Family waiting rooms and visitation policies in Japanese intensive care units: A multicentre questionnaire survey

Family waiting rooms and visitation policies in Japanese intensive care units: A multicentre questionnaire survey | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Family waiting rooms and visitation policies in Japanese intensive care units: A multicentre questionnaire survey Kasumi Shirasaki, Kaori Shimazu, Shinsuke Hashiuchi, Toru Hifumi, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6633060/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 04 Jul, 2025 Read the published version in Critical Care → Version 1 posted 11 You are reading this latest preprint version Abstract Background As part of family care to prevent PICS-F, it is recommended that restrictions on visitation be relaxed and the environment of family waiting rooms be made more comfortable. The aim of this study was to investigate the current status of family waiting rooms and visitation policies in Japanese ICUs. Methods A nationwide survey across 292 emergency and critical care centres in Japan using a combination of postal and web-based questionnaires, comprising 12 questions about institutional characteristics, waiting room facilities, and family visitation policies. Results Of the 292 emergency and critical care centres contacted, 151 (51.7%) responded. Of these, 144 institutions (95.4%) had family waiting rooms for ICUs. The waiting rooms typically included tables (76.4%) and chairs (96.5%), but only a few had books and magazines (13.9%), napping areas (10.4%), cooking facilities like microwaves and kettles (3.5%), shower rooms (2.1%), or refrigerators (0.7%). Only 47 institutions (32.6%) offered waiting rooms that adequately protected family privacy. In addition, while 120 institutions (79.5%) restricted visiting hours, typically limited to several hours in the afternoon and limited the number of visitors at the same time, these restrictions were often relaxed in cases of sudden clinical deterioration or near the end of the patient’s life. There were almost no statistical differences in the environment of the family waiting room or visitation policies depending on the number of hospital beds and ICU beds. Conclusions The majority of ICUs in Japan have waiting rooms for the families of patients; however, these institutions often lack essential amenities and do not sufficiently protect privacy compared to other countries. Regarding visitation policies, most institutions restricted family visiting hours to several hours in the afternoon and limited the number of visitors at the same time. It is important to ensure that ICU staffs are aware of the problems with the family waiting room environment and visitation policies in Japanese ICUs, particularly compared to other countries, and to promote the implementation of patient- and family-centred care. critical care intensive care unit post-intensive care syndrome questionnaire family waiting room Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Families of patients admitted to an intensive care unit (ICU) encounter a variety of burdens, and may experience psychological disorders such as anxiety, depression, and posttraumatic stress disorder (PTSD), collectively referred to as post intensive care syndrome-family (PICS-F) [ 1 , 2 ]. Supporting family caregivers is thought to improve patient outcomes, and the importance of providing such support has been increasingly emphasized in recent years [ 3 – 5 ]. As part of family care aimed at preventing PICS-F, it has been recommended that restrictions on visitation be relaxed and the environment of family waiting rooms be improved to make them more comfortable [ 6 , 7 ]. In other countries, nationwide surveys have been conducted on ICU visitation policies and the conditions of family waiting rooms, leading to the identification of various issues and the implementation of initiative to promote family-centred care [ 8 – 10 ]. However, no studies to date have investigated ICU visitation policies or family waiting room environments in Japan. The aim of this study was to investigate the current status of family waiting rooms and visitation policies in Japanese ICUs. Methods This research was conducted through a mixed-methods survey using a combination of postal and web-based questionnaires to investigate the current practices of family waiting rooms and visitation policies in Japanese ICUs. The study adhered to the ethical guidelines set forth in the Declaration of Helsinki and received approval from the Institutional Review Board of St. Luke’s International Hospital (Approval No. 23-R024). The requirement for patient consent was waived because this study was classified as non-interventional without invasive procedures or human-derived specimens. Participants indicated their willingness to participate in the study by selecting a checkbox at the start of the commencement of the survey. Consent was inferred from the returned forms where the box had been checked. Study design and participants A questionnaire was distributed to 292 medical institutions certified as emergency and critical care centres in Japan. The survey targeted at hospitals with emergency and critical care centres but did not assess whether institutions were billing for specific intensive care management fees or emergency medical management fees. In August 2024, a self-addressed questionnaire was mailed to the respondents, specifically addressed to their directors, requesting that they complete and return the questionnaire by 31 September 2024. Respondents, who could be physicians, nurses, administrative staff, or other employees, were provided a QR code for web-based responses. All respondents could select whether to return their responses by post or respond online. Initial consent was indicated through a checkbox on the survey form, which participants marked to signify their willingness to participate in the study. Data Collection The questionnaire comprised a total of 12 questions: two concerned the characteristics of the institutions (total number of beds and number of ICU beds); eight were related to the family waiting room and available services (including facilities to sleep on site); and two addressed visitation policies (including visiting hours and the possibility to extend them, and the maximum number of persons allowed as visitors). Waiting rooms were defined as places where family members of patients admitted to the ICU could spend time, for example, when waiting for a physician to explain the patient’s condition; it did not matter whether these places were a private room or not. If the institution had multiple ICUs or family waiting rooms, then they were asked to provide a general description of a typical ICU or waiting room. The questionnaire text can be accessed in the supplemental materials (Supplemental file 1). Statistical analysis For continuous variables, results are presented as medians with interquartile ranges, and categorical variables are presented as proportions. A univariate analysis was conducted to compare the differences in family waiting room facilities and visitation policies between institutions stratified by total hospital bed count (≥ 500 beds vs < 500 beds) and by number of ICU beds (≥ 10 beds vs < 10 beds). Statistical analyses were performed using JMP Version 18 statistical software (SAS Institute, Cary, NC). Missing data were excluded from the analyses. Results Of the 292 emergency and critical care centres that were initially contacted, 151 (51.7%) returned the questionnaire and provided consent for the use of the survey responses. Characteristics of institutions The characteristics of institutions that responded to the questionnaire are shown in Table 1 . Thirty-seven institutions (24.8%) were university hospitals. In terms of total bed capacity, five institutions (3.3%) had less than 300 beds, 47 institutions (31.1%) had 300 to 499 beds, 91 institutions (60.3%) had 500 to 999 beds, and eight institutions (5.3%) had more than 1000 beds. Regarding the number of ICU beds, six institutions (4.0%) had fewer than six ICU beds, 35 institutions (23.2%) had 6 to 10 ICU beds, 64 institutions (42.4%) had 11 to 20 ICU beds, and 46 institutions (30.4%) had more than 20 ICU beds. Seven institutions (4.6%) did not have any family waiting rooms. The institutions were distributed across Japan. Table 1 Baseline characteristics of institutions Characteristics Institutions (n = 151) Hospital classification University Hospital 37 (24.8%) Community Hospital 112 (75.2%) Hospital beds < 300 5 (3.3%) 300 − 499 47 (31.1%) 500 − 999 91 (60.3%) ≥ 1000 8 (5.3%) ICU beds < 6 6 (4.0%) 6 − 9 35 (23.2%) 10 − 19 64 (42.4%) ≥ 20 46 (30.4%) Family waiting rooms No family waiting room 7 (4.6%) Region Hokkaido 6 (4.0%) Tohoku 10 (6.7%) Kanto 45 (30.2%) Chubu 29 (19.5%) Kinki 28 (18.1%) Chugoku 10 (6.7%) Shikoku 9 (6.0%) Kyushu, Okinawa 13 (8.7%) Data are presented as numbers and percentages for categorical variables ICU, intensive care unit Family waiting rooms The specific details of the 144 institutions that reported having a family waiting room are given in Table 2 . Ninety-four institutions (65.0%) had a waiting room as part of the ICU, 48 institutions (33.0%) had their waiting rooms on the same floor but separate from the ICU, and four institutions (2.8%) had waiting rooms that were located on a different floor from the ICU. Over half of the family waiting rooms (59.9%) were smaller than 50 m 2 . Most of these family waiting rooms were furnished with tables (76.4%) and chairs (96.5%), but only a few had amenities such as books and magazines (13.9%), napping areas (10.4%), cooking facilities (microwave and kettle;3.5%), shower rooms (2.1%), and refrigerators (0.7%). Only one institution (0.7%) provided an information booklet about PICS in the family waiting room. Vending machines (50.0%) and restrooms (45.8%) were available in approximately half of the institutions (Fig. 1 ). Regarding privacy, 47 institutions (32.6%) reported having a private room or partitions to prevent interactions with other patients’ families, another 47 institutions (32.6%) had private rooms but shared the space with other families, and 55 facilities (38.2%) described their waiting area as an open space, such as a lobby, visible to others. Except for the item regarding the location of the family waiting room, no statistically significant differences were observed based on the number of hospital beds and ICU beds. Table 2 Characteristics of family waiting rooms Characteristics All institutions (n = 144) Institutions with ≥ 500 hospital beds (n = 97) Institutions with < 500 hospital beds (n = 47) p -value Institutions with ≥ 10 ICU beds (n = 108) Institutions with < 10 ICU beds (n = 36) p -value Location of the family waiting room Part of the ICU/Adjacent to the ICU 94 (65.0%) 64 (66.0%) 30 (63.8%) 0.85 75 (69.4%) 19 (52.8%) 0.10 Away from the ICU, but on the same floor 48 (33.0%) 35 (36.1%) 13 (27.7%) 0.35 34 (31.5%) 14 (38.9%) 0.42 On a different floor from the ICU 4 (2.8%) 1 (1.0%) 3 (6.4%) 0.10 1 (0.9%) 3 (8.3%) 0.04 Size of family waiting room < 50 m 2 85 (59.9%) 57 (60.0%) 28 (59.6%) 0.97 67 (62.6%) 18 (51.4%) 0.15 50 m 2 − 100 m 2 43 (30.3%) 29 (30.5%) 14 (29.8%) 28 (26.2%) 15 (42.9%) 101 m 2 − 150 m 2 12 (8.5%) 8 (8.4%) 4 (8.5%) 11 (10.3%) 1 (2.9%) ≥ 151 m 2 2 (1.4%) 1 (1.1%) 1 (2.1%) 1 (0.9%) 1 (2.9%) Facilities available in the family waiting room Chair 139 (96.5%) 92 (94.9%) 47 (100%) 0.17 103 (95.4%) 36 (100%) 0.33 Table 110 (76.4%) 77 (79.4%) 33 (70.2%) 0.30 83 (76.9%) 27 (75.0%) 0.82 Vending machine 72 (50.0%) 47 (48.5%) 25 (53.2%) 0.72 58 (53.7%) 36 (100%) 0.33 Restroom 66 (45.8%) 45 (46.4%) 21 (44.7%) 0.86 55 (50.9%) 11 (30.6%) 0.04 Television 52 (36.1%) 33 (34.0%) 19 (40.4%) 0.47 38 (35.2%) 14 (38.9%) 0.69 Books and magazines 20 (13.9%) 15 (15.5%) 5 (10.6%) 0.61 16 (14.8%) 4 (11.1%) 0.78 Napping area 15 (10.4%) 10 (10.3%) 5 (10.6%) 1.00 13 (12.0%) 2 (5.6%) 0.36 Cooking facilities such as a microwave and a kettle 5 (3.5%) 3 (3.1%) 2 (4.3%) 0.66 3 (2.8%) 2 (5.6%) 0.60 Shower room 3 (2.1%) 2 (2.1%) 1 (2.1%) 1.00 2 (1.9%) 1 (2.8%) 1.00 Refrigerator 1 (0.7%) 1 (1.0%) 0 (0%) 1.00 0 (0%) 1 (2.8%) 0.25 Information booklet about PICS or. PICS-F 1 (0.7%) 1 (1.0%) 0 (0%) 1.00 1 (0.9%) 0 (0%) 1.00 Privacy in the family waiting room Completely private rooms or partitions to avoid encountering other patients’ families 47 (32.6%) 33 (34.0%) 14 (29.8%) 0.71 35 (32.4%) 12 (33.3%) 1.00 Private rooms but shared with other patients’ families. 47 (32.6%) 33 (34.0%) 14 (29.8%) 0.71 34 (31.5%) 13 (36.1%) 0.68 Open space, like a lobby, visible to others 55 (38.2%) 36 (37.1%) 19 (40.4%) 0.72 42 (38.9%) 13 (36.1%) 0.84 Data are presented as numbers and percentages for categorical variables ICU, intensive care unit; PICS, post intensive care syndrome; PICS-F, post intensive care syndrome-family Family visitation policies The specific details of family visitation policies at each institution are summarised in Table 3 . Twenty-four institutions (15.9%) permitted 24-hour visitation. In contrast, 120 institutions (79.5%) imposed restrictions on visiting hours, and visiting hours were limited to a few hours (Fig. 2 ). Seven institutions (4.6%) prohibited family visitation entirely. In addition, the distribution of visiting hours through the day are shown in Fig. 3 , which shows that most institutions primarily allowed visits in the afternoon (Fig. 3 ). On the other hand, several institutions indicated that they would relax visitation restrictions under certain circumstances, especially near the end of the patient’s life (79.5%), in the cases of clinical deterioration (80.8%), or at the request of a family member (32.5%). However, only approximately half of the institutions indicated that they provided a place for family members to rest overnight if they were called to the hospital at night. Most institutions (81.3%) limited the number of visitors into the ICU at the same time, allowing only 2.3 people at a time (Fig. 4 ). In addition, 137 institutions (91.3%) had a dedicated room for explaining the patient’s medical conditions with family members. No statistically significant difference was observed depending on the number of hospital beds and ICU beds, except for the presence or absence of a dedicated room for explaining the patient's condition to family members. Table 3 Details of visitation policies Characteristics All institutions (n = 151) Institutions with ≥ 500 hospital beds (n = 97) Institutions with < 500 hospital beds (n = 47) p -value Institutions with ≥ 10 ICU beds (n = 108) Institutions with < 10 ICU beds (n = 36) p -value Time allowed for families to visit ICU patients 24-hour visitation permitted 24 (15.9%) 17 (17.1%) 7 (13.5%) 0.40 17 (15.5%) 7 (17.1%) 0.07 Restricted visitation hours 120 (79.5%) 76 (76.8%) 44 (84.6%) 88 (80.0%) 32 (78.1%) Visitation prohibition 7 (4.6%) 6 (6.1%) 1 (1.9%) 5 (4.6%) 2 (4.9%) Visiting hours Average visiting hours allowed (minutes) 180 [120–300] 180 [120–300] 180 [120–240] 0.10 180 [120–300] 180 [120–300] 0.72 Situations in which visiting policies may be extended Near end of life 120 (79.5%) 79 (79.8%) 41 (78.9%) 1.00 88 (80.0%) 32 (78.1%) 0.82 Clinical deterioration 122 (80.8%) 81 (81.8%) 41 (78.9%) 0.67 88 (80.0%) 34 (82.9%) 0.82 On family request 49 (32.5%) 31 (31.3%) 18 (34.6%) 0.72 38 (34.6%) 11 (26.8%) 0.44 Places for overnight stays if a family member is called in at night Cots at the patient's bedside 23 (15.2%) 17 (17.2%) 6 (11.5%) 0.48 19 (17.3%) 4 (9.8%) 0.32 Dedicated rooms in the hospital 31 (20.5%) 21 (21.2%) 10 (19.2%) 0.83 23 (20.9%) 8 (19.5%) 1.00 Accommodations provided by the hospital 6 (4.0%) 3 (3.0%) 3 (5.8%) 0.41 4 (3.6%) 2 (4.9%) 0.67 No place to sleep 77 (51.0%) 47 (47.5%) 30 (57.7%) 0.30 56 (50.9%) 21 (51.2%) 1.00 Other 21 (13.9%) 16 (16.1%) 5 (9.6%) 0.33 15 (13.6%) 6 (14.6%) 1.00 Restrictions on the number of visitors at one time Limit on the number of visitors to the ICU 122 (81.3%) 80 (80.8%) 42 (82.4%) 1.00 89 (80.9%) 33 (82.5%) 1.00 Maximum number of visitors at one time 2 [ 2 – 3 ] 2.5 [ 2 – 3 ] 2 [ 2 – 3 ] 0.06 2.5 [ 2 – 3 ] 2 [ 2 – 3 ] 0.67 Room for explaining the patient’s condition There is a dedicated room for doctors to explain the patient’s condition. 137 (91.3%) 93 (94.9%) 44 (84.6%) 0.06 104 (94.6%) 33 (82.5%) 0.04 Data are presented as numbers and percentages for categorical variables, otherwise as median and interquartile range. ICU, intensive care unit Discussion The present study investigated the current status of family waiting rooms and visitation policies in Japanese ICUs. It was found that most ICU family waiting rooms were furnished with basic furniture such as tables and chairs, whereas amenities such as microwaves, other cooking equipment, or areas for napping were less common. Furthermore, fewer than half of the institutions provided waiting rooms that adequately protected the privacy of families. Regarding visitation policies, most institutions restricted family visiting hours to several hours in the afternoon and limited the number of visitors permitted simultaneously. However, it was noted that many institutions relaxed visitation restrictions in specific cases, such as sudden deterioration in the patient’s condition or near the end of life. On the other hand, only approximately half of the institutions indicated that they provided a place for family members to rest overnight if they were called to the hospital at night. There were almost no statistical differences in the environment of the family waiting room or visitation policies depending on the number of hospital beds and ICU beds. In a previous study, the lack of a waiting room was reported as a contributing factor to causing depression among family members of ICU patients [ 11 ]. In 2001, 19% of ICUs in France were reported to lack family waiting rooms, and in a subsequent survey conducted in 2016 found that only 62.8% of ICUs had such facilities [ 9 , 10 ]. In the present study, most institutions had family waiting rooms, representing a higher proportion than that reported in the French survey. This difference may reflect national guidelines and cultural context rather than differences in hospital size. However, simply setting up a waiting room is insufficient. A study of two ICUs in Australia reported that family satisfaction was impacted by communication with medical staff, waiting room facilities, and visiting times [ 12 ]. The authors concluded that developing family-friendly clinical spaces and waiting rooms that ensure family privacy and provide amenities that support comfort and rest throughout the ICU stay may enhance family satisfaction levels [ 12 ]. The guidelines from the United States on ICU design recommend that family waiting rooms be located near the ICU and structured to ensure privacy [ 7 , 13 ]. In addition, it is recommended that vending machines, microwaves, refrigerators, and coffee makers be provided when hospital coffee shops or food services may not be available [ 7 , 13 ]. In many institutions surveyed in the present study, family waiting rooms were located in part of the ICU, adjacent to the ICU, or on the same floor as the ICU, but only about 30% of the institutions ensured privacy. The protection of family privacy and the provision of amenities in family waiting rooms are considered to be important factors that contribute to the physical and psychological well-being of families. For example, even if a waiting room is situated in an open area such as a lobby, installing partitions could easily increase privacy, preventing families from being in direct view of others [ 7 ]. As for the amenities in the family waiting room, most of the ICUs in The Netherlands have facilities for the family members including catering facilities like coffee, tea and meals [ 14 ]; however, few institutions in Japan were equipped with these facilities. The results of the present study indicate that, compared to ICUs in other countries, Japanese ICUs face challenges related to the provision of privacy in family waiting rooms and the availability of amenities that support a comfortable stay. A previous study found that visitation restrictions imposed on close family members of ICU patients caused significant distress in some families [ 15 ]. In addition, it has been reported that relaxing visitation restrictions can significantly reduce the incidence of delirium in ICU patients, indicating that unrestricted visitation policies may be beneficial for both patients and their families [ 16 ]. Previous guidelines recommend allowing patient family visits to be as flexible as possible, based on the needs of the family [ 6 , 17 ]. Nonetheless, in many countries, most institutions have restrictive visitation policies, such as having limits on visiting hours, visit duration, and the number of visitors [ 8 – 10 , 14 , 18 , 19 ]. The present study also found that most institutions typically allowed family visits to the ICU for only a few hours in the afternoon and that they also limited the number of visitors, which was consistent with the findings in other countries. In previous studies that evaluated the perceptions of physicians, nurses, and respiratory therapists of an open visitation policy (OVP), more than half of the healthcare professionals reported negative views, including concerns that OVP led to increased interruptions in their work [ 20 , 21 ]. There is also a risk of infection from recommending OVP [ 22 ]. These findings may help explain why, despite recommendations in clinical guidelines, open visitation policies are often subject to restrictions in practice across various countries [ 8 – 10 , 14 , 18 , 19 ]. Consistent with reports from other countries, most institutions in the present study relaxed visitation restrictions in cases of sudden clinical deterioration or when patients were near the end of the life. Previous studies have also shown that it is not uncommon for families of ICU patients families to spend the night in the family waiting room [ 23 ]. Furthermore, family members who spent one or more nights in the hospital exhibited significantly higher levels of sleep disturbance, anxiety, and fatigue [ 23 ]. In light of these findings, the establishment of one or more family sleep rooms near the lounge or ICU has been recommended [ 7 , 13 ]. However, similar to the findings of the present study, many ICUs in other countries do not provide facilities for overnight stays [ 24 ]. Day et al. reported that the family members of ICU patients remained in the waiting room because they were too anxious to go home [ 23 ]. Ideally, it would be desirable to integrate family overnight accommodation facilities into the ICU at the design phase; indeed, even if this is difficult, we should support families by alleviating their anxiety through effective communication so that they can go home and rest [ 24 ]. This is the first report to assess the issue of family waiting room environments and visitation policies in Japan. Despite the existence of several international guidelines regarding family waiting rooms and family visitation policies in ICUs, numerous ICUs in Japan had not implemented or adopted these policies. Although evidence showing that interventions capable of quantitatively preventing PICS-F remains limited, relaxing visitation restrictions and improving the waiting room environment are considered to reduce family anxiety and stress responses, which in turn reduce the risk of PICS-F. It is also necessary to inform ICU staff of the problems with the family waiting room environment and visitation policies at ICUs in Japan, and promote both patient- and family-centred care. The present study has several limitations. First, the response rate for the questionnaire was 51.7%, and the voluntary nature of the survey may introduce sampling bias. Second, the reliance on self-administered questionnaires means that there is a possibility that the data obtained may not be accurate. Third, this is a survey of ICUs in Japan, and it may not be possible to generalise the results. Fourth, this study was conducted after the COVID-19 pandemic, and the effects of restrictions on visits due to COVID-19 infection may have influenced the results. Finally, the present study did not collect data on whether or not institutions were charging specific intensive care management fees or emergency medical management fees. Conclusions The majority of ICUs in Japan have waiting rooms for the families of patients; however, compared to other countries, these institutions often lack essential amenities and do not sufficiently protect privacy. Regarding visitation policies, most institutions restricted family visiting hours to several hours in the afternoon and limited the number of visitors at the same time. It is necessary to inform ICU staff of the problems associated with the family waiting room environment and of the problems associated with visitation policies at ICUs in Japan, and to promote patient- and family-centred intensive care. Declarations Conflicts of Interest and Source of Funding Shirasaki received funding from the Shintaro Akatsu Young Scientist Incentive Program of the St. Luke’s Health Science Research Fund. The present study was supported by the Shintaro Akatsu Young Scientist Incentive Program of the St. Luke’s Health Science Research Fund.The remaining authors have no potential conflicts of interest to disclose. Ethics approval and consent to participate The study received approval from the Institutional Review Board of St. Luke’s International Hospital (Approval No. 23-R024). The requirement for patient consent was waived because this study was classified as non-interventional without invasive procedures or human-derived specimens. Participants indicated their willingness to participate in the study by selecting a checkbox at the start of the commencement of the survey. Consent was inferred from the returned forms where the box had been checked. Consent for publication Not applicable Competing interests Shirasaki received funding from the Shintaro Akatsu Young Scientist Incentive Program of the St. Luke’s Health Science Research Fund. The remaining authors disclose that they do not have any potential conflicts of interest. Funding The present study was supported by a grant from the Shintaro Akatsu Young Scientist Incentive Program of the St. Luke’s Health Science Research Fund. Author Contribution All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by KS, KS and SH. The first draft of the manuscript was written by KS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Acknowledgements The authors express their sincere gratitude to all of the emergency and critical care centres that participated in this survey. Availability of data and materials The datasets used and analysed during the current study are available from the corresponding author on reasonable request. References Davidson JE, Jones C, Bienvenu OJ. Family response to critical illness: postintensive care syndrome-family. Crit Care Med. 2012;40:618-624. doi: 10.1097/CCM.0b013e318236ebf9. Kentish-Barnes N, Lemiale V, Chaize M, Pochard F, Azoulay E. Assessing burden in families of critical care patients. Crit Care Med. 2009;37:448-456. doi: 10.1097/CCM.0b013e3181b6e145. Adelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS. Caregiver burden: a clinical review. JAMA. 2014;311:1052-1060. doi: 10.1001/jama.2014.304. Lynn J. Strategies to ease the burden of family caregivers. JAMA. 2014;311:1021-1022. doi: 10.1001/jama.2014.1769. Shirasaki K, Hifumi T, Nakanishi N et al. 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Partial liberalization of visiting policies and ICU staff: a before-and-after study. Intensive Care Med. 2013;39:2180-2187. doi: 10.1007/s00134-013-3087-5. da Silva Ramos FJ, Fumis RR, Azevedo LC, Schettino G. Perceptions of an open visitation policy by intensive care unit workers. Ann Intensive Care. 2013;3:34. doi: 10.1186/2110-5820-3-34. Boulton AJ, Jordan H, Adams CE, et al. Intensive care unit visiting and family communication during the COVID-19 pandemic: A UK survey. J Intensive Care Soc 2022;23:293-296. doi: 10.1177/17511437211007779. Day A, Haj-Bakri S, Lubchansky S, Mehta S. Sleep, anxiety and fatigue in family members of patients admitted to the intensive care unit: a questionnaire study. Crit Care. 2013;17:R91. doi: 10.1186/cc12736. Schmidt M, Azoulay E. Sleepless nights in the ICU: the awaken family. Crit Care. 2013;17:1003. doi: 10.1186/cc12781. Additional Declarations No competing interests reported. Supplementary Files SupplementalTable1.docx Cite Share Download PDF Status: Published Journal Publication published 04 Jul, 2025 Read the published version in Critical Care → Version 1 posted Editorial decision: Revision requested 20 May, 2025 Reviews received at journal 19 May, 2025 Reviewers agreed at journal 18 May, 2025 Reviews received at journal 15 May, 2025 Reviewers agreed at journal 14 May, 2025 Reviewers agreed at journal 14 May, 2025 Reviewers agreed at journal 13 May, 2025 Reviewers invited by journal 13 May, 2025 Editor assigned by journal 12 May, 2025 Submission checks completed at journal 12 May, 2025 First submitted to journal 10 May, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6633060","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":455871669,"identity":"e523ca35-abea-4e94-818a-b89cda5bb751","order_by":0,"name":"Kasumi Shirasaki","email":"data:image/png;base64,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","orcid":"","institution":"St. Luke’s International Hospital","correspondingAuthor":true,"prefix":"","firstName":"Kasumi","middleName":"","lastName":"Shirasaki","suffix":""},{"id":455871670,"identity":"129cd259-f1ea-48c6-9082-55617e782d87","order_by":1,"name":"Kaori Shimazu","email":"","orcid":"","institution":"St. Luke’s International Hospital","correspondingAuthor":false,"prefix":"","firstName":"Kaori","middleName":"","lastName":"Shimazu","suffix":""},{"id":455871671,"identity":"73f0d34c-c58f-4f1b-a4a6-0fb60d205a4f","order_by":2,"name":"Shinsuke Hashiuchi","email":"","orcid":"","institution":"St. Luke’s International Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shinsuke","middleName":"","lastName":"Hashiuchi","suffix":""},{"id":455871672,"identity":"32f791a7-757e-4b19-96c0-291e20056e3b","order_by":3,"name":"Toru Hifumi","email":"","orcid":"","institution":"Kyorin University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Toru","middleName":"","lastName":"Hifumi","suffix":""},{"id":455871673,"identity":"73047ef5-c710-4c98-b4e3-4c261cd2c7fa","order_by":4,"name":"Masaki Okajima","email":"","orcid":"","institution":"Kanazawa University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Masaki","middleName":"","lastName":"Okajima","suffix":""},{"id":455871674,"identity":"b310525b-bae9-4352-96d8-38a0e00b5c18","order_by":5,"name":"Norio Otani","email":"","orcid":"","institution":"St. Luke’s International Hospital","correspondingAuthor":false,"prefix":"","firstName":"Norio","middleName":"","lastName":"Otani","suffix":""}],"badges":[],"createdAt":"2025-05-10 07:08:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6633060/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6633060/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s13054-025-05533-1","type":"published","date":"2025-07-04T15:57:52+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":82797960,"identity":"428d6b39-2cc4-4cf8-b77f-c24a009b9f46","added_by":"auto","created_at":"2025-05-15 10:47:35","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":370472,"visible":true,"origin":"","legend":"\u003cp\u003eRelative proportions of amenities and equipment available in family waiting rooms.\u003c/p\u003e","description":"","filename":"fig1.tif.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6633060/v1/7ae2b600a0c51f1d5f963624.jpg"},{"id":82799269,"identity":"5c769c63-6cb5-4698-a634-0e2b800ab6aa","added_by":"auto","created_at":"2025-05-15 10:55:35","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":35599,"visible":true,"origin":"","legend":"\u003cp\u003eVisitation hours permitted for family members of ICU patients\u003c/p\u003e","description":"","filename":"Fig2r1.tiff.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6633060/v1/c3a2e2e169fd5eb2dca689de.jpg"},{"id":82800625,"identity":"a8c301a5-2c98-440c-a278-56369b348a82","added_by":"auto","created_at":"2025-05-15 11:11:35","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":54016,"visible":true,"origin":"","legend":"\u003cp\u003eFrequency distribution of visiting hours at intensive care units (ICUs) by time of the day. The graph shows the percentage of ICUs allowing family visits, with peak visiting times in the afternoon. Each data point represents the proportion of ICUs open to visitors per hour.\u003c/p\u003e","description":"","filename":"Figure3r1.tiff.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6633060/v1/018768c81862933f24815c36.jpg"},{"id":82797967,"identity":"ebc94c57-0c00-4745-8ae5-ba73a8d5c95f","added_by":"auto","created_at":"2025-05-15 10:47:35","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":34560,"visible":true,"origin":"","legend":"\u003cp\u003eNumber of family members permitted to visit ICU patients simultaneously.\u003c/p\u003e","description":"","filename":"Fig4r1.tiff.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6633060/v1/588e0dd4b315d135fb1eb66b.jpg"},{"id":86180122,"identity":"7af2e5ea-bcb2-4cb7-84b5-2d2ca2bce632","added_by":"auto","created_at":"2025-07-07 16:21:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1878503,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6633060/v1/ddc40f01-6aa6-4db4-b98b-bd880cb9b242.pdf"},{"id":82797969,"identity":"a84a8ad3-e99f-4d51-8b45-0c4d283b0ba7","added_by":"auto","created_at":"2025-05-15 10:47:35","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":23985,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementalTable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-6633060/v1/00206fe12b2e31b77bb6648d.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Family waiting rooms and visitation policies in Japanese intensive care units: A multicentre questionnaire survey","fulltext":[{"header":"Background","content":"\u003cp\u003eFamilies of patients admitted to an intensive care unit (ICU) encounter a variety of burdens, and may experience psychological disorders such as anxiety, depression, and posttraumatic stress disorder (PTSD), collectively referred to as post intensive care syndrome-family (PICS-F) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Supporting family caregivers is thought to improve patient outcomes, and the importance of providing such support has been increasingly emphasized in recent years [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs part of family care aimed at preventing PICS-F, it has been recommended that restrictions on visitation be relaxed and the environment of family waiting rooms be improved to make them more comfortable [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In other countries, nationwide surveys have been conducted on ICU visitation policies and the conditions of family waiting rooms, leading to the identification of various issues and the implementation of initiative to promote family-centred care [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. However, no studies to date have investigated ICU visitation policies or family waiting room environments in Japan.\u003c/p\u003e \u003cp\u003eThe aim of this study was to investigate the current status of family waiting rooms and visitation policies in Japanese ICUs.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis research was conducted through a mixed-methods survey using a combination of postal and web-based questionnaires to investigate the current practices of family waiting rooms and visitation policies in Japanese ICUs. The study adhered to the ethical guidelines set forth in the Declaration of Helsinki and received approval from the Institutional Review Board of St. Luke\u0026rsquo;s International Hospital (Approval No. 23-R024). The requirement for patient consent was waived because this study was classified as non-interventional without invasive procedures or human-derived specimens. Participants indicated their willingness to participate in the study by selecting a checkbox at the start of the commencement of the survey. Consent was inferred from the returned forms where the box had been checked.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and participants\u003c/h2\u003e \u003cp\u003eA questionnaire was distributed to 292 medical institutions certified as emergency and critical care centres in Japan. The survey targeted at hospitals with emergency and critical care centres but did not assess whether institutions were billing for specific intensive care management fees or emergency medical management fees. In August 2024, a self-addressed questionnaire was mailed to the respondents, specifically addressed to their directors, requesting that they complete and return the questionnaire by 31 September 2024. Respondents, who could be physicians, nurses, administrative staff, or other employees, were provided a QR code for web-based responses. All respondents could select whether to return their responses by post or respond online. Initial consent was indicated through a checkbox on the survey form, which participants marked to signify their willingness to participate in the study.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eThe questionnaire comprised a total of 12 questions: two concerned the characteristics of the institutions (total number of beds and number of ICU beds); eight were related to the family waiting room and available services (including facilities to sleep on site); and two addressed visitation policies (including visiting hours and the possibility to extend them, and the maximum number of persons allowed as visitors). Waiting rooms were defined as places where family members of patients admitted to the ICU could spend time, for example, when waiting for a physician to explain the patient\u0026rsquo;s condition; it did not matter whether these places were a private room or not. If the institution had multiple ICUs or family waiting rooms, then they were asked to provide a general description of a typical ICU or waiting room. The questionnaire text can be accessed in the supplemental materials (Supplemental file 1).\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eFor continuous variables, results are presented as medians with interquartile ranges, and categorical variables are presented as proportions. A univariate analysis was conducted to compare the differences in family waiting room facilities and visitation policies between institutions stratified by total hospital bed count (\u0026ge;\u0026thinsp;500 beds vs\u0026thinsp;\u0026lt;\u0026thinsp;500 beds) and by number of ICU beds (\u0026ge;\u0026thinsp;10 beds vs\u0026thinsp;\u0026lt;\u0026thinsp;10 beds). Statistical analyses were performed using JMP Version 18 statistical software (SAS Institute, Cary, NC). Missing data were excluded from the analyses.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eOf the 292 emergency and critical care centres that were initially contacted, 151 (51.7%) returned the questionnaire and provided consent for the use of the survey responses.\u003c/p\u003e\n\u003ch3\u003eCharacteristics of institutions\u003c/h3\u003e\n\u003cp\u003eThe characteristics of institutions that responded to the questionnaire are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Thirty-seven institutions (24.8%) were university hospitals. In terms of total bed capacity, five institutions (3.3%) had less than 300 beds, 47 institutions (31.1%) had 300 to 499 beds, 91 institutions (60.3%) had 500 to 999 beds, and eight institutions (5.3%) had more than 1000 beds. Regarding the number of ICU beds, six institutions (4.0%) had fewer than six ICU beds, 35 institutions (23.2%) had 6 to 10 ICU beds, 64 institutions (42.4%) had 11 to 20 ICU beds, and 46 institutions (30.4%) had more than 20 ICU beds. Seven institutions (4.6%) did not have any family waiting rooms. The institutions were distributed across Japan.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline characteristics of institutions\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInstitutions (n\u0026thinsp;=\u0026thinsp;151)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital classification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 (24.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCommunity Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112 (75.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHospital beds\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt; 300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (3.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e300\u0026thinsp;\u0026minus;\u0026thinsp;499\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47 (31.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e500\u0026thinsp;\u0026minus;\u0026thinsp;999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91 (60.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge; 1000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (5.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eICU beds\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt; 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (4.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u0026thinsp;\u0026minus;\u0026thinsp;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35 (23.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026thinsp;\u0026minus;\u0026thinsp;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64 (42.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46 (30.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFamily waiting rooms\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo family waiting room\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (4.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHokkaido\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6 (4.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTohoku\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKanto\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45 (30.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChubu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29 (19.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKinki\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (18.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChugoku\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShikoku\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9 (6.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKyushu, Okinawa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13 (8.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eData are presented as numbers and percentages for categorical variables\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eICU, intensive care unit\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eFamily waiting rooms\u003c/h2\u003e \u003cp\u003eThe specific details of the 144 institutions that reported having a family waiting room are given in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Ninety-four institutions (65.0%) had a waiting room as part of the ICU, 48 institutions (33.0%) had their waiting rooms on the same floor but separate from the ICU, and four institutions (2.8%) had waiting rooms that were located on a different floor from the ICU. Over half of the family waiting rooms (59.9%) were smaller than 50 m\u003csup\u003e2\u003c/sup\u003e. Most of these family waiting rooms were furnished with tables (76.4%) and chairs (96.5%), but only a few had amenities such as books and magazines (13.9%), napping areas (10.4%), cooking facilities (microwave and kettle;3.5%), shower rooms (2.1%), and refrigerators (0.7%). Only one institution (0.7%) provided an information booklet about PICS in the family waiting room. Vending machines (50.0%) and restrooms (45.8%) were available in approximately half of the institutions (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Regarding privacy, 47 institutions (32.6%) reported having a private room or partitions to prevent interactions with other patients\u0026rsquo; families, another 47 institutions (32.6%) had private rooms but shared the space with other families, and 55 facilities (38.2%) described their waiting area as an open space, such as a lobby, visible to others. Except for the item regarding the location of the family waiting room, no statistically significant differences were observed based on the number of hospital beds and ICU beds.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of family waiting rooms\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAll institutions\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;144)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInstitutions with\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;500 hospital beds\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;97)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eInstitutions with \u0026lt;\u0026thinsp;500 hospital beds\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eInstitutions with\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;10 ICU beds\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;108)\u003c/p\u003e\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eInstitutions with \u0026lt;\u0026thinsp;10 ICU beds\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;36)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocation of the family waiting room\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePart of the ICU/Adjacent to the ICU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e94 (65.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64 (66.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (63.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75 (69.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19 (52.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAway from the ICU, but on the same floor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48 (33.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35 (36.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (27.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34 (31.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14 (38.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOn a different floor from the ICU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (2.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (1.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (6.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (0.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSize of family waiting room\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;50 m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e85 (59.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57 (60.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (59.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e67 (62.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18 (51.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50 m\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;\u0026minus;\u0026thinsp;100 m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43 (30.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29 (30.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (29.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28 (26.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e15 (42.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e101 m\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;\u0026minus;\u0026thinsp;150 m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12 (8.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (8.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (8.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11 (10.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (2.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;151 m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (1.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (1.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (2.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (0.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (2.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFacilities available in the family waiting room\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e139 (96.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92 (94.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e103 (95.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e36 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e110 (76.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77 (79.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33 (70.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e83 (76.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e27 (75.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVending machine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47 (48.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (53.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e58 (53.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e36 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRestroom\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e66 (45.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45 (46.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (44.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e55 (50.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11 (30.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTelevision\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52 (36.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (34.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (40.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38 (35.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14 (38.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBooks and magazines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20 (13.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (15.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (10.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16 (14.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (11.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNapping area\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15 (10.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (10.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (10.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 (12.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (5.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCooking facilities such as a microwave and a kettle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (3.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (3.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (4.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (2.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (5.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShower room\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (2.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (2.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (2.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (2.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRefrigerator\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (1.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 (2.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInformation booklet about PICS or. PICS-F\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (1.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (0.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrivacy in the family waiting room\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompletely private rooms or partitions to avoid encountering other patients\u0026rsquo; families\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47 (32.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (34.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (29.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e35 (32.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate rooms but shared with other patients\u0026rsquo; families.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47 (32.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (34.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (29.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34 (31.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13 (36.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOpen space, like a lobby, visible to others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55 (38.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (37.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (40.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42 (38.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13 (36.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eData are presented as numbers and percentages for categorical variables\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eICU, intensive care unit; PICS, post intensive care syndrome; PICS-F, post intensive care syndrome-family\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eFamily visitation policies\u003c/h3\u003e\n\u003cp\u003eThe specific details of family visitation policies at each institution are summarised in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Twenty-four institutions (15.9%) permitted 24-hour visitation. In contrast, 120 institutions (79.5%) imposed restrictions on visiting hours, and visiting hours were limited to a few hours (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Seven institutions (4.6%) prohibited family visitation entirely. In addition, the distribution of visiting hours through the day are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, which shows that most institutions primarily allowed visits in the afternoon (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). On the other hand, several institutions indicated that they would relax visitation restrictions under certain circumstances, especially near the end of the patient\u0026rsquo;s life (79.5%), in the cases of clinical deterioration (80.8%), or at the request of a family member (32.5%). However, only approximately half of the institutions indicated that they provided a place for family members to rest overnight if they were called to the hospital at night. Most institutions (81.3%) limited the number of visitors into the ICU at the same time, allowing only 2.3 people at a time (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). In addition, 137 institutions (91.3%) had a dedicated room for explaining the patient\u0026rsquo;s medical conditions with family members. No statistically significant difference was observed depending on the number of hospital beds and ICU beds, except for the presence or absence of a dedicated room for explaining the patient's condition to family members.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDetails of visitation policies\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAll institutions\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;151)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInstitutions with\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;500 hospital beds\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;97)\u003c/p\u003e\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eInstitutions with \u0026lt;\u0026thinsp;500 hospital beds\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;47)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eInstitutions with\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;10 ICU beds\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;108)\u003c/p\u003e\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eInstitutions with \u0026lt;\u0026thinsp;10 ICU beds\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;36)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTime allowed for families to visit ICU patients\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24-hour visitation permitted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (15.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (17.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (13.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17 (15.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7 (17.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRestricted visitation hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120 (79.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76 (76.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44 (84.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e88 (80.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e32 (78.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVisitation prohibition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (4.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (6.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (1.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (4.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (4.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVisiting hours\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAverage visiting hours allowed (minutes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e180 [120\u0026ndash;300]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e180 [120\u0026ndash;300]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e180 [120\u0026ndash;240]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e180 [120\u0026ndash;300]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e180 [120\u0026ndash;300]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSituations in which visiting policies may be extended\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNear end of life\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120 (79.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79 (79.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41 (78.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e88 (80.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e32 (78.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical deterioration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e122 (80.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81 (81.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41 (78.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e88 (80.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e34 (82.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOn family request\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49 (32.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (31.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (34.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38 (34.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11 (26.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePlaces for overnight stays if a family member is called in at night\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCots at the patient's bedside\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23 (15.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (17.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (11.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19 (17.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 (9.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDedicated rooms in the hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (20.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (21.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (19.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23 (20.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 (19.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccommodations provided by the hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (4.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (3.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (5.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 (3.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (4.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo place to sleep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77 (51.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47 (47.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (57.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e56 (50.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21 (51.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (13.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (16.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (9.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15 (13.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6 (14.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRestrictions on the number of visitors at one time\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLimit on the number of visitors to the ICU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e122 (81.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80 (80.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42 (82.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e89 (80.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e33 (82.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaximum number of visitors at one time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.5 [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.5 [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRoom for explaining the patient\u0026rsquo;s condition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThere is a dedicated room for doctors to explain the patient\u0026rsquo;s condition.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e137 (91.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93 (94.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44 (84.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e104 (94.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e33 (82.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eData are presented as numbers and percentages for categorical variables, otherwise as median and interquartile range.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eICU, intensive care unit\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study investigated the current status of family waiting rooms and visitation policies in Japanese ICUs. It was found that most ICU family waiting rooms were furnished with basic furniture such as tables and chairs, whereas amenities such as microwaves, other cooking equipment, or areas for napping were less common. Furthermore, fewer than half of the institutions provided waiting rooms that adequately protected the privacy of families. Regarding visitation policies, most institutions restricted family visiting hours to several hours in the afternoon and limited the number of visitors permitted simultaneously. However, it was noted that many institutions relaxed visitation restrictions in specific cases, such as sudden deterioration in the patient\u0026rsquo;s condition or near the end of life. On the other hand, only approximately half of the institutions indicated that they provided a place for family members to rest overnight if they were called to the hospital at night. There were almost no statistical differences in the environment of the family waiting room or visitation policies depending on the number of hospital beds and ICU beds.\u003c/p\u003e \u003cp\u003eIn a previous study, the lack of a waiting room was reported as a contributing factor to causing depression among family members of ICU patients [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In 2001, 19% of ICUs in France were reported to lack family waiting rooms, and in a subsequent survey conducted in 2016 found that only 62.8% of ICUs had such facilities [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In the present study, most institutions had family waiting rooms, representing a higher proportion than that reported in the French survey. This difference may reflect national guidelines and cultural context rather than differences in hospital size.\u003c/p\u003e \u003cp\u003eHowever, simply setting up a waiting room is insufficient. A study of two ICUs in Australia reported that family satisfaction was impacted by communication with medical staff, waiting room facilities, and visiting times [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The authors concluded that developing family-friendly clinical spaces and waiting rooms that ensure family privacy and provide amenities that support comfort and rest throughout the ICU stay may enhance family satisfaction levels [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The guidelines from the United States on ICU design recommend that family waiting rooms be located near the ICU and structured to ensure privacy [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In addition, it is recommended that vending machines, microwaves, refrigerators, and coffee makers be provided when hospital coffee shops or food services may not be available [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In many institutions surveyed in the present study, family waiting rooms were located in part of the ICU, adjacent to the ICU, or on the same floor as the ICU, but only about 30% of the institutions ensured privacy. The protection of family privacy and the provision of amenities in family waiting rooms are considered to be important factors that contribute to the physical and psychological well-being of families. For example, even if a waiting room is situated in an open area such as a lobby, installing partitions could easily increase privacy, preventing families from being in direct view of others [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. As for the amenities in the family waiting room, most of the ICUs in The Netherlands have facilities for the family members including catering facilities like coffee, tea and meals [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]; however, few institutions in Japan were equipped with these facilities. The results of the present study indicate that, compared to ICUs in other countries, Japanese ICUs face challenges related to the provision of privacy in family waiting rooms and the availability of amenities that support a comfortable stay.\u003c/p\u003e \u003cp\u003eA previous study found that visitation restrictions imposed on close family members of ICU patients caused significant distress in some families [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In addition, it has been reported that relaxing visitation restrictions can significantly reduce the incidence of delirium in ICU patients, indicating that unrestricted visitation policies may be beneficial for both patients and their families [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Previous guidelines recommend allowing patient family visits to be as flexible as possible, based on the needs of the family [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Nonetheless, in many countries, most institutions have restrictive visitation policies, such as having limits on visiting hours, visit duration, and the number of visitors [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The present study also found that most institutions typically allowed family visits to the ICU for only a few hours in the afternoon and that they also limited the number of visitors, which was consistent with the findings in other countries. In previous studies that evaluated the perceptions of physicians, nurses, and respiratory therapists of an open visitation policy (OVP), more than half of the healthcare professionals reported negative views, including concerns that OVP led to increased interruptions in their work [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. There is also a risk of infection from recommending OVP [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. These findings may help explain why, despite recommendations in clinical guidelines, open visitation policies are often subject to restrictions in practice across various countries [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eConsistent with reports from other countries, most institutions in the present study relaxed visitation restrictions in cases of sudden clinical deterioration or when patients were near the end of the life. Previous studies have also shown that it is not uncommon for families of ICU patients families to spend the night in the family waiting room [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Furthermore, family members who spent one or more nights in the hospital exhibited significantly higher levels of sleep disturbance, anxiety, and fatigue [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. In light of these findings, the establishment of one or more family sleep rooms near the lounge or ICU has been recommended [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. However, similar to the findings of the present study, many ICUs in other countries do not provide facilities for overnight stays [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Day et al. reported that the family members of ICU patients remained in the waiting room because they were too anxious to go home [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Ideally, it would be desirable to integrate family overnight accommodation facilities into the ICU at the design phase; indeed, even if this is difficult, we should support families by alleviating their anxiety through effective communication so that they can go home and rest [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis is the first report to assess the issue of family waiting room environments and visitation policies in Japan. Despite the existence of several international guidelines regarding family waiting rooms and family visitation policies in ICUs, numerous ICUs in Japan had not implemented or adopted these policies. Although evidence showing that interventions capable of quantitatively preventing PICS-F remains limited, relaxing visitation restrictions and improving the waiting room environment are considered to reduce family anxiety and stress responses, which in turn reduce the risk of PICS-F. It is also necessary to inform ICU staff of the problems with the family waiting room environment and visitation policies at ICUs in Japan, and promote both patient- and family-centred care.\u003c/p\u003e \u003cp\u003eThe present study has several limitations. First, the response rate for the questionnaire was 51.7%, and the voluntary nature of the survey may introduce sampling bias. Second, the reliance on self-administered questionnaires means that there is a possibility that the data obtained may not be accurate. Third, this is a survey of ICUs in Japan, and it may not be possible to generalise the results. Fourth, this study was conducted after the COVID-19 pandemic, and the effects of restrictions on visits due to COVID-19 infection may have influenced the results. Finally, the present study did not collect data on whether or not institutions were charging specific intensive care management fees or emergency medical management fees.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe majority of ICUs in Japan have waiting rooms for the families of patients; however, compared to other countries, these institutions often lack essential amenities and do not sufficiently protect privacy. Regarding visitation policies, most institutions restricted family visiting hours to several hours in the afternoon and limited the number of visitors at the same time. It is necessary to inform ICU staff of the problems associated with the family waiting room environment and of the problems associated with visitation policies at ICUs in Japan, and to promote patient- and family-centred intensive care.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eConflicts of Interest and Source of Funding\u003c/h2\u003e \u003cp\u003e Shirasaki received funding from the Shintaro Akatsu Young Scientist Incentive Program of the St. Luke\u0026rsquo;s Health Science Research Fund. The present study was supported by the Shintaro Akatsu Young Scientist Incentive Program of the St. Luke\u0026rsquo;s Health Science Research Fund.The remaining authors have no potential conflicts of interest to disclose.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003e The study received approval from the Institutional Review Board of St. Luke\u0026rsquo;s International Hospital (Approval No. 23-R024). The requirement for patient consent was waived because this study was classified as non-interventional without invasive procedures or human-derived specimens. Participants indicated their willingness to participate in the study by selecting a checkbox at the start of the commencement of the survey. Consent was inferred from the returned forms where the box had been checked.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eShirasaki received funding from the Shintaro Akatsu Young Scientist Incentive Program of the St. Luke\u0026rsquo;s Health Science Research Fund. The remaining authors disclose that they do not have any potential conflicts of interest.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThe present study was supported by a grant from the Shintaro Akatsu Young Scientist Incentive Program of the St. Luke\u0026rsquo;s Health Science Research Fund.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAll authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by KS, KS and SH. The first draft of the manuscript was written by KS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003eThe authors express their sincere gratitude to all of the emergency and critical care centres that participated in this survey.\u003c/p\u003e\u003ch2\u003eAvailability of data and materials\u003c/h2\u003e \u003cp\u003eThe datasets used and analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDavidson JE, Jones C, Bienvenu OJ. Family response to critical illness: postintensive care syndrome-family. Crit Care Med. 2012;40:618-624. doi: 10.1097/CCM.0b013e318236ebf9.\u003c/li\u003e\n\u003cli\u003eKentish-Barnes N, Lemiale V, Chaize M, Pochard F, Azoulay E. Assessing burden in families of critical care patients. Crit Care Med. 2009;37:448-456. doi: 10.1097/CCM.0b013e3181b6e145.\u003c/li\u003e\n\u003cli\u003eAdelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS. Caregiver burden: a clinical review. JAMA. 2014;311:1052-1060. doi: 10.1001/jama.2014.304.\u003c/li\u003e\n\u003cli\u003eLynn J. Strategies to ease the burden of family caregivers. JAMA. 2014;311:1021-1022. doi: 10.1001/jama.2014.1769.\u003c/li\u003e\n\u003cli\u003eShirasaki K, Hifumi T, Nakanishi N et al. Postintensive care syndrome family: A comprehensive review. Acute Med Surg. 2024;11:e939. doi: 10.1002/ams2.939.\u003c/li\u003e\n\u003cli\u003eDavidson JE, Aslakson RA, Long AC, et al. Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU. Crit Care Med. 2017;45:103-128. doi: 10.1097/CCM.0000000000002169.\u003c/li\u003e\n\u003cli\u003eThompson DR, Hamilton DK, Cadenhead CD, et al. Guidelines for intensive care unit design. Crit Care Med. 2012;40:1587-1600. doi: 10.1097/CCM.0b013e3182413bb2.\u003c/li\u003e\n\u003cli\u003eLiu V, Read JL, Scruth E, Cheng E. Visitation policies and practices in US ICUs. Crit Care. 2013;17:R71. doi: 10.1186/cc12677.\u003c/li\u003e\n\u003cli\u003eQuinio P, Savry C, Deghelt A, Guilloux M, Catineau J, de Tint\u0026eacute;niac A. Intensive Care Med. 2002;28:1389-1394. doi: 10.1007/s00134-002-1402-7.\u003c/li\u003e\n\u003cli\u003eGarrouste-Orgeas M, Vinatier I, Tabah A, Misset B, Timsit JF. Reappraisal of visiting policies and procedures of patient\u0026apos;s family information in 188 French ICUs: a report of the Outcomerea Research Group. Ann Intensive Care. 2016;6:82. doi: 10.1186/s13613-016-0185-x.\u003c/li\u003e\n\u003cli\u003ePochard F, Azoulay E, Chevret S, et al. Symptoms of anxiety and depression in family members of intensive care unit patients: ethical hypothesis regarding decision-making capacity. Crit Care Med. 2001;29:1893-1897. doi: 10.1097/00003246-200207000-00002.\u003c/li\u003e\n\u003cli\u003eMcLennan M, Aggar C. Family satisfaction with care in the intensive care unit: A regional Australian perspective. Aust Crit Care. 2020;33:518-525. doi: 10.1016/j.aucc.2020.01.003.\u003c/li\u003e\n\u003cli\u003eHalpern NA. Innovative Designs for the Smart ICU. Chest. 2014;145:646-658. doi: 10.1378/chest.13-0004.\u003c/li\u003e\n\u003cli\u003eSpreen AE, Schuurmans MJ. Visiting policies in the adult intensive care units: a complete survey of Dutch ICUs. Intensive Crit Care Nurs. 2011;27:27-30. doi: 10.1016/j.iccn.2010.10.002.\u003c/li\u003e\n\u003cli\u003eChapman DK, Collingridge DS, Mitchell LA, Wright ES, Hopkins RO, Butler JM, Brown SM. Satisfaction With Elimination of all Visitation Restrictions in a Mixed-Profile Intensive Care Unit. Am J Crit Care. 2016;25:46-50. doi: 10.4037/ajcc2016789.\u003c/li\u003e\n\u003cli\u003eWu Y, Wang G, Zhang Z, et al. Efficacy and safety of unrestricted visiting policy for critically ill patients: a meta-analysis. Crit Care. 2022;26:267. doi: 10.1186/s13054-022-04129-3.\u003c/li\u003e\n\u003cli\u003eDavidson JE, Powers K, Hedayat KM, et al. Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004-2005. Crit Care Med. 2007;35:605-622. doi: 10.1097/01.CCM.0000254067.14607.\u003c/li\u003e\n\u003cli\u003eTabah A, Ramanan M, Bailey RL, et al. Family visitation policies, facilities, and support in Australia and New Zealand intensive care units: A multicentre, registry-linked survey. Aust Crit Care. 2022;35:375-382. doi: 10.1016/j.aucc.2021.06.009.\u003c/li\u003e\n\u003cli\u003eGiannini A, Miccinesi G, Leoncino S. Visiting policies in Italian intensive care units: a nationwide survey. Intensive Care Med. 2008;34:1256-1262. doi: 10.1007/s00134-008-1037-4.\u003c/li\u003e\n\u003cli\u003eGiannini A, Miccinesi G, Prandi E, Buzzoni C, Borreani C. Partial liberalization of visiting policies and ICU staff: a before-and-after study. Intensive Care Med. 2013;39:2180-2187. doi: 10.1007/s00134-013-3087-5.\u003c/li\u003e\n\u003cli\u003eda Silva Ramos FJ, Fumis RR, Azevedo LC, Schettino G. Perceptions of an open visitation policy by intensive care unit workers. Ann Intensive Care. 2013;3:34. doi: 10.1186/2110-5820-3-34.\u003c/li\u003e\n\u003cli\u003eBoulton AJ, Jordan H, Adams CE, et al. Intensive care unit visiting and family communication during the COVID-19 pandemic: A UK survey. J Intensive Care Soc 2022;23:293-296. doi: 10.1177/17511437211007779.\u003c/li\u003e\n\u003cli\u003eDay A, Haj-Bakri S, Lubchansky S, Mehta S. Sleep, anxiety and fatigue in family members of patients admitted to the intensive care unit: a questionnaire study. Crit Care. 2013;17:R91. doi: 10.1186/cc12736.\u003c/li\u003e\n\u003cli\u003eSchmidt M, Azoulay E. Sleepless nights in the ICU: the awaken family. Crit Care. 2013;17:1003. doi: 10.1186/cc12781.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"critical-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"cric","sideBox":"Learn more about [Critical Care](http://ccforum.biomedcentral.com/)","snPcode":"13054","submissionUrl":"https://submission.nature.com/new-submission/13054/3","title":"Critical Care","twitterHandle":"@Crit_Care","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"critical care, intensive care unit, post-intensive care syndrome, questionnaire, family, waiting room","lastPublishedDoi":"10.21203/rs.3.rs-6633060/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6633060/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003e As part of family care to prevent PICS-F, it is recommended that restrictions on visitation be relaxed and the environment of family waiting rooms be made more comfortable. The aim of this study was to investigate the current status of family waiting rooms and visitation policies in Japanese ICUs.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA nationwide survey across 292 emergency and critical care centres in Japan using a combination of postal and web-based questionnaires, comprising 12 questions about institutional characteristics, waiting room facilities, and family visitation policies.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOf the 292 emergency and critical care centres contacted, 151 (51.7%) responded. Of these, 144 institutions (95.4%) had family waiting rooms for ICUs. The waiting rooms typically included tables (76.4%) and chairs (96.5%), but only a few had books and magazines (13.9%), napping areas (10.4%), cooking facilities like microwaves and kettles (3.5%), shower rooms (2.1%), or refrigerators (0.7%). Only 47 institutions (32.6%) offered waiting rooms that adequately protected family privacy. In addition, while 120 institutions (79.5%) restricted visiting hours, typically limited to several hours in the afternoon and limited the number of visitors at the same time, these restrictions were often relaxed in cases of sudden clinical deterioration or near the end of the patient\u0026rsquo;s life. There were almost no statistical differences in the environment of the family waiting room or visitation policies depending on the number of hospital beds and ICU beds.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe majority of ICUs in Japan have waiting rooms for the families of patients; however, these institutions often lack essential amenities and do not sufficiently protect privacy compared to other countries. Regarding visitation policies, most institutions restricted family visiting hours to several hours in the afternoon and limited the number of visitors at the same time. It is important to ensure that ICU staffs are aware of the problems with the family waiting room environment and visitation policies in Japanese ICUs, particularly compared to other countries, and to promote the implementation of patient- and family-centred care.\u003c/p\u003e","manuscriptTitle":"Family waiting rooms and visitation policies in Japanese intensive care units: A multicentre questionnaire survey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-15 10:47:30","doi":"10.21203/rs.3.rs-6633060/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-05-20T08:38:06+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-19T18:35:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"264827355411601123715914346749779167249","date":"2025-05-18T17:36:44+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-16T00:11:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"8822445943233066062444808516968579366","date":"2025-05-14T23:30:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"17965037968499131134102699652546849159","date":"2025-05-14T20:05:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"5394407292543760522478808663886322741","date":"2025-05-13T09:48:06+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-13T04:28:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-12T05:05:12+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-12T05:03:59+00:00","index":"","fulltext":""},{"type":"submitted","content":"Critical Care","date":"2025-05-10T07:01:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"critical-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"cric","sideBox":"Learn more about [Critical Care](http://ccforum.biomedcentral.com/)","snPcode":"13054","submissionUrl":"https://submission.nature.com/new-submission/13054/3","title":"Critical Care","twitterHandle":"@Crit_Care","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a25ad09b-20f3-41b0-8d8c-bdba94751e74","owner":[],"postedDate":"May 15th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-07T16:15:14+00:00","versionOfRecord":{"articleIdentity":"rs-6633060","link":"https://doi.org/10.1186/s13054-025-05533-1","journal":{"identity":"critical-care","isVorOnly":false,"title":"Critical Care"},"publishedOn":"2025-07-04 15:57:52","publishedOnDateReadable":"July 4th, 2025"},"versionCreatedAt":"2025-05-15 10:47:30","video":"","vorDoi":"10.1186/s13054-025-05533-1","vorDoiUrl":"https://doi.org/10.1186/s13054-025-05533-1","workflowStages":[]},"version":"v1","identity":"rs-6633060","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6633060","identity":"rs-6633060","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}