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Raunkiaer M, Joergensen DS, Rasmussen A, Johannesen G, Thuesen J, Elnegaard CM, Dupont SB. Experiences of improvement of everyday life following a rehabilitation programme for people with long-term cognitive effects of COVID-19: Qualitative study. J Clin Nurs 2024; 33:137-148. [PMID: 37222026 DOI: 10.1111/jocn.16739] [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: 04/29/2022] [Revised: 02/13/2023] [Accepted: 04/12/2023] [Indexed: 05/25/2023]
Abstract
AIM AND OBJECTIVES To explore challenges in everyday life for people with long-term cognitive effects of COVID-19 and whether a rehabilitation programme contributed to the remedy thereof. BACKGROUND Healthcare systems around the world need knowledge about acute COVID-19 treatment, long-term effects exerting an impact on peoples' everyday lives, and how to remedy these. DESIGN This is a qualitative study with a phenomenological approach. METHODS Twelve people with long-term cognitive effects of COVID-19 participated in a multidisciplinary rehabilitation programme. Individual semi-structured interviews were made. Data were analysed thematically. RESULTS Three themes and eight sub-themes emerged with respect to everyday life challenges and experiences of the rehabilitation programme. The themes were (1) Personal insight and knowledge, (2) Changed daily routines at home and (3) Coping with working life. CONCLUSION Participants experienced long-term effects of COVID-19 as cognitive challenges, fatigue and headaches, which affected their everyday lives, that is inability to overcome daily tasks at home and at work, maintaining family roles and relations with relatives. The rehabilitation programme contributed to a vocabulary and insights related to the long-term effects of COVID-19 and the experience of being a different person. The programme contributed to changes in daily routines, organising breaks in everyday life and explaining challenges to family/relatives and the way in which they affected daily routines and their role in the family. In addition, the programme supported several of the participants in finding the right workload and working hours. RELEVANCE TO CLINICAL PRACTICE We recommend multidisciplinary rehabilitation programmes inspired by cognitive remediation of long-term COVID-19 cognitive effects. Municipalities and organisations could collaborate in the development and completion of such programmes, possibly comprising both virtual and physical elements. This could facilitate access and reduce costs. PATIENT OR PUBLIC CONTRIBUTION Patients contributed to the conduct of the study by participating in the data collection via interviews. CLINICAL TRIAL REGISTRATION NUMBER Data collection and processing of data are approved by the Region of Southern Denmark (journal number: 20/46585).
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Affiliation(s)
- Mette Raunkiaer
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Nyborg, Denmark
| | | | - Annette Rasmussen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Nyborg, Denmark
| | - Gitte Johannesen
- Department of Occupational Therapy and Physiotherapy, Zealand University Hospital, Koge, Denmark
| | - Jette Thuesen
- University of Southern Denmark, Odense, Denmark
- University College Absalon, Slagelse, Denmark
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Silwal S, Parajuli K, Acharya A, Ghimire A, Pandey S, Pandey A, Poudyal A, Bista B, Gyanwali P, Dhimal M. Physical, mental and social status after COVID-19 recovery in Nepal: A mixed method study. PLoS One 2023; 18:e0290693. [PMID: 37669253 PMCID: PMC10479937 DOI: 10.1371/journal.pone.0290693] [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: 08/09/2022] [Accepted: 08/15/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Nepal has been devastated by an unprecedented COVID-19 outbreak, affecting people emotionally, physically, and socially, resulting in significant morbidity and mortality. Approximately 10% of COVID-19 affected people have symptoms that last more than 3-4 weeks and experience numerous symptoms causing an impact on everyday functioning, social, and cognitive function. Thus, it is vital to know about the recovered patient's health status and undertake rigorous examinations to detect and treat infections. Hence, this study aims to assess the health status of COVID-19 post-recovery patients in Nepal. METHOD A descriptive cross-sectional mixed-method study was conducted in all seven provinces of Nepal. A total of 552 interviews were conducted for the quantitative study, and 25 in-depth interviews were conducted for the qualitative study among above 18 years COVID-19-recovered patients. The data was gathered over the phone through the purposive sampling method The results of a descriptive and thematic analysis were interpreted. FINDING The majority (more than 80%) of the recovered patients could routinely perform household duties, activities outside the home, and financial job accounting. However, a few of them required assistance in carrying out all of those tasks. Prior and then after COVID-19 infection, smoking habits reduced by about one-tenth and alcohol intake decreased by a twelve percent. A qualitative finding revealed that the majority of COVID-19 symptomatic patients experienced a variety of physical symptoms such as fever, headache, body pain, fatigue, tiredness, sore throat, cough, loss of taste, loss of smell, sneezing, loss of appetite, and difficulty breathing, while others felt completely fine after being recovered. Furthermore, there was no variation in the daily functional activities of the majority of the recovered patients, while a few were found conducting fewer activities than usual because they were concerned about their health. For social health, quantitative data indicated that more than half of the participants' social health was severely impacted. According to the IDI, the majority of the interviewees perceived society's ignorance and misbehavior. Family members were the most often solicited sources of support. Some participants got care and assistance, but the majority did not get affection or love from their relatives. Moreover, regarding mental health, 15 percent of participants had repeated disturbing and unwanted thoughts about COVID-19 after being recovered, 16 percent tried to avoid information on COVID-19 and 7 .7 percent of people had unfavorable ideas or sentiments about themselves. More than 16 percent of participants reported feeling some level of stress related to the workplace and home. While in-depth interviews participants revealed that COVID-infected patients who were asymptomatic didn't experience any emotional change in them but recovered patients who are symptomatic symptoms had anxiety and still being conscious of COVID-19 in fear of getting infected again Additionally, it was discovered that participants' mental health is influenced by ignorance of society, as well as by fake news posted to social media. CONCLUSION COVID-19 infection has had an impact on physical, mental, and social well-being. Hence, to aid in the early recovery of COVID-19 patients, provision of evaluating and reporting the clinical features, early detection and management of long COVID case is needed from the local and provincial and central government of Nepal.
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Affiliation(s)
- Sashi Silwal
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | | | - Astha Acharya
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Ajnish Ghimire
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Savita Pandey
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Ashok Pandey
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Anil Poudyal
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Bihungum Bista
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Pradip Gyanwali
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Meghnath Dhimal
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
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Ogungbe O, Slone S, Alharthi A, Tomiwa T, Kumbe B, Bergman A, McNabb K, Smith Wright R, Farley JE, Dennison Himmelfarb CR, Cooper LA, Post WS, Davidson PM, Commodore-Mensah Y. "Living like an empty gas tank with a leak": Mixed methods study on post-acute sequelae of COVID-19. PLoS One 2022; 17:e0279684. [PMID: 36584125 PMCID: PMC9803174 DOI: 10.1371/journal.pone.0279684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The burden and presentation of post-acute sequela of SARS-CoV-2 infection (PASC) are a developing major public health concern. OBJECTIVES To characterize the burden of PASC in community-dwelling individuals and understand the experiences of people living with PASC. METHODS This mixed-methods study of COVID-19 positive community-dwelling persons involved surveys and in-depth interviews. Main outcome was self-report of possible PASC symptoms 3 weeks or longer after positive COVID-19 test. In-depth interviews were guided by a semi-structured interview guide with open-ended questions and probes based on emerging literature on PASC and the impact of COVID-19. RESULTS With a survey response rate of 70%, 442 participants were included in this analysis, mean (SD) age 45.4 (16.2) years, 71% female, 12% Black/African American. Compared to those with no PASC symptoms, persons who reported PASC symptoms were more likely to be older (mean age: 46.5 vs. 42; p = 0.013), female (74.3% vs. 61.2%; p = 0.010), to have pre-existing conditions (49.6% vs. 34%; p = 0.005), and to have been hospitalized for COVID-19 (14.2% vs. 2.9%; p = 0.002). About 30% of the participants experienced severe fatigue; the proportion of persons reporting severe fatigue was 7-fold greater in those with PASC symptoms (Adjusted Prevalence Ratio [aPR] 6.73, 95%CI: 2.80-16.18). Persons with PASC symptoms were more likely to report poor quality of life (16% vs. 5%, p<0.001) and worse mental health functioning (Mean difference: -1.87 95%CI: -2.38, -1.37, p<0.001). Themes from in-depth interviews revealed PASC was experienced as debilitating. CONCLUSIONS In this study, the prevalence of PASC among community-dwelling adults was substantial. Participants reported considerable coping difficulties, restrictions in everyday activities, invisibility of symptoms and experiences, and impediments to getting and receiving PASC care.
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Affiliation(s)
- Oluwabunmi Ogungbe
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- * E-mail:
| | - Sarah Slone
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Abeer Alharthi
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Tosin Tomiwa
- Texas Tech University, Lubbock, Texas, United States of America
| | - Baridosia Kumbe
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Alanna Bergman
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Katherine McNabb
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Rhonda Smith Wright
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Jason E. Farley
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Cheryl R. Dennison Himmelfarb
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Lisa A. Cooper
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Wendy S. Post
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Patricia M. Davidson
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- University of Wollongong, Wollongong, Australia
| | - Yvonne Commodore-Mensah
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
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Nielsen TB, Leth S, Pedersen M, Harbo HD, Nielsen CV, Laursen CH, Schiøttz-Christensen B, Oestergaard LG. Mental Fatigue, Activities of Daily Living, Sick Leave and Functional Status among Patients with Long COVID: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192214739. [PMID: 36429458 PMCID: PMC9690484 DOI: 10.3390/ijerph192214739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 06/01/2023]
Abstract
Studies suggest that persistent symptoms after COVID-19 (long COVID) influence functioning and activities of daily living (ADL). However, it is still uncertain how and to what extent. This study aimed to describe patient-reported mental fatigue, ADL problems, ADL ability, sick leave and functional status among patients with long COVID. In this cross-sectional study, 448 patients, ≥18 years old and referred to occupational therapy at a Danish Post-COVID-19 Clinic, were included. Mental fatigue was measured by the Mental Fatigue Scale, ADL problems and ability were measured by the Canadian Occupational Performance Measure, sick leave was self-reported and functional status was evaluated by the Post-COVID-19 Functional Status Scale. Mean age was 46.8 years, 73% of the patients were female, and 75% suffered from moderate to severe mental fatigue. The majority reported difficulties performing productive and leisure activities. The median performance and satisfaction scores were 4.8 and 3, respectively. In total, 56% of the patients were on sick leave, and 94% were referred to rehabilitation. A decrease in functional status was found between pre-COVID-19 and assessment. Conclusively, the patients were highly affected in their everyday life and had distinct rehabilitation needs. Future research is needed to address causalities and rehabilitation for this patient group.
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Affiliation(s)
- Trine Brøns Nielsen
- DEFACTUM, Central Denmark Region, 8000 Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Steffen Leth
- Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus, Denmark
- Department of Infectious Diseases and Internal Medicine, Gødstrup Regional Hospital, 7400 Herning, Denmark
- Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Mathilde Pedersen
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Helle Dahl Harbo
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, 8200 Aarhus, Denmark
- AmbuFlex—Center for Patient-Reported Outcomes, Gødstrup Regional Hospital, 7400 Herning, Denmark
| | - Claus Vinther Nielsen
- DEFACTUM, Central Denmark Region, 8000 Aarhus, Denmark
- Department of Clinical Social Medicine and Rehabilitation, Gødstrup Regional Hospital, 7400 Herning, Denmark
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark
| | - Cecilia Hee Laursen
- DEFACTUM, Central Denmark Region, 8000 Aarhus, Denmark
- Department of Clinical Social Medicine and Rehabilitation, Gødstrup Regional Hospital, 7400 Herning, Denmark
| | - Berit Schiøttz-Christensen
- Department of Infectious Diseases, Aarhus University Hospital, 8200 Aarhus, Denmark
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Lisa Gregersen Oestergaard
- DEFACTUM, Central Denmark Region, 8000 Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, 8200 Aarhus, Denmark
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark
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