Generalist palliative care in hospitals during the first wave of the COVID-19 pandemic

Abstract

Background In the research network of German university palliative care centers (PallPan), as part of Network University Medicine (NUM), recommendations for action were developed in regard to the care provided for seriously ill and dying patients during a pandemic. For this purpose, the experiences and needs of hospital staff working closely with patients outside of specialized palliative care units during the first wave of the COVID-19 pandemic were also examined. Materials and methods Nationwide online survey of 8,882 physicians, nurses and therapists working in acute inpatient care in the period from December 2020 to January 2021 by means of a newly developed and piloted questionnaire on changes, burdens and cooperation with specialized palliative care. Grouping based on the changes in the number of seriously ill and dying people in the first wave of the pandemic. Due to the exploratory character of the survey, the data were analyzed descriptively. Results 505/8882 completed questionnaires were evaluated (5.7%). 167/505 (33.1%) of the respondents reported a lower quality of care for the critically ill and dying. 464/505 (91.8%) reported exemptions in place for visiting the dying. The most frequently mentioned stress factor was the perceived loneliness of the seriously ill and dying 437/505 (86.5%), followed by stricter hygiene rules 409/505 (81%), increased workload 372/505 (73.3%) and perceived psychological stress on relatives and survivors 395/505 (78.2%). 141/505 (27.9%) of respondents used Tablet PCs to support patient-family communication. 310/505 (61.4%) involved palliative care professionals in patient care, and 356/505 (70.5%) of respondents found other palliative care services helpful. Conclusion Experiences and suggestions for improving palliative care in pandemic times are integrated into the PallPan recommendations for action. Family visits should be allowed and supplemented by digital offers. Palliative Care should also be integrated into both pandemic and contingency plans.