Background

During the COVID-19 pandemic, visiting restrictions of different extents have been implemented. However, despite the long history of visiting restrictions in health care systems, little is known about their effects.

Objectives

This review sought to explore the consequences of visitor restrictions in health care services during the COVID-19 pandemic.

Methods

A systematic, integrative review was conducted in accordance with the PRISMA guidelines, based on a systematic search in PubMed, CHINAL full plus, Web of Science, PsychInfo, Scopus and the Cochrane Library.

Results

A total of 17 scientific papers covering intensive care, pediatric care, general medical care, hospital care, palliative care and nursing home settings were included. Although appreciation for the technical solutions enabling remote meetings was reported, visiting restrictions had several consequences, mainly negative, for the patient's health, the health and wellbeing of family members and the provision of care. Among physical health consequences, reduced nutrition intake, decreased activities of daily living and increased physical pain and symptoms were reported. Among mental health consequences for the patient, loneliness, depressive symptoms, agitation, aggression, reduced cognitive ability and overall dissatisfaction were observed. For family members, worry, anxiety and uncertainty occurred, and they reported an increased need for information from care providers. Family members of neonatal intensive care unit patients reported less bonding with their child and family relation disturbances due to the restrictions. For care providers, visiting restrictions added the burdens of ethical dilemmas, learning new technical means to enable social interaction and an increased demand for communication with families and providing social support to both family members and patients.

Conclusions

When implementing visiting restrictions in health care services, decision makers and nurses need to be aware of their potential negative effects and adapt the provision of care to compensate for such effects. Nurses in all sectors should be aware that visiting restrictions may affect patients, families, and health care services for longer than the actual pandemic. Since the level of evidence regarding effect from visiting restrictions is low, further studies is strongly needed.

中文翻译：

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COVID-19 大流行期间访问限制的后果：综合审查

背景

在 COVID-19 大流行期间，实施了不同程度的访问限制。然而，尽管医疗保健系统中的探视限制由来已久，但人们对其影响知之甚少。

目标

本综述旨在探讨 COVID-19 大流行期间医疗保健服务中访客限制的后果。

方法

根据 PRISMA 指南，基于 PubMed、CHINAL full plus、Web of Science、PsychInfo、Scopus 和 Cochrane 图书馆的系统搜索，进行了系统的综合评价。

结果

共收录 17 篇科学论文，涵盖重症监护、儿科护理、普通医疗、医院护理、姑息治疗和疗养院环境。尽管有报道称对支持远程会议的技术解决方案表示赞赏，但访问限制对患者的健康、家庭成员的健康和福祉以及提供的护理产生了一些影响，主要是负面的。据报道，在身体健康后果中，营养摄入减少、日常生活活动减少以及身体疼痛和症状增加。在对患者的心理健康后果中，观察到孤独、抑郁症状、激动、攻击性、认知能力下降和整体不满。对于家庭成员来说，担心、焦虑和不确定，他们报告说对护理提供者信息的需求增加。新生儿重症监护病房患者的家庭成员报告说，由于这些限制，他们与孩子的联系和家庭关系障碍较少。对于护理提供者来说，探视限制增加了道德困境的负担，学习了新的技术手段以实现社交互动，增加了与家人沟通的需求，并为家庭成员和患者提供社会支持。

结论

在医疗保健服务中实施探视限制时，决策者和护士需要意识到其潜在的负面影响，并调整提供的护理以弥补这些影响。所有部门的护士都应该意识到，探视限制对患者、家属和医疗保健服务的影响可能比实际大流行更久。由于访问限制影响的证据水平很低，因此强烈需要进一步研究。