Ethical considerations related to virtual visiting for families and critically ill patients in intensive care: a qualitative descriptive study.

IF 3 1区 哲学 Q1 ETHICS
Kirsty Clarke, Karen Borges, Sultan Hatab, Lauren Richardson, Jessica Taylor, Robyn Evans, Bethany Chung, Harriet Cleverdon, Andreas Xyrichis, Amelia Cook, Joel Meyer, Louise Rose
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Abstract

Background: During the COVID-19 pandemic, virtual visiting technologies were rapidly integrated into the care offered by intensive care units (ICUs) in the UK and across the globe. Today, these technologies offer a necessary adjunct to in-person visits for those with ICU access limited by geography, work/caregiving commitments, or frailty. However, few empirical studies explore the ethical issues associated with virtual visiting. This study aimed to explore the anticipated or unanticipated ethical issues raised by using virtual visiting in the ICU, such that healthcare professionals can be informed about how to carry out virtual visits ethically, safely and productively.

Methods: We used a descriptive exploratory qualitative research approach recruiting a convenience sample of newly-graduated junior doctors facilitating ICU virtual visits in a tertiary academic centre. Eight newly graduated junior doctors, seven female and one male, aged 23-27, participated in semi-structured interviews. We analysed transcripts using an inductive coding approach.

Results: Five overarching themes emerged. Two of the themes namely, 'fulfilling a moral instinct to connect families' and 'promoting autonomy', arose from participants' descriptions of how virtual visits aligned with healthcare standards and practices they considered ethical. Three further themes, 'preserving dignity and privacy', 'managing emotional distress', and 'providing equitable access' to virtual visiting technologies, highlight how virtual visits might exacerbate ethical issues related to family communications.

Conclusion: Virtual visiting may potentially both ameliorate and exacerbate aspects of ethical healthcare delivery for ICU patients and family members. ICU team members should consider unique ethical considerations related to using virtual visiting. We recommend virtual communications skills training for staff and advocate for the use of easily accessible educational resources for families who wish to visit critically unwell patients remotely.

为重症监护室的家属和重症患者提供虚拟探视的伦理考虑:一项定性描述性研究。
背景:在 COVID-19 大流行期间,虚拟探视技术迅速融入英国和全球重症监护病房 (ICU) 的护理工作中。如今,这些技术为那些因地理位置、工作/护理承诺或体弱而无法进入重症监护室的患者提供了亲自探视的必要辅助手段。然而,很少有实证研究探讨与虚拟探视相关的伦理问题。本研究旨在探讨在重症监护室使用虚拟探视所引发的预期或未预期的伦理问题,从而让医护人员了解如何以合乎伦理、安全和富有成效的方式进行虚拟探视:我们采用了一种描述性的探索性定性研究方法,在一个三级学术中心招募了一批方便抽样的新毕业的初级医生,为 ICU 虚拟探视提供便利。八名新毕业的初级医生(七女一男,年龄在 23-27 岁之间)参加了半结构化访谈。我们采用归纳编码法对访谈记录进行了分析:结果:我们发现了五个重要主题。其中两个主题,即 "实现连接家庭的道德本能 "和 "促进自主性",来自参与者对虚拟访问如何与他们认为合乎道德的医疗标准和实践相一致的描述。另外三个主题,即 "维护尊严和隐私"、"管理情绪困扰 "和 "提供公平使用虚拟探视技术的机会",强调了虚拟探视可能会如何加剧与家庭沟通相关的伦理问题:虚拟探视可能会改善和加剧为重症监护病房患者和家属提供医疗服务的伦理问题。ICU 团队成员应考虑与使用虚拟探视相关的独特伦理因素。我们建议对工作人员进行虚拟交流技能培训,并提倡为希望远程探视危重病人的家属提供易于获取的教育资源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Medical Ethics
BMC Medical Ethics MEDICAL ETHICS-
CiteScore
5.20
自引率
7.40%
发文量
108
审稿时长
>12 weeks
期刊介绍: BMC Medical Ethics is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies.
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