Department of Critical Care Medicine, Alberta Health Services and University of Calgary, Calgary, Alberta, Canada.
Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada; and.
Ann Am Thorac Soc. 2022 Jul;19(7):1169-1176. doi: 10.1513/AnnalsATS.202107-877OC.
Restricted visitation policies during the first wave of the coronavirus disease (COVID-19) pandemic have had a major impact on the ways that intensive care unit (ICU) clinicians communicated with patients and their families, requiring the use of innovative strategies to adapt to new communication structures. The purpose of this study is to describe the impact of restricted visitation policies on communication and to identify strategies that could be used to facilitate better communication within Canadian ICUs from the perspective of those affected. We conducted semistructured individual interviews with critically ill patients, their families, and clinicians from 23 Canadian ICUs during the first wave of the COVID-19 pandemic between July 2020 and October 2020. We used inductive thematic analysis to identify relevant themes and subthemes. Forty-one interviews were conducted with 3 patients, 8 family members, 17 nurses, and 13 physicians. Five themes were identified from the analysis: ) patient and family psychosocial and information needs; ) communication tools; ) quality of communication; ) changing roles and responsibilities of patients and nurses/physicians; and ) facilitators or barriers to implementing alternative communication. Participants identified strategies to leverage new videoconference technology and communication structures to preserve the quality of communication. Our study identified challenges and opportunities related to communication between critically ill patients, families, and ICU clinicians due to the restricted hospital visitation policies during the first wave of the COVID-19 pandemic. The use of videoconference technology and changes to communication structure were important strategies to facilitate effective communication within the ICU.
在冠状病毒病（COVID-19）大流行的第一波期间，限制探访政策对重症监护病房（ICU）临床医生与患者及其家属的沟通方式产生了重大影响，需要采用创新策略来适应新的沟通结构。本研究的目的是描述限制探访政策对沟通的影响，并从受影响者的角度确定可用于促进加拿大 ICU 内更好沟通的策略。我们在 2020 年 7 月至 2020 年 10 月 COVID-19 大流行的第一波期间，在 23 家加拿大 ICU 对重症患者、他们的家属和临床医生进行了半结构式个体访谈。我们使用归纳主题分析来确定相关主题和子主题。共进行了 41 次访谈，涉及 3 名患者、8 名家属、17 名护士和 13 名医生。分析确定了五个主题：）患者和家属的心理社会和信息需求；）沟通工具；）沟通质量；）患者和护士/医生角色和责任的变化；）实施替代沟通方式的促进因素或障碍。参与者确定了利用新的视频会议技术和沟通结构的策略，以保持沟通质量。我们的研究确定了由于 COVID-19 大流行第一波期间限制医院探访政策而导致重症患者、家属和 ICU 临床医生之间沟通所面临的挑战和机遇。视频会议技术的使用和沟通结构的改变是促进 ICU 内有效沟通的重要策略。
