Table 4.
Themes and contents provided by health care personnel (FG2).
| Information and communication |
| About patient’s health status communicated to the family caregivers* |
| • Continuous complete, simple and understandable updates** |
| • Worsening of clinical conditions communicated gradually |
| • Using the same professional for all communications |
| About patient’s discharge |
| • Clarifying rules of thumb about social isolation or quarantine when the patient is discharged and/or one or more family members are positive for COVID-19 |
| About patient’s decease |
| • What care was given to the patient when the condition worsened irremediably |
| • What procedures were used to prepare and preserve the corpse |
| • How many and which family members can attend the last farewell |
| • Reassuring about fears and doubts about loss or exchange of the corpses |
| Practical burden |
| Re-organization and administration in daily living‡ |
| • Difficulty in resuming daily activities once the patient has returned home |
| • Difficulty in retrieving objects the patient may have need that were left in the hospital |
| • Difficulty in obtaining sickness/ hospitalization certificates for the employer |
| Psychological burden |
| Helplessness and sense of isolation |
| • Not having helped or supported the patient enough |
| • Not having controlled or prevented the infection |
| • Sense of social and work isolation |
| Concerns for their own health‡‡ |
| • Anxiety, irritability, hyperactivity, sleep disorders |
| • Disease denial (their own and the patient) |
| Treatment and care coordination |
| Psychological care |
| • Family caregivers have difficulty in receiving remote psychological care |
| Coordination with primary care |
| • Difficulty in maintaining contacts with general practitioners (e.g., ‘As a physician, I would like to interact with patients and families’ general practitioners after discharge. There is a need for structured transfers from hospital to the assistance at home. General practitioners should act as case-managers and coordinate the transitions.’) |
Notes: *The communication with COVID-19 patient family members was managed by a doctor from the ‘Città della Salute e della Scienza di Torino’ University Hospital Health Department as a spokesperson for the ward doctors together with a clinical psychologist. The communication was conducted on the basis of a standardized format compiled by doctors and nurses who care for the patient. This approach was adopted with family members when the patient was hospitalized in COVID-19 or in Semi-intensive wards. When the patient was hospitalized in an Intensive Care Unit or in a Resuscitation ward, the communication was conducted by the anaesthetist, who offered the chance for psychological support when needed or desired. The communication took place by phone or via tablet and the hospital provided the devices for patients who did not have them.
**In particular, overall conditions, presence/absence of pneumonia, use of Continuous Positive Airway Pressure (CPAP) devices, pharmacotherapy, prognosis.
COVID-19 pandemic or worked at home in smart working.
‡‡When one or more family member is positive for COVID-19, some patients were discharged even when still positive themselves. Information on how and when to stop the quarantine were provided by the general practitioner.