Sacrifice and solidarity: a qualitative study of family experiences of death and bereavement in critical care settings during the pandemic.
BMJ Open
; 12(1): e058768, 2022 01 19.
Article
in English
| MEDLINE | ID: covidwho-1631653
ABSTRACT
BACKGROUND:
Pandemic-related restrictions are expected to continue to shape end-of-life care and impact the experiences of dying hospitalised patients and their families.OBJECTIVE:
To understand families' experiences of loss and bereavement during and after the death of their loved one amidst the SARS-CoV-2 (COVID-19) pandemic.DESIGN:
Qualitative descriptive study.SETTING:
Three acute care units in a Canadian tertiary care hospital.PARTICIPANTS:
Family members of 28 hospitalised patients who died from March-July 2020. MAIN OUTCOMEMEASURES:
Qualitative semistructured interviews conducted 6-16 months after patient death inquired about family experiences before and beyond the death of their loved one and garnered suggestions to improve end-of-life care.RESULTS:
Pandemic restrictions had consequences for families of dying hospitalised patients. Most family members described an attitude of acquiescence, some framing their experience as a sacrifice made for the public good. Families appreciated how clinicians engendered trust in the name of social solidarity while trying to mitigate the negative impact of family separation. However, fears about the patient's experience of isolation and changes to postmortem rituals also created despair and contributed to long-lasting grief.CONCLUSION:
Profound loss and enduring grief were described by family members whose final connections to their loved one were constrained by pandemic circumstances. Families observed solidarity among clinical staff and experienced a sense of unity with staff, which alleviated some distress. Their suggestions to improve end-of-life care given pandemic restrictions included frequent, flexible communication, exceptions for family presence when safe, and targeted efforts to connect patients whose isolation is intensified by functional impairment or limited technological access. TRIAL REGISTRATION NUMBER NCT04602520; Results.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Bereavement
/
COVID-19
Type of study:
Prognostic study
/
Qualitative research
/
Randomized controlled trials
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
BMJ Open
Year:
2022
Document Type:
Article
Affiliation country:
Bmjopen-2021-058768
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