Family Presence for Patients with Severe Acute Brain Injury and the Influence of the COVID-19 Pandemic

Abstract

Objectives: The global COVID-19 pandemic made strict visitation policies necessary. We explored the experiences of family members of patients with severe acute brain injury focusing on the impact of family presence in the hospital. Methods: Semistructured interviews (February 2018-April 2020) were audiotaped, transcribed, and analyzed using thematic analysis. Results: We interviewed family members of 19 patients with stroke, traumatic brain injury, or cardiac arrest; five interviews occurred after initiation of restrictive visitation policies. Four key themes highlight the role of visitation on family's ability to (1) cope by being at the bedside, (2) protect and advocate for the patient, (3) build trust with clinicians, and (4) receive emotional support in the intensive care unit. After visitation restrictions, families found ways to communicate and support virtually and wished for proactive communication from clinicians. Conclusions: Family presence at patient's bedside fulfills important needs. Visitation restrictions require hospitals to be creative and inclusive to help maintain these connections.

Consequences of visiting restrictions during the COVID‐19 pandemic: An integrative review

“…Long term effects are unknown. Creutzfeldt et al 2020 Intensive care unit USA Family members of ICU patients with traumatic brain injury (n=22) Family member experiences from visiting restrictions No physical visits allowed Qualitative study Individual interviews Visiting restrictions had serious negative impact on family members wellbeing and health. Heat et al 2020 Hospital palliative care unit UK Covid 19 patients referred to the hospital palliative care service (n=31) Symptoms, management, and family presence in palliative care of Covid 19 patients One family member allowed to be present in dying phase, no other visits permitted Descriptive retrospective cohort study Analysis of medical records.…”

“…Not being physically present for their hospitalized family member created worries, anxiety, sadness and a need for more information and updates on the family member's condition ( Creutzfeldt et al, 2020 ; Muniraman et al, 2020 ; Wammes et al, 2020 ; Yeh et al, 2020). A lower score of general psychosocial wellbeing of family members was reported both among family members of residents in nursing homes ( O'Caoimh et al, 2020 ) and parents of children in neonatal intensive care units ( Muniraman et al, 2020 ).…”

“…Sadness and anger were expressed among parents of hospitalized children ( Bembich et al, 2020 ). Many family members reported stress due to uncertainty ( Creutzfeldt et al, 2020 ; Muniraman et al, 2020 ). Not being allowed to be present in the hospital created moral concerns and a feeling of failing to support and protect their loved ones among family members of intensive care patients who were not infected with COVID-19 ( Creutzfeldt et al, 2020 ).…”

“…Many family members reported stress due to uncertainty ( Creutzfeldt et al, 2020 ; Muniraman et al, 2020 ). Not being allowed to be present in the hospital created moral concerns and a feeling of failing to support and protect their loved ones among family members of intensive care patients who were not infected with COVID-19 ( Creutzfeldt et al, 2020 ). Being present at the patient's side, on the other hand, supported family members in understanding and coping with the situation ( Creutzfeldt et al, 2020 ).…”

“… How valuable is the research? Overall Quality Assessment Anneser et al 2020 Y Y Y C C C C Y Y Y L Bembich et al 2020 Y Y Y C C C Y Y Y Y M Creutzfeldt et al 2020 Y Y Y Y Y Y Y Y Y Y M Sizoo et al 2020 Y Y C Y Y C Y Y Y Y M Verbeek et al 2020 Y Y Y Y Y C Y Y Y Y M Virani et al 2020 C C C C C C C N N Y L CASP Cohort Studies Checklist * , ⁎⁎ Did the study address a clearly focused issue? Was the cohort recruited in an acceptable way?…”