Consultant physician, Wellington Hospital, Wellington.
House Surgeon, Hawkes Bay Hospital.
N Z Med J. 2022 Apr 1;135:16-26.
A qualitative exploration of the experience of whānau whose relatives died in an acute hospital setting during Levels 3 ∓ 4 of the 2020 COVID-19 pandemic in Aotearoa New Zealand.
Next of kin for 22 patients who had died in Wellington Hospital during Levels 3 & 4 of the 2020 COVID-19 pandemic (16/22 under General Medicine with an additional 6/22 who identified as Māori) from a total of 70 hospital deaths were interviewed by phone in August 2020. Whānau were asked to describe their experience of a relative dying. Following transcription, thematic content analysis was undertaken by the researchers.
Whānau provided poignant and heartbreaking accounts of their experiences. Researchers broadly categorised their feedback as positive or negative. The dominant factors that contributed to positive experiences for whānau were excellence in nursing and medical care. Māori whānau benefitted from hospital staff understanding the importance of tikanga Māori relating to dying and death practices, and incorporating these into the care of the patient. Factors that contributed to negative experiences for whānau included separation from loved ones at the time of death. The findings underscore the importance of whānau accompanying the dying patient, and non-abandonment. Other negative experiences were not having time to say goodbye, and insufficient communication with medical personnel. There were also misunderstandings and uncertainty about the changing hospital rules around isolation with great variability in interpretation by different staff.
Pandemic policies should prioritise the needs of whānau and hospitalised patients who are dying of any illness, including: daily telephone/Zoom updates by doctors and/or nurses with whānau; emailing photos to whānau of doctors/nurses/patient's room; having a bereavement whānau coordinator keeping in touch with relatives of patients who are dying; making follow-up telephone calls to whānau after the death; prioritisation of fast COVID-19 testing if there is a possibility that the patient will die; ensuring availability of Māori healthcare staff to support Māori patients and whānau; and observation of Māori tikanga around dying and death for Māori and their whānau.
探索 2020 年新西兰奥克兰 COVID-19 大流行 3 级和 4 级期间，其亲属在急性医院环境中去世的 whānau 的体验。
2020 年 COVID-19 大流行 3 级和 4 级期间，惠灵顿医院共有 70 例死亡病例，其中 22 例患者（22 例中有 16 例在普通医学病房，另外 6 例被确定为毛利人）的亲属接受了电话采访。whānau 被要求描述他们亲属去世的经历。在转录之后，研究人员进行了主题内容分析。
whānau 提供了令人心酸和心碎的经历。研究人员将他们的反馈大致分为积极和消极。导致 whānau 积极体验的主要因素是护理和医疗的卓越水平。毛利 whānau 受益于医院工作人员理解毛利人临终和死亡习俗的重要性，并将这些习俗融入到患者的护理中。导致 whānau 负面体验的因素包括亲人在死亡时的分离。研究结果强调了 whānau 陪伴临终患者和不被遗弃的重要性。其他负面体验包括没有时间道别，以及与医务人员沟通不足。还有对医院隔离规定不断变化的误解和不确定性，不同工作人员的解释差异很大。
大流行政策应优先考虑 whānau 和临终患者的需求，无论他们死于何种疾病，包括：医生和/或护士每天与 whānau 进行电话/Zoom 更新；给 whānau 发电子邮件，发送医生/护士/患者房间的照片；指定一名临终亲属协调员与临终患者的亲属保持联系；在患者去世后，给 whānau 打电话回访；如果患者有可能去世，应优先进行快速 COVID-19 检测；确保有毛利医护人员为毛利患者及其 whānau 提供支持；观察毛利人临终和死亡习俗，为毛利人和他们的 whānau 提供服务。
