SYNDROME; SEIZURES; HEART ATTACK; STROKE; multiple CEREBRAL INFARCTIONS; KIDNEY FAILURE; catastrophic ANTIPHOSPHOLIPID ANTIBODY SYNDROME and/or DISSEMINATED INTRAVASCULAR COAGULATION). In younger patients, rare inflammatory syndromes are sometimes associated with COVID-19 (e.g., atypical KAWASAKI SYNDROME; TOXIC SHOCK SYNDROME; pediatric multisystem inflammatory disease; and CYTOKINE STORM SYNDROME). A coronavirus, SARS-CoV-2, in the genus BETACORONAVIRUS is the causative agent. 2019 Novel Coronavirus Disease,2019 Novel Coronavirus Infection,2019-nCoV Disease,2019-nCoV Infection,COVID-19 Pandemic,COVID-19 Pandemics,COVID-19 Virus Disease,COVID-19 Virus Infection,Coronavirus Disease 2019,Coronavirus Disease-19,SARS Coronavirus 2 Infection,SARS-CoV-2 Infection,Severe Acute Respiratory Syndrome Coronavirus 2 Infection,COVID19,2019 nCoV Disease,2019 nCoV Infection,2019-nCoV Diseases,2019-nCoV Infections,COVID 19,COVID 19 Pandemic,COVID 19 Virus Disease,COVID 19 Virus Infection,COVID-19 Virus Diseases,COVID-19 Virus Infections,Coronavirus Disease 19,Disease 2019, Coronavirus,Disease, 2019-nCoV,Disease, COVID-19 Virus,Infection, 2019-nCoV,Infection, COVID-19 Virus,Infection, SARS-CoV-2,Pandemic, COVID-19,SARS CoV 2 Infection,SARS-CoV-2 Infections,Virus Disease, COVID-19,Virus Infection, COVID-19
D001315 Australia The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra. Canton and Enderbury Islands,Christmas Island,Christmas Island (Australia)
D014789 Visitors to Patients Patients' guests and rules for visiting. Patients' Visitors,Patient Visitors,Patient's Visitors,Patients Visitors,Patients' Visitor,Visitor, Patients',Visitors to Patient,Visitors, Patients'
D058873 Pandemics Epidemics of infectious disease that have spread to many countries, often more than one continent, and usually affecting a large number of people. Pandemic
D036301 Qualitative Research Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997) Research, Qualitative

Related Publications

R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
August 2022, Journal of the Intensive Care Society,
R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
April 2023, Internal medicine journal,
R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
September 2023, Acta anaesthesiologica Scandinavica,
R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
November 2021, Nursing in critical care,
R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
June 2022, Critical care (London, England),
R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
June 2020, British journal of hospital medicine (London, England : 2005),
R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
August 2023, Advances in neonatal care : official journal of the National Association of Neonatal Nurses,
R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
January 2021, Journal of patient experience,
R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
August 2020, Anaesthesia,
R Digby, and E Manias, and K J Haines, and J Orosz, and J Ihle, and T K Bucknall
December 2021, Archives of disease in childhood. Education and practice edition,
Copied contents to your clipboard!