88 Family Absence at the Bedside during the COVID-19 Pandemic
Notice bibliographique
Résumé
Abstract Primary Subject area Hospital Paediatrics Background Child and family-centered care, a partnership approach to health care decision-making, is central to paediatric practice. To reduce transmission of SARS-CoV-2, healthcare institutions implemented policies to protect staff, patients and families. Family presence at the bedside was reduced to one caregiver, except in special circumstances requiring pre-approval by hospital leadership. Objectives We explored the impact of the COVID-19 pandemic on paediatric healthcare delivery, focusing on family presence. We describe the clinician's experience of restricted family presence during the COVID-19 pandemic in a paediatric hospital. Design/Methods Physicians, trainees, and nurses at The Hospital for Sick Children completed surveys between March-August 2020 to identify patients they perceived to have experienced a suboptimal quality of care or health-outcome related to changes that had occurred as a result of the pandemic and describe the impact. Data were analyzed via case report and thematic analysis. As part of a larger study, here we report on cases related to family presence in the hospital. Results A total of 212 clinicians reported 116 cases; eighteen cases specified an impact on child and family-centered care. Nine cases related to patient experiences and nine to family experiences of the restricted family presence policy. Clinicians reported a perceived distress in patients due to family members not being present. 6267 family restriction exemption requests were received. Cases described families who opted for a different location for end-of-life care so that extended family could be present. Further cases highlighted how important conversations such as disclosure of diagnosis involved one parent present and the other joining remotely. Siblings were also reported to be impacted by visitor restrictions and closure of the sibling play area. Exclusions were also reported to be challenging for children with complex medical needs and technology dependency whereby two-caregivers were often required. Clinicians reported experiencing stress and moral distress as part of being required to support family restriction policies, impairing their ability to provide care. Conclusion Family presence policies are a critical component of child and family-centered care and have been impacted by the pandemic as described both by family and clinician stress. Recommendations based on these findings would include: facilitating two-caregiver presence to support shared decision making, regular remote meetings to communicate information with families in cases where they cannot be physically present; using remote technology or implementing allotted visitation time for siblings, reviewing exceptions to caregiver restrictions, and mental health supports for clinicians such as peer-support groups, or wellness workshops.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,010 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».