How to communicate with families living in complete isolation

Giovanni Mistraletti, Giuseppe Gristina, Sara Mascarin, Emanuele Iacobone, Ilaria Giubbilo, Silvia Bonfanti, Federico Fiocca, Giorgio Fullin, Ennio Fuselli, Maria Grazia Bocci, Davide Mazzon, Gian Domenico Giusti, Alessandro Galazzi, Alessandra Negro, Fabio De Iaco, Enrico Gandolfo, Giulia Lamiani, Silvia Del Negro, Laura Monti, Fabrizia SalvagoSilvia Di Leo, Maria Nefeli Gribaudi, Mariassunta Piccinni, Luigi Riccioni, Alberto Giannini, Sergio Livigni, Carla Maglione, Marco Vergano, Franco Marinangeli, Luisa Lovato, Andrea Mezzetti, Elio Drigo, Elena Vegni, Sally Calva, Anna Aprile, Gianfranco Losi, Lucia Fontanella, Giulio Calegari, Cristina Ansaloni, Francesco Rocco Pugliese, Salvatore Manca, Luciano Orsi, Fabrizio Moggia, Silvia Scelsi, Antonio Corcione, Flavia Petrini

Research output: Contribution to journalArticlepeer-review

Abstract

IMPORTANCE: During the SARS-CoV-2 pandemic, a complete physical isolation has been worldwide introduced. The impossibility of visiting their loved ones during the hospital stay causes additional distress for families: in addition to the worries about clinical recovery, they may feel exclusion and powerlessness, anxiety, depression, mistrust in the care team and post-traumatic stress disorder. The impossibility of conducting the daily meetings with families poses a challenge for healthcare professionals.

OBJECTIVE: This paper aims to delineate and share consensus statements in order to enable healthcare team to provide by telephone or video calls an optimal level of communication with patient's relatives under circumstances of complete isolation.

EVIDENCE REVIEW: PubMed, Cochrane Database of Systematic Reviews, Database of Abstracts and Reviews of Effectiveness and the AHCPR Clinical Guidelines and Evidence Reports were explored from 1999 to 2019. Exclusion criteria were: poor or absent relevance regarding the aim of the consensus statements, studies prior to 1999, non-English language. Since the present pandemic context is completely new, unexpected and unexplored, there are not randomised controlled trials regarding clinical communication in a setting of complete isolation. Thus, a multiprofessional taskforce of physicians, nurses, psychologists and legal experts, together with some family members and former intensive care unit patients was established by four Italian national scientific societies. Using an e-Delphi methodology, general and specific questions were posed, relevant topics were argumented, until arriving to delineate position statements and practical checklist, which were set and evaluated through an evidence-based consensus procedure.

FINDINGS: Ten statements and two practical checklists for phone or video calls were drafted and evaluated; they are related to who, when, why and how family members must be given clinical information under circumstances of complete isolation.

CONCLUSIONS AND RELEVANCE: The statements and the checklists offer a structured methodology in order to ensure a good-quality communication between healthcare team and family members even in isolation, confirming that time dedicated to communication has to be intended as a time of care.

Original languageEnglish
JournalBMJ supportive & palliative care
DOIs
Publication statusE-pub ahead of print - Oct 15 2020

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