Department of Neurology, University of Washington, Harborview Medical Center, Seattle, Washington, USA.
Cambia Palliative Care Center of Excellence at University of Washington, Harborview Medical Center, Seattle, Washington, USA.
J Palliat Med. 2021 May;24(5):743-746. doi: 10.1089/jpm.2020.0520. Epub 2020 Nov 17.
The global COVID-19 pandemic made strict visitation policies necessary. We explored the experiences of family members of patients with severe acute brain injury focusing on the impact of family presence in the hospital. Semistructured interviews (February 2018-April 2020) were audiotaped, transcribed, and analyzed using thematic analysis. We interviewed family members of 19 patients with stroke, traumatic brain injury, or cardiac arrest; five interviews occurred after initiation of restrictive visitation policies. Four key themes highlight the role of visitation on family's ability to (1) cope by being at the bedside, (2) protect and advocate for the patient, (3) build trust with clinicians, and (4) receive emotional support in the intensive care unit. After visitation restrictions, families found ways to communicate and support virtually and wished for proactive communication from clinicians. Family presence at patient's bedside fulfills important needs. Visitation restrictions require hospitals to be creative and inclusive to help maintain these connections.
全球 COVID-19 大流行使得严格的探视政策成为必要。我们探讨了重症急性脑损伤患者家属的体验，重点关注了患者在医院时家属的存在所产生的影响。 我们于 2018 年 2 月至 2020 年 4 月期间进行了半结构化访谈，并使用主题分析法对访谈进行了录音、转录和分析。我们共访谈了 19 名脑卒中、创伤性脑损伤或心搏骤停患者的家属；5 次访谈是在限制探视政策实施后进行的。四个关键主题突出了探视对家属的作用：（1）在床边陪伴以应对，（2）保护和为患者争取权益，（3）与临床医生建立信任，以及（4）在重症监护病房中获得情感支持。在限制探视后，家属找到了通过虚拟方式进行沟通和支持的方法，他们希望临床医生能够主动进行沟通。 让患者家属在床边陪伴可以满足重要的需求。探视限制要求医院富有创造力和包容性，以帮助维持这些联系。
