Impact of Restricted Visitation Policies during the First Wave of the COVID-19 Pandemic on Communication between Critically Ill Patients, Families, and Clinicians: A Qualitative Interview Study
Karla D. Krewulak, Natalia Jaworska, Krista L. Spence, Sara J. Mizen, Shelly Kupsch, Henry T. Stelfox, Jeanna Parsons Leigh, Kirsten M. Fiest
Abstract
Abstract Rationale Restricted visitation policies during the first wave of the coronavirus disease (COVID-19) pandemic have had a major impact on the ways that intensive care unit (ICU) clinicians communicated with patients and their families, requiring the use of innovative strategies to adapt to new communication structures. Objectives The purpose of this study is to describe the impact of restricted visitation policies on communication and to identify strategies that could be used to facilitate better communication within Canadian ICUs from the perspective of those affected. Methods We conducted semistructured individual interviews with critically ill patients, their families, and clinicians from 23 Canadian ICUs during the first wave of the COVID-19 pandemic between July 2020 and October 2020. We used inductive thematic analysis to identify relevant themes and subthemes. Results Forty-one interviews were conducted with 3 patients, 8 family members, 17 nurses, and 13 physicians. Five themes were identified from the analysis: 1) patient and family psychosocial and information needs; 2) communication tools; 3) quality of communication; 4) changing roles and responsibilities of patients and nurses/physicians; and 5) facilitators or barriers to implementing alternative communication. Participants identified strategies to leverage new videoconference technology and communication structures to preserve the quality of communication. Conclusions Our study identified challenges and opportunities related to communication between critically ill patients, families, and ICU clinicians due to the restricted hospital visitation policies during the first wave of the COVID-19 pandemic. The use of videoconference technology and changes to communication structure were important strategies to facilitate effective communication within the ICU.