Coping in times of disruption and deprivation-Experiences of family members during COVID-19 patients' critical illness: A qualitative study.

AIM: To explore the experiences and needs of family members during the course of COVID-19 critical illness from onset to rehabilitation. DESIGN: An exploratory qualitative study. METHODS: Twelve family members of surviving critically ill COVID-19 patients and restricted from visiting the patients, were interviewed digitally. Reflexive thematic analysis was used. RESULTS: Three themes were generated from the data; 'Experiencing a double burden', 'Becoming an insignificant other' and 'Regaining significance'. Family members were often ill themselves, which represented an extra burden when the patient deteriorated. From admission, the family members became bystanders, deprived of most contact with the patients, as communication and information from the intensive care unit appeared unstructured and haphazard. However, when patients were discharged, great responsibility was placed on the family members.

Conditions and strategies to meet the challenges imposed by the COVID-19-related visiting restrictions in the intensive care unit: A Scandinavian cross-sectional study.

OBJECTIVES: To examine conditions and strategies to meet the challenges imposed by the coronavirus disease 2019 (COVID-19)-related visiting restrictions in Scandinavian intensive care units. RESEARCH METHODOLOGY/DESIGN: A cross-sectional survey. SETTING: Adult intensive care units in Denmark, Norway and Sweden. MAIN OUTCOME MEASURES: Likert scale responses and free-text comments within six areas: capacity and staffing, visiting policies and access to the unit, information and conferences with relatives, written information, children as relatives and follow-up initiatives. RESULTS: The overall response rate was 53% (74/140 participating units). All intensive care units had planned for capacity extensions; the majority ranging between 11 and 30 extra beds. From March-June 2020, units had a mean maximum of 9.4 COVID-19 patients simultaneously. Allowing restricted visiting was more common in Denmark (52%) and Norway (61%) than in Sweden where visiting was mostly denied except for dying patients (68%), due to a particular increased number of COVID-19 patients. The restrictions forced nurses to compromise on their usual standards of family care. Numerous models for maintaining contact between relatives and patients were described. CONCLUSION: Visitation restrictions compromised the quality of family care and entailed dilemmas for healthcare professionals but also spurred initiatives to developing new ways of providing family care.