Figure 1.

Descriptive model of family stress and support derived from qualitative interviews. Family members of intensive care unit patients with COVID-19 experienced substantial stress from a variety of factors, particularly ruminating around feeling isolated (center circle) owing to lack of physical touch, guilt, and decisional conflict, and feeling unable to appropriately advocate for loved ones. These factors led to stress (red box), which was also exacerbated by clinician factors (blue box on left), including the fractured therapeutic relationship from physical distancing. Pandemic factors (blue box on right) also contributed to the stress, such as societal discourse about the pandemic. That said, there were also clinician factors that supported the family (green box), and these included the 3Cs and videoconferencing. Pandemic factors, such as the dialogue and gratitude around the healthcare workers’ sacrifice, also contributed positively and supported families’ experiences. 3Cs = contact, consistency, and compassion; COVID-19 = coronavirus.