Family presence during patient acute deterioration: A survey of nurses' attitudes and reflection on COVID-19 in an African setting

患者病情急性恶化期间家属的陪伴:一项关于非洲地区护士对 COVID-19 的态度和反思的调查

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Abstract

INTRODUCTION: Acute deterioration refers to a patient who has become physiologically unstable requiring acute care. Family presence during resuscitation efforts has been widely supported by literature. Nurses are often the primary contact for the families of patients in the emergency centre, playing an important role in facilitating family presence during acute care. To describe nurses' attitudes regarding family presence during the management of acutely deteriorating patients in the emergency centre. METHODS: A descriptive quantitative study was conducted in the emergency centres of three public hospitals in the Eastern Cape, South Africa. A total sample of professional nurses (n = 57) were recruited, to complete the Emergency Department Family Presence (EDFP) survey. Statements about the negative effects of family presence during acute care of a deteriorating patient were presented and respondents were required to agree or disagree. Data were analysed using univariable and multivariable logistic regression. RESULTS: The majority of the nurses agreed with the items in the EDFP survey agreeing that present relatives may misinterpret activities of health care professionals (92.8%) which can result in complaints about the quality of care (91.1%). Nurses with more years of experience (11-21 years) were more likely to disagree with the statements on family presence having negative effects on patient care than nurses with fewer years of experience (0-10 years) (OR:6.92; 95%CI: 1.29-37.28). DISCUSSION: Nurses have the perception that family presence has a largely negative effect on patients, patient care and the families present during acute care. The contextual application of the practice of family presence during acute deterioration in an African setting needs investigation and the need for continued professional education on family centred care is emphasised. Alternative methods of facilitating family presence during the COVID-19 Pandemic must be considered as we advocate for the self determination of families and patients.

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