Perspectives on Telephone and Video Communication in the Intensive Care Unit during COVID-19.
Perspectives on Telephone and Video Communication in the Intensive Care Unit during COVID-19.
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DOI：
10.1513/annalsats.202006-729oc
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发表时间：
2021-05
影响因子：
8.3
通讯作者：
Elmer J
中科院分区：
文献类型：
--
作者：
Kennedy NR;Steinberg A;Arnold RM;Doshi AA;White DB;DeLair W;Nigra K;Elmer J
基本原理：在冠状病毒病（COVID-19）大流行期间，许多重症监护病房（ICU）已将与患者家属的沟通主要转向远程医疗方法（电话和视频），以减少COVID-19的传播。家庭和临床医生对COVID-19大流行期间ICU中电话和视频通信的看法尚未得到很好的理解。增加对临床医生和家庭远程医疗经验的了解可能有助于在COVID-19期间医院访客限制期间提高与家庭的远程互动质量。目的：探索在COVID-19医院访客限制期间，家庭成员和ICU临床医生对电话和视频互动的经验、观点和态度。研究方法：我们于2020年4月在一家学术医疗中心对心胸和神经科ICU患者的21名家庭成员和14名治疗临床医生进行了一项定性访谈研究。半结构化的定性访谈进行了每一个参与者。我们使用内容分析开发了一个代码本并分析了采访记录。我们专门探讨了有效性，好处和局限性，沟通策略，以及家庭和临床医生之间的远程讨论相关的不和谐的观点的主题。结果：受访者认为电话和视频通信有点有效，但不如在人的沟通。临床医生和家属都认为电话对于信息共享和简短更新是有用的，而视频通话对于协调临床医生和家属的观点是更可取的。临床医生和家属在多个主题上表达了不一致的观点例如，临床医生担心他们无法成功地远程传达同情，而家属则认为通过电话和视频可以成功地传达同情。家庭和临床医生建议的远程交互的沟通策略包括确定一个家庭点的人接收更新，经常检查家庭的理解，定位视频通话的摄像头，以帮助家庭看到病人和他们的临床设置，并提供时间的家庭和病人互动没有临床医生参与。结论：当无法进行面对面沟通时，ICU患者的家属和临床医生之间的远程医疗沟通似乎是一种有效的替代方案。使用特定的电话和视频通信策略可以改善临床医生和家庭的远程医疗体验。
Rationale: During the coronavirus disease (COVID-19) pandemic, many intensive care units (ICUs) have shifted communication with patients’ families toward chiefly telehealth methods (phone and video) to reduce COVID-19 transmission. Family and clinician perspectives about phone and video communication in the ICU during the COVID-19 pandemic are not yet well understood. Increased knowledge about clinicians’ and families’ experiences with telehealth may help to improve the quality of remote interactions with families during periods of hospital visitor restrictions during COVID-19. Objectives: To explore experiences, perspectives, and attitudes of family members and ICU clinicians about phone and video interactions during COVID-19 hospital visitor restrictions. Methods: We conducted a qualitative interviewing study with an intentional sample of 21 family members and 14 treating clinicians of cardiothoracic and neurologic ICU patients at an academic medical center in April 2020. Semistructured qualitative interviews were conducted with each participant. We used content analysis to develop a codebook and analyze interview transcripts. We specifically explored themes of effectiveness, benefits and limitations, communication strategies, and discordant perspectives between families and clinicians related to remote discussions. Results: Respondents viewed phone and video communication as somewhat effective but inferior to in-person communication. Both clinicians and families believed phone calls were useful for information sharing and brief updates, whereas video calls were preferable for aligning clinician and family perspectives. Clinicians and families expressed discordant views on multiple topics—for example, clinicians worried they were unsuccessful in conveying empathy remotely, whereas families believed empathy was conveyed successfully via phone and video. Communication strategies suggested by families and clinicians for remote interactions include identifying a family point person to receive updates, frequently checking family understanding, positioning the camera on video calls to help family see the patient and their clinical setting, and offering time for the family and patient to interact without clinicians participating. Conclusions: Telehealth communication between families and clinicians of ICU patients appears to be a somewhat effective alternative when in-person communication is not possible. Use of communication strategies specific to phone and video can improve clinician and family experiences with telehealth.