Centre for Chronic Conditions and Injuries, Public Health Foundation of India, New Delhi, India
Clinical Research, Centre for Chronic Disease Control, New Delhi, India.
BMJ Open. 2021 Jun 18;11(6):e048926. doi: 10.1136/bmjopen-2021-048926.
People with chronic conditions are known to be vulnerable to the COVID-19 pandemic. This study aims to describe patients' lived experiences, challenges faced by people with chronic conditions, their coping strategies, and the social and economic impacts of the COVID-19 pandemic.
DESIGN, SETTING AND PARTICIPANTS: We conducted a qualitative study using a syndemic framework to understand the patients' experiences of chronic disease care, challenges faced during the lockdown, their coping strategies and mitigators during the COVID-19 pandemic in the context of socioecological and biological factors. A diverse sample of 41 participants with chronic conditions (hypertension, diabetes, stroke and cardiovascular diseases) from four sites (Delhi, Haryana, Vizag and Chennai) in India participated in semistructured interviews. All interviews were audio recorded, transcribed, translated, anonymised and coded using MAXQDA software. We used the framework method to qualitatively analyse the COVID-19 pandemic impacts on health, social and economic well-being.
Participant experiences during the COVID-19 pandemic were categorised into four themes: challenges faced during the lockdown, experiences of the participants diagnosed with COVID-19, preventive measures taken and lessons learnt during the COVID-19 pandemic. A subgroup of participants faced difficulties in accessing healthcare while a few reported using teleconsultations. Most participants reported adverse economic impact of the pandemic which led to higher reporting of anxiety and stress. Participants who tested COVID-19 positive reported experiencing discrimination and stigma from neighbours. All participants reported taking essential preventive measures.
People with chronic conditions experienced a confluence (reciprocal effect) of COVID-19 pandemic and chronic diseases in the context of difficulty in accessing healthcare, sedentary lifestyle and increased stress and anxiety. Patients' lived experiences during the pandemic provide important insights to inform effective transition to a mixed realm of online consultations and 'distanced' physical clinic visits.
患有慢性病的人易受到 COVID-19 大流行的影响。本研究旨在描述患者的生活体验、慢性病患者面临的挑战、他们的应对策略，以及 COVID-19 大流行对社会和经济的影响。
设计、地点和参与者：我们使用综合征模型框架进行了一项定性研究，以了解患者在慢性疾病护理方面的体验、在封锁期间面临的挑战、他们在 COVID-19 大流行期间的应对策略和缓解因素，这些因素受到社会生态和生物因素的影响。我们从印度四个地点（德里、哈里亚纳邦、维扎格和钦奈）招募了患有高血压、糖尿病、中风和心血管疾病等慢性病的 41 名不同的参与者，参加半结构式访谈。所有访谈均使用 MAXQDA 软件进行录音、转录、翻译、匿名和编码。我们使用框架方法对 COVID-19 大流行对健康、社会和经济福祉的影响进行定性分析。
参与者在 COVID-19 大流行期间的经历分为四个主题：封锁期间面临的挑战、COVID-19 确诊患者的经历、采取的预防措施，以及 COVID-19 大流行期间吸取的教训。一小部分参与者在获取医疗保健方面遇到困难，而少数人报告使用远程咨询。大多数参与者报告称大流行对经济产生了不利影响，导致焦虑和压力的报告增加。COVID-19 检测呈阳性的参与者报告说，他们受到邻居的歧视和污名化。所有参与者都报告采取了基本的预防措施。
患有慢性病的人在获取医疗保健困难、久坐不动的生活方式以及压力和焦虑增加的情况下，经历了 COVID-19 大流行和慢性病的共同影响。患者在大流行期间的生活体验为提供了重要的见解，有助于为向在线咨询和“远距离”物理诊所就诊的混合模式转变提供信息。
