What does family involvement in care provision look like across hospital settings in Bangladesh, Indonesia, and South Korea?

Abstract

Background Family members provide care whilst staying in the patient’s room across a range of cultural settings, irrespective of resource availability in many Asian countries. This has been reported as a contributing factor to the spread of several outbreaks, including COVID-19. Despite these reports, very little is known about the risk of healthcare-associated infection (HAI) transmission related to the involvement of family and private carers in the clinical setting. As a starting point to understanding this issue, this study aimed to provide insights regarding the patient care activities undertaken by family and private carers and the guidance provided to these carers around infection control measures in hospitals located in Bangladesh, Indonesia, and South Korea. Method A qualitative study involving 57 semi-structured interviews was undertaken in five tertiary level hospitals across the selected countries. Two groups of individuals were interviewed: (1) patients and their family carers and private carers; and (2) healthcare workers, including doctors, nurses, hospital managers and staff members. Drawing upon the principles of grounded theory, an inductive approach to data analysis using thematic analysis was adopted. Results Five main themes were generated from the analysis of the data: (1) expectation of family carers staying with a patient; (2) residing in the patient’s environment: (3) caring activities undertaken by family carers; (4) supporting and educating family carers and (5) communication around healthcare-associated infection and infection prevention and control. Conclusion Based on the types of activities being undertaken, coupled with the length of time family and private carers are residing within the clinical setting, coupled with an apparent lack of guidance being given around IPC, more needs to be done to ensure that these carers are not being inadvertently exposed to HAI’s or other occupational risks.

Exploring factors influencing the compliance of patients and family carers with infection prevention and control recommendations across Bangladesh, Indonesia, and South Korea

“…Of the 64 participants, 49 were women, and 37 were in group 1. Detailed characteristics of interview participants have previously been published ( 28 ).…”

“…However, in a similar vein, it could be hypothesized that family/private carers who deliver direct patient care may pose or be at the same risk as HCWs. In fact, our previous research (28) exploring the family involvement in care provision in hospitals across BD, INA, and KR reported that family members in those countries are highly involved in a broader range of care activities, including (1) invasive care activities (i.e., intravenous injection, feeding via nasogastric tube, suctioning, wound dressing); (2) body fluid exposure activities (i.e., changing incontinent pads, cleaning up urine, feces or vomit, assisting patient with urinal/bedpan, emptying a urine bag); (3) direct contact activities (i.e., changing the position of the patient, sponging, toileting, assisting with ambulation, applying a nebulised medication, getting dressing, feeding); and (4) patient zone contact activities (i.e., making a bed, washing linens and clothes, organizing meals and medication).…”