Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
Arthritis Research Canada, Vancouver, British Columbia, Canada.
Health Expect. 2022 Apr;25(2):482-498. doi: 10.1111/hex.13341. Epub 2021 Aug 17.
This study aimed to explore the impact of the coronavirus disease 2019 (COVID-19) pandemic on self-care of individuals living with rheumatoid arthritis (RA).
Guided by a constructivist, qualitative design, we conducted one-to-one in-depth telephone interviews between March and October 2020 with participants with RA purposively sampled for maximum variation in age, sex and education, who were participating in one of two ongoing randomized-controlled trials. An inductive, reflexive thematic analysis approach was used.
Twenty-six participants (aged 27-73 years; 23 females) in British Columbia, Canada were interviewed. We identified three themes: (1) Adapting to maintain self-care describes how participants took measures to continue self-care activities while preventing virus transmissions. While spending more time at home, some participants reported improved self-care. (2) Managing emotions describes resilience-building strategies such as keeping perspective, positive reframing and avoiding negative thoughts. Participants described both letting go and maintaining a sense of control to accommodate difficulties and emotional responses. (3) Changing communication with health professionals outlined positive experiences of remote consultations with health professionals, particularly if good relationships had been established prepandemic.
The insights gained may inform clinicians and researchers on ways to support the self-care strategies of individuals with RA and other chronic illnesses during and after the COVID-19 pandemic. The findings reveal opportunities to further examine remote consultations to optimize patient engagement and care.
This project is jointly designed and conducted with patient partners in British Columbia, Canada. Patient partners across the United Kingdom also played in a key role in providing interpretations of themes during data analysis.
本研究旨在探讨 2019 年冠状病毒病（COVID-19）大流行对类风湿关节炎（RA）患者自我护理的影响。
本研究采用建构主义定性设计，于 2020 年 3 月至 10 月间对来自不列颠哥伦比亚省、正在参加两项正在进行的随机对照试验的 RA 患者进行了一对一的深入电话访谈，这些患者的年龄、性别和教育程度存在最大差异，他们是根据目的进行抽样的。采用归纳、反思性主题分析方法。
在加拿大不列颠哥伦比亚省，共对 26 名参与者（年龄 27-73 岁，23 名女性）进行了访谈。我们确定了三个主题：（1）适应以维持自我护理描述了参与者采取措施继续自我护理活动同时防止病毒传播的情况。虽然在家的时间更多了，但一些参与者报告说自我护理得到了改善。（2）管理情绪描述了建立韧性的策略，例如保持视角、积极重塑和避免消极想法。参与者描述了放手和保持控制感，以适应困难和情绪反应。（3）改变与卫生专业人员的沟通概述了与卫生专业人员进行远程咨询的积极体验，尤其是如果在大流行前已经建立了良好的关系。
本研究获得的见解可能为临床医生和研究人员提供在 COVID-19 大流行期间和之后支持 RA 患者和其他慢性病患者自我护理策略的信息。研究结果揭示了进一步研究远程咨询以优化患者参与和护理的机会。
本项目是与加拿大不列颠哥伦比亚省的患者伙伴共同设计和开展的。来自英国的患者伙伴也在数据分析过程中对主题的解释发挥了关键作用。
