Overcoming adversity: Insights into an acute hospital service of supported viewing for families bereaved during the Covid-19 pandemic

The number of people bereaved due to the Covid-19 pandemic is a major health and social care concern. At a time of unprecedented demand on acute and critical care services, restricted family presence to reduce transmission of the disease had a profound impact on the way bereavement support could be provided in the hospital setting. In response, relatively rapid adaptions to practices were required. This paper provides inspiration and guidance on an acute hospital initiative designed to address the emotional needs of the immediately bereaved. The core features of a supported viewing service are presented through the lens of key employees who played a central role in its development and delivery, and with reference to the prevailing literature. Formal evaluation of the service through qualitative inquiry is recommended, complementary to anecdotal evidence of appreciative uptake of the service during the pandemic.

Analisis Pengaruh Keterlibatan Keluarga terhadap Kinerja Perusahaan di Indonesia

Family businesses have steadily dominated the economy sector in recent decades. A number of scholars have focused on the link between management by family members and firm performance. However, the findings are not conclusive and vary. As a result, a re-examination is necessary. The goal of this research is to determine the possible influences caused by family presence, non-family shareholders, professional president directors, and founder-managed firms on firm performance, as well as the link between family presence and firm performance when family firm reputation is taken into the account. Firm performance was valued by measuring return on asset and equity, sales growth, and tobin’s q. This study examined 600 samples consisting 120 family firms in manufacturing and service sectors on Indonesia’s Stock Exchange beginning with the year 2016 – 2020. To make data analysis more straightforward, panel regression research (time series and cross-sectional data) was conducted utilizing PLS 3.0 software. The study results prove family presence, professional president directors, and founder-managed firms have positive impact on firm performance. Meanwhile, non-family shareholders showed negative impact towards firm performance. Furthermore, the findings of this study also show the favorable impact of family presence on firm performance may be bolstered by family firm reputation.

The Impact of Restrictive Family Presence Policies in Response to COVID-19 on Family Integrated Care in the NICU: A Qualitative Study

Objectives: To conduct a needs assessment with families and their healthcare team to understand the impact of restrictive family presence policies in the neonatal intensive care unit (NICU) in response to COVID-19. Background: In response to the COVID-19 pandemic, significant restrictive family presence policies were instituted in most NICUs globally intended to protect infants, families, and HCPs. However, knowledge on the impact of the stress of the pandemic and policies restricting family presence in the NICU on vulnerable neonates and their families remains limited. Methods: Individuals were eligible to participate if they were a caregiver of an infant requiring NICU care or a healthcare provider (HCP) in the NICU after March 1, 2020. Semi-structured interviews were conducted using a virtual communication platform, and transcripts were analyzed using inductive thematic qualitative content analysis. Results: Twenty-three participants were interviewed (12 families and 11 HCPs). Three themes emerged: (1) successes (family-integrated care, use of technology), (2) challenges (lack of standardized messaging and family engagement, impact on parental wellbeing, institutional barriers, and virtual care), and (3) moving forward (responsive and supportive leadership). Conclusions: Our findings highlight the significant impact of family restrictions on the mental well-being of families, physical closeness with parents, and empathetic stress to HCPs. Further study of potential long-term impact is warranted.

Family Presence During Invasive Procedures. A Pilot Study To Test a Tool

Background: Family presence during invasive procedures (FPDI) generates controversy in healthcare professionals.Objective: Evaluate the FPRB-FPSC tool for invasive procedures and find out the opinions of the medical and nursing staff on FPDI.Method: Descriptive quantitative. Online and paper questionnaire modified from a previous cross-cultural translation. A factor analysis was performed for the validity of the indices and a bivariate analysis for all the variables. Ethical approvals and research permissions were obtained according to national standards.Results: 120 healthcare professionals (22.18%) answered the survey. Cronbach’s α in Family Presence Risk-Benefit scale was 0.877. Cronbach’s α in Family Presence Self-Confidence scale was 0.937. The correlation between the Risk Benefit and Self-confidence variables is significant and with a moderate intensity of the relationship A lower predisposition to Family Presence during Invasive Procedures is observed. Doctors are more reluctant than nurses.Conclusions:The FPDI generates controversy since it alters the routines of health professionals when they decide whether to allow it or not. There is a tendency for younger professionals to support FPDI. In general, health professionals, mainly nurses, are not in favour of FPDI. Health workers who perceive fewer risks and more benefits in FPDI and have greater self-confidence are more in favour of FPDI. The psychometric properties and internal consistency of the questionnaire indicate validity and reliability of this tool.

A Descriptive Study of Chaplains’ Code Blue Responses

Background Family presence during resuscitation is the compassionate practice of allowing a patient’s family to witness treatment for cardiac or respiratory arrest (code blue event) when appropriate. Offering family presence during resuscitation as an interprofessional practice is consistent with patient- and family-centered care. In many institutions, the role of family facilitator is not formalized and may be performed by various staff members. At the large academic institution of this study, the family facilitator is a member of the chaplain staff. Objectives To examine the frequency of family presence during code blue events and describe the role of chaplains as family facilitators. Methods Chaplain staff documented information about their code responses daily from January 2012 through April 2020. They documented their response time, occurrence of patient death, presence of family at the event, and services they provided. A retrospective data review was performed. Results Chaplains responded to 1971 code blue pages during this time frame. Family members were present at 53% of code blue events. Chaplains provided multiple services, including crisis support, compassionate presence, spiritual care, bereavement support, staff debriefing, and prayer with and for patients, families, and staff. Conclusions Family members are frequently present during code blue events. Chaplains are available to respond to all such events and provide a variety of immediate and longitudinal services to patients, families, and members of the health care team. Their experience in crisis management, spiritual care, and bereavement support makes them ideally suited to serve as family facilitators during resuscitation events.

What are the needs and preferences of patients and family members discharged from the emergency department within 24 hours? A qualitative study towards a family-centred approach

ObjectiveThere is an increase in patients being discharged after short stays in the emergency department, but there is limited knowledge of their perspectives on treatment and care. This study aims to explore and understand the needs and preferences of emergency care from the perspective of patients and family members discharged from the emergency department within 24 hours of admission.DesignThe study reports from the first phase in an overall participatory design project. Systematic text condensation was used to identify key themes from field observations and interviews with patients and family members.SettingThis study was conducted in two emergency departments in the Region of Southern Denmark.ParticipantsAll adults aged ≥18 years who had been discharged from the emergency department within 24 hours were eligible to take part. Purposeful sampling was used to recruit patients and family members with different sociodemographic features.ResultsField observational studies (n=50 hours), individual interviews with patients (N=19) and family members (N=3), and joint interviews with patients and family members (N=4) were carried out. Four themes were derived from the material: (1) being in a vulnerable place—having emotional concerns; (2) having a need for person-centred information; (3) the atmosphere in the emergency department and (4) implications of family presence.ConclusionThis study demonstrates a gap between patients’ and family members’ needs and preferences and what current emergency departments deliver. The findings highlight the importance of family and person-centred care. Tailored communication and information with genuine involvement of family members is found to be essential needs during acute illness.

The effect of the family presence on anxiety and agitation of patients under mechanical ventilation after open heart surgery: a randomized clinical trial

Background Family-centered care has been considered as a philosophy of care. Family presence in intensive care units (ICUs), especially in the acute phase of the disease is controversial. This study has been carried out in order to determine the effect of the family presence on anxiety and agitation in patients undergoing coronary artery bypass grafting (CABG). Materials and methods In a clinical trial, 70 patients were randomly allocated into groups of experimental and control. In the experimental group, during the weaning process from the mechanical ventilation, a family member was present at the bedside. The degree of anxiety and Richmond’s Agitation and Sedation Scale (RASS) were compared in seven consecutive time stages, including the time of entry into the ICU, the first respiratory drive, the family entrance, 20 min and 1 h after the presence of the family member, the time of extubation, and 1 h after extubation. Results There was a significant difference between the two groups in the mean scores of the anxiety scale in the first (P =0.008), second (P=0.002), and third stages (P =0.005). This difference was not significant in the fourth to seventh stages (P>0.05). As the baseline anxiety levels were different, a covariate adjustment was used for comparisons between treatments, adjusting the main analyses for baseline anxiety levels. Analysis showed that groups were not different. Also, there was no significant difference in the mean scores of RASS between the two experimental and control groups at any of the seven stages (P> 0.05). Conclusion According to the findings of the present study, the presence of a family member does not reduce the level of anxiety and agitation of patients undergoing cardiac surgery. However, it can be concluded that this intervention is feasible in acute and complex situations after open heart surgeries. Trial registration This study has been registered in the Iranian Registry of Clinical Trials with the code IRCT201609014299N4.