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To explore how the restricted visitation policy impacts family members' visitation experiences and perceptions in an adult intensive care unit (ICU).
Focused ethnography.
Data collection included 39 observation sessions (totalling 65.3 h), 19 semi-structured interviews with family members, and document analysis of policies relevant to ICU visitation. Fieldwork was conducted in a general adult ICU at a tertiary hospital in China from April 2021 to December 2021. Data were analysed using reflexive thematic analysis.
Family visitation was represented by ‘being an outsider’ and ‘being an insider.’ ‘Being an outsider’ illustrates that the restricted visitation policy operated as a structural mechanism constructing the ICU as the staff's territory, positioning families as outsiders by limiting their access, information, and involvement in patient care. ‘Being an insider’ captures how family members constructed the waiting area as a socially meaningful family space where they reclaimed presence and formed a supportive community.
Family visitation was shaped by the intersection of structural constraints, culturally embedded family roles, and relational dynamics among families. Restricted visitation policies reinforced family members’ powerlessness and limited their involvement.
The findings highlight the need to critically reconsider restricted visitation policies. Flexible, context-sensitive visitation approaches that take into account cultural norms and family roles may better support family involvement in ICUs.
The study contributes theoretically informed and culturally grounded insights into how the restricted visitation policies function as active structural constraints on family members' visitation experiences. It supports global efforts to develop inclusive, family-centred ICU visitation practices that recognise the structural and relational needs of family members.
The Standards for Reporting Qualitative Research guidelines were followed.
No patient or public contribution.
To identify distinct social network types among young-old adults based on the characteristics of social network structure and to explore the relationship between different types, socio-demographic characteristics and subjective cognitive decline.
A cross-sectional study was conducted from July 2022 to October 2023.
A total of 652 young-old adults aged 60–74 years completed the sociodemographic questionnaire, the subjective cognitive decline questionnaire-9 and the self-designed egocentric social network questionnaire. The types of social networks were identified by latent profile analysis. Univariate analysis and binary logistic regression were used to analyse the influencing factors of subjective cognitive decline.
The incidence of subjective cognitive decline was 38%. Social networks of young-old adults tended to be large, predominantly family-centred and characterised by strong contact strength, high density and significant demographic heterogeneity among network members. Four social network types were identified: diverse-moderate, family-dense, family-strong and friend-loose. Young-old adults embedded in the family-dense and family-strong types were more likely to develop subjective cognitive decline than those in the diverse-moderate type. Additionally, age, education level, previous occupation, daily sleep duration and exercise were related to the incidence of subjective cognitive decline.
The findings highlight the relatively high incidence of subjective cognitive decline in young-old adults that is notably influenced by the type of social network they are embedded in. More attention needs to be paid to identifying and supporting young-old adults at high risk of subjective cognitive decline, especially to promote their social integration and friend network building, to improve their subjective cognitive function.
The findings emphasise the importance of considering the structure and composition of social networks when addressing subjective cognitive decline among young-old adults. A diversified social network incorporating both familial and friendship ties may provide enhanced cognitive protection. Therefore, interventions targeting subjective cognitive decline should promote the expansion of friendship-based relationships and foster the development of more heterogeneous and multi-source networks.
STROBE checklist.
Not applicable.
FreshRSS 