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COVID-19 探视限制下患者和照护者的住院体验。

Patients' and caregivers' experiences of hospitalization under COVID-19 visitation restrictions.

机构信息

Division of Population Sciences, Dana Farber Cancer Institute, Boston, Massachusetts, USA.

Maine Medical Center, Division of Palliative Medicine, Portland, Maine, USA.

出版信息

J Hosp Med. 2022 Oct;17(10):819-826. doi: 10.1002/jhm.12924. Epub 2022 Aug 3.

Abstract

BACKGROUND

During the COVID-19 pandemic, hospitals did not allow caregiver visitation. Little is known about how caregivers' absence affected patients' care.

OBJECTIVE

This study aimed to describe visitation restrictions' impact on patients and their caregivers experiences.

DESIGN

We used a sequential explanatory mixed-methods study design. First, we randomly selected 200 adult patients with cancer or heart failure hospitalized before (n = 100) and during visitor restrictions (n = 100) and abstracted data from the electronic medical record on communication between medical teams and caregivers and the topics discussed. Results from the quantitative analysis guided our thematic analysis of semi-structured interviews conducted with a subsample of patients hospitalized during visitor restrictions and their caregivers to understand the impact of visitor restrictions on their experiences.

RESULTS

Compared to prerestrictions, caregivers under visitation restrictions communicated less frequently with the medical team (29% vs. 37% of hospitalized days; p = .04), fewer received discharge counseling (37% vs. 52%; p = .04), and disproportionately more had no contact with the medical team (36% vs. 17%; p < .01). Video conferencing was documented for caregivers of only five patients. Qualitative analysis revealed that both caregivers and patients experienced emotional distress, increased conflict, and decreased perception of quality of care because of visitation restrictions.

CONCLUSIONS

Hospital visitor restrictions significantly reduced caregivers' communication with patients' medical team, causing caregivers and patients emotional distress. Protocols that facilitate communication between caregivers and care teams may benefit caregivers who cannot be physically present at care facilities, including distance caregivers.

摘要

背景

在 COVID-19 大流行期间,医院不允许探视。目前尚不清楚看护者的缺席如何影响患者的护理。

目的

本研究旨在描述探视限制对患者及其看护者体验的影响。

设计

我们采用了顺序解释性混合方法研究设计。首先,我们随机选择了 200 名患有癌症或心力衰竭的成年住院患者,其中 100 名在探视限制之前,100 名在探视限制期间,并从电子病历中提取医疗团队与看护者之间的沟通以及讨论的主题的数据。定量分析的结果指导了对在探视限制期间住院的患者及其看护者进行的半结构化访谈的主题分析,以了解探视限制对他们体验的影响。

结果

与限制前相比,探视限制下的看护者与医疗团队的沟通频率较低(29%对 37%的住院天数;p=0.04),接受出院咨询的比例较低(37%对 52%;p=0.04),并且不成比例地更多与医疗团队没有联系(36%对 17%;p<0.01)。仅为五名患者的看护者记录了视频会议。定性分析表明,由于探视限制,看护者和患者都经历了情绪困扰、增加了冲突以及降低了对护理质量的感知。

结论

医院探视限制显著减少了看护者与患者医疗团队的沟通,导致看护者和患者情绪困扰。促进看护者与护理团队之间沟通的协议可能使无法亲自在护理场所的看护者(包括远程看护者)受益。

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