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临床医生对 COVID-19 大流行期间 ICU 家属探视限制影响的看法:一项国际调查。

Clinician perceptions of the impact of ICU family visiting restrictions during the COVID-19 pandemic: an international investigation.

机构信息

The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.

AP-HP Nord, Saint Louis Hospital, Medical Intensive Care, Famiréa Research Group, Paris, France.

出版信息

Crit Care. 2023 Jan 21;27(1):33. doi: 10.1186/s13054-023-04318-8.

Abstract

PURPOSE

To guarantee the safety of the public, clinicians and patients during the COVID-19 pandemic, hospital visits were severely restricted internationally. There are limited data on the precise impact of these visiting restrictions on Intensive Care Unit clinicians. Our objectives therefore were to explore the impact of family visitation restrictions on clinicians and care delivery and describe innovation alongside areas for potential improvement.

METHODS

A qualitative approach using focus groups was employed. We recruited members of the multi-disciplinary team from Spain, France and the UK. Framework analysis was used to synthesize and interpret data.

RESULTS

In total, 28 staff from multiple international sites contributed to data across six focus groups: 12 from the UK, 9 from France and 7 from Spain. In relation to the key aims, we derived four themes: the emergence of new technologies, relationships and rapport establishment, communication challenges and end-of-life care provision. Across each theme, the overarching concepts of clinician emotional exhaustion and emotional distress emerged alongside the negative impact on job satisfaction.

CONCLUSION

The impact of COVID-19 family visitation restrictions is far reaching. Future research should examine the wider impact of family presence in the ICU.

摘要

目的

在 COVID-19 大流行期间,为了保障公众、临床医生和患者的安全,国际上严格限制了医院探视。关于这些探视限制对重症监护病房临床医生的具体影响的数据有限。因此,我们的目的是探讨家庭探视限制对临床医生和护理提供的影响,并描述创新点以及潜在的改进领域。

方法

采用焦点小组的定性方法。我们从西班牙、法国和英国招募了多学科团队的成员。采用框架分析法对数据进行综合和解释。

结果

共有来自多个国际地点的 28 名工作人员参加了六个焦点小组的讨论:英国 12 名,法国 9 名,西班牙 7 名。在与主要目标相关的问题上,我们得出了四个主题:新技术的出现、关系和融洽关系的建立、沟通挑战以及临终关怀的提供。在每个主题中,临床医生的情感耗竭和情绪困扰的概念以及对工作满意度的负面影响都浮现出来。

结论

COVID-19 家庭探视限制的影响深远。未来的研究应该检查家庭在 ICU 中的存在的更广泛影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/158d/9862862/d98e420069b7/13054_2023_4318_Fig1_HTML.jpg

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