Consequences of COVID-19 Visitation Restrictions
The article titled, Consequences of Visiting Restrictions during the COVID-19 Pandemic: An Integrative Review, focused on the effects and outcomes of the patients, family members, friends, and healthcare personnel affected during the restriction of visitation. Throughout the article, it discusses how the restriction of visitation negatively affected the outcomes and overall stability of patients and their families. While the article merely mentions COVID-19-positive patients and the effects of the visitation policy for them, this article focuses on the nationwide restrictions throughout all healthcare organizations. The purpose of this paper is to explore the objective, research methods, and results of the previously mentioned article. After examining this article, one should have a better understanding of how to apply this information to the health assessment process to facilitate better care for the patient populations involved.
Although there have been no true benefits noted from restricting visitation during the pandemic, this article sets out to identify the true risks and benefits of restricting visitation on the transmission of COVID-19 and other communicable diseases. The scarce amounts of studies and articles written are not enough to determine the effectiveness of visitation restrictions. This article does state some positives that came from the decrease in visitation such as, “visitor restrictions during the winter in a pediatric hospital were found to reduce hospital transmission of respiratory viruses (not specifically SARS COv-2) compared with when no restrictions were in place” (Hugelis et al., 2021). Another study reported a significant reduction in healthcare-acquired respiratory viral infections when implementing year-round visiting restrictions (Hugelis et al., 2021). However, there were multiple health consequences reported during the shutdown of visitation, some of which include, an increase in the level of body pain reported, the nutritional status of long-term patients decreased due to reduced oral intake during the visiting-restriction period, increased levels of perceived loneliness, depressive symptoms, agitation and aggression were found among residents in nursing homes during the visiting-restriction period when compared to periods with normal visiting procedures (Hugelis et al., 2021). When families were not able to visit patients, an increased need for information and regular updates from health care professionals on the patients’ conditions was reported (Hugelis et al., 2021). Many of these issues declined the overall progression and will to fight in the patients affected by the nationwide restriction throughout the healthcare facilities. Even with all the negative effects on the physical, mental, and emotional aspects of the visitation restrictions, more evidence is still needed to prove this precaution as ineffective.
The researchers used a systemic integrative review to research the consequences of visiting restrictions during COVID-19. The databases used to search were PubMed, Web of Science, PsychInfo, Scopus, Chinal Plus with full text, and Cochrane Library (Hugelis et al., 2021). The search terms used were “Covid 19”, “visiting restriction”, “SARS Cov 19”, “visitor restriction” and ‘visitor” (Hugelis et al., 2021). The search generated 408 papers from the previously mentioned sources and after the authors removed duplicate articles, 296 were left to sort through (Hugelis et al., 2021). The authors developed criteria for eligibility to narrow down the list of articles to 17. The criteria involved the following: reporting of visitor or family restrictions at hospitals or other facilities during the COVID-19 pandemic, full-text articles published in English, using qualitative, quantitative, or mixed design methods or a published case report, and presenting from a patient and family member or caring perspective (Hugelis et al., 2021). The papers were then assessed for quality of information and given a rating of moderate quality or low quality (Hugelis et al., 2021). Studies with rigorous and adequate reporting were assessed as moderate quality. The other studies were assigned low quality status due to the limited scientific publications on the subject and the ongoing pandemic (Hugelis et al., 2021). The authors analyzed the articles for themes and subthemes based on the results and conclusions of each study. This process was completed first as individuals and then as a group discussion (Hugelis et al., 2021). The results were reflected with regard to previous studies and the nursing practice in general (Hugelis et al., 2021).
Research findings were based on several different areas of patient care from palliative end-of- life care, nursing homes, hospital care, ICU, Neonatal ICU and care providers. Visitation restrictions during Covid-19 had negative impacts not only on the patient, but also on family members, care providers, and relationships within the family (Hugelis, et al., 2021). The overall family dynamics were affected due to social distancing which made it difficult to provide mental and physical support. The impact was significant on the end-of-life patients who were dying without family by their side, which caused prolonged distress and grief (Hugelis, et al., 2021). Visitation restrictions created a heavy burden for care providers as communication with family members increased tremendously as the patient’s family wanted to check on their loved ones whom they couldn’t visit. Patients were dying with care providers by their side instead of family members. Care providers were filling the void and trying to bridge the gap between patient and family (Hugelis, et al., 2021). Psychological burdens and mental health problems as well moral injury, which caused guilt with some care providers leading to burning out. In regards to Neonatal ICU, the absence of even one parent from the bedside could have effects on the development of the child. Similarly patients in ICU had no family at their bedside. Research has shown having family members at the bedside of patients in ICU, motivates the patient to stay alive. (Hugelis, et al., 2021)
In order to understand the effects of Covid-19 in regards to visitations, it is important to know the type of health setting of the patient at the time this occurred, as this can facilitate the health assessment process. The article enhances the reader’s understanding of how patients, family members, and providers experienced new standards of care. With the increase in technology and the decrease in visitors, providers were able to keep family members informed from afar, while filling the role of support person to the patients. The COVID-19 pandemic called for an improved psychosocial assessment (Hugelis et al., 2021). By knowing the age and location of the patient at the time of visitation restrictions, this will be an important foundation for the assessment in relation to physical and psychosocial issues. (Hugelis, et al., 2021).
References
Hugelis, K., Harada, N., & Marutani, M. (2021). Consequences of visiting restrictions during the COVID-19 pandemic: An integrative review. International Journal of Nursing Studies, 121, 1-10. https://doi.org/10.1016/j.ijnurstu.2021.104000
