Family Visitors Research Articles

Perspectives of Families and Healthcare Staff on the Design of Inpatient Hospital Rooms in Saudi Arabia.

Aim: This study aims to explore the relationship between the perspectives of both family members and healthcare staff regarding the design of hospital inpatient rooms. It investigates the impact of family presence on the healing environment and examines the influence of specific design elements within inpatient rooms on the extent of family presence. Background: The positive impact of family presence in healthcare settings is rooted in the notion that patients and their families are significant stakeholders in the care process. However, little is known about the influence of inpatient room design elements on family presence in healthcare settings in the Middle East. Methods: A questionnaire survey was conducted among 359 participants, encompassing patients, family visitors, and healthcare professionals from three hospitals in Saudi Arabia. The questionnaire items sought insights into the influence of design elements within inpatient rooms on family presence and the overall healing environment. Results: The results indicate a strong preference for single-patient rooms (74.5%), natural light (77.6%), comfortable seating (85.8%), and a family zone positioned by the window for unobstructed views of nature (50.5%). Furthermore, the study reveals that family presence is perceived to have positive effects on the healing environment (84.0%), patient safety (81.3%), and satisfaction with the care process (88.0%). Conclusion: This study proposes a design model for inpatient rooms that can effectively cater to the needs of patients and their families, thereby contributing to the overall improvement of healthcare building design.

Assessing infection prevention and control programs in residential aged care in Australia: A multi-methods cross-sectional study.

To assess infection prevention and control programs in residential aged care facilities. A cross-sectional survey and structured interviews from 10 residential aged care facilities in Victoria, Australia, were used. Infection prevention and control nurse leads from each facility completed a purpose-built survey based on best practice infection prevention control program core components, including staff training, policies and procedures, governance, and surveillance. Follow-up interviews with residential aged care staff, residents and family visitors were carried out to elaborate and verify survey data. Surveys from all 10 facilities were received and 75 interviews carried out. All facilities had an infection prevention and control lead nurse who had undergone additional training, and 60% of facilities had an infection prevention and control lead position description. All facilities had a committee to oversee their infection prevention and control program, and all had policies and procedures for standard and transmission-based precautions. One facility did not have a policy on healthcare-associated infection surveillance, and two facilities did not have an antimicrobial stewardship policy. All facilities provided staff training in hand hygiene and personal protective equipment use, but not all routinely assessed competency in these. The residential aged care facilities' infection prevention and control programs were generally in a strong position, although there were some areas that require improvement. Further assessment of the quality of infection prevention and control program components, such as content of education and training, and policies and procedures, and ongoing evaluation of programs is recommended. Geriatr Gerontol Int 2024; 24: 358-363.

인터랙티브 요소가 뮤지엄의 관람객 유치에 미치는 영향

With the growing application of interactive elements in the cultural and artistic field, researchers have begun to pay attention to how these elements are impacting the production, distribution, and consumption stages with a focus on their role in museums. Our study examines how the introduction of these elements in these institutions, which play a crucial role in the culture and arts ecosystem. We collected data from 1,563 museums from around the world through an online platform called Tripadvisor, using a web crawling method. We used regression analysis models to examine the effect of interactive elements, such as audio guides, on attracting visitors to museums. We also analyzed the data to find out its impact on different types of visitors, like families, couples, friends, and individuals. The results of our study show that museums with interactive elements are more popular among family visitors. This study provides valuable insights into the impact of interactive elements on the cultural and artistic field by complementing findings of qualitative research, which has to date prevailed research on this topic.

Thematic analysis of intensive care unit diaries kept by staff: insights for caring

ObjectiveTo explore recurrent themes in diaries kept by intensive care unit (ICU) staff during the coronavirus disease 2019 (COVID-19) pandemic. DesignQualitative study. SettingTwo ICUs in a tertiary level hospital (Milan, Italy) from January to December 2021. MethodsICU staff members wrote a digital diary while caring for adult patients hospitalized in the intensive care unit for >48 hours. A thematic analysis was performed. FindingsDiary entries described what happened and expressed emotions. Thematic analysis of 518 entries gleaned from 48 diaries identified four themes (plus ten subthemes): Presenting (Places and people; Diary project), Intensive Care Unit Stay (Clinical events; What the patient does; Patient support), Outside the Hospital (Family and topical events; The weather), Feelings and Thoughts (Encouragement and wishes; Farewell; Considerations). ConclusionThe themes were similar to published findings. They offer insight into care in an intensive care unit during a pandemic, with scarce resources and no family visitors permitted, reflecting on the patient as a person and on daily care. The staff wrote farewell entries to dying patients even though no one would read them. Implications for clinical practiceThe implementation of digital diaries kept by intensive care unit staff is feasible even during the COVID-19 pandemic. Diaries kept by staff can provide a tool to humanize critical care. Staff can improve their work by reflecting on diary records.

The beliefs and attitudes of intensive care unit nurses and patient families regarding an open visitation policy in China.

To investigate the beliefs and attitudes of intensive care unit (ICU) nurses and patients' family members towards an open visitation policy in the ICU in China and to explore the reasons that promote or hinder open visitation to improve visitation policy. Open visitation policies are widely recommended in many countries. However, there are gaps between evidence and practice. Most ICUs in China still use a restrictive policy for family visits, which raises controversy. There are limited visiting times, and family visitors are not allowed to enter the ICU. A multicentre survey was conducted in seven hospitals in China. The Beliefs and Attitudes towards Visitation in the Intensive Care Unit Questionnaire (BAVIQ) was administered to ICU nurses and patient families from 11 the ICUs of seven hospitals. A total of 275 questionnaires were completed and returned by ICU nurses and 139 by patients' family members. Among nurses, the belief scale score was 2.87 ± 0.33 (range 2-4), and the attitude scale score was 5.53 ± 1.12 (range 2.33-7). The belief scale was divided into three subscales: nurses, patients, and patients' families. The subscale score for patients' families was the highest, and the nurses' subscale score was the lowest. Most (84.0%) of the nurses were satisfied with the current ICU visitation policy. The belief and attitude scores were 3.13 ± 0.39 (range 1.96-4) and 6.18 ± 1.20 (range 1.67-7), respectively, for family members. The scores of the three subscales, that is, patients, patients' families and nurses, were 3.13 ± 0.40, 3.26 ± 0.43, and 3.04 ± 0.49, respectively. Nurses' beliefs and attitudes towards implementing an open visitation policy in China are at a less positive level than those of patient family members. The beliefs and attitudes of nurses towards open visitation policy in China need to be improved. The question of how to mobilize nurses' enthusiasm for an open visitation policy poses a challenge for ICU management.

Visitors not Welcome: Hospital Visitation Restrictions and Institutional Betrayal

Healthcare organizations’ continued restrictions on hospital visitation during the COVID-19 pandemic can be considered a violation of the rights of hospitalized patients to receive family visitors. Despite expert opinion related to the safety of visitation and low risk of visitor transmission with appropriate monitoring and precautions, hospital visitation restrictions have continued beyond the initial crisis phase of the pandemic, with little transparency or inclusion of key stakeholders in the decision-making process. Particularly on critical care units, blocking access to family visitors can contribute to additional harm and trauma for care-dependent hospitalized patients and their families. Utilizing an institutional betrayal framework, the aim of this commentary on hospital ICU visitation policy is to provide a discussion of how hospitals who serve a care-dependent population have placed critically ill patients, families, and healthcare workers at risk for complex trauma. Hospital social workers should incorporate an integrated social work approach to advocacy efforts which address not only individual hospitalized patient service needs, but also the uneven power differential that can contribute to inequity in visitation, medical mistrust, and long-term community trauma. On the interprofessional ICU team, social workers can function as trauma informed systems experts, coordinating and facilitating supports to help patients and families cope with hospitalization, while also advocating within their institution and with elected officials for policy change to protect patient and family–centered visitation rights.

Development of a Smoke-Free Home Intervention for Families of Babies Admitted to Neonatal Intensive Care.

Neonatal intensive care units (NICUs) have a disproportionately higher number of parents who smoke tobacco compared to the general population. A baby’s NICU admission offers a unique time to prompt behaviour change, and to emphasise the dangerous health risks of environmental tobacco smoke exposure to vulnerable infants. We sought to explore the views of mothers, fathers, wider family members, and healthcare professionals to develop an intervention to promote smoke-free homes, delivered on NICU. This article reports findings of a qualitative interview and focus group study with parents whose infants were in NICU (n = 42) and NICU healthcare professionals (n = 23). Thematic analysis was conducted to deductively explore aspects of intervention development including initiation, timing, components and delivery. Analysis of inductively occurring themes was also undertaken. Findings demonstrated that both parents and healthcare professionals supported the need for intervention. They felt it should be positioned around the promotion of smoke-free homes, but to achieve that end goal might incorporate direct cessation support during the NICU stay, support to stay smoke free (relapse prevention), and support and guidance for discussing smoking with family and household visitors. Qualitative analysis mapped well to an intervention based around the ‘3As’ approach (ask, advise, act). This informed a logic model and intervention pathway.

Liminal spaces and the shaping of family museum visits: a spatial ethnography of a major international art museum

ABSTRACT Museum managers face mounting pressures to increase and widen audiences, with families often perceived as a key audience requiring particular forms of engagement. The article utilises spatial ethnographic research at a major international art museum (Tate Modern) to examine how family museum practices relate to museum spatial design. Liminal spaces were found to be vital in shaping the experiences of family visitors by affording opportunies for more banal practices (such as playing, sitting, talking, eating and resting). Although they may be partially supported by collection displays, liminal spaces do not usually feature in museum management agendas. As the social purpose of museums continues to be debated, the paper argues for a greater understanding of the full range of affordances of museums for families, paying attention to the significance of different types of museum spaces in mediating experience and the importance of optimising those spaces for greater access.

Validation of a Measure of Loneliness for Homebound Older Adults

The pandemic has disproportionately impacted older adults, highlighting the need to address social isolation for this population. Homebound older adults are at risk for loneliness, which is a correlate of poor mental and physical health. COVID-19 has exacerbated effects of social isolation by limiting contact with family and other visitors. In-depth empirical validation of loneliness scales is needed to examine the measurement of this construct for homebound older adults who are aging in place. This study examined the reliability and validity of the UCLA Loneliness Scale (v3) for a community-dwelling population of older adults who received home-based support services due to their homebound status or have chronic illness resulting in ADL limitations. Using in-home interviews, data were collected for 175 older adults using the UCLA Loneliness Scale. Reliability and confirmatory factor analyses were conducted to examine its psychometric properties. Findings demonstrated the scale had good internal consistency reliability (ɑ = 0.91). Confirmatory factor analyses indicated a two-factor solution, 1) disconnectedness and 2) connectedness, accounting for 92% of the variability in the 20 items. The lack of meaningful relationships (ƛ = 0.73, p < 0.05) or having someone to turn to (ƛ = 0.68, p < 0.05) substantively contributed to disconnectedness. Feeling that there were people to talk to (ƛ = 0.67, p < 0.05) and turn to (ƛ = 0.76, p < 0.05) contributed to connectedness. Future research can further examine how quality of relationships and benefits of being connected to others can address loneliness and isolation for this population.

Reflection and Improvement on Museum's Educational Activities for Family Visitors

Reflection and Improvement on Museum's Educational Activities for Family Visitors

Fostering inclusion in art museums through mobile digital content

This paper deals with digitally mediated museum experiences of novice visitors at the Kunsthistorisches Museum in Vienna and discusses them in the context of museum inclusion. Research participants included families with young children and members of minority communities in Vienna whose visit was facilitated by two app-based guided tours developed for children. The research goal was to explore the impact of the mobile guide’s digital content and modes of communication on the visitors’ interaction with the guide, with the museum space and objects, and with family members. The families’ interactions were observed, recorded and analyzed. The results suggest that carefully considered and created content on mobile guides has the potential to provide novice family visitors with experiences that support their independence and active engagement, create opportunities for mutual facilitation, and support their different identities, all of which have been considered as conducive to inclusion.

“When you are working in this environment, you’re more likely to get sick”: Mapping Care Relationships in LTC

The pandemic has shone a light on problems within the long-term care (LTC) sector. As was true prior to COVID-19, many of the present issues in LTC can be traced to challenging working conditions, such as persistent understaffing of care workers. Working short-staffed means rushing through care, while only satisfying the most basic bodily needs of the resident. This presentation shares early findings from a thematic analysis of interviews conducted with seven care workers as part of the “Mapping Care Relationships” stream of the Seniors –Adding Life to Years (SALTY) project, a pan-Canadian research program that maps how promising approaches to care relationships are organized and experienced in LTC. The purpose of the analysis was to understand how short-staffing is affecting the formation and preservation of meaningful staff-resident relations, and what the impact is on quality of care. Two overarching themes emerged: 1) a relationship between time and work-place illness, injury and violence; 2) a relationship between care worker autonomy and resident quality of care. When working conditions do not support workers in voicing and/or addressing challenges they experience in the workplace, whether this results from understaffing or hierarchical power structures, care workers’ ability to deliver even basic care is jeopardized, and resident and worker health and wellness are placed at risk. Themes are discussed in the context of COVID-19 in light of responses to outbreaks in LTC that have reduced the availability of care workers, family visitors and volunteers, and emphasized top-down and even militarized approaches to care management.

Getty Museum Family Room – Educational Issues on Scaffolding and Transfer of Learning

AbstractIn order better to support children’s learning experiences, art museums have begun to establish interactive art exhibitions designed for family visitors. However, as more of these interactive exhibitions are established, some museum professionals are raising concerns about whether these exhibitions actually facilitate young visitors’ learning or impede them from engaging further with the art objects exhibited. Using the Family Room (FR) of the J. Paul Getty Museum in Los Angles as a case study, this research examines the educational principles considered and the challenges encountered when conceptualising and implementing its interactive exhibition. My research shows that the FR project team emphasised three educational principles to be integrated into the exhibition design: (1) interactive learning, (2) family as a learning unit, and (3) enhance the learning of basic artistic elements. The FR’s overarching educational objective is to encourage transfer of learning between the FR to the Getty traditional art galleries. My research concludes with three suggestions to be considered in future practices of art museum education (1) the limits and potentials of interactives, (2) the interactive exhibition design and scaffolding, and (3) transfer of learning between galleries.

Urban family ties and household latrines in rural India: A cross-sectional analysis of national data.

Access to toilets and latrines represents both a development indicator and a significant factor in child mortality and physical development. The lack of latrines in rural India therefore constitutes a major global health challenge. Given the urban-rural gap in latrine ownership across India, I investigated how family ties to major cities, which extend beyond the local community affected by neighbors’ defecation practices, shaped latrine ownership in rural India. Using the national Rural Economic & Demographic Survey 2006 (n = 7,949), I analyzed the geographies of family ties, types of exchange and rural latrine ownership. Receiving family visits from major cities increased the likelihood of having a latrine (33% higher odds). The relationship between family visitors from major cities and rural latrine ownership was stronger for wealthier households (.031 increase in average marginal effect of urban visitors for a .5 standard deviation increase in household assets at the mean). Material support from family also increased the likelihood of latrine ownership (7.8% higher odds for each additional $200USD) suggesting that family members not living in major cities may still contribute necessary resources. The importance of personalized connections beyond the village, particularly to major cities, suggests that linking geographically disparate sanitation interventions may produce synergies.

Examining Students' Gains in Natural History Museum Science Content Knowledge with Access to Signed Vocabulary

With findings from a study conducted at the Museum of Science, Boston showed how family and school visitors used signing dictionaries in situations that involve physical interaction with phenomena. Research described in this article extended this study to an examination of how school visitors who are deaf or hard of hearing use the dictionaries in a setting, in which interactions with the phenomena are primarily observational. This additional research was conducted by TERC at the Harvard Museum of Natural History (HMNH). Its purpose was to examine the degree to which use of a Signing Science Pictionary and a Signing Science Dictionary results in gains in knowledge of the science content incorporated into exhibits focusing on Arthropods. The study involved 20 grade 1-6 students from a school for the deaf. They were divided into a treatment and a control group. The mixed methods design incorporated a protocol that involved a pre-test, a treatment group that used the dictionaries and a control group did not, and a post-test. Results from the pre- and post-test scores show that both groups, on average, demonstrated some gain in content knowledge. They also show that gains were similar for the treatment group and control group. Students' perceptions that they learned something support these findings. This first-of-its kind study confirmed how challenging it is to measure how the dictionaries enhance content learning beyond vocabulary learning. It also showed that additional research is needed to demonstrate impacts of the signing dictionaries on informal learning for this population.

Prison Staff and Family Visits: United Kingdom Case Study

Recent studies have illuminated how families are affected by prison staff engagement during prison visits. Prison staff, by virtue of their positions, exercise power and authority over families during prison visits processes and potentially play a vital role in shaping inmate-family experiences. Although some interactions with prison staff may be cordial, others have been reported as stressful for visitors, especially families with children. Yet many family visitors endure stressful encounters since visits can serve as portals for bonding between inmates and their families. Over the past two decades, some prisons in the United Kingdom (UK) have invested in developing family-oriented practices and visits protocol, where prison staff oversee the visits process. This is in contrast to prison staff who tend to take on a police-officer mentality whereby policing behaviors or personal philosophies are aligned with implied suspicion, mistrust, and apprehension towards inmates and families. Given such, prison staff interpretation of their roles and engagement with families is of research interest. The purpose of this qualitative multiple case study was to understand how UK prison staff interpreted their roles during family visits and determine why this evolution towards family-focus visiting took place. To answer the research inquiry, a heterogeneous sample of prison staff from private and public sector prisons and advocacy center contractors employed at two prisons in the United Kingdom were recruited to provide broad perspectives on staff roles during the process of the visit. Within these facilities, we interviewed a total of 13 (n=13) staff members. Data collection and semi-structured interviews occurred at two prison facilities and two advocacy centers. Three researchers conducted cross-case analyses and applied triangulation methods to establish a clear chain of evidence documented through step-by-step processes: audit trails; flexible and parallel data analysis during data collection, and first- and second-order coding processes. Findings from this study indicate that prison staff perceives their roles during the visiting processes as an evolution from traditional corrections-based punitive practices (i.e. policing) to a visiting program capable of accommodating three goals: low-stress family visits, inmate conformance, and reduced recidivism. This study adds to the literature on detailing how prison staff dichotomous roles were interpreted as balancing tensions between institutional controls and minimizing traumatic experiences for visiting families through prison-based interventions.

Craft museum visitors’ interactive experiences, benefits and behavioural intentions: perspectives of Chinese parents

ABSTRACT Family visitors are important audiences for museums. This paper develops a model that examines the influence of Chinese family visitors’ leisure experiences in museums on their behavioural intentions (BI) with their perceived benefits (mindful benefits and non-mindful benefits, MB and NMB) as the mediating variables. Based on the theoretical framework of an interactive experience model, parents’ experiences in museums were divided into experience of existential authenticity (interaction with the exhibits) (EA) and experience of parents-children interaction (PCI). A total of 375 local family visitors at a cluster of craft museums in Hangzhou, China participated in the survey. The PLS-SEM analysis indicates that both EA and PCI have positive effects on perceived benefits. EA, which emphasises the personal interactions between visitors and exhibited objects as well as their intangible meanings, is found to be more powerful than PCI in shaping visitors’ BI. MB and NMB differ in their influence on visitors’ behaviours. Only MB is linked with visitors’ BI. Further, MB partially mediates the relationship between EA and BI, and fully mediates the relationship between PCI and BI. Implications are offered to enhance family visitors’ experiences through appropriate service management strategies.

Cardio-respiratory signal extraction from video camera data for continuous non-contact vital sign monitoring using deep learning

Non-contact vital sign monitoring enables the estimation of vital signs, such as heart rate, respiratory rate and oxygen saturation (SpO2), by measuring subtle color changes on the skin surface using a video camera. For patients in a hospital ward, the main challenges in the development of continuous and robust non-contact monitoring techniques are the identification of time periods and the segmentation of skin regions of interest (ROIs) from which vital signs can be estimated. We propose a deep learning framework to tackle these challenges. Approach: This paper presents two convolutional neural network (CNN) models. The first network was designed for detecting the presence of a patient and segmenting the patient’s skin area. The second network combined the output from the first network with optical flow for identifying time periods of clinical intervention so that these periods can be excluded from the estimation of vital signs. Both networks were trained using video recordings from a clinical study involving 15 pre-term infants conducted in the high dependency area of the neonatal intensive care unit (NICU) of the John Radcliffe Hospital in Oxford, UK. Main results: Our proposed methods achieved an accuracy of 98.8% for patient detection, a mean intersection-over-union (IOU) score of 88.6% for skin segmentation and an accuracy of 94.5% for clinical intervention detection using two-fold cross validation. Our deep learning models produced accurate results and were robust to different skin tones, changes in light conditions, pose variations and different clinical interventions by medical staff and family visitors. Significance: Our approach allows cardio-respiratory signals to be continuously derived from the patient’s skin during which the patient is present and no clinical intervention is undertaken.

Single-Bed or Multibed Room Designs Influence ICU Staff Stress and Family Satisfaction, But Do Not Influence ICU Staff Burnout.

To compare the impact of single-bed versus multibed room intensive care units (ICU) architectural designs on the stress and burnout of ICU staff and on the stress and satisfaction of family visitors. There are countless architectural variations among ICUs, but all involve single-bed or multibed rooms. Although it is well known that ICU design affects important patient outcomes, the effect of ICU design on family and staff has been insufficiently studied. Among ICU staff and family visitors, stress was evaluated with Lipp's Inventory of Stress Symptoms. ICU staff burnout was evaluated with the Maslach Burnout Inventory. Family visitor satisfaction was evaluated with Molter's Critical Care Family Needs Inventory. Among 156 ICU professionals who were interviewed, similar burnout rates were observed between ICU staff who worked single-bed versus multibed rooms. However, stress reported by ICU staff within the previous 24 hr was higher among the ICU staff who worked in single-bed rooms (14.3% vs. 4.7%, p = .04). Among 176 family visitors who were interviewed, a similar level of stress was reported by family members who visited patients in single-bed or multibed rooms. However, the satisfaction of family members visiting patients in single-bed rooms was higher (96.0% vs. 84.6%, p = .02). Single-bed ICU design was associated with greater satisfaction of family visitors yet with higher levels of stress for ICU staff. Meanwhile, similar burnout levels were observed for ICU staff who worked in single-bed or multibed rooms.

A Case Study Evaluating the Risk of Infection from Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) in a Hospital Setting Through Bioaerosols.

Middle Eastern respiratory syndrome, an emerging viral infection with a global case fatality rate of 35.5%, caused major outbreaks first in 2012 and 2015, though new cases are continuously reported around the world. Transmission is believed to mainly occur in healthcare settings through aerosolized particles. This study uses Quantitative Microbial Risk Assessment to develop a generalizable model that can assist with interpreting reported outbreak data or predict risk of infection with or without the recommended strategies. The exposure scenario includes a single index patient emitting virus‐containing aerosols into the air by coughing, leading to short‐ and long‐range airborne exposures for other patients in the same room, nurses, healthcare workers, and family visitors. Aerosol transport modeling was coupled with Monte Carlo simulation to evaluate the risk of MERS illness for the exposed population. Results from a typical scenario show the daily mean risk of infection to be the highest for the nurses and healthcare workers (8.49 × 10−4 and 7.91 × 10−4, respectively), and the lowest for family visitors and patients staying in the same room (3.12 × 10−4 and 1.29 × 10−4, respectively). Sensitivity analysis indicates that more than 90% of the uncertainty in the risk characterization is due to the viral concentration in saliva. Assessment of risk interventions showed that respiratory masks were found to have a greater effect in reducing the risks for all the groups evaluated (>90% risk reduction), while increasing the air exchange was effective for the other patients in the same room only (up to 58% risk reduction).