Content and Communication of Inpatient Family Visitation Policies During the COVID-19 Pandemic: Sequential Mixed Methods Study.
Content and Communication of Inpatient Family Visitation Policies During the COVID-19 Pandemic: Sequential Mixed Methods Study.
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DOI：
10.2196/28897
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发表时间：
2021-09-24
影响因子：
7.4
通讯作者：
Clapp JT
中科院分区：
文献类型：
--
作者：
Hart J;Summer A;Yadav KN;Peace S;Hong D;Konu M;Clapp JT
由于2019冠状病毒病疫情，住院医疗设施限制住院病人探视。目前没有证据表明他们如何向公众传达这些政策，也没有证据表明他们的沟通选择对公众看法的影响。本研究旨在描述美国COVID-19大流行最初高峰期间住院患者探视政策的模式，以及这些政策与公众的沟通，并确定沟通策略，以最大限度地提高对设施的积极印象，尽管探视限制。我们进行了一项连续、探索性、混合方法的研究，包括对2020年4月30日至5月20日（即美国COVID-19大流行的第一个高峰期）期间宾夕法尼亚州设施网站上发布的COVID-19时代探视政策进行定性分析。我们还进行了一项基于析因调查的实验，以测试医院探视政策沟通的关键要素如何与2020年10月个人寻求护理的意愿相关。为了分析政策，我们包括宾夕法尼亚州的所有住院设施。在析因实验中，美国成年人来自互联网研究小组。析因调查为基础的实验提出了复合政策，不同的理由限制探视，在何种程度上该设施表示所有权的政策，并列入以家庭为中心的护理支持计划。我们的主要结果是参与者愿意推荐使用5点李克特量表的假设设施。我们从363个机构的网站上确定了104项关于住院病人探视的独特政策。这些保单的平均Flesch-Kincaid等级为14.2。大多数政策禁止家庭团聚（99/104，95.2%）。设施根据社区保护（59/104，56.7%）、当局的指导或法规（34/104，32.7%）或科学依据（23/104，22.1%）证明限制探视政策的合理性。少数人（38/104，36.5%）指出限制性探视可能损害以家庭为中心的护理。分析的大多数政策使用被动语态来传达限制。共有1321名参与者完成了基于网络的调查。与推荐设施意愿显著相关的访问政策要素包括基于社区保护（OR 1.44，95%CI 1.24-1.68）或科学依据（OR 1.30，95%CI 1.12-1.51）的理由，而不是基于管理当局的理由。该机构对该决定表示高度的所有权（OR 1.16，95% CI 1.04-1.29），而不是低程度的所有权;包括以家庭为中心的护理支持计划（OR 2.80，95% CI 2.51-3.12），而不是没有这种支持。卫生系统可以通过强调社区保护、对设施政策的所有权和促进以家庭为中心的护理，立即提高公众对限制性探视政策的接受程度。
Inpatient health care facilities restricted inpatient visitation due to the COVID-19 pandemic. There is no existing evidence of how they communicated these policies to the public nor the impact of their communication choices on public perception. This study aims to describe patterns of inpatient visitation policies during the initial peak of the COVID-19 pandemic in the United States and the communication of these policies to the general public, as well as to identify communication strategies that maximize positive impressions of the facility despite visitation restrictions. We conducted a sequential, exploratory, mixed methods study including a qualitative analysis of COVID-19 era visitation policies published on Pennsylvania-based facility websites, as captured between April 30 and May 20, 2020 (ie, during the first peak of the COVID-19 pandemic in the United States). We also conducted a factorial survey-based experiment to test how key elements of hospitals’ visitation policy communication are associated with individuals’ willingness to seek care in October 2020. For analysis of the policies, we included all inpatient facilities in Pennsylvania. For the factorial experiment, US adults were drawn from internet research panels. The factorial survey-based experiment presented composite policies that varied in their justification for restricted visitation, the degree to which the facility expressed ownership of the policy, and the inclusion of family-centered care support plans. Our primary outcome was participants’ willingness to recommend the hypothetical facility using a 5-point Likert scale. We identified 104 unique policies on inpatient visitation from 363 facilities’ websites. The mean Flesch-Kincaid Grade Level for the policies was 14.2. Most policies prohibited family presence (99/104, 95.2%). Facilities justified the restricted visitation policies on the basis of community protection (59/104, 56.7%), authorities’ guidance or regulations (34/104, 32.7%), or scientific rationale (23/104, 22.1%). A minority (38/104, 36.5%) addressed how restrictive visitation may impair family-centered care. Most of the policies analyzed used passive voice to communicate restrictions. A total of 1321 participants completed the web-based survey. Visitation policy elements significantly associated with willingness to recommend the facility included justifications based on community protection (OR 1.44, 95% CI 1.24-1.68) or scientific rationale (OR 1.30, 95% CI 1.12-1.51), rather than those based on a governing authority. The facility expressed a high degree of ownership over the decision (OR 1.16, 95% CI 1.04-1.29), rather than a low degree of ownership; and inclusion of family-centered care support plans (OR 2.80, 95% CI 2.51-3.12), rather than no such support. Health systems can immediately improve public receptiveness of restrictive visitation policies by emphasizing community protection, ownership over the facility’s policy, and promoting family-centered care.
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