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Restricted family presence for hospitalized surgical patients during the COVID-19 pandemic: How hospital care providers and families navigated ethical tensions and experiences of institutional betrayal.
Gotlib Conn, Lesley; Coburn, Natalie G; Di Prospero, Lisa; Hallet, Julie; Legere, Laurie; MacCharles, Tracy; Slutsker, Jessica; Tagger, Ru; Wright, Frances C; Haas, Barbara.
  • Gotlib Conn L; Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
  • Coburn NG; Division of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
  • Di Prospero L; Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
  • Hallet J; Division of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
  • Legere L; Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
  • MacCharles T; Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
  • Slutsker J; Division of General Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
  • Tagger R; Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
  • Wright FC; Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
  • Haas B; Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N3M5, Canada.
SSM Qual Res Health ; 2: 100147, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1967155
ABSTRACT
Early in the COVID-19 pandemic restricted family presence in hospitals was a widespread public health intervention to preserve critical resources and mitigate the virus's spread. In this study, we explore the experiences of surgical care providers and family members of hospitalized surgical patients during the period of highly restricted visiting (March 2020 to April 2021) in a large Canadian academic hospital. Thirty-four interviews were completed with hospital providers, family members and members of the hospital's visitor task force. To understand hospital providers' experiences, we highlight the ethical tensions produced by the biomedical and public health ethics frameworks that converged during COVID-19 in hospital providers' bedside practice. Providers grappled with mixed feelings in support of and against restricted visiting, while simultaneously experiencing gaps in resources and care and acting as patient gatekeepers. To understand family members' experiences of communication and care, we use the theory of institutional betrayal to interpret the negative impacts of episodic and systemic communication failures during restricted visiting. Family members of the most vulnerable patients (and patients) experienced short- and long-term effects including anxiety, fear, and refusal of further care. Our analysis draws attention to the complex ways that hospital care providers and families of hospitalized surgical patients sought to establish and reconfigure how trust and patient-centeredness could be achieved under these unprecedented conditions. Practical learnings from this study suggest that if family presence in hospitals must be limited in the future, dedicated personnel for communication and emotional support for patients, families and staff must be prioritized.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Qualitative research Language: English Journal: SSM Qual Res Health Year: 2022 Document Type: Article Affiliation country: J.ssmqr.2022.100147

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Qualitative research Language: English Journal: SSM Qual Res Health Year: 2022 Document Type: Article Affiliation country: J.ssmqr.2022.100147