ABSTRACT
PURPOSE: To guarantee the safety of the public, clinicians and patients during the COVID-19 pandemic, hospital visits were severely restricted internationally. There are limited data on the precise impact of these visiting restrictions on Intensive Care Unit clinicians. Our objectives therefore were to explore the impact of family visitation restrictions on clinicians and care delivery and describe innovation alongside areas for potential improvement. METHODS: A qualitative approach using focus groups was employed. We recruited members of the multi-disciplinary team from Spain, France and the UK. Framework analysis was used to synthesize and interpret data. RESULTS: In total, 28 staff from multiple international sites contributed to data across six focus groups: 12 from the UK, 9 from France and 7 from Spain. In relation to the key aims, we derived four themes: the emergence of new technologies, relationships and rapport establishment, communication challenges and end-of-life care provision. Across each theme, the overarching concepts of clinician emotional exhaustion and emotional distress emerged alongside the negative impact on job satisfaction. CONCLUSION: The impact of COVID-19 family visitation restrictions is far reaching. Future research should examine the wider impact of family presence in the ICU.
Subject(s)
COVID-19 , Terminal Care , Humans , Pandemics , Intensive Care Units , Focus Groups , Family/psychologyABSTRACT
The COVID-19 pandemic has put healthcare workers under important psychological pressure. Concerns have been raised regarding the mental health and psychological status of healthcare workers and have underlined the need for institutions to develop long-term interventions to support their resilience. The current case study presents the way a large university hospital in Brussels, Belgium, has evolved to deal with this health crisis and support its workers. Initiatives were multiple and complementary, as it was decided to combine different forms of clinical interventions that were developed by psychologists, psychiatrists, and human resources, to an empirical approach including a large survey that permitted to reach a much larger audience (the results of the study have been published previously). We describe the initially proposed measures of psychological support, including the creation of a telephone hotline, the presence of psychologists among teams of dedicated COVID-19 units, discussion groups, and individualized follow-ups, and their consequences on healthcare workers. Second, we address how these initial measures of support were modified to tailor in the best way possible the needs of healthcare workers, using a research action project that used a survey to measure and address the psychological distress of healthcare workers. We explain how, through different objectives (screening of distress, adaptation of initial measures based on reported needs, active reinforcement of individual and collective resilience, reminder of availability of help, and normalization of distress), a research action project can be a form of support and is an effective way for an institution to show its pre-occupation for the mental health of its teams. The current case study highlights how an institution can provide support and the importance of the use of a combined strategy to limit the consequences of a major health crisis on the mental health of its healthcare workers. Improving the resilience of healthcare workers both in the short and long term is of the essence to maintain optimal care of patients.
ABSTRACT
To contain the SARS-CoV-2 infection rate, health authorities have encouraged the population to enhance protective behaviors such as physical distancing and handwashing. Behavioral sciences emphasize the role of sociocognitive determinants to explain health behaviors, while largely ignoring emotional factors. In a large online study (N > 4000), we investigated the role of sociodemographic, cognitive, emotional, and social factors that can facilitate or hinder handwashing and limitation of social contacts. Data were collected from March 18 until April 19, 2020, which corresponds to the spring lockdown and the first peak of the pandemic in Belgium. Logistic regressions showed that sociodemographic factors (gender, age, level of education) and the dimensions of the Theory of Planned Behavior (intentions, attitudes, perceived behavioral control and subjective norms) had a strong impact on health behaviors, but that emotional factors explained an additional part of the variance. Being more attentive/determined and frightened/anxious, along with scoring higher on health anxiety were related to a higher frequency of handwashing. In contrast, being enthusiastic/happy was related to lower adherence to limiting social contacts. Our results suggest that the type of predictors and the direction of associations depend on the type of health behavior considered. The role of specific emotional factors in addition to more classical predictors is discussed. The study offers new perspectives regarding the factors that are associated with the adherence to behaviors recommended to adopt when faced with a pandemic.