Department of Health Professions, Azienda USL - IRCCS di Reggio Emilia, Via Amendola n°2, 42122, Reggio Emilia, Italy.
Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento n°80, 42123, Reggio Emilia, Italy.
BMC Public Health. 2022 Mar 28;22(1):599. doi: 10.1186/s12889-022-13035-w.
Post-acute sequelae of SARS-CoV-2 infection (PASC) affect millions of individuals worldwide. Rehabilitation interventions could support individuals during the recovery phase of COVID-19, but a comprehensive understanding of this new disease and its associated needs is crucial. This qualitative study investigated the experience of individuals who had been hospitalized for COVID-19, focusing on those needs and difficulties they perceived as most urgent.
This naturalistic qualitative study was part of a single-center mix-method cross-sectional study (REACT) conducted in Italy during the first peak of the SARS-CoV-2 pandemic. The qualitative data collection took place through a telephone interview conducted 3 months after hospital discharge. The experience of individuals discharged after hospitalization for COVID-19 was investigated through the main research question - "Tell me, how has it been going since you were discharged?". Two secondary questions investigated symptoms, activities, and participation. Data were recorded and transcribed verbatim within 48 h. An empirical phenomenological approach was used by the researchers, who independently analyzed the data and, through consensus, developed an interpretative model to answer the research question. Translation occurred after data was analyzed.
During the first peak of the COVID-19 pandemic, 784 individuals with COVID-19 were discharged from the hospitals of the Local Health Authority of the Province of Reggio Emilia (Italy); 446 were excluded due to the presence of acute or chronic conditions causing disability other than COVID-19 (n. 339), inability to participate in the study procedures (n. 56), insufficient medical documentation to allow for screening (n. 21), discharge to residential facilities (n. 25), and pregnancy (n. 5). Overall, 150 individuals consented to participate in the REACT study, and 56 individuals (60.7% male, average age 62.8 years ±11.8) were interviewed in June-July 2020, up to data saturation. Persistent symptoms, feelings of isolation, fear and stigma, emotional distress, a fatalistic attitude, and return to (adapted) life course were the key themes that characterized the participants' experience after hospital discharge.
The experience as narrated by the participants in this study confirms the persistence of symptoms described in PASC and highlights the sense of isolation and psychological distress. These phenomena may trigger a vicious circle, but the participants also reported adaptation processes that allowed them to gradually return to their life course. Whether all individuals are able to rapidly activate these mechanisms and whether rehabilitation can help to break this vicious circle by improving residual symptoms remain to be seen.
ClinicalTrials.com NCT04438239.
新冠病毒感染的急性后期后遗症（PASC）影响着全球数百万人。康复干预措施可以在 COVID-19 患者的恢复期为其提供支持，但全面了解这种新疾病及其相关需求至关重要。本定性研究调查了因 COVID-19 住院的个体的体验，重点关注他们认为最紧迫的需求和困难。
这是一项自然主义定性研究，是意大利艾米利亚-罗马涅地区地方卫生当局（意大利）在 SARS-CoV-2 大流行的第一个高峰期进行的一项单中心混合方法横断面研究（REACT）的一部分。定性数据采集是在出院后 3 个月通过电话访谈进行的。通过主要研究问题“告诉我，自从你出院后情况如何？”来调查出院后因 COVID-19 住院的个体的体验。通过两个次要问题调查症状、活动和参与情况。数据在 48 小时内记录并逐字转录。研究人员采用经验现象学方法，独立分析数据，并通过共识制定解释模型来回答研究问题。翻译是在数据分析之后进行的。
在 COVID-19 大流行的第一个高峰期，艾米利亚-罗马涅地区地方卫生当局（意大利）的医院有 784 名 COVID-19 患者出院；由于存在除 COVID-19 以外的急性或慢性疾病导致残疾（n=339）、无法参与研究程序（n=56）、医学文件不足无法进行筛查（n=21）、出院到住宿设施（n=25）和怀孕（n=5）等原因，有 446 人被排除在外。总体而言，有 150 名患者同意参加 REACT 研究，有 56 名患者（60.7%为男性，平均年龄 62.8±11.8 岁）于 2020 年 6 月至 7 月接受了访谈，直到数据饱和。持续存在的症状、孤立感、恐惧和耻辱感、情绪困扰、宿命论态度以及回归（适应）生活轨迹是描述参与者出院后体验的关键主题。
本研究中参与者叙述的经历证实了 PASC 中描述的症状持续存在，并强调了孤立感和心理困扰。这些现象可能引发恶性循环，但参与者也报告了适应过程，使他们能够逐渐回归生活轨迹。是否所有个体都能迅速激活这些机制，以及康复是否可以通过改善残留症状来帮助打破这种恶性循环，仍有待观察。
ClinicalTrials.com NCT04438239。
