Caton Emma, Chaplin Hema, Carpenter Lewis, Sweeney Melissa, Tung Hsiu Yen, de Souza Savia, Galloway James, Nikiphorou Elena, Norton Sam
Health Psychology Section, 5th Floor, Bermondsey Wing, Guy's Hospital, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London Bridge, London, SE1 9RT, UK.
Centre for Rheumatic Diseases, King's College London, London, UK.
BMC Rheumatol. 2021 Oct 18;5(1):58. doi: 10.1186/s41927-021-00231-1.
Inflammatory arthritis (IA) patients have been identified as at greater risk of severe illness from COVID-19. It is likely that lockdown restrictions (enforced by the UK government in response to the COVID-19 pandemic) and subsequent changes made to healthcare provision could impact patients' abilities to effectively manage their condition. The aim of this study was to qualitatively explore the impact of COVID-19 on self-management behaviours and healthcare access for people with IA.
Semi-structured interviews were conducted with 21 IA patients in June-July 2020, with nine follow-up interviews in November 2020. Interview schedules were developed with a Patient Research Partner and explored participants' experiences of the COVID-19 pandemic. Interviews were conducted via telephone and analysed using inductive thematic analysis.
Participants were aged between 24 and 79 years (mean = 50.1, SD = 15.8), largely female (71%) and White British (86%). Four initial themes were identified: (1) Impact of COVID-19 on medication adherence, (2) Impact of COVID-19 on physical activity, (3) Impact of COVID-19 on diet, and (4) Impact of COVID-19 on healthcare access and delivery. Subthemes focused on positive and negative changes made to these areas, as well as behaviours which remained consistent. Follow-up interviews highlighted differences in participants' experiences during the two lockdown periods.
COVID-19 has affected patients' abilities to manage their IA. Healthcare professionals need to recognise the ongoing impact of COVID-19 on patient self-management and healthcare access to ensure that adequate understanding and support is available to patients who may have inadequate disease control as a result.
炎症性关节炎（IA）患者已被确定感染新冠病毒后患重症的风险更高。封锁限制措施（英国政府为应对新冠疫情而实施）以及随后医疗服务的变化可能会影响患者有效管理自身病情的能力。本研究的目的是定性探究新冠病毒对IA患者自我管理行为和医疗服务获取的影响。
2020年6月至7月对21名IA患者进行了半结构式访谈，并于2020年11月进行了9次随访访谈。访谈提纲由一名患者研究伙伴共同制定，探讨了参与者在新冠疫情中的经历。访谈通过电话进行，并采用归纳主题分析法进行分析。
参与者年龄在24岁至79岁之间（平均年龄=50.1岁，标准差=15.8），大部分为女性（71%），且为英国白人（86%）。确定了四个初始主题：（1）新冠病毒对药物依从性的影响，（2）新冠病毒对身体活动的影响，（3）新冠病毒对饮食的影响，以及（4）新冠病毒对医疗服务获取和提供的影响。子主题聚焦于这些领域发生的积极和消极变化，以及保持不变的行为。随访访谈突出了参与者在两个封锁期的经历差异。
新冠病毒影响了患者管理IA的能力。医疗专业人员需要认识到新冠病毒对患者自我管理和医疗服务获取的持续影响，以确保为可能因疾病控制不佳的患者提供充分的理解和支持。
