Experiences, challenges and potential solutions of generalist palliative care in inpatient setting during the SARS-CoV2 pandemic

Background: During the SARS-CoV-2 pandemic all health care systems faced enormous challenges. Due to increased severity of illness, palliative care patients continued to require comprehensive care. In order to provide general palliative care during a pandemic, experiences of staff should be utilized. Aim: Description and analysis of experiences, challenges and potential solutions of multiprofessional hospital staff in general palliative care with regard to care of severely ill and dying patients (with/without SARSCoV- 2) and their relatives. Method: After ethical approval qualitative semi-structured online focus groups were conducted. Individual interviews were also used when necessary. The results were recorded, transcribed, and analysed with the qualitative content analysis by Kuckartz. Results: Five focus groups having four to eight participants and one additional individual interview were conducted. The participants either work in intensive care, isolation wards or with patients being exceedingly burdened (e.g. dementia). Fifteen main categories with two to eight subcategories were formed. Patients, relatives and staff as well as visitation regulations and farewell were elaborated as most important main categories. Subcategories are for example insecurity, strain and reprocessing or with regards to visitation: restraints, guidelines or exceptions. The biggest challenge addressed by all interviewees were visitations as the restrictions caused a lot of suffering for everyone involved. Discussion: Current general precautions and general palliative care are insufficiently meeting the needs of severely ill and dying patients. Their needs are still existing throughout the pandemic and should be addressed accordingly. Interprofessional and -disciplinary cooperation is a precondition for individualised care of seriously ill patients and their relatives. Measures preventing infections (e.g. concepts) should be transparently communicated in hospitals. Funding: BMBF.