Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care, King's College London, London, England, UK.
University of Hertfordshire, Hatfield, England, UK.
BMJ Open. 2022 Apr 29;12(4):e055679. doi: 10.1136/bmjopen-2021-055679.
To understand the experiences and perceived benefits of virtual visiting from the perspectives of intensive care unit (ICU)-experienced clinicians and non-ICU-experienced family liaison team members.
Qualitative descriptive study.
Adult intensive care setting across 14 hospitals within the UK National Health Service.
ICU-experienced clinicians and non-ICU-experienced family liaison team members deployed during the first wave of the COVID-19 pandemic.
Semistructured telephone/video interviews were conducted with ICU clinicians. Analytical themes were developed inductively following a standard thematic approach, using 'family-centred care' and 'sensemaking' as sensitising concepts.
We completed 36 interviews, with 17 ICU-experienced clinicians and 19 non-ICU-experienced family liaison team members. In the context of inperson visiting restrictions, virtual visiting offered an alternative conduit to (1) restoring the family unit, (2) facilitating family involvement, and (3) enabling sensemaking for the family. Virtual visits with multiple family members concurrently and with those living in distant geographical locations restored a sense of family unit. Family involvement in rehabilitation, communication and orientation activities, as well as presence at the end of life, highlighted how virtual visiting could contribute to family-centred care. Virtual visits were emotionally challenging for many family members, but also cathartic in helping make sense of their own emotions and experience by visualising their relatives in the ICU. Being able to see and interact with loved ones and their immediate care providers afforded important cues to enable family sensemaking of the ICU experience.
In this UK qualitative study of clinicians using virtual ICU visiting, in the absence of inperson visiting, virtual visiting was perceived positively as an alternative that promoted family-centred care through virtual presence. We anticipate the perceived benefits of virtual visiting may extend to non-pandemic conditions through improved equity and timeliness of family access to the ICU by offering an alternative option alongside inperson visiting.
从重症监护病房（ICU）经验丰富的临床医生和非 ICU 经验丰富的家庭联络小组成员的角度了解虚拟探视的体验和感知益处。
定性描述性研究。
英国国民保健署 14 家医院的成人重症监护病房。
在 COVID-19 大流行第一波期间部署的 ICU 经验丰富的临床医生和非 ICU 经验丰富的家庭联络小组成员。
对 ICU 临床医生进行半结构化电话/视频访谈。使用“以家庭为中心的护理”和“意义建构”作为敏感概念，采用标准主题方法，对分析主题进行归纳式发展。
我们完成了 36 次访谈，其中包括 17 名 ICU 经验丰富的临床医生和 19 名非 ICU 经验丰富的家庭联络小组成员。在限制亲自探视的情况下，虚拟探视提供了一种替代途径，可（1）恢复家庭单位，（2）促进家庭参与，（3）为家庭提供意义建构。可让多名家庭成员同时进行虚拟探访，并让那些居住在遥远地理位置的家庭成员进行虚拟探访，可恢复家庭单位的感觉。家庭参与康复、沟通和定向活动，以及在生命末期的存在，突出了虚拟探视如何有助于以家庭为中心的护理。对许多家庭成员来说，虚拟探视具有情感挑战性，但通过在 ICU 可视化他们的亲人，也可以宣泄自己的情绪和体验，从而具有意义。能够看到和与亲人及其直接护理人员互动，为家庭对 ICU 体验的意义建构提供了重要线索。
在这项英国对使用虚拟 ICU 探视的临床医生的定性研究中，在没有亲自探视的情况下，虚拟探视被认为是一种替代方案，通过虚拟存在促进了以家庭为中心的护理，因此受到了积极评价。我们预计，通过提供亲自探视的替代方案，虚拟探视的好处可能会通过改善家庭获得 ICU 的公平性和及时性而扩展到非大流行情况，从而为家庭提供另一种选择。
