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The COVID-19 Pandemic: A Family Affair

The COVID-19 Pandemic: A Family Affair 920883 JFNXXX10.1177/1074840720920883Journal of Family NursingGuest Editorial editorial2020 Guest Editorial Journal of Family Nursing 2020, Vol. 26(2) 87 –89 The COVID-19 Pandemic: A Family Affair © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions https://doi.org/10.1177/1074840720920883 DOI: 10.1177/1074840720920883 journals.sagepub.com/home/jfn A new viral illness called coronavirus disease 2019 (COVID- without a family member present and those patients who are 19) is currently spreading throughout the world at an alarm- admitted to an intensive care unit (ICU) who have to say ing rate (Dong et al., 2020). As family nursing practitioners, goodbye to their family in the emergency department not educators, and researchers, we work from a guiding assump- knowing whether they will see each other again. A nurse tion that health and “illness is a family affair” (Wright & working at the front line of triage reported, “His family was Bell, 2009, p. ix). Patients, clients, residents, and their fami- not allowed to come to the hospital, because they may also be lies are inextricably connected. The science and practice of infected. He was alone and couldn’t say goodbye.” Family Nursing is based on a systemic premise offered by Wright and Leahey (2013) that serious illness and life chal- Families are Concerned About Their Loved Ones lenges impact the family unit, and reciprocally, the function- ing of the family unit (including their structure, development, Many of these patients, clients, and residents are members of and function) influences the health and well-being of each families who miss their loved ones and who are worried. family member. This especially holds true for the current Mothers, fathers, and other family members of children coronavirus pandemic which is creating unique hardships receiving psychiatric care report being unable visit their and suffering in an alarmingly large number of patients and child for an extended period of time and are afraid their child their families around the world. will become ill from the coronavirus. Families of very seri- ously ill and dying patients are not allowed to visit their loved one and may not be able to say a final goodbye. Impact of COVID-19 on Families The assumption that disease and its prevention is a family affair Families and Family Relationships Are Under is manifested in the full spectrum and scale of the current coro- Pressure navirus pandemic. Measures that have been taken in many countries to control the spread of the coronavirus are having a The lockdown/quarantine measures instituted in many coun- disruptive effect on relationships in general and family rela- tries have also invited vulnerability and risk within families. tionships specifically. Families are reporting loss of commu- Schools are being closed which leads to distress in many nity and freedom of movement in response to quarantine/lock families not accustomed to being so closely confined for a down measures. Other tangible losses include income, access long time period. Moreover, as a result of the COVID-19 to resources, and planned activities or celebrations. Compelling crisis, much, if not all, of the support given to families who and heartbreaking stories of the challenges and suffering that provide long-term care for an ill parent, partner, or child is families are experiencing engulf us. Individuals and families lost. Families with a child who requires specialized care and who are most vulnerable are particularly at risk. guidance now have to care for their child 24 hr a day without the outside guidance provided by medical nursery, daycare, or special education services. Families who care for a father, Patients, Clients, and Residents Miss Their Family mother, or partner with dementia or other serious illness now and Loved Ones have to manage without day care or daytime activity. School Residents in long-term care facilities miss their partners and closures have created a family environment where children children who are no longer allowed to visit because of the are rarely allowed to leave the house and are confronted by COVID-19 policies to contain the spread of the coronavirus. the vulnerabilities of a family member’s addiction, aggres- People with intellectual disabilities who live in institutions sion, and violence. Children of divorced co-parents are sud- are upset because their father, mother, brothers, or sisters are denly being refused alternating parental care because one of no longer allowed to visit, and they often cannot understand the parents now works from home and cannot provide child why. care. All of these families and their interrelationships are Distressing stories abound of patients who have to deal often under great pressure as a result of the stresses created with the news of their COVID-19 diagnosis all by themselves by coronavirus pandemic. 88 Journal of Family Nursing 26(2) unexpected long-term consequences of this pandemic The Urgent Need for Family Nursing (International, Family, Nursing, & Association, 2015, 2017). Now and in the Aftermath of The aftermath of COVID-19 calls for a substantial increase COVID-19 in the resources needed to (a) enable nurses to assess and Health care professionals, including nurses and doctors, are intervene with families in need of support, (b) educate nurses also going through a very intensive and perhaps traumatic to offer highly skilled family nursing care, and (c) conduct time. As a nurse working in the ICU reported, “Many people research which provides compelling evidence that family die without family present. The sorrow that comes with it nursing assessment and intervention is effective in address- hurts the nurses mentally.” It is encouraging to see how inno- ing illness suffering (Wright, 2017; Wright & Bell, 2009) and vative and creative many nurses are becoming during this optimizing family health. Family nursing has never been pandemic as they find ways to involve families. Despite being more relevant or more urgently needed than now. committed to the care of the ill person, they assure families This Guest Editorial has been written by members of the that their family member is being cared for and will not die FAMily health in Europe-Research in Nursing (FAME-RN) alone. They are sometimes able to connect family members to group: each other using new technology. Mobile phone or video con- ference calls made by the nurse allow family members to Marie Louise A. Luttik, PhD, RN, Professor in Family “see” the patient in the ICU or in the nursing home. Nursing & Family Care, Hanze University of Applied Our concerns also focus on the long-term implications for Sciences, Research Group Nursing Diagnostics, Groningen, patients and their families; how will they cope once the coro- the Netherlands. Email: m.l.a.luttik@pl.hanze.nl ORCID: navirus is under control? How will they be able to resume https://orcid.org/0000-0002-7853-9773 normal life again? Individuals and families are often flexible and resilient (Walsh, 2016) and many will likely be able to Romy Mahrer-Imhof, PhD, Professor for Family-Centered process the experiences of this pandemic and resume their Care, Nursing Science & Care Limited, Winterthur, lives. However, there will also be long-term mental and Switzerland; Visiting Professor, Department of Clinical physical health consequences or even permanent damage. Research, University of Southern Denmark, Denmark. Email: For example, how will patients and families recover after a romy.mahrer@ns-c.ch ORCID: https://orcid.org/0000-0002- long period of intensive care? Research has documented that 8587-3817 many patients experience many physical and psychological problems after such a long period of ventilation, even after dis- Cristina García-Vivar, PhD, RN, Senior Associate charge to their home environment (Rawal et al., 2017). We also Professor, Faculty of Health Sciences, Public University of know that family members of these patients also suffer greater Navarre; Researcher, IdiSNA, Navarra Institute for Health levels of depression and anxiety (Davidson et al., 2012). Research, Spain. Email: cristina.garciavivar@unavarra.es We also hold our hearts out for families who have lost ORCID: https://orcid.org/0000-0002-6022-559X someone without being able to say goodbye and without being able to be present in the final dying phase of their Anne Brødsgaard, PhD, RN, Senior Researcher, loved one. How will we assist these families to cope with Department of Pediatrics and Adolescent Medicine, their loss and complex grief? Copenhagen University Hospital Amager Hvidovre; The Our concerns also go out to the health care professionals, Capital Region of Denmark & Section for Nursing, especially nurses and doctors, in the aftermath of this Department of Public Health; The Faculty of Health, Aarhus COVID-19 crisis. They too will need support in recovering University, Denmark. Email: anne.broedsgaard.madsen@ from their suffering and distress. regionh.dk ORCID: https://orcid.org/0000-0002-5029-9480 The good news is that there is compelling evidence that our family nursing assessment and intervention skills can Karin B. Dieperink, PhD, RN, Associate Professor, Head assist families to heal. This pandemic makes us more deeply of research, Family focused health care research Center aware of the important role of family in the lives of patients, (FaCe) and Vice Head, Department of Clinical Research, clients, and residents. We anticipate that this increased University of Southern Denmark; Department of Oncology, awareness will help us advocate even more strongly for the Odense University Hospital, Denmark. Email: Karin.dieper- importance of family nursing during and after this coronavi- ink@rsyd.dk ORCID: https://orcid.org/0000-0003-4766- rus crisis. Rightfully, a great amount of money and resources 3242 are now being spent to fight the COVID-19 virus. But lives saved must also be lives worth living afterwards. Lorenz Imhof, PhD, Professor for Community-Based We believe that family nursing knowledge, developed Care, Nursing Science & Care Limited, Winterthur, over the last 40 years, unequivocally offers the necessary Switzerland. Email: lorenz.imhof@ns-c.ch ORCID: https:// skills to help families recover and heal from the expected and orcid.org/0000-0001-8441-3598 Guest Editorial 89 Birte Østergaard, PhD, Associate Professor, Department Dong, E., Du, J., & Gardner, L. (2020). An interactive web-based dashboard to track COVID-19 in real time. The Lancet. of Clinical Research, University of Southern Denmark, Advance online publication. https://doi.org/10.1016/S1473- Denmark. Email: boestergaard@health.sdu.dk ORCID: 3099(20)30120-1 https://orcid.org/0000-0002-9094-8123 International Family Nursing Association. (2015). IFNA Position Statement on Generalist Competencies for Family Nursing Erla Kolbrun Svavarsdottir, RN, PhD, FAAN, Professor, Practice. https://internationalfamilynursing.org/2015/07/31/ School of Health Sciences, Faculty of Nursing, University of ifna-position-statement-on-generalist-competencies-for- Iceland, Iceland. Email: eks@hi.is ORCID: https://orcid. family-nursing-practice/ org/0000-0003-1284-1088 International Family Nursing Association. (2017). IFNA Position Statement on Advanced Practice Competencies Hanne Konradsen, PhD, Professor, Herlev and Gentofte for Family Nursing. https://internationalfamilynursing.org/ Hospital, Department of Gastroenterology, Denmark, 2017/05/19/advanced-practice-competencies/ Rawal, G., Sankalp, Y., & Kumar, Y. (2017). Post-intensive care Department of Clinical Medicine, Faculty of Health and syndrome: An overview. Journal of Translational Internal Medical Sciences, University of Copenhagen, Denmark; Medicine, 5(2), 90–92. https://doi.org/10.1515/jtim-2016-0016 Associate Professor, Department of Neurobiology, Care Walsh, F. (2016). Applying a Family Resilience Framework in Sciences and Society, NVS, Karolinska Instituttet, Sweden. training, practice, and research: Mastering the art of the pos- Email: hanne.konradsen@regionh.dk ORCID: https://orcid. sible. Family Process, 55(4), 616–632. https://doi.org/10.1111/ org/0000-0002-7477-125 famp.12260 Wright, L. M. (2017). Suffering and spirituality: The path to illness References healing. 4th Floor Press. Davidson, J. E., Jones, C., & Bienvenu, O. J. (2012). Family Wright, L. M., & Bell, J. M. (2009). Beliefs and illness: A model for response to critical illness: Postintensive care syndrome- healing. 4th Floor Press. family. Critical Care Medicine, 40(2), 618–624. https://doi. Wright, L. M., & Leahey, M. (2013). Nurses and families: A guide org/10.1097/CCM.0b013e318236ebf9 to family assessment and intervention (6th ed.). F.A. Davis. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Family Nursing SAGE

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SAGE
Copyright
© The Author(s) 2020
ISSN
1074-8407
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1552-549X
DOI
10.1177/1074840720920883
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Abstract

920883 JFNXXX10.1177/1074840720920883Journal of Family NursingGuest Editorial editorial2020 Guest Editorial Journal of Family Nursing 2020, Vol. 26(2) 87 –89 The COVID-19 Pandemic: A Family Affair © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions https://doi.org/10.1177/1074840720920883 DOI: 10.1177/1074840720920883 journals.sagepub.com/home/jfn A new viral illness called coronavirus disease 2019 (COVID- without a family member present and those patients who are 19) is currently spreading throughout the world at an alarm- admitted to an intensive care unit (ICU) who have to say ing rate (Dong et al., 2020). As family nursing practitioners, goodbye to their family in the emergency department not educators, and researchers, we work from a guiding assump- knowing whether they will see each other again. A nurse tion that health and “illness is a family affair” (Wright & working at the front line of triage reported, “His family was Bell, 2009, p. ix). Patients, clients, residents, and their fami- not allowed to come to the hospital, because they may also be lies are inextricably connected. The science and practice of infected. He was alone and couldn’t say goodbye.” Family Nursing is based on a systemic premise offered by Wright and Leahey (2013) that serious illness and life chal- Families are Concerned About Their Loved Ones lenges impact the family unit, and reciprocally, the function- ing of the family unit (including their structure, development, Many of these patients, clients, and residents are members of and function) influences the health and well-being of each families who miss their loved ones and who are worried. family member. This especially holds true for the current Mothers, fathers, and other family members of children coronavirus pandemic which is creating unique hardships receiving psychiatric care report being unable visit their and suffering in an alarmingly large number of patients and child for an extended period of time and are afraid their child their families around the world. will become ill from the coronavirus. Families of very seri- ously ill and dying patients are not allowed to visit their loved one and may not be able to say a final goodbye. Impact of COVID-19 on Families The assumption that disease and its prevention is a family affair Families and Family Relationships Are Under is manifested in the full spectrum and scale of the current coro- Pressure navirus pandemic. Measures that have been taken in many countries to control the spread of the coronavirus are having a The lockdown/quarantine measures instituted in many coun- disruptive effect on relationships in general and family rela- tries have also invited vulnerability and risk within families. tionships specifically. Families are reporting loss of commu- Schools are being closed which leads to distress in many nity and freedom of movement in response to quarantine/lock families not accustomed to being so closely confined for a down measures. Other tangible losses include income, access long time period. Moreover, as a result of the COVID-19 to resources, and planned activities or celebrations. Compelling crisis, much, if not all, of the support given to families who and heartbreaking stories of the challenges and suffering that provide long-term care for an ill parent, partner, or child is families are experiencing engulf us. Individuals and families lost. Families with a child who requires specialized care and who are most vulnerable are particularly at risk. guidance now have to care for their child 24 hr a day without the outside guidance provided by medical nursery, daycare, or special education services. Families who care for a father, Patients, Clients, and Residents Miss Their Family mother, or partner with dementia or other serious illness now and Loved Ones have to manage without day care or daytime activity. School Residents in long-term care facilities miss their partners and closures have created a family environment where children children who are no longer allowed to visit because of the are rarely allowed to leave the house and are confronted by COVID-19 policies to contain the spread of the coronavirus. the vulnerabilities of a family member’s addiction, aggres- People with intellectual disabilities who live in institutions sion, and violence. Children of divorced co-parents are sud- are upset because their father, mother, brothers, or sisters are denly being refused alternating parental care because one of no longer allowed to visit, and they often cannot understand the parents now works from home and cannot provide child why. care. All of these families and their interrelationships are Distressing stories abound of patients who have to deal often under great pressure as a result of the stresses created with the news of their COVID-19 diagnosis all by themselves by coronavirus pandemic. 88 Journal of Family Nursing 26(2) unexpected long-term consequences of this pandemic The Urgent Need for Family Nursing (International, Family, Nursing, & Association, 2015, 2017). Now and in the Aftermath of The aftermath of COVID-19 calls for a substantial increase COVID-19 in the resources needed to (a) enable nurses to assess and Health care professionals, including nurses and doctors, are intervene with families in need of support, (b) educate nurses also going through a very intensive and perhaps traumatic to offer highly skilled family nursing care, and (c) conduct time. As a nurse working in the ICU reported, “Many people research which provides compelling evidence that family die without family present. The sorrow that comes with it nursing assessment and intervention is effective in address- hurts the nurses mentally.” It is encouraging to see how inno- ing illness suffering (Wright, 2017; Wright & Bell, 2009) and vative and creative many nurses are becoming during this optimizing family health. Family nursing has never been pandemic as they find ways to involve families. Despite being more relevant or more urgently needed than now. committed to the care of the ill person, they assure families This Guest Editorial has been written by members of the that their family member is being cared for and will not die FAMily health in Europe-Research in Nursing (FAME-RN) alone. They are sometimes able to connect family members to group: each other using new technology. Mobile phone or video con- ference calls made by the nurse allow family members to Marie Louise A. Luttik, PhD, RN, Professor in Family “see” the patient in the ICU or in the nursing home. Nursing & Family Care, Hanze University of Applied Our concerns also focus on the long-term implications for Sciences, Research Group Nursing Diagnostics, Groningen, patients and their families; how will they cope once the coro- the Netherlands. Email: m.l.a.luttik@pl.hanze.nl ORCID: navirus is under control? How will they be able to resume https://orcid.org/0000-0002-7853-9773 normal life again? Individuals and families are often flexible and resilient (Walsh, 2016) and many will likely be able to Romy Mahrer-Imhof, PhD, Professor for Family-Centered process the experiences of this pandemic and resume their Care, Nursing Science & Care Limited, Winterthur, lives. However, there will also be long-term mental and Switzerland; Visiting Professor, Department of Clinical physical health consequences or even permanent damage. Research, University of Southern Denmark, Denmark. Email: For example, how will patients and families recover after a romy.mahrer@ns-c.ch ORCID: https://orcid.org/0000-0002- long period of intensive care? Research has documented that 8587-3817 many patients experience many physical and psychological problems after such a long period of ventilation, even after dis- Cristina García-Vivar, PhD, RN, Senior Associate charge to their home environment (Rawal et al., 2017). We also Professor, Faculty of Health Sciences, Public University of know that family members of these patients also suffer greater Navarre; Researcher, IdiSNA, Navarra Institute for Health levels of depression and anxiety (Davidson et al., 2012). Research, Spain. Email: cristina.garciavivar@unavarra.es We also hold our hearts out for families who have lost ORCID: https://orcid.org/0000-0002-6022-559X someone without being able to say goodbye and without being able to be present in the final dying phase of their Anne Brødsgaard, PhD, RN, Senior Researcher, loved one. How will we assist these families to cope with Department of Pediatrics and Adolescent Medicine, their loss and complex grief? Copenhagen University Hospital Amager Hvidovre; The Our concerns also go out to the health care professionals, Capital Region of Denmark & Section for Nursing, especially nurses and doctors, in the aftermath of this Department of Public Health; The Faculty of Health, Aarhus COVID-19 crisis. They too will need support in recovering University, Denmark. Email: anne.broedsgaard.madsen@ from their suffering and distress. regionh.dk ORCID: https://orcid.org/0000-0002-5029-9480 The good news is that there is compelling evidence that our family nursing assessment and intervention skills can Karin B. Dieperink, PhD, RN, Associate Professor, Head assist families to heal. This pandemic makes us more deeply of research, Family focused health care research Center aware of the important role of family in the lives of patients, (FaCe) and Vice Head, Department of Clinical Research, clients, and residents. We anticipate that this increased University of Southern Denmark; Department of Oncology, awareness will help us advocate even more strongly for the Odense University Hospital, Denmark. Email: Karin.dieper- importance of family nursing during and after this coronavi- ink@rsyd.dk ORCID: https://orcid.org/0000-0003-4766- rus crisis. Rightfully, a great amount of money and resources 3242 are now being spent to fight the COVID-19 virus. But lives saved must also be lives worth living afterwards. Lorenz Imhof, PhD, Professor for Community-Based We believe that family nursing knowledge, developed Care, Nursing Science & Care Limited, Winterthur, over the last 40 years, unequivocally offers the necessary Switzerland. Email: lorenz.imhof@ns-c.ch ORCID: https:// skills to help families recover and heal from the expected and orcid.org/0000-0001-8441-3598 Guest Editorial 89 Birte Østergaard, PhD, Associate Professor, Department Dong, E., Du, J., & Gardner, L. (2020). An interactive web-based dashboard to track COVID-19 in real time. The Lancet. of Clinical Research, University of Southern Denmark, Advance online publication. https://doi.org/10.1016/S1473- Denmark. Email: boestergaard@health.sdu.dk ORCID: 3099(20)30120-1 https://orcid.org/0000-0002-9094-8123 International Family Nursing Association. (2015). IFNA Position Statement on Generalist Competencies for Family Nursing Erla Kolbrun Svavarsdottir, RN, PhD, FAAN, Professor, Practice. https://internationalfamilynursing.org/2015/07/31/ School of Health Sciences, Faculty of Nursing, University of ifna-position-statement-on-generalist-competencies-for- Iceland, Iceland. Email: eks@hi.is ORCID: https://orcid. family-nursing-practice/ org/0000-0003-1284-1088 International Family Nursing Association. (2017). IFNA Position Statement on Advanced Practice Competencies Hanne Konradsen, PhD, Professor, Herlev and Gentofte for Family Nursing. https://internationalfamilynursing.org/ Hospital, Department of Gastroenterology, Denmark, 2017/05/19/advanced-practice-competencies/ Rawal, G., Sankalp, Y., & Kumar, Y. (2017). Post-intensive care Department of Clinical Medicine, Faculty of Health and syndrome: An overview. Journal of Translational Internal Medical Sciences, University of Copenhagen, Denmark; Medicine, 5(2), 90–92. https://doi.org/10.1515/jtim-2016-0016 Associate Professor, Department of Neurobiology, Care Walsh, F. (2016). Applying a Family Resilience Framework in Sciences and Society, NVS, Karolinska Instituttet, Sweden. training, practice, and research: Mastering the art of the pos- Email: hanne.konradsen@regionh.dk ORCID: https://orcid. sible. Family Process, 55(4), 616–632. https://doi.org/10.1111/ org/0000-0002-7477-125 famp.12260 Wright, L. M. (2017). Suffering and spirituality: The path to illness References healing. 4th Floor Press. Davidson, J. E., Jones, C., & Bienvenu, O. J. (2012). Family Wright, L. M., & Bell, J. M. (2009). Beliefs and illness: A model for response to critical illness: Postintensive care syndrome- healing. 4th Floor Press. family. Critical Care Medicine, 40(2), 618–624. https://doi. Wright, L. M., & Leahey, M. (2013). Nurses and families: A guide org/10.1097/CCM.0b013e318236ebf9 to family assessment and intervention (6th ed.). F.A. Davis.

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Journal of Family NursingSAGE

Published: May 1, 2020

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