ABSTRACT
Background/aims: During the first COVID-19 wave intensive care unit (ICU) visits of relatives were highly restricted in the Netherlands. Frequent contact with relatives of patients is a vital pillar of normal ICU care. Yet, the pandemic forced ICU teams to considerably modify their communication with relatives. Therefore, interventions including regular telephonic updates by medical (ICU and non-ICU) staff, social and spiritual workers, were started to support the relatives. Aim: Examine to what extent relatives of ICU patients with COVID-19 felt supported during the first COVID-19 wave in six Dutch ICUs and how this differs from experiences of relatives of patients at these ICUs before the pandemic. Methods: A written survey among first contact persons of ICU patients: 1) with COVID-19 during the first wave (t1: 15-3-2020 - 15-5- 2020), and 2) with mechanical ventilation pre-COVID-19 (t0: 1-12-2019 - 31-1- 2020) including items of the validated 'Consumer Quality Index - relatives' and an item on emotional support. Differences between t1 and t0 were tested using logistic regression analyses. Results: Relatives of t1 (n=130;response 71%) and t0 (n=94;response 61%) were equally positive in regard to receiving comprehensible information, receiving contradictory information, feeling taken serious by professionals, having a voice in decision-making, having enough time for questions during decision-making, and being offered emotional support. Interestingly, relatives of t1 were compared to those of t0 significantly more positive (p<0.05) about professionals having enough time for support (t1: 92.1%;to: 80.2%) and listening carefully (t1: 96.1%;to: 88.9%). Conclusions: The interventions during the first wave were able to offer similar levels of support to relatives as before COVID-19;on some aspects support was more favorably evaluated. The results give pointers for how to best support relatives in future pandemics and in 'normal' situations.
ABSTRACT
Background: The death of a loved one is considered as one of the most stressful life events. During the COVID-19 pandemic, grief processes are potentially affected due to measures such as social distancing and selfquarantine. This can result in lack of practical and emotional support and intensify feelings of loneliness. Personal self-care can be hindered by COVID-19 since social activities are cancelled and contact with friends and family is limited. Aims: The aim of this study was to give insight in the impact of the COVID-19 pandemic on the experienced quality of life (QoL), social support, and self-care of bereaved relatives in order to evaluate whether care for bereaved relatives during the COVID-19 pandemic should be improved. Methods: A cross-sectional analysis using data of bereaved relatives of a prospective, longitudinal, multicenter, observational study on quality of care and QoL of patients with advanced cancer and their (bereaved) relatives (eQuiPe). QoL (EORTC QLQ-C30), social support (FACT-G) and self-care (SCPS) of bereaved relatives who completed a questionnaire within 3-6 months after their loved one died, during the COVID-19 pandemic (April-November 2020) were compared with bereaved relatives who completed this questionnaire pre-COVID-19 (April-November 2019). Results: 91 bereaved relatives were included in the analysis, 44 bereaved relatives completed the questionnaire pre-COVID-19 pandemic and 47 post-COVID-19 pandemic. The median age of the participants was 65 (IQR=14) years and 58% was female. There were no significant differences between the pre-COVID-19 and the post-COVID-19 bereaved relatives in QoL (68 vs 69), emotional functioning (72 vs 71), social functioning (82 vs 82), self-care (20 vs 19) and social support (17 vs 18). Conclusion / Discussion: On the short-term, the COVID-19 pandemic does not have significant impact on bereaved relatives' wellbeing. However, long-term impact of the pandemic on their wellbeing should be assessed.