Impact of restricted family presence during the COVID-19 pandemic on critically ill patients, families, and critical care clinicians: a qualitative systematic review.


Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
15 Aug 2024
Historique:
received: 20 03 2024
accepted: 02 08 2024
medline: 16 8 2024
pubmed: 16 8 2024
entrez: 15 8 2024
Statut: epublish

Résumé

We aimed to synthesize the qualitative evidence on the impacts of COVID-19-related restricted family presence policies from the perspective of patients, families, and healthcare professionals from neonatal (NICU), pediatric (PICU), or adult ICUs. We searched MEDLINE, EMBASE, Cochrane Databases of Reviews and Clinical Trials, CINAHL, Scopus, PsycINFO, and Web of Science. Two researchers independently reviewed titles/abstracts and full-text articles for inclusion. Thematic analysis was completed following appraising article quality and assessing confidence in the individual review findings using standardized tools. We synthesized 54 findings from 184 studies, revealing the impacts of these policies in children and adults on: (1) Family integrated care and patient and family-centered care (e.g., disruption to breastfeeding/kangaroo care, dehumanizing of patients); (2) Patients, families, and healthcare professionals (e.g., negative mental health consequences, moral distress); (3) Support systems (e.g., loss of support from friends/families); and (4) Relationships (e.g., loss of essential bonding with infant, struggle to develop trust). Strategies to mitigate these impacts are reported. This review highlights the multifaceted impacts of restricted visitation policies across distinct care settings and strategies to mitigate the harmful effects of these policies and guide the creation of compassionate family presence policies in future health crises. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=290263 .

Sections du résumé

BACKGROUND BACKGROUND
We aimed to synthesize the qualitative evidence on the impacts of COVID-19-related restricted family presence policies from the perspective of patients, families, and healthcare professionals from neonatal (NICU), pediatric (PICU), or adult ICUs.
METHODS METHODS
We searched MEDLINE, EMBASE, Cochrane Databases of Reviews and Clinical Trials, CINAHL, Scopus, PsycINFO, and Web of Science. Two researchers independently reviewed titles/abstracts and full-text articles for inclusion. Thematic analysis was completed following appraising article quality and assessing confidence in the individual review findings using standardized tools.
RESULTS RESULTS
We synthesized 54 findings from 184 studies, revealing the impacts of these policies in children and adults on: (1) Family integrated care and patient and family-centered care (e.g., disruption to breastfeeding/kangaroo care, dehumanizing of patients); (2) Patients, families, and healthcare professionals (e.g., negative mental health consequences, moral distress); (3) Support systems (e.g., loss of support from friends/families); and (4) Relationships (e.g., loss of essential bonding with infant, struggle to develop trust). Strategies to mitigate these impacts are reported.
CONCLUSION CONCLUSIONS
This review highlights the multifaceted impacts of restricted visitation policies across distinct care settings and strategies to mitigate the harmful effects of these policies and guide the creation of compassionate family presence policies in future health crises.
REGISTRATION BACKGROUND
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=290263 .

Identifiants

pubmed: 39148067
doi: 10.1186/s12913-024-11398-x
pii: 10.1186/s12913-024-11398-x
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

936

Informations de copyright

© 2024. The Author(s).

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Auteurs

Karla D Krewulak (KD)

Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada.

Natalia Jaworska (N)

Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada.

Laurie Lee (L)

Department of Pediatrics, Cumming School of Medicine, Pediatric Intensive Care Unit, Children's Hospital Research Institute, Faculty of Nursing, University of Calgary, Calgary, Alberta, AB, Canada.

Julia St Louis (JS)

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.

Olesya Dmitrieva (O)

Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada.

Madison P Leia (MP)

Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada.

Christopher Doig (C)

Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada.

Daniel J Niven (DJ)

Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada.

Ken Kuljit S Parhar (KKS)

Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada.

Bram Rochwerg (B)

Department of Medicine, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.

Andrew West (A)

Canadian Society of Respiratory Therapists, Ottawa, ON, Canada.

Henry T Stelfox (HT)

Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada.
Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.

Jeanna Parsons Leigh (JP)

Faculty of Health, School of Health Administration, Dalhousie University, Halifax, NS, Canada.

Kirsten M Fiest (KM)

Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada. kmfiest@ucalgary.ca.
Department of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada. kmfiest@ucalgary.ca.
Department of Psychiatry & Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada. kmfiest@ucalgary.ca.

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