Reflections and Practical Insights on Communication and Care for Patients and Families in Japanese Intensive Care Units During COVID-19: A Semi-structured Interview Study of Healthcare Providers

Abstract

This study explored challenges experienced by healthcare providers (HCPs) in intensive care units (ICUs) during the COVID-19 pandemic, focusing specifically on communication and care interactions, and examined how these experiences impacted ICU practices and provided opportunities for improvements. Semi-structured interviews were conducted with 16 ICU physicians and nurses from October 2022 to March 2023. Interview data were analyzed through thematic analysis. Nine themes emerged, categorized into three key areas. (1) “Challenges and Adaptations Experienced by HCPs” described how stringent infection-control measures created emotional and practical difficulties, prompting adaptive strategies to maintain effective care. The pandemic reinforced the critical role of interdisciplinary cooperation; in response, an interdisciplinary conference was organized, and HCPs intentionally sought closer collaboration than was usual to ensure coordinated decision-making and the continuity of care. (2) “Interactions Among Patients, Families, and HCPs” emphasized that visitation restrictions impaired family involvement, although proactive measures by nurses, such as the introduction of remote visits, significantly facilitated family engagement and emotional support. (3) “Lessons Learned from the Pandemic” highlighted improved healthcare practices and reinforced the value of interdisciplinary collaboration and family-centered approaches in ICU care. The findings underscore the necessity of robust communication practices and interdisciplinary teamwork within ICUs. These pandemic-related experiences offer valuable insights for improving communication, supporting flexible visitation policies, and promoting patient- and family-centered approaches. Collectively, these lessons offer essential guidance for developing more resilient and compassionate ICU care strategies, applicable in future crises and in everyday practice.