Implementation of video-calls between patients admitted to intensive care unit during the COVID-19 pandemic and their families: a pilot study of psychological effects

Abstract

Background The coronavirus disease 2019 (COVID-19) pandemic has caused over 530 million infections to date (June 2022), with a high percentage of intensive care unit (ICU) admissions. In this context, relatives have been restricted from visiting their loved ones admitted to hospital. This situation has led to an inevitable separation between patients and their families. Video communication could reduce the negative effects of such phenomenon, but the impact of this strategy on levels of anxiety, depression, and PTSD disorder in caregivers is not well-known. Methods We conducted a prospective study (6 October 2020–18 February 2022) at the Policlinico University Hospital in Catania, including caregivers of both COVID-19 and non-COVID-19 ICU patients admitted during the second wave of the pandemic. Video-calls were implemented twice a week. Assessment of anxiety, depression, and PTSD was performed at 1-week distance (before the first, T1, and before the third, video-call, T2) using the following validated questionnaires: Impact of Event Scale (Revised IES-R), Center for Epidemiologic Studies Depression Scale (CES-D), and Hospital Anxiety and Depression Scale (HADS). Results Twenty caregivers of 17 patients completed the study (T1 + T2). Eleven patients survived (n = 9/11 in the COVID-19 and n = 2/6 in the “non-COVID” group). The average results of the questionnaires completed by caregivers between T1 and T2 showed no significant difference in terms of CES-D (T1 = 19.6 ± 10, T2 = 22 ± 9.6; p = 0.17), HADS depression (T1 = 9.5 ± 1.6, T2 = 9 ± 3.9; p = 0.59), HADS anxiety (T1 = 8.7 ± 2.4, T2 = 8.4 ± 3.8; p = 0.67), and IES-R (T1 = 20.9 ± 10.8, T2 = 23.1 ± 12; p = 0.19). Similar nonsignificant results were observed in the two subgroups of caregivers (COVID-19 and “non-COVID”). However, at T1 and T2, caregivers of “non-COVID” patients had higher scores of CES-D (p = 0.01 and p = 0.04, respectively) and IES-R (p = 0.049 and p = 0.02, respectively), while HADS depression was higher only at T2 (p = 0.02). At T1, caregivers of non-survivors had higher scores of CES-D (27.6 ± 10.6 vs 15.3 ± 6.7, p = 0.005) and IES-R (27.7 ± 10.0 vs 17.2 ± 9.6, p = 0.03). We also found a significant increase in CES-D at T2 in ICU-survivors (p = 0.04). Conclusions Our preliminary results showed that a video-call implementation strategy between caregivers and patients admitted to the ICU is feasible. However, this strategy did not show an improvement in terms of the risk of depression, anxiety, and PTSD among caregivers. Our pilot study remains exploratory and limited to a small sample.

Experiences of healthcare professionals, patients and families with video calls to stimulate patient‐ and family‐centred care during hospitalization: A scoping review

“…In 19 studies, video calls were used for virtual visits between patients and families (Dainty et al, 2023;Dhahri et al, 2021;Dhala et al, 2020;Dürst et al, 2022;Ehrler et al, 2021;Kebapcı & Türkmen, 2022;Moolla et al, 2020;Moraes & Chiaradia Mendes-Castillo, 2023;Nicholas et al, 2011;Padua et al, 2021;Parsapour et al, 2011;Ranu et al, 2021;Rose et al, 2021;Rose, Cook, et al, 2022;Sanfilippo et al, 2022;Thomas et al, 2021;Wong & Merchant, 2021;Yang et al, 2014;Yuan et al, 2023), and between patients, families and healthcare professionals in 24 studies (Bansal et al, 2022;Bavare et al, 2021;Bettini, 2020;Carlucci et al, 2020;Cherniwchan, 2022;Chua, 2022;Conroy et al, 2021;de Havenon et al, 2015;Dol et al, 2017;Elma et al, 2022;Epstein et al, 2017;Galazzi et al, 2021;Giuseppe et al, 2022;Kennedy et al, 2021;Nelson et al, 2022;Otte et al, 2022;Rose et al, 2021;Rose, Graham, et al, 2022;Sasangohar et al, 2021;Shunker, 2022;Webb et al, 2020;…”

Experiences with remote communication in adult intensive care units during the COVID-19 pandemic: a systematic review protocol

“…Checklists when establishing contact with families by telephone or video were also used to share information. More recent studies reported the use of videoconferencing 16 or video calls 7,17 . Other methods to engage families were also found, such as the creation of liaison groups to encourage family engagement with health care teams, including ICU family liaison services, 16 family support teams, 8 or video diaries 18…”

“…More recent studies reported the use of videoconferencing 16 or video calls. 7,17 Other methods to engage families were also found, such as the creation of liaison groups to encourage family engagement with health care teams, including ICU family liaison services, 16 family support teams, 8 or video diaries. 18 Some evidence points out that virtual communication between families and health care professionals in ICUs is a useful alternative to in-person meetings.…”