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BMC Health Serv Res . Impact of restricted family presence during the COVID-19 pandemic on critically ill patients, families, and critical care cli

tetano

Editor, Senior Moderator
BMC Health Serv Res


. 2024 Aug 15;24(1):936.
doi: 10.1186/s12913-024-11398-x. Impact of restricted family presence during the COVID-19 pandemic on critically ill patients, families, and critical care clinicians: a qualitative systematic review

Karla D Krewulak[SUP] 1 [/SUP], Natalia Jaworska[SUP] 1 [/SUP], Laurie Lee[SUP] 2 [/SUP], Julia St Louis[SUP] 3 [/SUP], Olesya Dmitrieva[SUP] 1 [/SUP], Madison P Leia[SUP] 1 [/SUP], Christopher Doig[SUP] 1 [/SUP], Daniel J Niven[SUP] 1 [/SUP], Ken Kuljit S Parhar[SUP] 1 [/SUP], Bram Rochwerg[SUP] 4 [/SUP], Andrew West[SUP] 5 [/SUP], Henry T Stelfox[SUP] 1 6 [/SUP], Jeanna Parsons Leigh[SUP] 7 [/SUP], Kirsten M Fiest[SUP] 8 9 10 [/SUP]



Affiliations
Abstract

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: 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: 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: 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: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=290263 .

Keywords: COVID-19; Critical care; Family centred care; Intensive care unit; Pandemic; Qualitative research; Relatives; SARS-CoV-2; Visiting restrictions.

 
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