Family experiences and perceptions of intensive care unit care and communication during the COVID-19 pandemic.

INTRODUCTION: In 2020, during the first wave of the COVID-19 pandemic in Melbourne, visitor access to acute hospitals including intensive care units (ICUs) was initially barred, followed by a limit of one person per patient for one hour per day. This study explores the care and communication experienced by family members of ICU patients during this time. METHODS: This qualitative descriptive study was conducted at an Australian quaternary hospital. Semistructured phone interviews were conducted using an aide-memoire designed to understand participants' experiences as family of a patient during this time. Interviews were recorded, transcribed, and thematically analysed. FINDINGS: Twenty family members of patients in the ICU participated. Three major themes were identified: 'impact of restricting visiting procedures', 'family experiences of communication', and 'care and support'. Inflexible visiting restrictions had a momentous impact on families. Participants objected to having to nominate only two people to visit during the admission and the short visiting time limit. Some family members suffered extreme stress and anxiety during their absence from the bedside. Additional challenges were experienced by rural families, visitors with disabilities, and the young children of patients who were excluded. Communication with clinicians varied. Telehealth was valued by some but not universally embraced. The relationship between staff members and families and involvement in decision-making were unaffected. CONCLUSION: Families experienced significant psychological distress from being separated from their critically ill relatives. Patient care and involvement in decision-making appeared to be unchanged, but communication with staff felt to be lacking. Better alternatives to face-to-face communication must be sought to limit the impact of family separation on mental health. Families are a key link between the patient and clinicians and often play a major role in patient support and recovery after discharge. There is an urgent need to support them and facilitate meaningful engagement despite the obstacles.

Effect of the Covid 19 pandemic on depression and mother-infant bonding in uninfected postpartum women in a rural region.

BACKGROUND: Postpartum depression and maternal-infant attachment scores were examined in uninfected women during the COVID 19 pandemic in Kutahya, a rural province in Turkey's North Aegean region. METHODS: This cohort study was conducted in the Kutahya Health Sciences University Hospital obstetrics unit between April 2021 and August 2021. 178 low-risk term pregnant women who gave birth were given the surveys Edinburgh Postpartum Depression Scale and Mother-to-Infant Bonding Scale (MIBQ) 6 weeks after birth. The Edinburgh Postpartum Depression Scale was used to determine postpartum depression and the Mother-to-Infant Bonding Scale was used to determine maternal attachment. RESULTS: In this study, the postpartum depression rate was calculated as 17.4%. When depressed and non-depressed patients were compared, education level, maternal age, BMI, MIBQ score, history of previous pregnancies, route of delivery, previous operation history, economic status, employment status and pregnancy follow-up information were found to be similar (p > 0.05). The ratings on the Mother-to-Infant Bonding Scale were found to be similar in depressed and non-depressed patients (p > 0.05). The odds of maternal depression for patients who received guests at home was 3.068 (95%CI [1.149-8.191]) times the odds of patients who did not receive guests at home. CONCLUSIONS: Although a relationship has been found between accepting guests in the postpartum period and postpartum depression, it is necessary to investigate in further studies whether there is a causal relationship.

The Impact of Outpatient Prenatal Care Visitor Restrictions on Pregnant Patients and Partners During the COVID-19 Pandemic.

Introduction: During the early months of the COVID-19 pandemic, several health care facilities enacted visitor restrictions to help reduce the spread of SARS-CoV-2 among patients, front-line workers in health care systems, and communities. The impact and burden of policy updates on visitor restrictions put forth by the COVID-19 pandemic can be seen on patients and families, most often in the acute care setting and skilled nursing facilities. Yet, the effects of visitor restrictions in the prenatal care setting were unknown. We conducted a study to investigate the impact of these policies on pregnant patients who received outpatient prenatal care. Methods: We conducted a qualitative study to explore pregnant patients' experiences with prenatal health care delivery between May and July 2020. In-depth interviews were conducted with pregnant patients in the first and second trimester of pregnancy, who received their prenatal care at the onset of the pandemic in the United States. Results: Participants noted increased maternal concern, anxiety, and mental health concerns stemming from the lack of in-person partner support. They noted disappointment and lost experiences for the patient during pregnancy, seeking support from her partner during pregnancy, experiences felt to be critical for postpartum health and wellbeing. There was also concern about the negative impact of restrictions on prenatal care quality and experience. Conclusions: This study demonstrates the impact of visitor restrictions on patients' prenatal care experience and perception of health care quality during the COVID-19 pandemic. Future public health strategies should be individualized to different patient populations addressing knowledge, health literacy, and socioeconomic status, and developed in conjunction with pregnant patients as key stakeholders in the delivery of prenatal health care.

Women's and Nurses' Perceptions of Visitor Restrictions After Childbirth During the COVID-19 Pandemic.

OBJECTIVE: To examine the perceptions of labor and delivery (L&D) nurses and childbearing women in the postpartum period regarding a restricted visitor policy during the COVID-19 pandemic. DESIGN: Descriptive mixed-methods survey and open-ended questions. SETTING/LOCAL PROBLEM: One hospital in the southwestern United States. There is limited evidence regarding recently imposed visitor restrictions related to COVID-19. PARTICIPANTS: Individuals who were pregnant and self-identified as women who gave birth during October 2020 through March 2021 (n = 674) and L&D nurses (n = 47). INTERVENTION/MEASUREMENTS: Participants who had given birth with visitor restrictions completed an online survey, and L&D nurses completed a paper survey. RESULTS: Childbearing women had positive and negative views; they valued a more intimate familial bonding and recovery without visitors and appreciated decreased pressure to accommodate family/friends. They were also disappointed with sibling restrictions and were sad and frustrated with visitor limitations, especially in special circumstances (e.g., NICU admission or extended stays). Nurses expressed that visitor restrictions allowed more time for higher-quality nursing care/patient teaching and decreased distractions in emergencies, leading to safer care. Women and nurses reported that visitor restrictions allowed women more rest and relaxation as well as less worry and strain from juggling family and friends who wanted to visit, but they also identified that there was decreased family support when it was needed. CONCLUSION: Women's responses were mixed, with some preferring support from many visitors, while others appreciated the intimate focus of just their partner. Most nurses preferred fewer visitors but could empathize with women.