1
|
Newlands F, Lewis C, d’Oelsnitz A, Pinto Pereira SM, Stephenson T, Chalder T, Coughtrey A, Dalrymple E, Heyman I, Harnden A, Ford T, Ladhani SN, Powell C, McOwat K, Bhopal R, Dudley J, Kolasinska P, Muhid MZ, Nugawela M, Rojas NK, Shittu A, Simmons R, Shafran R. " People don't have the answers": A qualitative exploration of the experiences of young people with Long COVID. Clin Child Psychol Psychiatry 2024; 29:783-798. [PMID: 38718276 PMCID: PMC11188547 DOI: 10.1177/13591045241252463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Young people living with Long COVID are learning to navigate life with a constellation of poorly understood symptoms. Most qualitative studies on experiences living with Long COVID focus on adult populations. This study aimed to understand the experiences of young people living with Long COVID. Qualitative, semi-structured interviews were conducted (n = 16); 11 young people (aged 13-19) and five parents were recruited from the Children and Young People with Long COVID (CLoCk) study (n = 11) or its patient and public involvement and engagement (PPIE) group (n = 5). Thematic analysis generated four themes: (i) Unravelling Long COVID: Exploring Symptom Journeys and Diagnostic Dilemmas; (ii) Identity Disruption and Adjustment; (iii) Long COVID's Ripple Effect: the impact on Mental Health, Connections, and Education; and (iv) Navigating Long COVID: barriers to support and accessing services. Treatment options were perceived as not widely available or ineffective, emphasising the need for viable and accessible interventions for young people living with Long COVID.
Collapse
Affiliation(s)
- Fiona Newlands
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Celine Lewis
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
- NHS North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children NHS Foundation Trust, UK
| | - Anais d’Oelsnitz
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Snehal M Pinto Pereira
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, UK
| | - Terence Stephenson
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Anna Coughtrey
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Emma Dalrymple
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Isobel Heyman
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Anthony Harnden
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, UK
| | - Shamez N Ladhani
- Immunisation Department, UK Health Security Agency, UK
- Paediatric Infectious Diseases Research Group, St George’s University of London, UK
| | - Claire Powell
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Kelsey McOwat
- Immunisation Department, UK Health Security Agency, UK
| | - Rowan Bhopal
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Jake Dudley
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Paige Kolasinska
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Mohammed Z Muhid
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Manjula Nugawela
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Natalia K Rojas
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, UK
| | - Angel Shittu
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| | - Ruth Simmons
- Immunisation Department, UK Health Security Agency, UK
| | - Roz Shafran
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, UK
| |
Collapse
|
2
|
Laestadius LI, Guidry JPD, Wahl MM, Perrin PB, Carlyle KE, Dong X, Garbo R, Campos-Castillo C. "The dream is that there's one place you go": a qualitative study of women's experiences seeking care from Long COVID clinics in the USA. BMC Med 2024; 22:243. [PMID: 38867247 PMCID: PMC11170900 DOI: 10.1186/s12916-024-03465-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 06/05/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Seeking and obtaining effective health care for Long COVID remains a challenge in the USA. Women have particularly been impacted, as they are both at higher risk of developing Long COVID and of facing gendered barriers to having symptoms acknowledged. Long COVID clinics, which provide multidisciplinary and coordinated care, have emerged as a potential solution. To date, however, there has been little examination of U.S. patient experiences with Long COVID clinics and how patients may or may not have come to access care at a Long COVID clinic. METHODS We conducted semi-structured interviews with 30 U.S. women aged 18 or older who had experienced Long COVID symptoms for at least 3 months, who had not been hospitalized for acute COVID-19, and who had seen at least one medical provider about their symptoms. Participants were asked about experiences seeking medical care for Long COVID. Long COVID clinic-related responses were analyzed using qualitative framework analysis to identify key themes in experiences with Long COVID clinics. RESULTS Of the 30 women, 43.3% (n = 13) had been seen at a Long COVID clinic or by a provider affiliated with a Long COVID clinic and 30.0% (n = 9) had explored or attempted to see a Long COVID clinic but had not been seen at time of interview. Participants expressed five key themes concerning their experiences with seeking care from Long COVID clinics: (1) Access to clinics remains an issue, (2) Clinics are not a one stop shop, (3) Not all clinic providers have sufficient Long COVID knowledge, (4) Clinics can offer validation and care, and (5) Treatment options are critical and urgent. CONCLUSIONS While the potential for Long COVID clinics is significant, findings indicate that ongoing barriers to care and challenges related to quality and coordination of care hamper that potential and contribute to distress among women seeking Long COVID care. Since Long COVID clinics are uniquely positioned and framed as being the place to go to manage complex symptoms, it is critical to patient wellbeing that they be properly resourced to provide a level of care that complies with emerging best practices.
Collapse
Affiliation(s)
- Linnea I Laestadius
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Jeanine P D Guidry
- Department of Communication and Cognition, Tilburg University, Tilburg, The Netherlands
| | - Megan M Wahl
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Paul B Perrin
- School of Data Science and Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Kellie E Carlyle
- School of Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Xiaobei Dong
- Zilber College of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Raouf Garbo
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | | |
Collapse
|
3
|
Jones F, Domeny A, Fish J, Leggat F, Patel I, McRae J, Rowe C, Busse ME. Using co-design methods to develop new personalised support for people living with Long Covid: The 'LISTEN' intervention. Health Expect 2024; 27:e14093. [PMID: 38783782 PMCID: PMC11116943 DOI: 10.1111/hex.14093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Many Covid-19 survivors are living with unresolved, relapsing and remitting symptoms and no 'one size' of treatment is likely to be effective for everyone. Supported self-management for the varied symptoms of Long Covid (LC) is recommended by the National Institute for Health and Care Excellence in the United Kingdom. We aimed to develop a new personalised support intervention for people living with LC using a structured co-design framework to guide replication and evaluation. METHODS We used the improvement methodology, Experience-Based Co-Design, in an accelerated form to harness the collective experiences of people with LC. Incorporating evidence from 'Bridges Self-Management' (Bridges) an approach in which healthcare professionals (HCPs)are trained to support knowledge, confidence and skills of individuals living with long term conditions. Co-designed resources are also central to Bridges. Adults who self-identified as living with or recovered from LC, from England or Wales, aged 18 years and over were recruited, and HCPs, with experience of supporting people with LC. Participants took part in a series of small co-design group meetings and larger mixed meetings to agree priorities, core principles and generate resources and intervention content. RESULTS People with LC (n = 28), and HCPs (n = 9) supported co-design of a book (hard-copy and digital form) to be used in 1:1 support sessions with a trained HCP. Co-design stages prioritised stories about physical symptoms first, and psychological and social challenges which followed, nonlinear journeys and reconceptualising stability as progress, rich descriptions of strategies and links to reputable advice and support for navigating healthcare services. Co-design enabled formulation of eight core intervention principles which underpinned the training and language used by HCPs and fidelity assessments. CONCLUSION We have developed a new personalised support intervention, with core principles to be used in one-to-one sessions delivered by trained HCPs, with a new co-designed book as a prompt to build personalised strategies and plans using narratives, ideas, and solutions from other people with LC. Effectiveness and cost effectiveness of the 'LISTEN' intervention will be evaluated in a randomised controlled trial set within the context of the updated Framework for Developing and Evaluating Complex Interventions. PATIENT AND PUBLIC CONTRIBUTION The LISTEN Public and Patient Involvement (PPI) group comprised seven people living with LC. They all contributed to the design of this study and five members were part of a larger co-design community described in this paper. They have contributed to this paper by interpreting stages of intervention design and analysis of results. Three members of our PPI group are co-authors of this paper.
Collapse
Affiliation(s)
- Fiona Jones
- Population Health Research InstituteSt George's University of LondonLondonUK
- Bridges Self‐ManagementLondonUK
| | - Anne Domeny
- Bridges Self‐ManagementLondonUK
- LISTEN Lived Experience Advisory GroupLondonUK
| | - Jessica Fish
- Department of Clinical Neuropsychology and Clinical Health PsychologySt George's University Hospitals NHS Foundation TrustLondonUK
- Mental Health and Wellbeing, School of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - Fiona Leggat
- Population Health Research InstituteSt George's University of LondonLondonUK
| | - Ian Patel
- LISTEN Lived Experience Advisory GroupLondonUK
| | - Jackie McRae
- Centre for Allied Health, Institute for Medical, Biomedical and Allied EducationSt George's University of LondonLondonUK
| | - Carol Rowe
- LISTEN Lived Experience Advisory GroupLondonUK
| | - Monica E. Busse
- Centre For Trials Research, School of MedicineCardiff UniversityCardiffWalesUK
| |
Collapse
|
4
|
Kalfas M, Jolley C, Hart N, Rafferty GF, Duncan EL, Nicholson T, Ashworth M, Brewin D, Barrett B, Witard OC, Ridge D, Chalder T. Exploring the Experiences of Living With the Post-COVID Syndrome: A Qualitative Study. Health Expect 2024; 27:e14108. [PMID: 38898594 PMCID: PMC11186847 DOI: 10.1111/hex.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 05/20/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION Many people experience persistent symptoms for more than 12 weeks following SARS-CoV-2 infection, which is known as post-COVID-19 condition (PCS) or Long COVID (LC). PCS can impair people's quality of life and daily functioning. However, there is a lack of in-depth research exploring the PCS patient journey, as well as gendered aspects of patients' experiences. METHODS Nineteen semi-structured qualitative interviews were conducted with people living with PCS in the United Kingdom (13 women, 6 men). Interviews were transcribed verbatim and analysed inductively using reflexive thematic analysis. RESULTS Five main themes were identified: 'Symptom dismissal', 'Lack of information and support', 'Life before and after Long COVID', 'Psychological impact' and 'Acceptance'. A shift overtime to self-management of symptoms was evident. These themes represent different stages of patients' PCS journey. Narratives indicated that women highlighted dismissal by healthcare professionals (HCPs), which was not as prominent in men's narratives. In addition, women went into more detail about the psychological impact of PCS compared to men. CONCLUSION Women with PCS reported symptom dismissal by HCPs, which may have delayed their diagnosis and negatively affected their well-being. We were not able to explore the experiences of people from non-conforming gender groups. Raising awareness of these issues among HCPs, particularly general practitioners, could improve patient care in PCS. PATIENT OR PUBLIC CONTRIBUTION Patient and public involvement consisted of people who took part in the interviews and commented on the themes' interpretation and study conclusions.
Collapse
Affiliation(s)
- Michail Kalfas
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Caroline Jolley
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
- King's College Hospital NHS Foundation TrustLondonUK
| | - Nicholas Hart
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
- Lane Fox Clinical Respiratory Physiology Research CentreGuy's & St Thomas's NHS Foundation TrustLondonUK
| | - Gerrard F. Rafferty
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
| | - Emma L. Duncan
- Department of Twin Research and Genetic EpidemiologyKing's College LondonLondonUK
- Guy's & St Thomas's NHS Foundation TrustLondonUK
| | - Timothy Nicholson
- Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
| | - Mark Ashworth
- School of Life Course & Population Sciences, King's College LondonGuy's CampusLondonUK
| | - Debbie Brewin
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Barbara Barrett
- School of Life Course & Population Sciences, King's College LondonGuy's CampusLondonUK
| | - Oliver C. Witard
- Centre for Human and Applied Physiological Sciences, King's College LondonFaculty of Life Sciences & MedicineLondonUK
| | - Damien Ridge
- School of Social SciencesUniversity of WestminsterLondonUK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| |
Collapse
|
5
|
Sunkersing D, Ramasawmy M, Alwan NA, Clutterbuck D, Mu Y, Horstmanshof K, Banerjee A, Heightman M. What is current care for people with Long COVID in England? A qualitative interview study. BMJ Open 2024; 14:e080967. [PMID: 38760030 PMCID: PMC11107429 DOI: 10.1136/bmjopen-2023-080967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 05/01/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVE To investigate current care for people with Long COVID in England. DESIGN In-depth, semistructured interviews with people living with Long COVID and Long COVID healthcare professionals; data analysed using thematic analysis. SETTING National Health Service England post-COVID-19 services in six clinics from November 2022 to July 2023. PARTICIPANTS 15 healthcare professionals and 21 people living with Long COVID currently attending or discharged (18 female; 3 male). RESULTS Health professionals and people with lived experience highlighted the multifaceted nature of Long COVID, including its varied symptoms, its impact on people's lives and the complexity involved in managing this condition. These impacts encompass physical, social, mental and environmental dimensions. People with Long COVID reported barriers in accessing primary care, as well as negative general practitioner consultations where they felt unheard or invalidated, though some positive interactions were also noted. Peer support or support systems proved highly valuable and beneficial for individuals, aiding their recovery and well-being. Post-COVID-19 services were viewed as spaces where overlooked voices found validation, offering more than medical expertise. Despite initial challenges, healthcare providers' increasing expertise in diagnosing and treating Long COVID has helped refine care approaches for this condition. CONCLUSION Long COVID care in England is not uniform across all locations. Effective communication, specialised expertise and comprehensive support systems are crucial. A patient-centred approach considering the unique complexities of Long COVID, including physical, mental health, social and environmental aspects is needed. Sustained access to post-COVID-19 services is imperative, with success dependent on offering continuous rehabilitation beyond rapid recovery, acknowledging the condition's enduring impacts and complexities.
Collapse
Affiliation(s)
- David Sunkersing
- Institute of Health Informatics, University College London, London, UK
| | - Mel Ramasawmy
- Institute of Health Informatics, University College London, London, UK
| | - Nisreen A Alwan
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Donna Clutterbuck
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Yi Mu
- Institute of Health Informatics, University College London, London, UK
| | | | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, UK
| | - Melissa Heightman
- University College London Hospitals NHS Foundation Trust, London, UK
| |
Collapse
|
6
|
Greenhalgh T, Darbyshire JL, Lee C, Ladds E, Ceolta-Smith J. What is quality in long covid care? Lessons from a national quality improvement collaborative and multi-site ethnography. BMC Med 2024; 22:159. [PMID: 38616276 PMCID: PMC11017565 DOI: 10.1186/s12916-024-03371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Long covid (post covid-19 condition) is a complex condition with diverse manifestations, uncertain prognosis and wide variation in current approaches to management. There have been calls for formal quality standards to reduce a so-called "postcode lottery" of care. The original aim of this study-to examine the nature of quality in long covid care and reduce unwarranted variation in services-evolved to focus on examining the reasons why standardizing care was so challenging in this condition. METHODS In 2021-2023, we ran a quality improvement collaborative across 10 UK sites. The dataset reported here was mostly but not entirely qualitative. It included data on the origins and current context of each clinic, interviews with staff and patients, and ethnographic observations at 13 clinics (50 consultations) and 45 multidisciplinary team (MDT) meetings (244 patient cases). Data collection and analysis were informed by relevant lenses from clinical care (e.g. evidence-based guidelines), improvement science (e.g. quality improvement cycles) and philosophy of knowledge. RESULTS Participating clinics made progress towards standardizing assessment and management in some topics; some variation remained but this could usually be explained. Clinics had different histories and path dependencies, occupied a different place in their healthcare ecosystem and served a varied caseload including a high proportion of patients with comorbidities. A key mechanism for achieving high-quality long covid care was when local MDTs deliberated on unusual, complex or challenging cases for which evidence-based guidelines provided no easy answers. In such cases, collective learning occurred through idiographic (case-based) reasoning, in which practitioners build lessons from the particular to the general. This contrasts with the nomothetic reasoning implicit in evidence-based guidelines, in which reasoning is assumed to go from the general (e.g. findings of clinical trials) to the particular (management of individual patients). CONCLUSION Not all variation in long covid services is unwarranted. Largely because long covid's manifestations are so varied and comorbidities common, generic "evidence-based" standards require much individual adaptation. In this complex condition, quality improvement resources may be productively spent supporting MDTs to optimise their case-based learning through interdisciplinary discussion. Quality assessment of a long covid service should include review of a sample of individual cases to assess how guidelines have been interpreted and personalized to meet patients' unique needs. STUDY REGISTRATION NCT05057260, ISRCTN15022307.
Collapse
Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford, OX2 6GG, UK.
| | - Julie L Darbyshire
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford, OX2 6GG, UK
| | - Cassie Lee
- Imperial College Healthcare NHS Trust, London, UK
| | - Emma Ladds
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Rd, Oxford, OX2 6GG, UK
| | - Jenny Ceolta-Smith
- LOCOMOTION Patient Advisory Group and Lived Experience Representative, London, UK
| |
Collapse
|
7
|
Faux-Nightingale A, Saunders B, Burton C, Chew-Graham CA, Somayajula G, Twohig H, Welsh V. Experiences and care needs of children with long COVID: a qualitative study. BJGP Open 2024; 8:BJGPO.2023.0143. [PMID: 37914226 PMCID: PMC11169971 DOI: 10.3399/bjgpo.2023.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/10/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Long COVID, the patient-preferred term, describes symptoms persisting after an acute episode of COVID-19 infection. Symptoms in children and young people (CYP) can affect daily routine, with broader impacts on education, health-related quality of life, and social activities, which may have long-term effects on health and wellbeing. AIM To explore the lived experiences and care needs of CYP with long COVID from the perspectives of CYP with long COVID, their parents, and professionals associated with the care of children and families living with the condition. DESIGN & SETTING CYP and their parent or carer were invited for interview following participation in a cohort study, which recruited the sample from a primary care setting. METHOD Interviews were carried out with four CYP with long COVID (all female, aged 10-17 years); three interviews included a parent. Two focus groups were conducted, which included seven professionals involved with care of CYP or long COVID, from a range of disciplines. Interviews and focus groups were transcribed verbatim, and data analysed thematically using constant comparison techniques. RESULTS The three main themes presented are as follows: living with long COVID; uncertainty surrounding long COVID; and seeking help for symptoms. CONCLUSION Long COVID can severely impact the lives of CYP and their families. CYP and their families need to be listened to by professionals and have any uncertainties acknowledged. It is imperative that agencies working with them understand the condition and its impact, and are able to offer support where needed.
Collapse
Affiliation(s)
| | | | - Claire Burton
- School of Medicine, Keele University, Staffordshire, UK
| | | | | | - Helen Twohig
- School of Medicine, Keele University, Staffordshire, UK
| | | |
Collapse
|
8
|
Turk F, Sweetman J, Chew‐Graham CA, Gabbay M, Shepherd J, van der Feltz‐Cornelis C. Accessing care for Long Covid from the perspectives of patients and healthcare practitioners: A qualitative study. Health Expect 2024; 27:e14008. [PMID: 38481384 PMCID: PMC10938067 DOI: 10.1111/hex.14008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/08/2024] [Accepted: 02/21/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Long Covid is an emerging long-term condition, with those affected raising concerns about lack of healthcare support. OBJECTIVE We conducted a qualitative study to identify facilitators and barriers to healthcare access for people with Long Covid, aiming to enhance our understanding of the specific nature of these barriers and how patient experiences may vary. SETTING AND PARTICIPANTS In the context of the Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (STIMULATE-ICP) Delphi study, a nationally distributed online survey was conducted. Eight patients and eight healthcare practitioners (HCP) were interviewed via telephone or video call. Framework analysis, sensitised by the candidacy theory, was used to identify barriers and facilitators over four levels of access to care. RESULTS Three themes were identified: (i) patients' efforts to navigate emerging pathways for Long Covid, (ii) the patient-HCP interaction and (iii) service resources and structural constraints. Barriers to specialist care included long waiting times, communication gaps across services and a lack of continuity in care. Facilitators included collaborative, patient-centred approaches, patients' active role in their healthcare and blended approaches for appointments. The perspectives of both patients and HCPs largely aligned. DISCUSSION The candidacy framework was valuable in understanding the experiences of people with Long Covid seeking access to healthcare. Individuals perceived themselves as eligible for care, but they often encountered obstacles in obtaining the expected level of care or, in some cases, did not receive it at all. Our findings are discussed in the context of the candidacy model through multiple processes of identification, negotiation, permeability and appearances at health services. These themes seem to be especially important for the emerging new pathway model and are relevant to both primary and secondary care. CONCLUSIONS This study highlights that despite these interviews being conducted two years after the start of the COVID-19 pandemic, people with Long Covid still struggle to access healthcare, emphasising the ongoing need to provide equitable timely healthcare access for people with Long Covid. PATIENT OR PUBLIC CONTRIBUTION People with Long Covid advised on all stages of this research.
Collapse
Affiliation(s)
- Fidan Turk
- Department of Health SciencesUniversity of YorkYorkUK
| | | | | | - Mark Gabbay
- Department of Primary Care and Mental HealthUniversity of LiverpoolLiverpoolUK
- NIHR ARC NWCLiverpoolUK
| | | | - Christina van der Feltz‐Cornelis
- Department of Health SciencesUniversity of YorkYorkUK
- Hull York Medical School (HYMS)University of YorkYorkUK
- Institute of Health InformaticsUniversity College LondonLondonUK
| | | |
Collapse
|
9
|
Harrison M, Rhodes T, Lancaster K. Constitution of Long COVID illness, patienthood and recovery: a critical synthesis of qualitative studies. BMJ Open 2024; 14:e083340. [PMID: 38548364 PMCID: PMC10982801 DOI: 10.1136/bmjopen-2023-083340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/18/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES To investigate the lived experiences of Long COVID. DESIGN Critical interpretive synthesis of qualitative research. DATA SOURCES PubMed and Web of Science databases were searched on 14 September 2023. ELIGIBILITY CRITERIA Original peer-reviewed qualitative studies describing the experiences of Long COVID were eligible for inclusion. DATA EXTRACTION AND SYNTHESIS We used established qualitative synthesis methods to search, screen and manually code the included studies. Critical interpretation methods were used to analyse the data and develop synthetic constructs. RESULTS 68 articles were identified in the first phase of sampling, with 16 studies and 879 participants included in the final synthesis. The analysis of these studies was organised into three thematic constructions of Long COVID: (1) the illness, (2) the patient and (3) recovery. Long COVID was diversely characterised across study approaches, designs and findings but was underpinned by shared diagnostic logics, which shaped the identification and measurement of symptoms. The boundaries between different constitutions of Long COVID in qualitative accounts of illness experience were often imprecise. Slippages between different definitions of Long COVID had implications for patient experiences in relation to diagnosis, help-seeking and care, and expectations of recovery. CONCLUSIONS Long COVID is a site of multiple and diverse qualitative interpretation. Accounts of lived experience emphasise the constitutions of illness, patienthood and recovery as situated and emergent. The ongoing context-based negotiation of Long COVID is a defining qualitative feature of the condition. Approaches to researching, diagnosing and developing health interventions must be as adaptive as the varieties of Long COVID lived experience.
Collapse
Affiliation(s)
- Mia Harrison
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tim Rhodes
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
- London School of Hygiene & Tropical Medicine, London, UK
| | - Kari Lancaster
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
- Goldsmiths, University of London, London, UK
| |
Collapse
|
10
|
Von Nordheim D, Johnson M, Caburnay C, Alleman S, Kreuter M, McQueen A. Describing the Lived Experience and Resource Needs of Individuals With Long COVID. Health Promot Pract 2024:15248399241228823. [PMID: 38361434 DOI: 10.1177/15248399241228823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Individuals with long COVID report diverse symptoms lasting weeks or months after initial infection, causing significant psychosocial distress. Navigating health care interactions are often difficult for these individuals due to the diffuse nature of their symptoms, a lack of effective treatment options, and skepticism from some providers. To better understand these challenges, this study sought to further describe the lived experience of individuals with long COVID. A survey was conducted with individuals evaluated for long COVID at a specialty clinic (n = 200), which included questions about prior conditions, symptoms, use of medical and support services, and information and resource needs. Participants reported a mean of 10.75 persistent symptoms, the most common being fatigue and difficulty concentrating, with broad effects on daily functioning. Participants saw a mean of 5.92 providers for treatment of their symptoms, and 88.5% identified health care providers as a trusted source of information. Interest in research findings (60.5%) and opportunities for participation (47.5%) were moderate and varied by COVID vaccination status. Unvaccinated individuals (n = 27) also reported less trust in government sources of information, less college education, lower household income, and greater likelihood of having public insurance. Our findings suggest that individuals with long COVID experience many ongoing and complex symptoms with diverse effects on daily living; that health care providers are an important source for public health messaging about long COVID; and that unvaccinated individuals are likely to have differing needs and receptiveness to information than vaccinated individuals with long COVID.
Collapse
Affiliation(s)
| | | | | | - Sarah Alleman
- Washington University in St. Louis, St. Louis, MO, USA
| | | | - Amy McQueen
- Washington University in St. Louis, St. Louis, MO, USA
| |
Collapse
|
11
|
Pommer A, Halas G, Mendis R, Campbell C, Semenko B, Stadnyk B, Thalman L, Mair S, Sun Y, Johnston N, Sanchez-Ramirez DC. Reaching out to Patients with Long COVID to Better Understand Their Life Experiences and How to Support Their Recovery: A Patient-Oriented Knowledge Sharing Session. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:187. [PMID: 38397678 PMCID: PMC10888221 DOI: 10.3390/ijerph21020187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024]
Abstract
This article reports on participants' experiences with long COVID-19 (LC) (symptoms, impact, healthcare use, and perceived needs) and satisfaction with a patient-oriented knowledge-sharing session organized by a multidisciplinary team of healthcare professionals, researchers, and a patient partner. Twenty-six participants completed a pre-session survey. On average, they were 21 months post-COVID-19 infection (SD 10.9); 81% of them were female, and 84% were 40+ years old. The main symptoms reported included fatigue (96%), cognitive problems (92%), and general pain or discomfort (40%). More than half of the participants reported that LC has had a significant impact on their health-related quality of life. Eighty-one percent of the participants reported seeking medical help for their LC symptoms and found the services provided by physical therapists, primary care providers, and acupuncturists to be helpful in managing their condition. Participants would like to have access to healthcare providers and clinics specializing in LC. They liked the session and found the information presented useful. This information helps to better understand the experiences of people living with LC and how to support their recovery.
Collapse
Affiliation(s)
- Alexa Pommer
- Department of Respiratory Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada
| | - Gayle Halas
- Department of Respiratory Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada
| | - Rukmali Mendis
- Winnipeg Regional Health Authority, Winnipeg, MB R3E 0M1, Canada
| | - Cindy Campbell
- Winnipeg Regional Health Authority, Winnipeg, MB R3E 0M1, Canada
| | - Brenda Semenko
- Winnipeg Regional Health Authority, Winnipeg, MB R3E 0M1, Canada
| | - Brandy Stadnyk
- Winnipeg Regional Health Authority, Winnipeg, MB R3E 0M1, Canada
| | - Leyda Thalman
- Misericordia Health Centre, Winnipeg, MB R3C 1A2, Canada
| | - Susan Mair
- Misericordia Health Centre, Winnipeg, MB R3C 1A2, Canada
| | - Yue Sun
- Department of Respiratory Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada
| | - Neil Johnston
- The Manitoba Lung Association, Winnipeg, MB R3A 1M5, Canada
| | - Diana C. Sanchez-Ramirez
- Department of Respiratory Therapy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada
| |
Collapse
|
12
|
Zhang Y, Chinchilli VM, Ssentongo P, Ba DM. Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA. BMJ Open 2024; 14:e079267. [PMID: 38309763 PMCID: PMC10840030 DOI: 10.1136/bmjopen-2023-079267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 01/22/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVES Mental health disorders (MHD) rank third for US adult hospitalisations. Given the substantial prevalence of 'Long COVID' in SARS-CoV-2 survivors, this study aims to assess its association with increased MHD risk using extensive real-world data. DESIGN A retrospective cohort study with propensity score matching was conducted. We used the International Classification of Diseases, 10th Revision codes to identify individuals with Long COVID status and COVID-19 histories. Multivariable stratified Cox proportional hazards regression analysis was conducted to determine the association of Long COVID status with MHD. SETTING Data were sourced from the TriNetX database, spanning records from 1 October 2021 to 16 April 2023. PARTICIPANTS Two distinct cohorts were established: one comprising individuals diagnosed with Long COVID and another comprising individuals with no history of Long COVID or COVID-19. At the start of the study, none of the participants had a recorded MHD. PRIMARY AND SECONDARY OUTCOME MEASURES The main outcome of interest was a composite diagnosis of MHD. Secondary outcomes were individual mental health conditions. RESULTS The study included 43 060 control participants without Long COVID and 4306 Long COVID participants, demonstrating well-balanced distribution across all covariates. After adjusting for 4 demographic factors and 10 comorbidities, Long COVID was associated with MHD (adjusted HR, aHR 2.60; 95% CI 2.37 to 2.85). In subgroup analysis, Long COVID was associated with major depression disorder (aHR 3.36; 95% CI 2.82 to 4.00) and generalised anxiety disorder (aHR 3.44; 95% CI 2.99 to 3.96). CONCLUSIONS In this retrospective large real-world cohort study, Long COVID was associated with an increased risk of incident MHD. The MHD impact is significant considering the vast number of patients with Long COVID. Enhanced MHD screening among COVID-19 survivors should be a priority.
Collapse
Affiliation(s)
- Yue Zhang
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Vernon M Chinchilli
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Paddy Ssentongo
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Medicine, Penn State Health Medical Center, Hershey, PA, USA
| | - Djibril M Ba
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| |
Collapse
|
13
|
Au L, Capotescu C, Curi A, Gonçalves Leonel da Silva R, Eyal G. Long Covid requires a global response centred on equity and dialogue. Glob Health Action 2023; 16:2244757. [PMID: 37581581 PMCID: PMC10431739 DOI: 10.1080/16549716.2023.2244757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/01/2023] [Indexed: 08/16/2023] Open
Abstract
Long Covid, or Post-Covid Conditions, is a global health problem. Yet we know strikingly little about the different experiences of Long Covid patients cross-nationally. To address this shortcoming, we conducted an online survey of Long Covid patients active on social media in the U.S. (n = 334, October to December 2021) and Brazil (n = 144, January to April 2022). Our analysis of short answer responses indicates patient dissatisfaction with medical care provided for Long Covid in both the U.S. and Brazil. For Long Covid patients in Brazil, there were additional concerns raised about the lack of local expertise about their condition. Based on these results, we urge policymakers to expand the education of medical professionals in order to raise awareness of Long Covid. Experts in the Global North should also be encouraged to engage in dialogue with patient groups and experts in the Global South, in order to better understand how local contexts shape the experience of Long Covid.
Collapse
Affiliation(s)
- Larry Au
- Department of Sociology, The City College of New York, New York, NY, USA
| | | | - Amanda Curi
- Trust Collaboratory, Columbia University, New York, NY, USA
| | | | - Gil Eyal
- Department of Sociology and Trust Collaboratory, Columbia University, New York, NY, USA
| |
Collapse
|
14
|
Horlick S, Krysa JA, Brehon K, Pohar Manhas K, Kovacs Burns K, Russell K, Papathanassoglou E, Gross DP, Ho C. Exploring Rehabilitation Provider Experiences of Providing Health Services for People Living with Long COVID in Alberta. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7176. [PMID: 38131727 PMCID: PMC10743286 DOI: 10.3390/ijerph20247176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/10/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND COVID-19 infection can result in persistent symptoms, known as long COVID. Understanding the provider experience of service provision for people with long COVID symptoms is crucial for improving care quality and addressing potential challenges. Currently, there is limited knowledge about the provider experience of long COVID service delivery. AIM To explore the provider experience of delivering health services to people living with long COVID at select primary, rehabilitation, and specialty care sites. DESIGN AND SETTING This study employed qualitative description methodology. Semi-structured interviews were conducted with frontline providers at primary care, rehabilitation, and specialty care sites across Alberta. Participants were interviewed between June and September 2022. METHOD Interviews were conducted virtually over zoom, audio-recorded, and transcribed with consent. Iterative inductive qualitative content analysis of transcripts was employed. Relationships between emergent themes were examined for causality or reciprocity, then clustered into content areas and further abstracted into a priori categories through their interpretive joint meaning. PARTICIPANTS A total of 15 participants across Alberta representing diverse health care disciplines were interviewed. RESULTS Main themes include: the importance of education for long COVID recognition; the role of symptom acknowledgement in patient-centred long COVID service delivery; the need to develop recovery expectations; and opportunities for improvement of navigation and wayfinding to long COVID services. CONCLUSIONS Provider experience of delivering long COVID care can be used to inform patient-centred service delivery for persons with long COVID symptoms.
Collapse
Affiliation(s)
- Sidney Horlick
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada (J.A.K.); (K.P.M.); (K.R.); (E.P.)
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Jacqueline A. Krysa
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada (J.A.K.); (K.P.M.); (K.R.); (E.P.)
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB T6G 2E1, Canada
| | - Katelyn Brehon
- Rehabilitation Research Centre, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (K.B.); (D.P.G.)
| | - Kiran Pohar Manhas
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada (J.A.K.); (K.P.M.); (K.R.); (E.P.)
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Katharina Kovacs Burns
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada;
- Department of Clinical Quality Metrics, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Kristine Russell
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada (J.A.K.); (K.P.M.); (K.R.); (E.P.)
| | - Elizabeth Papathanassoglou
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada (J.A.K.); (K.P.M.); (K.R.); (E.P.)
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Douglas P. Gross
- Rehabilitation Research Centre, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (K.B.); (D.P.G.)
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada
| | - Chester Ho
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada (J.A.K.); (K.P.M.); (K.R.); (E.P.)
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB T6G 2E1, Canada
| |
Collapse
|
15
|
Munda M, Velnar T, Bosnjak R, Zele T, Gradisnik L, Spazzapan P, Kos N, Kocivnik N, Benedicic M, Prestor B. COVID-19 and Surgical Practice in Slovenia: Managing the Crisis in Neurosurgery during the COVID-19 Pandemic. Life (Basel) 2023; 13:2095. [PMID: 37895476 PMCID: PMC10608538 DOI: 10.3390/life13102095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Worldwide, the novel coronavirus disease 2019 (COVID-19) has become a significant threat to global health. Worldwide, COVID-19 has affected the health service also in Slovenia. During this time, neurosurgery is facing difficulties in its service, both in emergency and elective surgeries. In the article, we describe the anti-COVID-19 measures taken at our neurosurgical department in a medical centre in Ljubljana, Slovenia, and analysed and compared the number of emergency and elective neurosurgical procedures during the time of the pandemic.
Collapse
Affiliation(s)
- Matic Munda
- Department of Neurosurgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.M.); (R.B.); (T.Z.); (P.S.); (M.B.); (B.P.)
| | - Tomaz Velnar
- Department of Neurosurgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.M.); (R.B.); (T.Z.); (P.S.); (M.B.); (B.P.)
- AMEU-ECM Maribor, 2000 Maribor, Slovenia;
| | - Roman Bosnjak
- Department of Neurosurgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.M.); (R.B.); (T.Z.); (P.S.); (M.B.); (B.P.)
| | - Tilen Zele
- Department of Neurosurgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.M.); (R.B.); (T.Z.); (P.S.); (M.B.); (B.P.)
- AMEU-ECM Maribor, 2000 Maribor, Slovenia;
| | - Lidija Gradisnik
- Institute of Biomedical Sciences, Medical Faculty Maribor, 2000 Maribor, Slovenia;
| | - Peter Spazzapan
- Department of Neurosurgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.M.); (R.B.); (T.Z.); (P.S.); (M.B.); (B.P.)
| | - Natasa Kos
- AMEU-ECM Maribor, 2000 Maribor, Slovenia;
- Department of Rehabilitation, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Nina Kocivnik
- Faculty of Pharmacy, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Mitja Benedicic
- Department of Neurosurgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.M.); (R.B.); (T.Z.); (P.S.); (M.B.); (B.P.)
| | - Borut Prestor
- Department of Neurosurgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.M.); (R.B.); (T.Z.); (P.S.); (M.B.); (B.P.)
| |
Collapse
|
16
|
Cao B, Wang L. When Epidemic Outbreaks Meet Social Media: Collective Illness Narratives on WeChat During COVID-19 Omicron Infection in China. HEALTH COMMUNICATION 2023:1-14. [PMID: 37731170 DOI: 10.1080/10410236.2023.2259695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
This study investigates the landscape of collective illness narratives on social media in China during December 2022 and January 2023, when nearly one billion people were infected with the COVID-19 Omicron virus. By analyzing 655 private social media posts, conducting in-depth interviews with 50 individuals, and organizing 6 focus group discussions with 24 participants, this study explores how COVID-19 Omicron infection became normalized and widely discussed on private social media platforms, notably WeChat Moments. This study unveils distinct features that arise when illness narratives and social media intersect and reveals how people exercised moral imagination and depathologized perception in social media illness narratives. The article provides narrative dynamics during the pandemic in a collective manner and sheds light on the reshaping of illness narratives in the era of social media, offering insights for future pandemic responses.
Collapse
Affiliation(s)
- Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, People's Republic of China
| | - Lei Wang
- State Key Lab Media Convergence of Media Convergence and Communication, Internet Information Research Institution, Communication University of China, Beijing, People's Republic of China
| |
Collapse
|
17
|
Gertsman S, Ene IC, Palmert S, Liu A, Makkar M, Shao I, Shapiro J, Williams C. Clinical empathy as perceived by patients with chronic illness in Canada: a qualitative focus group study. CMAJ Open 2023; 11:E859-E868. [PMID: 37751921 PMCID: PMC10521922 DOI: 10.9778/cmajo.20220211] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Although clinical empathy - the ability of a physician to understand a patient's illness experience, communicate this understanding and act collaboratively to create a treatment plan - provides substantial benefits to both physicians and patients, medical students typically experience a decline in empathy during training. The primary objective of this study was to generate a model of clinical empathy grounded in the perspectives of people with chronic illness living in Canada, to promote empathy-focused curricular development in Canadian medical education. METHODS We conducted a qualitative focus group study using a constructivist grounded theory approach. We recruited adults (age ≥ 18 yr) with chronic illness who had recently seen a physician in Canada from virtual support groups. Six semistructured virtual focus groups with 3-5 participants each were scheduled between June and September 2021. We coded the transcripts using the constant comparative method, allowing for the construction of an overarching theory. RESULTS Twenty patients (17 women and 3 men) participated in the focus groups; 1 group had 2 participants because 1 participant failed to appear. The majority of participants (14 [70%]) had at least a college degree. The mean rating for overall satisfaction with the Canadian health care system was 5.4/10.0 (median 5.0). The emergent theory showed that the perceived presence of physician empathy engendered positive internal processing by patients, leading to increased health care efficacy and enhanced mental health outcomes. Negative patient processing in response to the perceived absence of empathy led to reduced quality of health care delivery (e.g., ineffective referrals and more appointments), increased use of health care resources, disruptions in patients' personal lives, and negative physical and mental health outcomes. INTERPRETATION Clinical empathy can have life-altering impacts on patients, and its absence may increase resource use. As empathy involves understanding patients' lived experiences, any valid intervention to improve clinical empathy must be informed by patient perspectives.
Collapse
Affiliation(s)
- Shira Gertsman
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont.
| | - Ioana Cezara Ene
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Sasha Palmert
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Amy Liu
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Mallika Makkar
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Ian Shao
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Johanna Shapiro
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Connie Williams
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| |
Collapse
|
18
|
Nandonik AJ, Das Pooja S, Ahmed T, Parvez A, Kabir ZN. Experiences of aftermath of COVID-19 in relation to social, financial and health related aspects among previously hospitalized patients: a qualitative exploration. Front Public Health 2023; 11:1196810. [PMID: 37397755 PMCID: PMC10311015 DOI: 10.3389/fpubh.2023.1196810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
Background There is increasing evidence of long-term consequences of COVID-19. The world has seen multidimensional impact of the pandemic and Bangladesh is no exception to that. Policymakers in Bangladesh laid out strategies to curb the initial spread of COVID-19. However, long-term consequences of COVID-19 received little or no attention in the country. Evidence suggests that people presumed to be recovered face multidimensional post-covid consequences. This study aimed to describe the aftermath of COVID-19 in relation to social, financial and health related aspects among previously hospitalized patients. Methods This descriptive qualitative study includes participants (n = 14) who were previously hospitalized for COVID-19 and returned home after recovery. The participants were part of a mixed method study from which they were purposively selected. Semi-structured in-depth interviews were conducted over telephone. Inductive content analysis was used to analyze the data. Results Twelve sub-categories emerged from the data analysis which converged into five main categories. The main categories included perspective on physical health, financial struggle, life adjustment, interplay between different domains, and spontaneous support. Conclusion The lived experiences of COVID-19 recovered patients highlighted multidimensional impact on their daily lives. Physical and psychological wellbeing found to be related to the effort of restoring financial status. People's perception about life altered due to pandemic, for few the pandemic was an opportunity to grow while others found it difficult to accept the hardship. Such multidimensional post COVID-19 impact on people's lives and wellbeing holds considerable implication for response and mitigation plan for future related pandemics.
Collapse
|
19
|
Spence NJ, Russell D, Bouldin ED, Tumminello CM, Schwartz T. Getting back to normal? Identity and role disruptions among adults with Long COVID. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:914-934. [PMID: 36880317 DOI: 10.1111/1467-9566.13628] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 02/09/2023] [Indexed: 05/04/2023]
Abstract
Long COVID is a novel chronic illness with a variety of symptoms that people who have labelled themselves 'long-haulers' experience for an extended duration following a COVID-19 infection. We draw on in-depth interviews conducted in March-April 2021 with 20 working-aged adults in the U.S. who self-identified as long-haulers to understand the consequences for identities. The results demonstrate that Long COVID has important consequences for identities and sense of self. Long-haulers described experiencing three stages of biographical disruptions: realising their illness experience as misaligned with sense of self and embodied, age-based expectations; facing challenges to identities and changes in social roles; and reconciling illness and identity in the context of an uncertain prognosis. It remains unclear how long-haulers will resolve biographical disruptions and identity conflicts, especially as scientific insights about this novel condition emerge. Such outcomes may depend largely on whether Long COVID remains a contested illness or medical knowledge progresses to improve their quality of life. For now, healthcare providers may approach Long COVID holistically to address the identity disruptions that long-haulers face as they manage the consequences of this chronic illness.
Collapse
Affiliation(s)
- Naomi J Spence
- Department of Sociology, Lehman College, City University of New York, Bronx, New York, USA
| | - David Russell
- Department of Sociology, Appalachian State University, Boone, North Carolina, USA
| | - Erin D Bouldin
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - Tatum Schwartz
- Department of Sociology, Appalachian State University, Boone, North Carolina, USA
| |
Collapse
|
20
|
Kelly CE. Parosmia and altered taste in patients recovering from Covid 19. CLINICAL NUTRITION OPEN SCIENCE 2023; 48:1-10. [PMID: 36514442 PMCID: PMC9731923 DOI: 10.1016/j.nutos.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
Parosmia is a well-documented consequence of smell loss associated with Covid 19. Those who experience this qualitative olfactory disorder during recovery find that the odour of common foods and household items is distorted, and the experience can range from merely altered to profoundly disgusting. This can lead to a greatly altered relationship with food, including the physical symptoms of loss of appetite, nausea, vomiting, as well as wider reaching issues such as withdrawal from social situations, emotional distancing from others in their close social circles, and anhedonia. There is at present no known cure or intervention to mitigate the condition. The AbScent Parosmia and Phantosmia support group on Facebook became an important resource for patients with this condition during the early part of the pandemic, and the crowd-sourcing of experiences, tips and peer-to-peer advice became a valuable source of information for the community as well as researchers trying to understand the condition. Using protocols described in earlier literature on the use of social media for qualitative research, this paper provides information on the management of parosmia based on the experiences of over 30k patients in the AbScent Parosmia and Phantosmia group on Facebook and 6k member of the AbScent Network.
Collapse
|
21
|
O'Brien KK, Brown DA, McDuff K, St Clair-Sullivan N, Solomon P, Chan Carusone S, McCorkell L, Wei H, Goulding S, O'Hara M, Thomson C, Roche N, Stokes R, Vera JH, Erlandson KM, Bergin C, Robinson L, Cheung AM, Torres B, Avery L, Bannan C, Harding R. Conceptualising the episodic nature of disability among adults living with Long COVID: a qualitative study. BMJ Glob Health 2023; 8:bmjgh-2022-011276. [PMID: 36863719 PMCID: PMC9979585 DOI: 10.1136/bmjgh-2022-011276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/09/2023] [Indexed: 03/04/2023] Open
Abstract
INTRODUCTION Our aim was to describe episodic nature of disability among adults living with Long COVID. METHODS We conducted a community-engaged qualitative descriptive study involving online semistructured interviews and participant visual illustrations. We recruited participants via collaborator community organisations in Canada, Ireland, UK and USA.We recruited adults who self-identified as living with Long COVID with diversity in age, gender, race/ethnicity, sexual orientation and duration since initial COVID infection between December 2021 and May 2022. We used a semistructured interview guide to explore experiences of disability living with Long COVID, specifically health-related challenges and how they were experienced over time. We asked participants to draw their health trajectory and conducted a group-based content analysis. RESULTS Among the 40 participants, the median age was 39 years (IQR: 32-49); majority were women (63%), white (73%), heterosexual (75%) and living with Long COVID for ≥1 year (83%). Participants described their disability experiences as episodic in nature, characterised by fluctuations in presence and severity of health-related challenges (disability) that may occur both within a day and over the long-term living with Long COVID. They described living with 'ups and downs', 'flare-ups' and 'peaks' followed by 'crashes', 'troughs' and 'valleys', likened to a 'yo-yo', 'rolling hills' and 'rollercoaster ride' with 'relapsing/remitting', 'waxing/waning', 'fluctuations' in health. Drawn illustrations demonstrated variety of trajectories across health dimensions, some more episodic than others. Uncertainty intersected with the episodic nature of disability, characterised as unpredictability of episodes, their length, severity and triggers, and process of long-term trajectory, which had implications on broader health. CONCLUSION Among this sample of adults living with Long COVID, experiences of disability were described as episodic, characterised by fluctuating health challenges, which may be unpredictable in nature. Results can help to better understand experiences of disability among adults living with Long COVID to inform healthcare and rehabilitation.
Collapse
Affiliation(s)
- Kelly K O'Brien
- Department of Physical Therapy, Termerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada .,Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada.,Long COVID Physio, Toronto, Ontario, Canada
| | - Darren A Brown
- Therapies Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.,Long COVID Physio, London, UK
| | - Kiera McDuff
- Department of Physical Therapy, Termerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Natalie St Clair-Sullivan
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.,Royal Sussex Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Patricia Solomon
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Soo Chan Carusone
- McMaster Collaborative for Health and Aging, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Lisa McCorkell
- Patient-Led Research Collaborative, Oakland, California, USA
| | - Hannah Wei
- Patient-Led Research Collaborative, Ottawa, Ontario, Canada
| | - Susie Goulding
- COVID Long-Haulers Support Group Canada, Toronto, Ontario, Canada
| | | | | | | | | | - Jaime H Vera
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.,Royal Sussex Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | | | - Colm Bergin
- GUIDE Clinic, St. James's Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Larry Robinson
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Angela M Cheung
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Brittany Torres
- Department of Physical Therapy, Termerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Avery
- Biostatistics Department, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Ciaran Bannan
- GUIDE Clinic, St. James's Hospital, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Richard Harding
- Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| |
Collapse
|
22
|
Mullard JCR, Kawalek J, Parkin A, Rayner C, Mir G, Sivan M, Greenhalgh T. Towards evidence-based and inclusive models of peer support for long covid: A hermeneutic systematic review. Soc Sci Med 2023; 320:115669. [PMID: 36708608 PMCID: PMC9840228 DOI: 10.1016/j.socscimed.2023.115669] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/14/2022] [Accepted: 01/07/2023] [Indexed: 01/15/2023]
Abstract
Since the first wave of COVID-19 in March 2020 the number of people living with post-COVID syndrome has risen rapidly at global pace, however, questions still remain as to whether there is a hidden cohort of sufferers not accessing mainstream clinics. This group are likely to be constituted by already marginalised people at the sharp end of existing health inequalities and not accessing formal clinics. The challenge of supporting such patients includes the question of how best to organise and facilitate different forms of support. As such, we aim to examine whether peer support is a potential option for hidden or hardly reached populations of long COVID sufferers with a specific focus on the UK, though not exclusively. Through a systematic hermeneutic literature review of peer support in other conditions (57 papers), we evaluate the global potential of peer support for the ongoing needs of people living with long COVID. Through our analysis, we highlight three key peer support perspectives in healthcare reflecting particular theoretical perspectives, goals, and understandings of what is 'good health', we call these: biomedical (disease control/management), relational (intersubjective mutual support) and socio-political (advocacy, campaigning & social context). Additionally, we identify three broad models for delivering peer support: service-led, community-based and social media. Attention to power relations, social and cultural capital, and a co-design approach are key when developing peer support services for disadvantaged and underserved groups. Models from other long-term conditions suggest that peer support for long COVID can and should go beyond biomedical goals and harness the power of relational support and collective advocacy. This may be particularly important when seeking to reduce health inequalities and improve access for a potentially hidden cohort of sufferers.
Collapse
Affiliation(s)
- Jordan C R Mullard
- Durham University and University of Leeds, UK; University of Johannesburg, South Africa.
| | | | | | - Clare Rayner
- University of Leeds LOCOMOTION Patient Advisory Group (Co-Lead), UK.
| | | | | | | |
Collapse
|
23
|
Cavalcante TF, Lourenço CE, Ferreira JEDSM, Oliveira LR, Neto JC, Amaro JP, Moreira RP. Models of Support for Caregivers and Patients with the Post-COVID-19 Condition: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2563. [PMID: 36767926 PMCID: PMC9916224 DOI: 10.3390/ijerph20032563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In December 2019, an outbreak of the coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in the city of Wuhan, China. On 30 January 2020, the World Health Organization declared the outbreak a public health emergency of international concern. In October 2021, with the advancement of the disease, the World Health Organization defined the post-COVID-19 condition. The post-COVID-19 condition occurs in individuals with a history of probable or confirmed infection with SARS-CoV-2, usually 3 months after the onset of the disease. The chronicity of COVID-19 has increased the importance of recognizing caregivers and their needs. METHODS We conducted a scoping review following international guidelines to map the models of support for caregivers and patients with the post-COVID-19 condition. The searches were conducted in electronic databases and the grey literature. The Population, Concept, and Context framework was used: Population: patients with the post-COVID-19 condition and caregivers; Concept: models of caregiver and patient support; and Context: post-COVID-19 condition. A total of 3258 records were identified through the electronic search, and 20 articles were included in the final sample. RESULTS The studies approached existing guidelines and health policies for post-COVID-19 condition patients and support services for patients and home caregivers such as telerehabilitation, multidisciplinary care, hybrid models of care, and follow-up services. Only one study specifically addressed the home caregivers of patients with this clinical condition. CONCLUSIONS The review indicates that strategies such as telerehabilitation are effective for training and monitoring the patient-family dyad, but the conditions of access and digital literacy must be considered.
Collapse
|
24
|
Kocivnik N, Velnar T. A Review Pertaining to SARS-CoV-2 and Autoimmune Diseases: What Is the Connection? LIFE (BASEL, SWITZERLAND) 2022; 12:life12111918. [PMID: 36431053 PMCID: PMC9698792 DOI: 10.3390/life12111918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious viral disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It is known that infection with SARS-CoV-2 can lead to various autoimmune and autoinflammatory diseases. There are few reports in the literature on the association between SARS-CoV-2 and autoimmune diseases, and the number of reports has been increasing since 2020. Autoimmune diseases and SARS-CoV-2 infections are intertwined in several ways. Both conditions lead to immune-mediated tissue damage, the immune response is accompanied by the increased secretion of inflammatory cytokines and both conditions can be treated using immunomodulatory drugs. Patients with certain autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, type 1 diabetes, cardiac sarcoidosis, idiopathic pulmonary fibrosis, autoimmune hepatitis, multiple sclerosis and others, are more susceptible to SARS-CoV-2 infection, either because of the active autoimmune disease or because of the medications used to treat it. Conversely, SARS-CoV-2 infection can also cause certain autoimmune diseases. In this paper, we describe the development of autoimmune diseases after COVID-19 and the recovery from COVID-19 in people with autoimmune diseases.
Collapse
Affiliation(s)
- Nina Kocivnik
- Faculty of Pharmacy, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Tomaz Velnar
- Department of Neurosurgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Correspondence:
| |
Collapse
|
25
|
Wang H, Sha H, Liu L, Zhao H. Exploring the Relationship between Perceived Community Support and Psychological Well-Being of Tourist Destinations Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14553. [PMID: 36361433 PMCID: PMC9656341 DOI: 10.3390/ijerph192114553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
To explore the relationship between community support in tourist destinations and residents' psychological well-being in the post-COVID-19 pandemic period, this study adopts the questionnaire survey method and draws the following conclusions by constructing a structural equation model: (1) perceived community support is very helpful for the psychological well-being of residents, (2) psychological resilience significantly mediates the relationship between perceived community support and residents' psychological well-being, (3) the resident-tourist interaction mediates the relationship between perceived community support and residents' psychological well-being, and (4) the resident-tourist interaction and psychological resilience play an ordered chain-mediating role between perceived community support and residents' psychological well-being. These findings not only fill the gap in tourism research regarding destination-based community support studies but also provide a theoretical basis for maintaining residents' psychological well-being in a given destination in the context of the COVID-19 pandemic. To a certain extent, improving residents' well-being is helpful for promoting the healthy and sustainable development of tourism activities and realizing a "win-win" situation in which tourist destinations develop economically while promoting their residents' living standards.
Collapse
Affiliation(s)
- Haihong Wang
- Department of Tourism Management, Business School, Liaoning University, Shenyang 110036, China
| | - Hongxia Sha
- Department of Tourism Management, Business School, Liaoning University, Shenyang 110036, China
| | - Litong Liu
- Department of Tourism Management, Business School, Liaoning University, Shenyang 110036, China
| | - Hengwei Zhao
- Department of International Economy and Trade, International School, Jinan University, Guangzhou 511486, China
| |
Collapse
|
26
|
Moretti C, Collaro C, Terzoni C, Colucci G, Copelli M, Sarli L, Artioli G. Dealing with uncertainty. A qualitative study on the illness' experience in patients with Long-COVID in Italy. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022349. [PMID: 36533738 PMCID: PMC9828911 DOI: 10.23750/abm.v93i6.14059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND GOALS An unknown proportion of people who had COVID-19 infection continue to experience symptoms such as fatigue, breathlessness, joint or muscle pain, difficulty sleeping, and brain fog. These symptoms have a significant impact on the quality of life. Long-COVID is a new multisystem disease still under investigation. This research aims to explore the illness experienced by patients suffering from Long-COVID in Italy. RESEARCH DESIGN AND METHODS Qualitative methodology with semi-structured interviews. Participants were recruited on the Facebook patient group between October 2021 and January 2022. Participants had been experiencing symptoms for at least three months following confirmed COVID-19 infection. Interviews were conducted by video call, recorded and transcribed with consent. The thematic analysis method has been chosen to infer data from textual material. RESULTS 17 interviews with women with Long-COVID have been analysed. The main themes include: a total change of life due to the symptomatology, loss of autonomy that affects social, family and professional life; social isolation, a sense of abandonment often increased by stigma, the difficulty of being believed and achieving diagnosis; difficulty in managing symptoms and accessing to care services; living with uncertainty caused by the lack of institutional, social, professional, familial and medical support. Conclusions: Intervention programs, both institutional and social-health policies should be developed for patients with Long-COVID. The impact of symptoms could be reduced by developing standards and protocols, and by ensuring access to care and to multi-disciplinary rehabilitation. Further development of knowledge on Long-COVID is essential.
Collapse
Affiliation(s)
- Chiara Moretti
- Department of Medicine and Surgery, University of Parma, Parma (Italy)
| | - Concetta Collaro
- Department of Neurology, Hospital of Piacenza - AUSL PC, Piacenza (Italy)
| | - Cristina Terzoni
- Department of DPS, Hospital of Piacenza - AUSL PC, Piacenza (Italy)
| | - Gennaro Colucci
- Department of Radiological Functions, Hospital of Piacenza - AUSL PC, Piacenza (Italy)
| | - MariaRosa Copelli
- Department of Primary Care, Hospital of Piacenza - AUSL PC, Piacenza (Italy)
| | - Leopoldo Sarli
- Department of Medicine and Surgery, University of Parma, Parma (Italy)
| | - Giovanna Artioli
- Department of Medicine and Surgery, University of Parma, Parma (Italy)
| |
Collapse
|