Use of telecritical care for family visitation to ICU during the COVID-19 pandemic: an interview study and sentiment analysis

Abstract

BackgroundWhen the COVID-19 pandemic restricted visitation between intensive care unit patients and their families, the virtual intensive care unit (vICU) in our large tertiary hospital was adapted to facilitate virtual family visitation. The objective of this paper is to document findings from interviews conducted with family members on three categories: (1) feelings experienced during the visit, (2) barriers, challenges or concerns faced using this service, and (3) opportunities for improvements.MethodsFamily members were interviewed postvisit via phone. For category 1 (feelings), automated analysis in Python using the Valence Aware Dictionary for sentiment Reasoner package produced weighted valence (extent of positive, negative or neutral emotive connotations) of the interviewees’ word choices. Outputs were compared with a manual coder’s valence ratings to assess reliability. Two raters conducted inductive thematic analysis on the notes from these interviews to analyse categories 2 (barriers) and 3 (opportunities).ResultsValence-based and manual sentiment analysis of 230 comments received on feelings showed over 86% positive sentiments (88.2% and 86.8%, respectively) with some neutral (7.3% and 6.8%) and negative (4.5% and 6.4%) sentiments. The qualitative analysis of data from 57 participants who commented on barriers showed four primary concerns: inability to communicate due to patient status (44% of respondents); technical difficulties (35%); lack of touch and physical presence (11%); and frequency and clarity of communications with the care team (11%). Suggested improvements from 59 participants included: on demand access (51%); improved communication with the care team (17%); improved scheduling processes (10%); and improved system feedback and technical capabilities (17%).ConclusionsUse of vICU for remote family visitations evoked happiness, joy, gratitude and relief and a sense of closure for those who lost loved ones. Identified areas for concern and improvement should be addressed in future implementations of telecritical care for this purpose.

The Benefits and Risks of the Provision of a Hospital-Wide High-Definition Video Conferencing Virtual Visiting Service for Patients and Their Relatives

“…The COVID-19 pandemic provided the opportunity based on the need for the rapid deployment of existing technology, and physical visits from visitors were replaced by VV. VV is now available in many hospitals in the UK [ 6 ]. The choice of the video conference platform needs to be made with consideration for healthcare cybersecurity and patient confidentiality, making some widely used social media platforms an unsuitable choice for VV.…”

“…VV has enabled visitors to connect with their loved ones-each person can see the expressions on their faces, hear their laughter, hear their concern, and hear their love [ 8 ]. The overwhelming support for VV has been based on the appreciative factors identified by frontline clinical staff, especially those in the critical care setting [ 6 , 10 ]. This has encouraged the widespread adoption of VV as an addition to patient care.…”

“…Telemedicine has a spectrum of provision, ranging from text messages and telephonic interaction to video consultation as a replacement for face-to-face consultation. Such provisions have been utilized not only in the outpatient areas but also within the hospital wards as virtual visiting (VV) [ 4 - 6 ]. VV in this paper is defined as high-resolution video communication between admitted COVID-19 patients and their loved ones in the presence of a staff member using a dedicated healthcare platform.…”

“…VV in this paper is defined as high-resolution video communication between admitted COVID-19 patients and their loved ones in the presence of a staff member using a dedicated healthcare platform. Further emphasis has been put on VV since the start of the COVID-19 pandemic when family and friends’ in-person visits to hospital patients were canceled across the world [ 6 , 7 ]. Devices like tablets or iPad can be used while being fixed to a pole, for example, near the isolated patient for communication as a video conferencing tool [ 8 ].…”

“…With the rise in psychological distress around the world, related to the COVID-19 pandemic, VV has come to the forefront with positive and promising outcomes across the globe. The general population and healthcare workers have widely accepted VV in patient-centered care [ 3 , 6 , 10 ]. However, there is little published literature on the possible negative effects of delivering a VV service in the hospital setting.…”