Family member experience with restricted family presence in Canadian PICUs: an interpretive descriptive study.

Purpose: We performed this study to explore family member experiences with restrictions to family presence during their child's PICU admission, leveraging the unique context of the COVID-19 pandemic to aid in future ethical and informed decision-making.

Methods: Qualitative interpretive descriptive study with family members of Canadian PICU patients admitted from March 2020 to April 2021 who experienced restricted family presence (RFP) policies. Respondents were purposively sampled for demographic-based maximum variation.We generated themes through inductive thematic analysis of open-ended interviews.

Results: Fourteen parental figures from five regions across Canada participated. We identified four themes associated with the lived experience and impact of the restrictions on family members of critically ill children: (1) challenges to fulfilling the parent role, (2) isolation from primary supports during a time of crisis, (3) navigating increased logistical difficulties, and (4) seeking compassionate approaches within the healthcare system.

Conclusion: RFP policies created a range of barriers for family members of critically ill children. Healthcare organizations and teams may play a role in removing barriers through consistent and empathetic application of rules with consideration for the duality of the parent role in PICUs, providing important post-pandemic policy and practice implications.

What Is Known: • Parental presence with critically ill children may improve health outcomes for patients and their families. • Restrictions to family presence in PICUs continue to occur internationally and, during COVID-19, resulted in parental isolation, anxiety, and increased stress.  What is new: • By isolating family members and removing supports, COVID-19-related restrictions in Canadian PICUs challenged family members' ability to fulfil their parent roles while meeting their own needs.  • Families need empathetic, advocacy-based approaches from clinicians and healthcare systems to maintain trust and therapeutic relationships in a family-centered organization.