Abstract
BACKGROUND: Preventing post-traumatic stress disorder (PTSD) symptoms in family members of intensive care unit (ICU) patients underscores the importance of patient-family interactions. The COVID-19 pandemic restricted direct visits, prompting video calls as an alternative. AIM: To examine the association between video calls and the development of PTSD symptoms in family members of patients admitted to a COVID-19 ICU. STUDY DESIGN: This mixed-methods study was conducted at a single facility in Tokyo. Video calls were introduced in August 2020 and were used based on family preferences. Using quantitative data obtained from a questionnaire postal survey and the qualitative analysis of free-text responses, family members of severe COVID-19 ICU patients from July 2020 to June 2022 completed self-administered questionnaires, including the Impact of Event Scale-Revised (IES-R) and open-ended questions regarding the patient's ICU stay. Multivariate logistic regression analysis assessed the association between video calls and PTSD symptoms (IES-R > 24). Free-text responses were analysed using text mining techniques. RESULTS: Out of the 97 eligible families, 68 participated. Video calls were not significantly associated with a reduction in PTSD symptoms. Among those who experienced video calls, text analysis showed that participants with PTSD symptoms more frequently used words related to "doctors," whereas those without symptoms more often mentioned "nurses." CONCLUSION: Video calls did not significantly reduce PTSD symptoms in family members of ICU patients with severe COVID-19. However, the presence of bedside nurses during video calls may help foster a sense of connection and support. RELEVANCE TO CLINICAL PRACTICE: When implementing video calls (i.e., virtual visitation), active involvement and compassionate presence of bedside nurses may enhance the emotional quality of communication. Structured approaches that support nurse-family interaction may contribute to better psychological outcomes for families.