Countries have been affected by the COVID-19 pandemic at different levels, and the precautions taken by them have also differed in terms of their general characteristics resulting from normative regulations and cultural values. The number of cases still shows marked fluctuations for each region. With some exceptions, the general trend in most countries, including Germany , was a dramatic increase from the second week of March to the end of April . In this time interval, considering the uncertainty regarding the pandemic, the purpose of the authorities was to slow the spread of the virus and to limit the pressure on the health care systems . Later, when the spread of the virus was – at least temporarily – brought under control, a steady decline in confirmed cases was observed, and cases of the virus exhibited only minor fluctuations towards the middle of August . Following this period of ‘normalization’, however, more recently, the number of cases for many countries shows considerable growth, creating concern among both the public and the authorities, and bringing back the debates on expanding precautions in a controlled manner, rather than loosening them.
The COVID-19 pandemic has rapidly influenced day-to-day life, and in particular, its consequences on healthcare services are among the most salient. This includes the need to increase the capacity for COVID-19 patients, the adaptation of operational procedures, the postponement of individual diagnostic measures and therapeutic interventions . The primary objective of health care facilities has been to maintain adequate and patient-centered health care as best as possible, while implementing measures to ensure the wellbeing and safety of their employees and patients and following the recommendations of authorities. The UK government, for example, has mandated strict visitor rules, only allowing essential visitors, such as birth partners or parents of underage children, access to healthcare facilities . In Germany, the roadmaps for coping with COVID-19 have included the general rule of social distancing, wearing of mouth-nose covers, bans on visits with some exceptions for maternity and children’s wards and for close relatives on palliative wards and hospices, as well as a ban on events and collective worship .
The ban on visitors to health care facilities is a common regulation imposed by many authorities, along with social distancing and hygiene measures. However, precautions such as visiting bans and social distancing have led to multiple difficulties and limitations, which also put high demands on the communication between the health care facilities and health care users. The high load of information with respect to the spread of SARS-CoV-2, the symptoms of COVID-19, and rapid changes in regulations in response to daily developments have created the need and expectation for up-to-date information from the respective facilities. Confronting everyday practices that are drastically unfamiliar  has led to the emergence of emotional stress, especially in vulnerable populations such as the elderly and those with chronic diseases. Healthcare professionals and other nursing staff have similarly tried to cope with emotional stressors, such as the increased risk of exposure to the virus, extreme workloads, and moral dilemmas .
Taken as a whole, innovative measures/approaches  have been needed to support optimal communication, while reducing the risk of direct person-to-person contact. The websites of health care facilities can serve that purpose by providing health care users and their relatives with COVID-19-related health information and practical guidelines. In that respect, health care providers can accordingly be regarded as potential mediators for the presentation of up-to-date health-related information among stakeholders in times of public health crises. Regional and national authorities are indirectly decisive in the choice of website content. Regarding this content, the preferences of the facilities to abide by the recommendations and regulations of the authorities can be seen as mandatory volunteerism, because the pandemic itself as a global threat constitutes one of the most important factors affecting the decision-making mechanisms of facilities in determining the steps to be taken and the measures to communicate.
Little is known about how health care facilities use their websites as media instruments to inform health care users about necessary changes in health care processes and regulations. Using the case of nursing, palliative and hospice care facilities in Germany as an example and drawing on agenda-setting theory [10, 11], the present study aims to shed light on how health care facilities, by means of their websites, inform (potential) health care users about new protective measures implemented and about recommendations in the context of the COVID-19 pandemic. It seeks to unfold the strategies developed by facilities providing different types of health services at the institutional level and intends to explore how health facilities have approached the rights and concerns of health care users and staff as well as how those are communicated. Considering that the COVID-19 pandemic has affected facilities to different degrees corresponding to the type of service they provide, this study further aims to reveal in which aspects the pandemic agenda shows similarities or distinct differences between facilities, by comparing websites of nursing, palliative and hospice care facilities.