The experiences of patients, family caregivers, healthcare providers, and health service leaders with compassionate care following hospitalization with COVID-19: a qualitative study

Figures & data

Figure 1. Compassionate care themes for people hospitalized with COVID-19.

Four interconnected themes relating to how compassion features in the care of people hospitalized with COVID-19. Theme 1 is about healthcare providers feeling safe. Theme 2 is about how people with COVID-19 suffer in isolation. Theme 3 is about compassionate care in different hospital settings. Theme 4 is about how compassion fatigue and burnout threaten compassionate care of people with COVID-19.

Table 1. Participant demographics.

Characteristic	Patient (n = 10)	Caregiver (n = 5)	HCP (n = 12)
Age in Years (mean, SD)	62.78 (17.89)	60.17 (4.28)
Length of Stay in Rehab, days (mean, SD)	12.44 (1.81)
Positive COVID Status Upon Admission	4 (40%)
Sex
Male (n, %)	2 (20)	2 (40)
Female (n, %)	7 (70)	3 (60)
Did not disclose (n, %)	1 (10)
Ethnicity
Black (n, %)	1 (10)	1 (20)
Chinese (n, %)	2 (2)
Filipino (n, %)	2 (20)	1 (20)
Indian (n, %)	1 (10)
South Asian (n, %)	1 (10)
White (n, %)	3 (30)	3 (60)
Marital Status
Married (n, %)	2 (20)	5 (100)
Widowed (n, %)	4 (40)
Single (n, %)	2 (20)
Common law (n, %)	1 (10)
Did not disclose (n, %)	1 (10)
Education
Some high school (n, %)	3 (30)
Completed college (n, %)	3 (30)	2 (40)
Completed university (n, %)	3 (30)	3 (60)
Graduate program (n, %)	1 (10)		12 (100)
Yearly Income (CAD)
10,000–19,999	2 (20)
20,000–29,999	2 (20)
30,000–39,999	2 (20)	1 (20)
40,000–49,999		1 (20)
50,000–59,999
60,000–69,999	1 (10)	2 (40)
Did not disclose	3 (30)	1 (20)
Profession
Occupational therapist (n, %)			3 (35)
Patient care manager (n, %)			2 (17)
Registered nurse (n, %)			2 (17)
Pharmacist			1 (8)
Medical department head (n, %)			2 (17)
Collaborative practice leader (n, %)			2 (17)

Table 2. Participant quotes.

Quote no.	Quote	Participant number, role, location
1.	What they did was they asked for a couple of volunteers to start the unit, because we didn’t know how many patients we were going to get. And I looked around and said, okay. I think everybody was stunned. People were saying, I have children. Other people were saying, I have my parents living with me. Others were saying, I’m high risk, I have asthma. And so, I was the first nurse to say, I’m a healthy person, my children are grown, I don’t have comorbidities, and if we’re going to make it work, I’ll make it work.	HCP08, Registered Nurse (RN), rehab hospital COVID-19 unit
2.	I think had they asked for proper volunteers, upper management going in and saying who wants to volunteer? Who wants to do…? I guess they figured nobody would want to. But honestly, there was a spectrum. There were people who really wanted to do this. And that came out later. And there were people who adamantly did not want to do this.	HCP07, Occupational Therapist (OT), rehab hospital COVID-19 unit
3.	To be quite honest, it was one of those things where I felt compelled to go and be a part of that unit and see what I could provide in terms of the care because it was such an uncertain time.	HCP11, RN, acute hospital COVID-19 unit
4.	It really even wasn’t even about the patients, to be honest. You don’t even get to that thought. Your first thoughts are how am I going to survive. Nobody wants to catch it, no one wants to help. No one knows the patient, suddenly. No one wants to go and get them something. It was really incredible	HCP07, OT, rehab hospital COVID-19 unit
5.	So, there’s was the panic over the issue of whether or not the PPE was appropriate for the conditions and, of course, that caused a lot of anxiety for people about whether or not they were being exposed to COVID and that they could get it and bring it home. Once that was dealt with and people were educated in terms of what was needed, then that work related anxiety subsided?	HCP01, Professional Practice Leader (PPL), rehab hospital COVID-19 unit
6.	A patient was admitted. Nobody knew that they were positive and all of a sudden eight patients have it. But no staff member came back positive, not one. So, I think that made people realize, we’re all wearing masks, we’re all wearing visors, we’re not going to catch this.	HCP01, PPL, rehab hospital COVID-19 unit
7.	And to be quite honest, when I sit back and reflect on the person coming on the stretcher, people are patient transferring in hazmat suits, and so we are all covered from head to toe, but it’s only when you go and say, hello, Mr. So and So, and you’re, like, hey, this is a person, we must help him	HCP06, Patient Care Manager (PCM), rehab hospital COVID-19 unit
8.	I’m telling you, these are all angels, don’t misunderstand how I feel about these people.	PT07, below mean age, COVID + ve on admission, rehab length of stay (LOS) 8 days
9.	I guess it was as a patience that they were able to conduct themselves professionally	Care Giver (CG)07
10.	When she first arrived there and when she was told she had to stay in her room. She got very upset because she thought somebody was treating her like an animal	CG04
11.	They don’t care about the patient. They don’t even sympathize with you. You know, I can, how this transfers, the disease, but it’s not good that you feel that way, and still, you feel like nobody cares	PT11, below mean age, COVID –ve on admission, rehab LOS 13 days
12.	And the biggest thing is that I had to have the door to my room closed all the time, and I hated it, and it was just I didn’t know, I felt like I was in jail	PT05, below mean age, COVID –ve on admission, rehab LOS 14 days
13.	One of the things that I have actually said is I went back to my work with more compassion for the patients because now I know how they feel. So, it's a learning for me that I have taken that even when I was giving to my patients, at the time before this happened, it improved me more as a care provider to be really more empathizing and sympathizing with the patients and the families as well.	CG10
14.	what sets human beings apart from other animals and mammals in particular? When an elephant, a mammal, breaks their femur, you know what happens to them? They’re left to die. Human beings, we don’t do that. We do not do that. We take care. With this COVID-19, I saw them leave. I saw them leave the human being. And I’ve got to tell you, it made me go aye-aye-aye	HCP07, OT, rehab hospital COVID-19 unit
15.	It humanized it a bit for us. I think healthcare providers, by their nature, are empathic, right, or you’re in the wrong line of work, I would say. For a lot of us, it was heartbreaking. It still is heartbreaking [..] to have people not have visitors	HCP12, Senior Leader, acute hospital COVID-19 unit
16.	Yes. I was really happy. And then they’re going to come to the phone and say, hi, grandma, hope you feel better, and really make my day	PT14, above mean age, COVID –ve on admission, rehab LOS 13 days
17.	I found that a lot of patients that we were dealing with were very lonely and very needy of attention. I don’t really want to spend any extra time in there than I had to, but a lot of the time you just did that because that’s what these patients needed. They needed somebody to just sit with them. Sometimes they needed somebody to hold their hand	HCP10, OT, rehab hospital COVID-19 unit
18.	The people that were there, they were wonderfully kind, helpful, and loving to me… They were kind to you, so your heart feels well	PT17, above mean age, COVID + ve on admission, rehab LOS 13 days
19.	I just felt like I was part of a big family… it was the cheer in their voice, and they were giving me time	PT06, above mean age, COVID –ve on admission, rehab LOS 14 days
20.	I mean, that’s a traumatic experience. They don’t care about the patient. They don’t even sympathize with you.	PT07, below mean age, COVID + ve on admission, rehab LOS 8 days
21.	If they came near her [patient], she was treated like you treat dirt. Something that is dirty, and you don’t want to get contaminated. She said she was treated like a person at the rehab. She felt warm at the rehab. She got attention at the rehab. Now she wasn’t COVID positive anymore, so people won’t be afraid to touch her, and to come into close communication with her, and those kinds of things	CG07
22.	I would suggest that they say we have to really treat patients with respect and dignity and be sympathizing actually	CG10
23.	Because she felt like she wasn’t presentable enough, so I used…She had some lipstick in her purse. So, we put on her lipstick. We washed her hair. She looked good. And that way, she will be able to face her family. Otherwise, she was at risk of isolation, too. So, just taking that extra minute to do those little things, I want to say that was so important because that helped with the psychosocial component with our patients as well	HCP 11, RN, acute hospital COVID-19 unit
24.	So, on the COVID unit, I would spend an hour with each of my patients, if that makes sense. And as a result, it was some of the most healthy nursing I’ve done in years. But again, those things don’t happen on our regular, day to day basis. They happen because you have the time to do the job properly	HCP08, RN, rehab hospital COVID-19 unit
25.	I’m no longer a part of the COVID unit anymore. I kind of got burnt out	HCP 11, RN, acute hospital COVID-19 unit
26.	I heard many, many stories of people who felt completely burnt out and didn’t feel that they were able to provide the care that they wanted to	HCP03, Patient Care Manager, rehab hospital COVID-19 unit
27.	I did get COVID-19 burnout very early in the process, I’ll be honest. I saw people get it later. I had it very early	HCP07, OT, rehab hospital COVID-19 unit
28.	We didn’t have issues with speaking up if something was wrong. We would address many things to our manager if we felt like things can be improved. It was one of those team dynamics where it was very open and very supportive	HCP 11, RN, acute hospital COVID-19 unit
29.	..seriously someone from upper management should come and say hey staff, yes, great job. You’re doing… You know what, this is really hard. We get it. Listen, you’re sacrificing X, Y, Z. We didn’t get that. You know what we got? We got stop your whining, quit your whining. You know all the hospitals are going through this.	HCP07, OT, rehab hospital COVID-19 unit
30.	Listen empathically is probably the thing that I most needed to do	HCP04, Senior Leader, rehab hospital COVID-19 unit
31.	I think the safety officer program was successful. I think it helps keep the staff, make the staff feel safe, that we were caring for them as well as for the patient. I think that was very important	HCP12, Senior Leader, acute hospital COVID-19 unit