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Partial liberalization of visiting policies and ICU staff: a before-and-after study

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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)

Author information

Authors and Affiliations

  1. Pediatric Intensive Care Unit, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Via della Commenda 9, 20122, Milan, Italy

    Alberto Giannini & Edi Prandi

  2. Unit of Clinical and Descriptive Epidemiology, Istituto per lo Studio e la Prevenzione Oncologica—ISPO, Via Cosimo il Vecchio, 2, 50139, Florence, Italy

    Guido Miccinesi & Carlotta Buzzoni

  3. Unit of Clinical Psychology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, 20133, Milan, Italy

    Claudia Borreani

Authors
  1. Alberto Giannini
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  2. Guido Miccinesi
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  3. Edi Prandi
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  4. Carlotta Buzzoni
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  5. Claudia Borreani
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Consortia

The ODIN Study Group

Corresponding author

Correspondence to Alberto Giannini.

Additional information

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

  • Massimo Audisio (Intensive Care Unit, Ospedale di Ciriè, Ciriè, Italy)

  • Antonino Bencivinni (Intensive Care Unit, Ospedale Nuovo del Mugello, Borgo San Lorenzo, Italy)

  • Emanuela Biagioni (Intensive Care Unit, Azienda Ospedaliera Universitaria di Modena, Modena, Italy)

  • Enzo Castenetto (Intensive Care Unit, Ospedale Civico, Chivasso, Italy)

  • Ignazia Laganà (Pediatric Intensive Care Unit, Azienda Ospedaliera “G. Salesi”, Ancona, Italy)

  • Roberto Oggioni (Intensive Care Unit, Ospedale Nuovo del Mugello, Borgo San Lorenzo, Italy)

  • Virginia Porta (Intensive Care Unit, Ospedale Civile, Legnano, Italy)

  • Rosa Salcuni (Intensive Care Unit, Ospedale di Ivrea, Ivrea, Italy)

  • Armando Sarti (Intensive Care Unit, Ospedale S. Maria Nuova, Florence, Italy)

  • 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

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