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1.
Can J Anaesth ; 2022 Aug 17.
Article in English | MEDLINE | ID: covidwho-1990795

ABSTRACT

PURPOSE: During the first wave of the COVID-19 pandemic, restricted visitation policies were enacted at acute care facilities to reduce the spread of COVID-19 and conserve personal protective equipment. In this study, we aimed to describe the impact of restricted visitation policies on critically ill patients, families, critical care clinicians, and decision-makers; highlight the challenges faced in translating these policies into practice; and delineate strategies to mitigate their effects. METHOD: A qualitative description design was used. We conducted semistructured interviews with critically ill adult patients and their family members, critical care clinicians, and decision-makers (i.e., policy makers or enforcers) affected by restricted visitation policies. We transcribed semistructured interviews verbatim and analyzed the transcripts using inductive thematic analysis. RESULTS: Three patients, eight family members, 30 clinicians (13 physicians, 17 nurses from 23 Canadian intensive care units [ICUs]), and three decision-makers participated in interviews. Thematic analysis was used to identify five themes: 1) acceptance of restricted visitation (e.g., accepting with concerns); 2) impact of restricted visitation (e.g., ethical challenges, moral distress, patients dying alone, intensified workload); 3) trust in the healthcare system during the pandemic (e.g., mistrust of clinical team); 4) modes of communication (e.g., communication using virtual platforms); and 5) impact of policy implementation on clinical practice (e.g., frequent changes and inconsistent implementation). CONCLUSIONS: Restricted visitation policies across ICUs during the COVID-19 pandemic negatively affected critically ill patients and their families, critical care clinicians, and decision-makers.


RéSUMé: OBJECTIF: Au cours de la première vague de la pandémie de COVID-19, des politiques de visite restreintes ont été adoptées dans les établissements de soins aigus afin de réduire la propagation de la COVID-19 et d'économiser les équipements de protection individuelle. Dans cette étude, nous avons cherché à décrire l'impact des politiques de visite restreintes sur les patients gravement malades, les familles, les intensivistes et les décideurs, ainsi qu'à souligner les difficultés rencontrées dans la mise en pratique de ces politiques et à définir des stratégies pour en atténuer les effets. MéTHODE: Une méthodologie de description qualitative a été utilisée. Nous avons mené des entretiens semi-structurés avec des patients adultes gravement malades et les membres de leur famille, les intensivistes et les décideurs (c.-à-d. les stratèges ou les responsables de l'application de la loi) touchés par les politiques de visite restreintes. Nous avons transcrit textuellement les entretiens semi-structurés et analysé les transcriptions à l'aide d'une analyse thématique inductive. RéSULTATS: Trois patients, huit membres de leur famille, 30 cliniciens (13 médecins, 17 infirmières de 23 unités de soins intensifs canadiennes) et trois décideurs ont participé à ces entrevues. L'analyse thématique a été utilisée pour identifier cinq thèmes : 1) l'acceptation des visites restreintes (p. ex., accepter avec des préoccupations); 2) l'impact des visites restreintes (p. ex., défis éthiques, détresse morale, patients mourant seuls, charge de travail accrue); 3) la confiance dans le système de santé pendant la pandémie (p. ex., méfiance à l'égard de l'équipe clinique); 4) les modes de communication (p. ex., communication à l'aide de plateformes virtuelles); et 5) l'incidence de la mise en œuvre des politiques sur la pratique clinique (p. ex., changements fréquents et mise en œuvre incohérente). CONCLUSION: Les politiques de visite restreintes dans les unités de soins intensifs pendant la pandémie de COVID-19 ont eu un impact négatif sur les patients gravement malades et leurs familles, les intensivistes et les décideurs.

2.
Intensive Care Med ; 2022 Aug 01.
Article in English | MEDLINE | ID: covidwho-1966121

ABSTRACT

PURPOSE: During the coronavirus disease 2019 (COVID-19) pandemic, intensive care units (ICUs) around the world introduced virtual visiting to mediate the psychological impact of in-person visiting restrictions. Our objective was to evaluate levels of distress, depression, anxiety, and stress among family members experiencing virtual visits. METHODS: Multi-centre prospective observational study recruiting adult family members of critically ill patients in the United Kingdom (UK) using a bespoke virtual visiting solution (aTouchAway). We recruited participants and administered validated questionnaires digitally via their aTouchAway account. Prior to first virtual visit, participants completed the Distress Thermometer (score range 0-10) and the Depression, Anxiety and Stress Scale (DASS)-21. Following first and subsequent virtual visits, participants repeated the Distress Thermometer and completed the Discrete Emotions Questionnaire. RESULTS: We recruited 2166 adult family members of ICU patients in 37 UK hospitals. Most were grown up children (33%) or spouses/partners (23%). Most (91%) were ≤ 65 years. Mean (SD) pre-virtual-visit Distress Thermometer score was 7 (2.6) with 1349/2153 (62%) reporting severe distress. Pre-visit Distress Thermometer scores were associated with relationship type (spouse/partner OR 1.65, 95% CI 1.27-2.12) but not family member age, or length of ICU stay. Mean (SD) post-visit Distress Thermometer score provided by 762 (35%) participants was 1.6 (3.2) points lower than pre-visit (P < 0.001). Of participants experiencing multiple visits, 22% continued to report severe distress. Median (IQR) pre-visit DASS-21 score was 18 (2-42) (1754 participants). Severe-to-extremely severe depression, anxiety, or stress were reported by 249 (14%), 321 (18%), and 165 (9%) participants, respectively. Participants reported a range of emotions with reassurance being the most common, anger being the least. CONCLUSION: Family members exposed to COVID-19 pandemic ICU visiting restrictions experienced severe distress. One fifth of family members reported severe-to-extremely sever anxiety or depression. Distress score magnitude and prevalence of severe distress decreased after undertaking one or more virtual visits.

3.
Community Practitioner ; 95(4):40-43, 2022.
Article in English | ProQuest Central | ID: covidwho-1958033

ABSTRACT

In the second of a two-part series, Holland shares the outstanding work done during the pandemic. Among others, Rachel Raymond supported the development of local health visiting hubs and ways to deliver the Welsh Government's Healthy Child Wales Programme from 2016. She also supported staff through the Covid-19 pandemic as they adapted to different ways of working and assisted at vaccination centres.

4.
Community Practitioner ; 95(4):7, 2022.
Article in English | ProQuest Central | ID: covidwho-1957783
5.
BMC Palliat Care ; 21(1): 63, 2022 May 03.
Article in English | MEDLINE | ID: covidwho-1951172

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic has presented major challenges to the health system. Despite high acute case numbers, patients without Covid-19 still need to be cared for. Due to the severity of the disease and a possible stressful overall situation, patients with palliative care needs also require comprehensive care during pandemic times. In addition to specialized palliative care facilities, this also takes place in non palliative care wards. In order to ensure this general palliative care also in pandemic times, the experience of the staff should be used. The aim of this paper is to examine challenges and possible solutions for general palliative care inpatients in relation to the care of seriously ill and dying patients and their relatives. METHODS: Qualitative semi-structured focus groups were conducted online for the study. Participants were staff from intensive care or isolation wards or from units where vulnerable patients (e.g. with cognitive impairment) are cared for. The focus groups were recorded and subsequently transcribed. The data material was analysed with the content structuring content analysis according to Kuckartz. RESULTS: Five focus groups with four to eight health care professionals with various backgrounds were conducted. Fifteen main categories with two to eight subcategories were identified. Based on frequency and the importance expressed by the focus groups, six categories were extracted as central aspects: visiting regulations, communication with relatives, hygiene measures, cooperation, determination of the patients will and the possibility to say good bye. CONCLUSION: The pandemic situation produced several challenges needing specific solutions in order to manage the care of seriously ill and dying patients. Especially visiting needs regulation to prevent social isolation and dying alone. Finding alternative communication ways as well as interprofessional and interdisciplinary cooperation is a precondition for individualised care of seriously ill and dying patients and their relatives. Measures preventing infections should be transparently communicated in hospitals.


Subject(s)
COVID-19 , Palliative Care , Health Personnel/psychology , Humans , Inpatients , Palliative Care/psychology , Pandemics , SARS-CoV-2
6.
SAGE Open Nurs ; 8: 23779608221103627, 2022.
Article in English | MEDLINE | ID: covidwho-1950990

ABSTRACT

Introduction: Health care workers faced new challenges during the COVID-19 pandemic when physical contact with relatives more or less disappeared. Objectives: The aim of this study is to describe the experiences of critical care nurses (CCNs) working in intensive care units (ICUs) under the visiting restrictions imposed as a result of COVID-19. Method: This study followed a qualitative design. The purposive sample included CCNs with at least 1 year of experience working in an ICU with a visiting policy affected by the pandemic. Data collection was carried out via semi-structured interviews and analyzed through a qualitative content analysis with an inductive approach. Results: The study results are presented in three categories with 10 subcategories. CCNs value the presence of patients' relatives at the bedside and described many challenges when relatives could not be present with the patient during the pandemic. Conclusion: Close relatives are able to share essential information about the patients and provide much-needed emotional support to them, the relatives' role is of central importance and CCNs value their presence in ICUs more than any positive consequences of them not being there.

7.
Healthcare (Basel) ; 10(5)2022 May 23.
Article in English | MEDLINE | ID: covidwho-1953227

ABSTRACT

Hospitals have established visiting restrictions to block coronavirus disease 2019 (COVID-19) external transmission routes. This study investigated factors associated with nurses' internal transfer intentions and changes in their workloads, burdens, and daily lives owing to pandemic-related family visiting restrictions. Participants were nurses from three medical institutions designated for infectious diseases in Ishikawa Prefecture, Japan. An original self-report questionnaire was developed based on previous studies and a web-based survey conducted. Responses were received from 152 nurses and 84 were included in the analysis. Factors influencing internal transfer intentions were age ≥30 years [odds ratio (OR): 6.54, 95% confidence interval (CI): 1.19-35.83]; ≥11 years of experience (OR: 12.57, 95% CI: 2.32-68.02); and longer working hours (OR: 4.51, 95% CI: 1.48-13.72). The effect of visitation restrictions on daily life and internal transfer intentions was greater in nurses with ≥11 years of experience (OR: 4.31, 95% CI: 1.09-17.04), those with increased night awakening (OR: 3.68, 95% CI: 1.33-10.18), and those who desired to receive counseling (OR: 4.38, 95% CI: 1.07-17.91). In conclusion, excessive working hours may affect nurses' internal transfer intentions during the COVID-19 pandemic. Nocturnal awakening and desire to receive counseling may predict nurses' internal transfer intentions.

8.
Can J Anaesth ; 69(7): 868-879, 2022 07.
Article in English | MEDLINE | ID: covidwho-1930581

ABSTRACT

PURPOSE: Hospital policies forbidding or limiting families from visiting relatives on the intensive care unit (ICU) has affected patients, families, healthcare professionals, and patient- and family-centered care (PFCC). We sought to refine evidence-informed consensus statements to guide the creation of ICU visitation policies during the current COVID-19 pandemic and future pandemics and to identify barriers and facilitators to their implementation and sustained uptake in Canadian ICUs. METHODS: We created consensus statements from 36 evidence-informed experiences (i.e., impacts on patients, families, healthcare professionals, and PFCC) and 63 evidence-informed strategies (i.e., ways to improve restricted visitation) identified during a modified Delphi process (described elsewhere). Over two half-day virtual meetings on 7 and 8 April 2021, 45 stakeholders (patients, families, researchers, clinicians, decision-makers) discussed and refined these consensus statements. Through qualitative descriptive content analysis, we evaluated the following points for 99 consensus statements: 1) their importance for improving restricted visitation policies; 2) suggested modifications to make them more applicable; and 3) facilitators and barriers to implementing these statements when creating ICU visitation policies. RESULTS: Through discussion, participants identified three areas for improvement: 1) clarity, 2) accessibility, and 3) feasibility. Stakeholders identified several implementation facilitators (clear, flexible, succinct, and prioritized statements available in multiple modes), barriers (perceived lack of flexibility, lack of partnership between government and hospital, change fatigue), and ways to measure and monitor their use (e.g., family satisfaction, qualitative interviews). CONCLUSIONS: Existing guidance on policies that disallowed or restricted visitation in intensive care units were confusing, hard to operationalize, and often lacked supporting evidence. Prioritized, succinct, and clear consensus statements allowing for local adaptability are necessary to guide the creation of ICU visitation policies and to optimize PFCC.


RéSUMé: OBJECTIF: Les politiques hospitalières interdisant ou limitant les visites des familles à des proches à l'unité de soins intensifs (USI) ont affecté les patients, les familles, les professionnels de la santé et les soins centrés sur le patient et la famille (SCPF). Nous avons cherché à affiner les déclarations de consensus fondées sur des données probantes afin de guider la création de politiques de visite aux soins intensifs pendant la pandémie actuelle de COVID-19 et les pandémies futures, et dans le but d'identifier les obstacles et les critères facilitants à leur mise en œuvre et à leur adoption répandue dans les unités de soins intensifs canadiennes. MéTHODE: Nous avons créé des déclarations de consensus à partir de 36 expériences fondées sur des données probantes (c.-à-d. impacts sur les patients, les familles, les professionnels de la santé et les SCPF) et 63 stratégies fondées sur des données probantes (c.-à-d. moyens d'améliorer les restrictions des visites) identifiées au cours d'un processus Delphi modifié (décrit ailleurs). Au cours de deux réunions virtuelles d'une demi-journée tenues les 7 et 8 avril 2021, 45 intervenants (patients, familles, chercheurs, cliniciens, décideurs) ont discuté et affiné ces déclarations de consensus. Grâce à une analyse descriptive qualitative du contenu, nous avons évalué les points suivants pour 99 déclarations de consensus : 1) leur importance pour l'amélioration des politiques de restriction des visites; 2) les modifications suggérées pour les rendre plus applicables; et 3) les critères facilitants et les obstacles à la mise en œuvre de ces déclarations lors de la création de politiques de visite aux soins intensifs. RéSULTATS: En discutant, les participants ont identifié trois domaines à améliorer : 1) la clarté, 2) l'accessibilité et 3) la faisabilité. Les intervenants ont identifié plusieurs critères facilitants à la mise en œuvre (énoncés clairs, flexibles, succincts et hiérarchisés disponibles dans plusieurs modes), des obstacles (manque perçu de flexibilité, manque de partenariat entre le gouvernement et l'hôpital, fatigue du changement) et des moyens de mesurer et de surveiller leur utilisation (p. ex., satisfaction des familles, entrevues qualitatives). CONCLUSION: Les directives existantes sur les politiques qui interdisaient ou limitaient les visites dans les unités de soins intensifs étaient déroutantes, difficiles à mettre en oeuvre et manquaient souvent de données probantes à l'appui. Des déclarations de consensus hiérarchisées, succinctes et claires permettant une adaptabilité locale sont nécessaires pour guider la création de politiques de visite en soins intensifs et pour optimiser les soins centrés sur le patient et la famille.


Subject(s)
COVID-19 , Visitors to Patients , Canada , Humans , Intensive Care Units , Pandemics/prevention & control , Policy
9.
Community Practitioner ; 95(3):40-43, 2022.
Article in English | ProQuest Central | ID: covidwho-1929209

ABSTRACT

Two years have passed since Covid-19 first spread across the world, causing widespread illness and death. Today, individuals, families and communities continue to face unprecedented hardships as a result of the pandemic, affecting all aspects of public health. The long-term impact of Covid-19 is yet to be understood, with the most vulnerable in society disproportionately affected by persistent health inequalities. Within the UK health visiting professions, the pandemic presented numerous challenges, such as restricted home visits and a depleted workforce due to staff redeployment, absence and retiring employees. The pace and scale of service delivery has been second to none as teams rose to the challenge of continuing to prioritize the needs of children, families and communities, and tackling enduring health inequalities head on. Here, in the first of a two-part article, Holland gathers together some of the outstanding work by health visitors in Wales during the pandemic.

10.
Community Practitioner ; 93(3):23, 2020.
Article in English | ProQuest Central | ID: covidwho-1929200

ABSTRACT

As the UK adjusts to life in lockdown, how are CPs carrying out crucial work while staying safe? Here's just a snapshot of your current situations...

11.
BJPsych Open ; 8(S1):S14-S15, 2022.
Article in English | ProQuest Central | ID: covidwho-1902452

ABSTRACT

AimsThroughout the development of the NHS Lothian Perinatal Mental Health Service, their goals alongside maternity and neonatal teams, family nurse and health visiting services have been to strengthen interdisciplinary working and improve the quality of perinatal mental health care delivered to birthing people. The aims of developing a programme of multidisciplinary education sessions were to develop the knowledge and confidence of non-mental health professionals in caring for birthing people experiencing mental health difficulties, and aid understanding of available services and referral pathways to facilitate appropriate care.MethodsThe programme has been delivered by a Perinatal Psychiatrist and Clinical Midwifery Educators in bimonthly sessions lasting two hours. Sessions have included scenario-based learning, education regarding illnesses and disorders, and promotion of infant mental health and trauma-informed care.Participants have attended virtually via Microsoft Teams or in person. Sessions have been recorded and accessed following teaching. Confidentiality is upheld throughout. A standard operating procedure utilising multi-modal methods has been designed to maximise staff engagement with sessions. Feedback accessed via a QR code has been collated via a Microsoft Forms questionnaire comprising of Likert scale and free-text answer questions. Feedback has guided programme development and topic selection.Initially, sessions were open to inpatient maternity services, but now outpatient maternity services, neonatology, and health visiting and family nursing colleagues are invited to maximise the reach of the staff delivering sessions.ResultsSessions have been well accessed by a variety of professionals, with increasing attendance at each session. Feedback has been obtained from 43% of those attending. Results have been very positive: 100% of respondents strongly agreed or agreed that the format of the session worked well with 92% of respondents strongly agreeing or agreeing that the session content was pitched at the appropriate level. 100% of respondents felt that the content covered was useful in their clinical role which supports the emphasis of the sessions on linking knowledge to clinical application to build confidence. 100% of respondents would recommend these education sessions to a colleague.ConclusionFeedback to date has shown that participants have found the sessions to be accessible and the content appropriately pitched and clinically valuable. Despite launching the programme amidst the challenges of COVID-19, participants have found the delivery of the sessions to be supportive and collaborative.The next phase in the development of the programme will be to understand in more detail what participants are learning and the impact on their practice.

12.
Primary Health Care (2014+) ; 32(3):14-16, 2022.
Article in English | ProQuest Central | ID: covidwho-1879640

ABSTRACT

A nurse who set up innovative projects to support isolated families during the pandemic has demonstrated the hugely positive impact that the health visiting service can have on vulnerable parents and their children.

13.
Journal of Long-Term Care ; 2021:167-176, 2021.
Article in English | Scopus | ID: covidwho-1876498

ABSTRACT

An important part of care home life is the support given to older residents by their families/friends through regular visiting. Social visits to residents by their families ceased in response to the COVID-19 pandemic and residents were confined to their rooms. This paper reports on how care home staff improvised to address this situation during the first wave of the pandemic. It focuses on steps taken to maintain communication between residents and families to support emotional well-being. We undertook in-depth café-style interviews with twenty-one staff to explore creative practices that they introduced. It was part of a wider Scottish study examining the effect of lockdown on families whose relative was living/dying in a care home (May–October, 2020). Findings reveal the enormous effort by care staff to maintain family connections and the rapid acclimatisation involved working with a number of different on-line platforms, the pulling together of staff from across the care home, and, the attention to emotional well-being of residents living and dying in the care home. Findings highlight the professionalism and commitment of the leadership and staff involved. Whilst some of the staff accounts need no further comment, we draw on some themes from the care home research literature to make sense of the findings in terms of what we might learn going forward. This in-depth qualitative study emphasises the importance of recognising, fostering and nurturing relational compassionate care within long-term care. There is however little evidence whether health and social care policies recognise the importance of this on-going relationship. © 2021 The Author(s).

14.
Intensive Crit Care Nurs ; 72: 103264, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1851181

ABSTRACT

OBJECTIVE: To gain perspectives from family members about barriers and facilitators to virtual visit set up and conduct across intensive care unit settings in the United Kingdom to inform understanding of best practices. METHODS: We conducted a qualitative descriptive study recruiting a purposive sample of family members of adult intensive care unit patients experiencing virtual visiting during Jan to May 2021 of the COVID-19 pandemic. We used semi-structured qualitative interviews and a standard Thematic Analysis approach. RESULTS: We recruited 41 family-member participants from 16 hospitals in the United Kingdom. Facilitators to successful virtual visit set-up were preparation of the family, negotiating a preferred time, and easy-to-use technology. Facilitators to successful conduct were intensive care unit team member presence; enabling family involvement in care; inclusivity, accessibility, and flexibility; and having a sense of control. Barriers that created distress or conflict included restrictive virtual visiting practices; raising expectations then failing to meet them; lack of virtual visit pre-planning; and failing to prepare the patient. Barriers to visit conduct were incorrect camera positioning, insufficient technical and staff resources, issues with three-way connectivity, and lack of call closure. Recommendations included emotional self-preparation, increased technology availability, and preparing conversation topics. CONCLUSION: These data may guide virtual visiting practices during the ongoing pandemic but also to continue virtual visiting outside of pandemic conditions. This will benefit family members suffering from ill health, living at a distance, unable to afford travel, and those with work and care commitments, thereby reducing inequities of access and promoting family-centered care.


Subject(s)
COVID-19 , Adult , Critical Care/psychology , Family/psychology , Humans , Pandemics , Qualitative Research
15.
Nursing Children and Young People ; 33(4):9-9, 2021.
Article in English | ProQuest Central | ID: covidwho-1835690

ABSTRACT

Our public health capabilities have been tested to the limit during COVID-19. In particular, the value of an effective health visiting service is being recognised, with families speaking out on social media about the effects on them and their children when they miss out on this vital support. Frustrated parents have criticised health visitors for a lack of face-to-face contact, with suggestions that they have been ‘allowed to bow out’ during the pandemic. Some stories on social media are heartbreaking.

16.
BMJ Open ; 12(4): e055679, 2022 04 29.
Article in English | MEDLINE | ID: covidwho-1832448

ABSTRACT

OBJECTIVE: To understand the experiences and perceived benefits of virtual visiting from the perspectives of intensive care unit (ICU)-experienced clinicians and non-ICU-experienced family liaison team members. DESIGN: Qualitative descriptive study. SETTING: Adult intensive care setting across 14 hospitals within the UK National Health Service. PARTICIPANTS: ICU-experienced clinicians and non-ICU-experienced family liaison team members deployed during the first wave of the COVID-19 pandemic. METHODS: Semistructured telephone/video interviews were conducted with ICU clinicians. Analytical themes were developed inductively following a standard thematic approach, using 'family-centred care' and 'sensemaking' as sensitising concepts. RESULTS: We completed 36 interviews, with 17 ICU-experienced clinicians and 19 non-ICU-experienced family liaison team members. In the context of inperson visiting restrictions, virtual visiting offered an alternative conduit to (1) restoring the family unit, (2) facilitating family involvement, and (3) enabling sensemaking for the family. Virtual visits with multiple family members concurrently and with those living in distant geographical locations restored a sense of family unit. Family involvement in rehabilitation, communication and orientation activities, as well as presence at the end of life, highlighted how virtual visiting could contribute to family-centred care. Virtual visits were emotionally challenging for many family members, but also cathartic in helping make sense of their own emotions and experience by visualising their relatives in the ICU. Being able to see and interact with loved ones and their immediate care providers afforded important cues to enable family sensemaking of the ICU experience. CONCLUSIONS: In this UK qualitative study of clinicians using virtual ICU visiting, in the absence of inperson visiting, virtual visiting was perceived positively as an alternative that promoted family-centred care through virtual presence. We anticipate the perceived benefits of virtual visiting may extend to non-pandemic conditions through improved equity and timeliness of family access to the ICU by offering an alternative option alongside inperson visiting.


Subject(s)
COVID-19 , Adult , Critical Care/psychology , Humans , Intensive Care Units , Pandemics , State Medicine
17.
J Crit Care ; 71: 154050, 2022 May 04.
Article in English | MEDLINE | ID: covidwho-1819524

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, intensive care units (ICU) introduced restrictions to in-person family visiting to safeguard patients, healthcare personnel, and visitors. METHODS: We conducted a web-based survey (March-July 2021) investigating ICU visiting practices before the pandemic, at peak COVID-19 ICU admissions, and at the time of survey response. We sought data on visiting policies and communication modes including use of virtual visiting (videoconferencing). RESULTS: We obtained 667 valid responses representing ICUs in all continents. Before the pandemic, 20% (106/525) had unrestricted visiting hours; 6% (30/525) did not allow in-person visiting. At peak, 84% (558/667) did not allow in-person visiting for patients with COVID-19; 66% for patients without COVID-19. This proportion had decreased to 55% (369/667) at time of survey reporting. A government mandate to restrict hospital visiting was reported by 53% (354/646). Most ICUs (55%, 353/615) used regular telephone updates; 50% (306/667) used telephone for formal meetings and discussions regarding prognosis or end-of-life. Virtual visiting was available in 63% (418/667) at time of survey. CONCLUSIONS: Highly restrictive visiting policies were introduced at the initial pandemic peaks, were subsequently liberalized, but without returning to pre-pandemic practices. Telephone became the primary communication mode in most ICUs, supplemented with virtual visits.

18.
Community Practitioner ; 95(2):19, 2022.
Article in English | ProQuest Central | ID: covidwho-1801397

ABSTRACT

A health visitor reveals how she coped and thrived while in post (and shielding) during the pandemic, plus member recognition is presented. Griffin is a 63-year-old health visitor living in West Sussex and she has remained in her post throughout the pandemic. She worked from home for much of 2020 and into the autumn of 2021 as part of the shielding population. The positives from this were that she had time to reflect and plan her work far more, without the daily stresses that we all face driving to see different families and trying not to run late with visits. The pandemic offered the chance to remember that we are all human. It has given me time to work hard and give her best to families, and to think through all the doubts we share as practitioners.

19.
Sustainability ; 14(7):4352, 2022.
Article in English | ProQuest Central | ID: covidwho-1785954

ABSTRACT

What is the thread that unites tourism and migration? A review of existing literature suggests two forms of tourism linked to migration: visiting friends and relatives and second home tourism. Tourism related to visiting friends and relatives can be stimulated by migratory movements, and, in turn, gives rise to new migrations. Second home ownership, however, serves as the main connection between tourism and migration, promoting tourism that generates from or relates to current and past migrations. This exploratory study is based on a qualitative systematic literature review and focuses on the characteristics of second home and visiting friends and relatives-related tourism, and migration, in order to clarify little studied linkages among them that can affect tourism-related development. The study shows that many of the migration-led tourism segments reflect factors that may promote sustainable development.

20.
J Perinat Med ; 50(5): 539-548, 2022 Jun 27.
Article in English | MEDLINE | ID: covidwho-1770799

ABSTRACT

OBJECTIVES: We examined the mental health of mothers after unaccompanied birth (unaccompanied group, UG) due to COVID-19-related visiting bans and compared the data with a control group with accompanied birth (AG). Additionally, a distinction was made between caesarean section (CS) and vaginal birth (VB), as existing research indicates a higher risk for mental distress after CS. METHODS: The cross-sectional study included 27 mothers in the UG and 27 matched controls (AG). Anxiety, depression, postpartum traumatic stress symptoms (PTSS), and psychological well-being were assessed. Additionally, emotions and attitudes related to the restrictions were measured by self-developed items. RESULTS: Psychological distress was high especially in the UG (anxiety: 23%, PTSS: 34.6%, low well-being: 42.3%, depression: 11.5%). Mothers in the AG had lower psychological distress than those in the UG, but still had enhanced rates of PTSS (11.1%) and diminished well-being (22.2%). In both groups, women with CS reported higher anxiety and trauma scores and lower well-being than women with VB. Unaccompanied mothers with CS perceived visitation restrictions as less appropriate and felt more helpless, angry, worried, and frustrated about the partner's absence than women with VB. CONCLUSIONS: The partner's absence during, but also after childbirth has a major impact on psychological outcomes. Particularly, higher rates of anxiety and PTSS can lead to negative consequences for mothers and their children. Therefore, it is strongly recommended to relax visitation bans and avoid unaccompanied births. Psychological treatment in obstetric units is more urgently needed than ever, especially for women with a caesarean section.


Subject(s)
COVID-19 , Psychological Distress , COVID-19/epidemiology , Cesarean Section/psychology , Child , Cross-Sectional Studies , Female , Hospitals , Humans , Parturition/psychology , Pregnancy
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