The marked body - a qualitative study on survivors embodied experiences of a COVID-19 illness trajectory

Pain and temporality: a merleau-pontyian approach

Chronic pain is a common disorder with enormous sociomedical importance. A major part of primary and secondary costs of illness is caused by the various pain syndromes. Nociception - the sensory perception of a painful stimulus - is a complex process relying on an intricate system of anatomical, neurophysiological and biochemical networks. This applies even more so to pain - the state of experiencing a nociceptive event, of interpreting it in terms of meaning for the affected individual and of suffering a range of emotions it elicits. This intricacy renders it obvious, that the empirical medical sciences alone cannot explain all aspects of pain. Hence, it has also become a focus of phenomenological research. One aspect of these investigations is the interaction of pain and the perception of the lived body's spatiality. The focus of this article will build on these concepts to develop a construct of the alteration of temporality caused by chronic pain and the effects this spells out for the affected subject. To this end, I will primarily draw on Merleau-Ponty's ideas of the lived body as well as on theories of enactivism and embodiment. I will also point out parallels to neuroscientific data, thereby demonstrating the proximity of phenomenology and neuroscience. A possible partial solution to the pain dilemma may be derived from psychology: techniques relying on cognitive behavioural intervention, awareness training, and existential analysis may provide alleviation to patients suffering from chronic pain.

Foreign-born nurses as COVID-19 survivors in the Nordic region: A descriptive phenomenological study

OBJECTIVE

In 2020, amid limited COVID-19 vaccination access, many nurses from Black, Asian and Minority Ethnic (BAME) groups in the United States of America and United Kingdom succumbed to the virus. No fatalities among Filipino foreign-born nurses (FBNs) in the BAME groups were recorded in the Nordic region. This study explored the experiences of Filipino FBNs in the Nordic region who, during the initial 2020 pandemic wave, cared for COVID-19 patients, contracted the virus and subsequently recovered.

METHODS

The research employed a descriptive phenomenological methodology to explore the experiences of six Filipino FBNs who had recovered from COVID-19 in various regions of the Nordic countries, including Finland (n = 1), Sweden (n = 1), Denmark (n = 2), Norway (n = 1) and Iceland (n = 1). Data collection occurred through online videoconferencing between September 2020 and February 2021, utilising a semi-structured approach. The data analysis was conducted following Sundler and colleagues' qualitative thematic analysis, which is grounded in descriptive phenomenology.

RESULTS

The data analysis yielded three primary themes and twelve sub-themes, which explored the experiences of Filipino FBNs with COVID-19 infection. The study demonstrated that unclear national guidelines impacted nurses' preparedness in caring for COVID-19 patients, contributing to their susceptibility to contracting the virus. The lack of occupational healthcare services for nurses during and after the pandemic affected their work morale in an unfamiliar setting.

CONCLUSION

The study provided valuable insights into the experiences of Filipino FBNs during the COVID-19 pandemic, emphasising the need for clearer guidelines, enhanced training and improved support for healthcare workers. It highlighted the psychological impact of COVID-19, emphasising the importance of mental health support and stigma reduction efforts. The study also emphasised the significance of improving occupational health services to support the well-being and recovery of healthcare workers during and after the pandemic, with implications for developing comprehensive strategies to protect frontline healthcare workers in health crises.

Searching for a brighter future-Lived experiences of ongoing recovery processes following COVID-19 infection

BACKGROUND

Research in Denmark indicates that approximately 30% of people with confirmed COVID-19 infection experience at least one physical symptom 6-12 months after the acute infection. The lived experiences of undergoing prolonged recovery processes and how these processes unfold need further attention.

AIM

To contribute in-depth knowledge about recovery, as experienced over time by people living with the post COVID-19 condition.

METHODS

Within a qualitative research design, nine women and six men were interviewed. Ten of them gave a follow-up interview. Prompt cards and participant-generated photographs were included. A phenomenological-hermeneutic approach inspired by Ricoeur's theory of interpretation guided the data analysis.

FINDINGS

Living with long-term health problems associated with the post COVID-19 condition involved recovery processes where participants struggled with reduced capacity, new unpredictability and uncertainty in everyday life. Participants continuously searched for improvement and aimed for regaining former health and well-being. Lack of knowledge, acknowledgement and support made it difficult to find clear directions for improvement. Participants created a protective shield and struggled, often jointly with family and friends, to cope with bodily, cognitive, emotional, existential and social challenges. Over time, some participants realised that they might not be able to fully return to their earlier habitus. However, some of them gained a new foothold and sense of hope for the future.

CONCLUSION

This study provides in-depth insight into the experience of changing and open-ended recovery processes while living with the post COVID-19 condition. Over time, some participants learned to rebuild their lives, adapting to their reduced capacities. Future care and rehabilitation models for these patients must address the complex and challenging nature of recovery processes associated with living with post-COVID-19 condition.

Implications for long COVID: A systematic review and meta-aggregation of experience of patients diagnosed with COVID-19

AIMS AND OBJECTIVES

This review aims to synthesize the available evidence of what patients experience when infected with COVID-19, both in hospital and post-discharge settings.

DESIGN

This review was conducted using the Joanna Briggs Institute (JBI) methodology for qualitative systematic reviews and evidence synthesis. Reporting of results was presented according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist.

BACKGROUND

Coronavirus disease 2019 (COVID-19) continues to be a public health crisis worldwide. Many patients diagnosed with COVID-19 have varied levels of persisting mental disorders. Previous studies have reported the degree, prevalence and outcome of psychological problems. Minimal research explored the experience of patients with long COVID. The real-life experience of patients with COVID-19 from diagnosis to post-discharge can deepen the understanding of nurses, physicians and policymakers.

METHODS

All studies describing the experience of patients were included. Two authors independently appraised the methodological quality of the included studies using the JBI Critical Appraisal Checklist for Qualitative Research 2020.

RESULTS

This systematic review aggregated patients' experience of being diagnosed with COVID-19 in both hospitalized and post-discharge settings. Finally, 17 studies met inclusion criteria and quality appraisal guidelines. The selected studies in the meta-synthesis resulted in 12 categories, and further were concluded as five synthesized findings: physical symptoms caused by the virus, positive and negative emotional responses to the virus, positive coping strategies as facilitators of epidemic prevention and control, negative coping strategies as obstacles of epidemic prevention and control, and unmet needs for medical resource.

CONCLUSIONS

The psychological burden of patients diagnosed with COVID-19 is heavy and persistent. Social support is essential in the control and prevention of the epidemic. Nurses and other staff should pay more attention to the mental health of the infected patients both in and after hospitalization.

RELEVANCE TO CLINICAL PRACTICE

Nurses should care about the persistent mental trauma of COVID-19 survivors and provide appropriate psychological interventions to mitigate the negative psychological consequences of them. Besides, nurses, as healthcare professionals who may have the most touch with patients, should evaluate the level of social support and deploy it for them. It is also needed for nurses to listen to patient's needs and treat them with carefulness and adequate patience in order to decrease the unmet needs of patients.

The pandemic body: the lived body during the COVID-19 pandemic

In this study, we conduct a detailed analysis of qualitative survey data focusing on adult populations in the UK, Japan and Mexico to address the following question: How has the COVID-19 pandemic changed people's lived experience of their bodies, other people's bodies and the world? We identify five themes: (i) fear and danger, (ii) bodily doubt and hypervigilance, (iii) risk and trust, (iv) adapting and enduring and (v) changes in perspective. We use two theoretical frameworks: first, Mary Douglas' anthropological work on purity, risk, danger and symbolism is applied to understand how social and cultural meanings attached to the body have changed during the pandemic. Second, we use the concept of bodily doubt developed by Havi Carel to interpret how people experience their bodies and other people's bodies differently during the pandemic. While we recognise the significant variation in people's embodied experience of the pandemic, our findings suggest there are commonalities that span different countries and cultures. Specifically, we look at responses to COVID-19 protective countermeasures such as national lockdowns and physical distancing which we suggest have reduced people's ability to put faith in their own bodies, trust other people and trust the political leadership. We conclude by proposing that the changes to our lived experience during the COVID-19 pandemic have prompted changes in perspective and a renewed focus on what people consider important in life from a social, moral, cultural and political point of view.

Patients' Perspectives on Life and Recovery 1 Year After COVID-19 Hospitalization

BACKGROUND

Many patients hospitalized for COVID-19 experience prolonged symptoms months after discharge. Little is known abou t patients' personal experiences recovering from COVID-19 in the United States (US), where medically underserved populations are at particular risk of adverse outcomes.

OBJECTIVE

To explore patients' perspectives on the impact of COVID-19 hospitalization and barriers to and facilitators of recovery 1 year after hospital discharge in a predominantly Black American study population with high neighborhood-level socioeconomic disadvantage.

DESIGN

Qualitative study utilizing individual, semi-structured interviews.

PARTICIPANTS

Adult patients hospitalized for COVID-19 approximately 1 year after discharge home who were engaged in a COVID-19 longitudinal cohort study.

APPROACH

The interview guide was developed and piloted by a multidisciplinary team. Interviews were audio-recorded and transcribed. Data were coded and organized into discrete themes using qualitative content analysis with constant comparison techniques.

KEY RESULTS

Of 24 participants, 17 (71%) self-identified as Black, and 13 (54%) resided in neighborhoods with the most severe neighborhood-level socioeconomic disadvantage. One year after discharge, participants described persistent deficits in physical, cognitive, or psychological health that impacted their current lives. Repercussions included financial suffering and a loss of identity. Participants reported that clinicians often focused on physical health over cognitive and psychological health, an emphasis that posed a barrier to recovering holistically. Facilitators of recovery included robust financial or social support systems and personal agency in health maintenance. Spirituality and gratitude were common coping mechanisms.

CONCLUSIONS

Persistent health deficits after COVID-19 resulted in downstream consequences in participants' lives. Though participants received adequate care to address physical needs, many described persistent unmet cognitive and psychological needs. A more comprehensive understanding of barriers and facilitators for COVID-19 recovery, contextualized by specific healthcare and socioeconomic needs related to socioeconomic disadvantage, is needed to better inform intervention delivery to patients that experience long-term sequelae of COVID-19 hospitalization.

Psychological capital and alienation among patients with COVID-19 infection: the mediating role of social support

BACKGROUND

COVID-19 infection continues all over the world, causing serious physical and psychological impacts to patients. Patients with COVID-19 infection suffer from various negative emotional experiences such as anxiety, depression, mania, and alienation, which seriously affect their normal life and is detrimental to the prognosis. Our study is aimed to investigate the effect of psychological capital on alienation among patients with COVID-19 and the mediating role of social support in this relationship.

METHODS

The data were collected in China by the convenient sampling. A sample of 259 COVID-19 patients completed the psychological capital, social support and social alienation scale and the structural equation model was adopted to verify the research hypotheses.

RESULTS

Psychological capital was significantly and negatively related to the COVID-19 patients' social alienation (p < .01). And social support partially mediated the correlation between psychological capital and patients' social alienation (p < .01).

CONCLUSION

Psychological capital is critical to predicting COVID-19 patients' social alienation. Social support plays an intermediary role and explains how psychological capital alleviates the sense of social alienation among patients with COVID-19 infection.

From fearful to hopeful: A thematic content analysis of COVID-19 survivors' YouTube videos

COVID-19 survivors experienced a spectrum of emotions as a result of surviving the said disease. Employing thematic content analysis, the researchers characterized the various emotional manifestations among recovered COVID-19 patients, which are crucial indicators of their mental well-being postinfection. From March 2020 to June 2021, data was collated from 31 Filipino COVID-19 Survivors' YouTube videos. 51.61% of the videos were posted in 2020 and 48.39% were posted in 2021 where 70.97% of the survivors were female while 29.03% were male. 579 primary codes emerged and were narrowed down into sixteen themes where Hope (18.83%) arose as the most predominant emotion followed by Gratitude (14.68%), Joy and Relief (14.16%), Faith (11.57%), Plight Response (10.88%), Sadness (10.88%), Fear (6.39%), and nine others (12.61%).

Care trajectories of COVID-19 patients: from preventive measures to rehabilitation

This study aims to analyze the care trajectories of patients diagnosed with COVID-19 who were hospitalized and are currently undergoing rehabilitation regarding their use of and access to the healthcare network (HN). An evaluative, qualitative study was carried out based on interviews with patients in the city of Niterói, Rio de Janeiro State, Brazil. The care trajectories were reconstructed at three different occasions that express their experiences with the healthcare and support network during the pandemic: prevention, support and diagnosis measures; hospitalization; post-COVID-19 care, rehabilitation and support. The results indicate that the main source of information about COVID-19 was TV newscasts. Preventive hygiene measures were the most widely adopted. The family was the main support network. There was no waiting time for admission to the municipal referral hospital. Hospitalization was very well evaluated in terms of user embracement, multidisciplinary care, virtual visits and daily contact between doctor and family members. A post-discharge "care vacuum" was identified, with no follow-up by primary health care (PHC) and other public services. Low-cost health insurance plans and private specialized post-COVID-19 services were frequently and spontaneously sought until the implementation of the rehabilitation service. In summary, solitary and discontinuous care trajectories of individuals and families shed light on several challenges to the health system, including guaranteed access to coordinated PHC and expanded offer of specialized public services and rehabilitation, aligned with the principles of humanized care, in addition to the maintenance of social support measures.

Care trajectories of COVID-19 patients: from preventive measures to rehabilitation

This study aims to analyze the care trajectories of patients diagnosed with COVID-19 who were hospitalized and are currently undergoing rehabilitation regarding their use of and access to the healthcare network (HN). An evaluative, qualitative study was carried out based on interviews with patients in the city of Niterói, Rio de Janeiro State, Brazil. The care trajectories were reconstructed at three different occasions that express their experiences with the healthcare and support network during the pandemic: prevention, support and diagnosis measures; hospitalization; post-COVID-19 care, rehabilitation and support. The results indicate that the main source of information about COVID-19 was TV newscasts. Preventive hygiene measures were the most widely adopted. The family was the main support network. There was no waiting time for admission to the municipal referral hospital. Hospitalization was very well evaluated in terms of user embracement, multidisciplinary care, virtual visits and daily contact between doctor and family members. A post-discharge “care vacuum” was identified, with no follow-up by primary health care (PHC) and other public services. Low-cost health insurance plans and private specialized post-COVID-19 services were frequently and spontaneously sought until the implementation of the rehabilitation service. In summary, solitary and discontinuous care trajectories of individuals and families shed light on several challenges to the health system, including guaranteed access to coordinated PHC and expanded offer of specialized public services and rehabilitation, aligned with the principles of humanized care, in addition to the maintenance of social support measures.

"The whole sky has broken down on me. I might die alone": A qualitative study on the lived experiences of COVID-19 positive frontline workers in Bangladesh

Many countries, including Bangladesh, have conducted research on the mental health of frontline workers and their challenges in adjusting to their new workplaces. However, the authors are unaware of any studies on their real-life experiences as COVID-19-positive patients in Bangladesh. This study intends to investigate the lived experiences of Bangladeshi frontline workers who were isolated as a result of the COVID-19 infection and tested positive for the virus. We used a qualitative methodology and a semi-structured interview guide to conduct ten interviews between July 26 and August 12, 2020. The participants were recruited via a social media campaign and purposive sampling. All interviews were conducted via telephone and online and were transcribed and analyzed using Colaizzi's phenomenological method. The study does, however, identify four primary themes and 13 supporting themes, including (1) experience in a new working environment (subthemes: workload and adaptation, maintaining health protocol and social distance, and the fear of infection), (2) diagnosis (subthemes: the origin of infection, physiological problems, experiences at the diagnosis center), (3) recovery days (subthemes: earlier reactions, experiences in isolation, coping mechanisms), and (4) post-COVID-19 (subthemes: excitement, fear, and confusion; physiological problems; increased religiosity; and changes in philosophy). This study is important for healthcare policymakers because it helps them design healthcare management systems that take Bangladeshi society's social context into account. This study also recommends that long-term behavioral change programs be implemented by national policymakers to lessen societal stigma. At the same time, it suggests that the government should help lessen the barriers to health care services that persons with lower socioeconomic status confront.

Patient-Experienced Quality During Postoperative Pain Management - A Phenomenological-Hermeneutic Study

PURPOSE

The aim of this study was to describe an in-depth understanding of patients' experiences and perspectives after use of the erector spinae plane block (ESP) in patients undergoing laparoscopic hemicolectomy due to malignant disease. Knowledge gained throughout the study aimed to ensure increased patient-experienced quality, patient safety and adequate post-surgery pain treatment.

DESIGN

A qualitative approach based on a phenomenological-hermeneutic framework inspired by Paul Ricoeur's perspectives was used.

METHODS

The empirical material consisted of 11 semi-structured individual interviews with patients, who underwent laparoscopic hemicolectomy and received an ESP block as postoperative pain treatment.

FINDINGS

Four themes emerged during the analysis and represent the findings: (1)"The significance of the pain for everyday life", in which everyday life and social relations emerged as fundamental for patients' experience of pain and pain management; (2) "Joy and anxiety - two opposites" showed experiences of conflicting feelings causing uncertainty and insecurity (3); The theme "Painlessness - or not?" showed experiences of satisfaction with the ESP block and how patients considered the time perspective of having pain as an element of further insecurity; (4)"Losing control over one's own life" demonstrated how patients tried regaining control over their own lives during pain and after surgery.

CONCLUSIONS

The findings indicate that the majority of patients were happy with the ESP block because among other things, it reduced the need for rescue medicine including side-effects. Because of an acceptable pain intensity, patients paid more attention to other factors associated with their surgical intervention. Adequate pain management was described as of great importance for their experience of well-being and increased quality of life.