“We Aren’t Meant to Go Through the Hardest Parts of Our Lives Alone”: Family Experience With Restricted PICU Presence During the COVID-19 Pandemic-Reference-Cited by-同舟云学术

“We Aren’t Meant to Go Through the Hardest Parts of Our Lives Alone”: Family Experience With Restricted PICU Presence During the COVID-19 Pandemic

Published:2023-10-27 Issue:11 Volume:5 Page:e0989
ISSN:2639-8028
Container-title:Critical Care Explorations
language:en
Short-container-title:

Author:

Lee Laurie A.¹²,Foster Jennifer R.³⁴,Nikitovic Dejana¹,Garros Daniel⁵⁶,Ryan Molly J.³,Moghadam Neda⁷,Slumkoski Corey⁷,Walls Martha⁷,Curran Janet A.⁸⁹,Seabrook Jamie A.,Burgess Stacy⁸,Betts Laura³,Barclay Amanda,Choong Karen¹⁰¹¹,Fontela Patricia¹²,Murthy Srinivas¹³,Nicoll Jessica¹⁴,O’Hearn Katie¹⁵,Sehgal Anupam¹⁶,Tijssen Janice¹⁷,

Affiliation:

1. Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

2. Faculty of Nursing, University of Calgary, Calgary, AB, Canada.

3. Department of Pediatric Critical Care, IWK Health, Halifax, NS, Canada.

4. Department of Critical Care, Dalhousie University, Halifax, NS, Canada.

5. Stollery Children’s Hospital, Edmonton, AB, Canada.

6. Department of Pediatrics, Division of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada.

7. Patient Partner, Department of Pediatric Critical Care, IWK Health, Halifax, NS, Canada.

8. IWK Health, Halifax, NS, Canada.

9. Dalhousie School of Nursing, Dalhousie University, Halifax, NS, Canada.

10. Departments of Pediatrics and Critical Care, McMaster University, Hamilton, ON, Canada.

11. McMaster Children’s Hospital, Hamilton, ON, Canada.

12. Division of Pediatric Critical Care, Department of Pediatrics, McGill University, Montreal, QC, Canada.

13. Division of Critical Care, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.

14. Janeway Children’s Health and Rehabilitation Centre, St. John’s, NL, Canada.

15. Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.

16. Department of Pediatrics, Queen’s University, Kingston Health Sciences Centre, Kingston, ON, Canada.

17. Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Abstract

CONTEXT: PICUs across Canada restricted family presence (RFP) in response to the COVID-19 pandemic from allowing two or more family members to often only one family member at the bedside. The objective of this study was to describe the experiences and impact of RFP on families of critically ill children to inform future policy and practice. HYPOTHESIS: RFP policies negatively impacted families of PICU patients and caused moral distress. METHODS AND MODELS: National, cross-sectional, online, self-administered survey. Family members of children admitted to a Canadian PICU between March 2020 and February 2021 were invited to complete the survey. RFP-attributable distress was measured with a modified distress thermometer (0–10). Closed-ended questions were reported with descriptive statistics and multivariable linear regression assessed factors associated with RFP-attributable distress. Open-ended questions were analyzed using inductive content analysis. RESULTS: Of 250 respondents who experienced RFP, 124 (49.6%) were restricted to one family member at the bedside. The median amount of distress that families attributed to RFP policies was 6 (range: 0–10). Families described isolation, removal of supports, and perception of trauma related to RFP. Most families (183, 73.2%) felt that policies were enforced in a way that made them feel valued by PICU clinicians, which was associated with less RFP-attributable distress. Differential impact was seen where families with lower household income indicated higher RFP-attributable distress score (2.35; 95% CI, 0.53–4.17; p = 0.03). Most respondents suggested that future policies should allow at least two family members at the bedside. INTERPRETATIONS AND CONCLUSIONS: Families of children admitted to PICUs during the COVID-19 pandemic described increased distress, trauma, and removal of supports due to RFP policies. Vulnerable families showed an increased odds of higher distress. Healthcare professionals played an important role in mitigating distress. Allowance of at least two family members at the bedside should be considered for future policy.

Funder

IWK Health

CIHR

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Critical Care and Intensive Care Medicine

Reference38 articles.

1. Impact of COVID-19 pandemic on pediatric intensive care units (PICUs) visiting policies: A worldwide survey.;Camporesi;J Pediatr Intensive Care,2021.

2. An environmental scan of visitation policies in Canadian intensive care units during the first wave of the COVID-19 pandemic.;Fiest;Can J Anaesth,2021

3. Impact of restricted visitation policies during the first wave of the COVID-19 pandemic on communication between critically ill patients, families, and clinicians: A qualitative interview study.;Krewulak;Ann Am Thorac Soc,2022

4. Voices from the pandemic: A qualitative study of family experiences and suggestions regarding the care of critically ill patients.;Hochendoner;Ann Am Thorac Soc,2022

5. Family presence in Canadian PICUs during the COVID-19 pandemic: A mixed-methods environmental scan of policy and practice.;Foster;CMAJ Open,2022