Content and communication of inpatient family visitation policies during the COVID-19 pandemic: a sequential mixed methods study.

Autor: Hart, Joanna1,2,3,4 (AUTHOR), Summer, Amy3 (AUTHOR), Yadav, Kuldeep N2,3 (AUTHOR), Peace, Summer3 (AUTHOR), Hong, David3 (AUTHOR), Konu, Michael3 (AUTHOR), Clapp, Justin T2,4,5 (AUTHOR)
Zdroj: Journal of Medical Internet Research. Sep2021, Vol. 23 Issue 9, pN.PAG-N.PAG. 1p. 4 Charts.
Abstrakt: Background: Inpatient health care facilities restricted inpatient visitation due to COVID-19. There is no existing evidence of how they communicated these policies to the public nor the impact of their communication choices on public perception.Objective: To describe patterns of inpatient visitation policies during the initial peak of COVID-19 in the United States and the communication of these policies to the general public, and to identify communication strategies that maximize positive impressions of the facility despite visitation restrictions.Methods: We conducted a sequential exploratory mixed-methods study including a qualitative analysis of COVID-era visitation policies published on facility websites in Pennsylvania captured between April 30 and May 20, 2020 (i.e., during the first peak of COVID-19 in the United States) and 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 policies, we included all inpatient facilities in Pennsylvania. For the factorial experiment, U.S. adults were drawn from an online research panel. 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.Results: We identified 104 unique policies on inpatient visitation from 363 facilities' websites. The policies' mean Flesch-Kincaid Grade Level was 14.2. Most policies prohibited family presence (99, 95.2%). Facilities justified the restricted visitation on the basis of community protection (59, 56.7%), authorities' guidance or regulations (34, 32.7%), or scientific rationale (23, 22.1%). A minority (38, 36.5%) addressed how restrictive visitation may impair family-centered care. Most used passive voice to communicate restrictions. A total of 1321 participants completed the online survey. Visitation policy elements significantly associated with willingness to recommend the facility included justifications promoting community protection (OR 1.44, 95% CI 1.24-1.68) or based on scientific rationale (OR 1.30, 95% CI 1.12-1.51), rather than based on governing authority; the facility expressing a high degree of ownership over the decision (OR 1.16, 95% CI 1.04-1.29); and inclusion of family-centered care support plans (OR 2.80, 95% CI 2.51-3.12).Conclusions: 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.Clinicaltrial: [ABSTRACT FROM AUTHOR]
Databáze: Library, Information Science & Technology Abstracts
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