Abstract
Purpose
To investigate possible psychological distress among staff after partial liberalization of visiting policies in intensive care units (ICUs).
Methods
We surveyed eight Italian ICUs planning to increase daily visiting to at least 8 h. Participants completed the Maslach–Jackson Burnout Inventory and the State-Trait Anxiety Inventory before policy change (T0), after 6 months (T1) and 12 months (T2). At T0 and T2, their opinions on the new policy were solicited. Analyses were adjusted for main known confounders (age, gender, centre, educational and marital status, experience in ICU, baseline level of burnout or anxiety, and mortality rate).
Results
Baseline response rate was 89 % (230/258); 198 subjects (77 %) responded at T0 and T2, whereas 184 (71 %) participated in all three phases. High burnout levels were identified in 34.5 % of participants at T0 and 42.6 % at T2 (adjusted p = 0.001). All three phases showed a predominance of high burnout among nurses (adjusted p = 0.002). State and trait anxiety scores remained stable (adjusted p = 0.100 and 0.288, respectively). Most participants viewed the change positively at T0 (doctors 81.7 %; nurses 67.7 %) and T2 (doctors 87.0 %; nurses 62.7 %). At T2, 129 participants made comments (180 positive, 136 negative). Subjects with high burnout were more likely to comment negatively (p = 0.011).
Conclusions
Partial liberalization of ICU visiting policies was associated over the course of a year with a small but significant increase in staff members’ burnout levels. Nonetheless, doctors and nurses viewed the policy positively, maintaining this opinion after 1 year. Negative views were strongly correlated with burnout.
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Acknowledgments
We thank all doctors and nurses of surveyed ICUs for their cooperation in this study. This study was supported by ABN (Associazione per il Bambino Nefropatico, Milan, Italy) and by Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico (Milan, Italy)
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Members of ODIN (Open Doors in INtensive care) Study Group are listed in the Appendix.
Appendix: Members of ODIN (Open Doors in INtensive care) Study Group
Appendix: Members of ODIN (Open Doors in INtensive care) Study Group
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Massimo Audisio (Intensive Care Unit, Ospedale di Ciriè, Ciriè, Italy)
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Antonino Bencivinni (Intensive Care Unit, Ospedale Nuovo del Mugello, Borgo San Lorenzo, Italy)
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Emanuela Biagioni (Intensive Care Unit, Azienda Ospedaliera Universitaria di Modena, Modena, Italy)
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Enzo Castenetto (Intensive Care Unit, Ospedale Civico, Chivasso, Italy)
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Ignazia Laganà (Pediatric Intensive Care Unit, Azienda Ospedaliera “G. Salesi”, Ancona, Italy)
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Roberto Oggioni (Intensive Care Unit, Ospedale Nuovo del Mugello, Borgo San Lorenzo, Italy)
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Virginia Porta (Intensive Care Unit, Ospedale Civile, Legnano, Italy)
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Rosa Salcuni (Intensive Care Unit, Ospedale di Ivrea, Ivrea, Italy)
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Armando Sarti (Intensive Care Unit, Ospedale S. Maria Nuova, Florence, Italy)
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Maria Grazia Visconti (Intensive Care Unit, Ospedale “A. Uboldo”, Cernusco sul Naviglio, Italy)
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Giannini, A., Miccinesi, G., Prandi, E. et al. Partial liberalization of visiting policies and ICU staff: a before-and-after study. Intensive Care Med 39, 2180–2187 (2013). https://doi.org/10.1007/s00134-013-3087-5
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DOI: https://doi.org/10.1007/s00134-013-3087-5