Video calls at end of life are feasible but not enough: A 1‐year intensive care unit experience during the coronavirus disease‐19 pandemic

Galazzi, Alessandro; Binda, Filippo; Gambazza, Simone; Lusignani, Maura; Grasselli, Giacomo; Laquintana, Dario

doi:10.1111/nicc.12647

Cited by 20 publications

(34 citation statements)

References 15 publications

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“…It has been shown that telephone and virtual visits became the primary communication methods in many ICUs during the pandemic [ 22 ]. Feasibility of video-calls is supported by previously published studies [ 23 , 24 ], although an uneven distribution in the access to technology by the caregivers enrolled may be a concern [ 25 ]. Our single-center prospective study confirmed these results about the feasibility of the implementation of a videocall strategy between caregivers and patients.…”

Section: Discussionmentioning

confidence: 96%

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

Sanfilippo

Via

Schembari

et al. 2022

J Anesth Analg Crit Care

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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.

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Section: Discussionmentioning

confidence: 96%

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

Sanfilippo

Via

Schembari

et al. 2022

J Anesth Analg Crit Care

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“…Despite these conditions, communication mediated by phone and computer were perceived as solutions to the communication problem; these devices imposed a huge transformation in relational dynamics, causing many misunderstandings and did not help in the construction of the therapeutic alliance. As observed in the literature [15], despite it being extremely hard for them, nurses tried to make the video calls when they recognised the last moments of the patient's life and felt it was their duty to grant a last goodbye, but all these experiences deeply hurt them. Difficulties were related to the language, the impossibility of explaining everything, lack of intimacy, lack of cultural mediators, and scarce ability in the use of the devices.…”

Section: Discussionmentioning

confidence: 99%

“…During the first phases of the COVID-19 pandemic, DN in CCUs and ESs was particularly difficult because of the exorbitant number of sudden and traumatic deaths. To humanise the moment of separation, some hospitals have made a call or video call before the death of the patient [15]. During the COVID-19 pandemic, the Italian Society of Anaesthesia and Intensive Care (SIAARTI) association together with the Italian Society of Critical Care Nurses (ANIARTI), the Italian Society of Palliative Care (SICP) and the Italian Society of Emergency Medicine (SIMEU) associations, which include physicians, nurses working in intensive care, emergency and palliative care units, collaborated to produce a document: "CommuniCoViD: How to communicate with families living in complete isolation" [16].…”

Section: Introductionmentioning

confidence: 99%

Death Notification in Italian Critical Care Unites and Emergency Services. A Qualitative Study with Physicians, Nurses and Relatives

Testoni

Iacona

Palazzo

et al. 2021

IJERPH

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This qualitative study was conducted in critical care units and emergency services and was aimed at considering the death notification (DN) phenomenology among physicians (notifiers), patient relatives (receivers) and those who work between them (nurses). Through the qualitative method, a systemic perspective was adopted to recognise three different categories of representation: 23 clinicians, 13 nurses and 11 family members of COVID-19 victims were interviewed, totalling 47 people from all over Italy (25 females, mean age: 46,36; SD: 10,26). With respect to notifiers, the following themes emerged: the changes in the relational dimension, protective factors and difficulties related to DN. With respect to receivers, the hospital was perceived as a prison, bereavement between DN, lost rituals and continuing bonds. Among nurses, changes in the relational dimension, protective factors and the impact of the death. Some common issues between physicians and nurses were relational difficulties in managing distancing and empathy and the support of relatives and colleagues. The perspective of receivers showed suffering related to loss and health care professionals’ inefficacy in communication. Specifically, everyone considered DNs mismanaged because of the COVID-19 emergency. Some considerations inherent in death education for DN management among health professionals were presented.

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“…The final article in this issue is a critical commentary by Galazzi et al 25 who discussed and shared their experiences of using of video calls at the end of life, during the COVID‐19 pandemic. They argue that even though these video calls have been valuable, they are not without their problems for both staff and families.…”

mentioning

confidence: 99%

“…This is an interesting conclusion, but routine pre-or intra-employment psychological screening is not routine in nurses (or indeed in health care) and the identification of those low self-esteem would be challenging to implement in practice. The final article in this issue is a critical commentary by Galazzi et al 25 who discussed and shared their experiences of using of video calls at the end of life, during the COVID-19 pandemic. They argue that even though these video calls have been valuable, they are not without their problems for both staff and families.…”

mentioning

confidence: 99%

What's in this journal? The workforce issue

Vollam

Tume

2021

Nursing in Critical Care

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Critical care nursing has come under intense scrutiny during the coronavirus disease 2019 (COVID-19) pandemic, particularly in relation to retention of such as highly skilled workforce and the prolonged training required to work in this technical and challenging environment.Although COVID-19 has brought this into sharp focus, the issue of retention of critical care nurses is long-standing, with a wealth of international research focussed on this. 1 In this special issue, we have brought together recent research focussed on nursing workload, resilience, stress reduction and patient outcomes. The articles included in this issue utilize a variety of research, quality improvement and review methods to examine the nursing workforce from a variety of perspectives, with representation from many countries including Iran, Malaysia and the United Kingdom.

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Video calls at end of life are feasible but not enough: A 1‐year intensive care unit experience during the coronavirus disease‐19 pandemic

Cited by 20 publications

References 15 publications

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

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

Death Notification in Italian Critical Care Unites and Emergency Services. A Qualitative Study with Physicians, Nurses and Relatives

What's in this journal? The workforce issue

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