Visitation policies at NCI-designated comprehensive cancer centers during the COVID-19 pandemic.
Visitation policies at NCI-designated comprehensive cancer centers during the COVID-19 pandemic.
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DOI：
10.1007/s00520-021-06183-z
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Sinclair CT
中科院分区：
文献类型：
--
作者：
Yeh JC;Subbiah IM;Dhawan N;Thompson BW;Hildner Z;Jawed A;Prommer E;Sinclair CT
家庭/照顾者探视为癌症患者提供了关键支持，并与积极的治疗结果相关。然而，新冠疫情带来了历史性的干扰，包括广泛的探视限制。在此，我们深入描述了美国国家癌症研究所（NCI）指定的综合癌症中心（CCCs）的探视政策，并分析了这些中心在地理和时间上的模式。
对面向公众的综合癌症中心网站（包括存档网页）进行了审查，以提取初始探视政策及其修订内容，包括临终（EoL）例外情况以及探视限制相对于地区封锁的时间。采用卡方检验和费舍尔精确检验来分析地理区域、时间以及限制的严格程度之间的关联。
大多数综合癌症中心（n = 43，86%）在2020年3月15日至4月15日期间实施了探视限制。约一半的中心禁止所有新冠检测阴性的住院患者（n = 24，48%）或门诊患者（n = 26，52%）的探视者进入。大多数（n = 36，72%）禁止确诊/疑似新冠患者有探视者。大多数（n = 40，80%）公布了临终例外情况，但具体细节差异很大。从最初实施限制到政府强制封锁的中位时间为1天，范围很广（从提前25天到滞后26天）。初始限制的时间与地理位置（p = 0.14）或住院政策的严格程度（p = 1.0）之间没有关联，即使在同一城市的中心之间也是如此。被动（在封锁之后）公布的门诊政策比主动（在封锁之前）公布的政策更为严格（p = 0.04）。
综合癌症中心实施了严格但差异显著的新冠探视限制，这对寻求癌症治疗的患者/家庭具有重要影响。需要一种统一的、基于证据的探视政策制定方法，以在已证实的感染控制措施与患者及家属的需求之间取得平衡。
Family/caregiver visitation provides critical support for patients confronting cancer and is associated with positive outcomes. However, the COVID-19 pandemic brought historic disruptions including widespread visitation restrictions. Here, we characterize in-depth the visitor policies of NCI-designated comprehensive cancer centers (CCCs) and analyze geographic/temporal patterns across CCCs. The public-facing CCC websites, including archived webpages, were reviewed to abstract initial visitation policies and revisions, including end-of-life (EoL) exceptions and timing of visitation restrictions relative to regional lockdowns. Chi-squared and Fisher’s exact tests were employed to analyze associations between geographic region, timing, and severity of restrictions. Most CCCs (n=43, 86%) enacted visitation restrictions between March 15 and April 15, 2020. About half barred all visitors for COVID-negative inpatients (n=24, 48%) or outpatients (n=26, 52%). Most (n=36, 72%) prohibited visitors for patients with confirmed/suspected COVID-19. Most (n=40, 80%) published EoL exceptions but the specifics were highly variable. The median time from initial restrictions to government-mandated lockdowns was 1 day, with a wide range (25 days before to 26 days after). There was no association between timing of initial restrictions and geographic location (p=0.14) or severity of inpatient policies (p=1.0), even among centers in the same city. Outpatient policies published reactively (after lockdown) were more restrictive than those published proactively (p=0.04). CCCs enacted strict but strikingly variable COVID-19 visitation restrictions, with important implications for patients/families seeking cancer care. A unified, evidence-based approach to visitation policies is needed to balance proven infection control measures with the needs of patients and families.
影响因子：
8.8
作者：
Poalillo, F. Elizabeth;Geiling, James;Jimenez, Edgar J.
通讯作者：
Jimenez, Edgar J.
影响因子：
37.8
作者：
Fumagalli, S;Boncinelli, L;Marchionni, N
通讯作者：
Marchionni, N