Consequences of visiting restrictions during the COVID-19 pandemic: An integrative review.
Karin Hugelius, Nahoko Harada, Miki Marutani
PMID 34242976WHAT IT FOUND
During visiting restrictions, patients and families reported more distress, poorer self-care and intake, and staff faced heavier communication loads.
Digital visits did not replace family presence. The review could not separate these effects from pandemic stress.
Key findings
01Nursing home residents were reported to have reduced self-care, including personal hygiene maintenance, and decreased nutritional status from reduced oral intake during visiting restrictions.
02Families reported more worry, anxiety and need for updates, while health care staff faced increased communication workload and digital visits could not substitute for physical presence.
03The review included no control group or baseline data, so reported harms cannot be separated from general pandemic stress.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
No included study used a control group or baseline data, so symptoms cannot be confidently attributed to visiting restrictions rather than the wider stress of the pandemic. Many studies used study-specific surveys rather than standard measures. This makes settings and populations hard to compare. Only 17 papers were available, and only two focused specifically on COVID-19-positive patients or their families. The included evidence was mostly descriptive and rated low or moderate quality, and the authors state the overall level of evidence is low. Case reports and brief reports were included because the field was new, but they cannot show that restrictions caused effects. The review did not distinguish visiting restrictions from other infection-control precautions, so no study separated the effect of visiting restrictions alone.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not conclude that visiting restrictions caused these harms or that they should be removed. The review had no control group or baseline data, and the harms could reflect general pandemic stress or other infection-control measures.