Division of Hematology, Oncology and Palliative Care, Massey Cancer Center, Virginia Commonwealth University, Richmond, Va; Department of Pediatrics, Baylor College of Medicine, Houston, Tex.
Department of Bioengineering, College of Engineering, Virginia Commonwealth University, Richmond, Va.
Am J Med. 2022 Oct;135(10):1158-1167.e3. doi: 10.1016/j.amjmed.2022.04.005. Epub 2022 Apr 25.
Health care policymaking during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has questioned the precedent of restricting hospital visitors. We aimed to synthesize available data describing the resulting impact on patient, family/visitor, and health care provider well-being. We systematically reviewed articles from the World Health Organization COVID-19 Global Literature on Coronavirus Disease Database published between December 2019 through April 2021. Included studies focused on hospitalized patients and reported 1 or more prespecified main or secondary outcome (coronavirus disease 2019 [COVID-19] disease transmission, global well-being, mortality, morbidity, or health care resource utilization). Two authors independently extracted data into a standardized form with a third author resolving discrepancies. A total of 1153 abstracts were screened, and 26 final full-text articles were included. Ten studies were qualitative, with 7 cohort studies, and no randomized controlled trials. Critically ill patients were the most represented (12 out of 26 studies). Blanket hospital visitor policies were associated with failure to address the unique needs of patients, their visitors, and health care providers in various clinical environments. Overall, a patient-centered, thoughtful, and nuanced approach to hospital visitor policies is likely to benefit all stakeholders while minimizing potential harms.
在严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 大流行期间，医疗保健政策制定对限制医院探视者的先例提出了质疑。我们旨在综合现有数据，描述由此对患者、家属/探视者和医疗保健提供者的健康产生的影响。我们系统地审查了 2019 年 12 月至 2021 年 4 月期间世界卫生组织 COVID-19 全球冠状病毒疾病数据库中发表的文章。纳入的研究重点关注住院患者，并报告了 1 个或多个预先指定的主要或次要结局（2019 年冠状病毒病 [COVID-19] 疾病传播、全球福祉、死亡率、发病率或医疗资源利用）。两名作者独立地将数据提取到标准化表格中，第三名作者解决了差异。共筛选了 1153 篇摘要，最终纳入了 26 篇全文文章。其中 10 项研究为定性研究，7 项为队列研究，无随机对照试验。危重症患者的代表性最高（26 项研究中有 12 项）。全面的医院探视者政策未能解决各种临床环境中患者、其探视者和医疗保健提供者的独特需求。总体而言，对医院探视者政策采取以患者为中心、深思熟虑且细致入微的方法可能有利于所有利益相关者，同时最大限度地减少潜在危害。
