Family member experience with restricted family presence in Canadian PICUs: an interpretive descriptive study

Jennifer R Foster; Molly J Ryan; Daniel Garros; Martha Walls; Corey Slumkoski; Neda Moghadam; Adedayo Ajidahun; Jamie A Seabrook; Laurie A Lee; RFP-PICU research group for the Canadian Critical Care Trials Group

doi:10.1007/s00431-024-05854-3

Family member experience with restricted family presence in Canadian PICUs: an interpretive descriptive study

Eur J Pediatr. 2024 Nov 29;184(1):52. doi: 10.1007/s00431-024-05854-3.

Authors

Jennifer R Foster^{1

2

3}, Molly J Ryan^{4

5}, Daniel Garros^{6

7}, Martha Walls⁸, Corey Slumkoski⁸, Neda Moghadam⁸, Adedayo Ajidahun^{9

10}, Jamie A Seabrook^{11

12

13

14}, Laurie A Lee^{15

16

17}; RFP-PICU research group for the Canadian Critical Care Trials Group

Collaborators

RFP-PICU research group for the Canadian Critical Care Trials Group:
Laura J Betts, Stacy A Burgess, Karen Choong, Jeannette Comeau, Janet A Curran, Kirsten M Fiest, Patricia Fontela, Sangeeta Mehta, Srinivas Murthy, Katie O'Hearn

Affiliations

¹ Department of Critical Care, Dalhousie University, Halifax, NS, Canada. jennifer.foster@dal.ca.
² Department of Pediatric Critical Care, IWK Health, 5980 University Ave, Halifax, NS, B3K 6R8, Canada. jennifer.foster@dal.ca.
³ Lawson Health Research Institute, London, ON, Canada. jennifer.foster@dal.ca.
⁴ Department of Critical Care, Dalhousie University, Halifax, NS, Canada.
⁵ Department of Pediatric Critical Care, IWK Health, 5980 University Ave, Halifax, NS, B3K 6R8, Canada.
⁶ Pediatric Intensive Care Unit, Stollery Children's Hospital, Edmonton, AB, Canada.
⁷ Division of Critical Care, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
⁸ Patient Partner, IWK Health, Halifax, NS, Canada.
⁹ British Columbia Center for Excellence in HIV/AIDS, Vancouver, BC, Canada.
¹⁰ Department of Physiotherapy, University of the Witwatersrand, Johannesburg, South Africa.
¹¹ Lawson Health Research Institute, London, ON, Canada.
¹² Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
¹³ Department of Paediatrics, Western University, London, ON, Canada.
¹⁴ School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada.
¹⁵ Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹⁶ Faculty of Nursing, University of Calgary, Calgary, AB, Canada.
¹⁷ Alberta Children's Hospital Research Institute, Calgary, AB, Canada.

Abstract

Purpose: We performed this study to explore family member experiences with restrictions to family presence during their child's PICU admission, leveraging the unique context of the COVID-19 pandemic to aid in future ethical and informed decision-making.

Methods: Qualitative interpretive descriptive study with family members of Canadian PICU patients admitted from March 2020 to April 2021 who experienced restricted family presence (RFP) policies. Respondents were purposively sampled for demographic-based maximum variation.We generated themes through inductive thematic analysis of open-ended interviews.

Results: Fourteen parental figures from five regions across Canada participated. We identified four themes associated with the lived experience and impact of the restrictions on family members of critically ill children: (1) challenges to fulfilling the parent role, (2) isolation from primary supports during a time of crisis, (3) navigating increased logistical difficulties, and (4) seeking compassionate approaches within the healthcare system.

Conclusion: RFP policies created a range of barriers for family members of critically ill children. Healthcare organizations and teams may play a role in removing barriers through consistent and empathetic application of rules with consideration for the duality of the parent role in PICUs, providing important post-pandemic policy and practice implications.

What is known: • Parental presence with critically ill children may improve health outcomes for patients and their families. • Restrictions to family presence in PICUs continue to occur internationally and, during COVID-19, resulted in parental isolation, anxiety, and increased stress. What is new: • By isolating family members and removing supports, COVID-19-related restrictions in Canadian PICUs challenged family members' ability to fulfil their parent roles while meeting their own needs. • Families need empathetic, advocacy-based approaches from clinicians and healthcare systems to maintain trust and therapeutic relationships in a family-centered organization.

Keywords: COVID-19; Family members; Intensive care unit; Pediatric; Qualitative; Visitors.

MeSH terms

Adult
COVID-19* / epidemiology
COVID-19* / psychology
Canada
Child
Child, Preschool
Critical Illness / psychology
Family / psychology
Female
Humans
Intensive Care Units, Pediatric* / statistics & numerical data
Male
Middle Aged
Parents / psychology
Qualitative Research*
SARS-CoV-2
Visitors to Patients / psychology

Abstract

MeSH terms

Grants and funding