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Leese J, Therrien S, Ramachandran S, Backman CL, Ma JK, Koehn CL, Hoens AM, English K, Davidson E, McQuitty S, Gavin J, Adams J, Li LC. Decision-Making Around COVID-19 Public Health Measures and Implications for Self-Care Activities: Experiences of Persons With Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2024; 76:140-152. [PMID: 37870115 DOI: 10.1002/acr.25262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 10/11/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE We aimed to advance understanding of how persons with rheumatoid arthritis (RA) experience decision-making about adopting public health measures during the COVID-19 pandemic. METHODS Persons living with RA partnered throughout this nested qualitative study. One-to-one semistructured telephone interviews were conducted with participants with RA between December 2020 and December 2021. They were strategically sampled from a randomized controlled trial that was underway to test a physical activity counseling intervention. Analysis was guided by reflexive thematic analysis. RESULTS Thirty-nine participants (aged 26-86 years; 36 women) in British Columbia, Canada were interviewed. We developed three themes. Participants described how their decision-making about public health measures related to 1) "upholding moral values of togetherness" because decisions were intertwined with moral values of neighborliness and reciprocity. Some adapted their self-care routines to uphold these moral values; 2) "relational autonomy-supports and challenges," because they sometimes felt supported and undermined in different relational settings (eg, by family, local community, or provincial government); and 3) "differing trust in information sources," in which decisions were shaped by the degree of faith they had in various information sources, including their rheumatologists. CONCLUSION Across themes, experiences of decision-making about public health measures during the pandemic were embedded with moral concepts of solidarity, autonomy, and trust, with implications for how persons with RA chose and sustained their self-care activities. Insights gained help sensitize researchers and clinicians to moral issues experienced by persons with RA, which may inform support for self-care activities during and after the pandemic.
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Affiliation(s)
- Jenny Leese
- Arthritis Research Canada, Vancouver, British Columbia, and University of Ottawa, Ottawa, Ontario, Canada
| | | | - Smruthi Ramachandran
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
| | - Catherine L Backman
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
| | - Jasmin K Ma
- Arthritis Research Canada and University of British Columbia and International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
| | - Cheryl L Koehn
- Arthritis Consumer Experts, Vancouver, British Columbia, Canada
| | - Alison M Hoens
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly English
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Eileen Davidson
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Shanon McQuitty
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | | | - Jo Adams
- University of Southampton, Southampton, UK
| | - Linda C Li
- Arthritis Research Canada and University of British Columbia, Vancouver, British Columbia, Canada
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Strafford H, Lacey AS, Hollinghurst J, Akbari A, Watkins A, Paterson J, Jennings D, Lyons RA, Powell HR, Kerr MP, Chin RW, Pickrell WO. COVID-19 vaccination uptake in people with epilepsy in wales. Seizure 2023; 108:49-52. [PMID: 37080124 PMCID: PMC10076248 DOI: 10.1016/j.seizure.2023.04.006] [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: 10/31/2022] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/09/2023] Open
Abstract
PURPOSE People with epilepsy (PWE) are at increased risk of severe COVID-19. Assessing COVID-19 vaccine uptake is therefore important. We compared COVID-19 vaccination uptake for PWE in Wales with a matched control cohort. METHODS We performed a retrospective, population, cohort study using linked, anonymised, Welsh electronic health records within the Secure Anonymised Information Linkage (SAIL) Databank (Welsh population=3.1 million).We identified PWE in Wales between 1st March 2020 and 31st December 2021 and created a control cohort using exact 5:1 matching (sex, age and socioeconomic status). We recorded 1st, 2nd and booster COVID-19 vaccinations. RESULTS There were 25,404 adults with epilepsy (127,020 controls). 23,454 (92.3%) had a first vaccination, 22,826 (89.9%) a second, and 17,797 (70.1%) a booster. Comparative figures for controls were: 112,334 (87.8%), 109,057 (85.2%) and 79,980 (62.4%).PWE had higher vaccination rates in all age, sex and socioeconomic subgroups apart from booster uptake in older subgroups. Vaccination rates were higher in older subgroups, women and less deprived areas for both cohorts. People with intellectual disability and epilepsy had higher vaccination rates when compared with controls with intellectual disability. CONCLUSIONS COVID-19 vaccination uptake for PWE in Wales was higher than that for a matched control group.
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Affiliation(s)
- H Strafford
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK.
| | - A S Lacey
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK
| | - J Hollinghurst
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK
| | - A Akbari
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK
| | - A Watkins
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK
| | - J Paterson
- Epilepsy Action, New Anstey House, Gate Way Drive, Yeadon, Leeds, England, UK
| | - D Jennings
- Epilepsy Action, New Anstey House, Gate Way Drive, Yeadon, Leeds, England, UK
| | - R A Lyons
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK
| | - H R Powell
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK; Morriston Hospital, Swansea Bay University Health Board, Swansea, Wales, UK
| | - M P Kerr
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, Wales, UK
| | - R W Chin
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences and Department of Child Life and Health, The University of Edinburgh, Scotland, UK; Royal Hospital for Children and Young People, Edinburgh, Scotland, UK
| | - W O Pickrell
- Neurology Research Group, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Swansea, Wales SA2 8PP, UK; Morriston Hospital, Swansea Bay University Health Board, Swansea, Wales, UK
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