慢性疾病自我管理:老年 COVID-19 后急性后遗症患者的混合方法分析。
Chronic Disease Self-Management of Post-Acute Sequelae of COVID-19 Among Older Adults: A Mixed-Methods Analysis.
机构信息
Department of Health Science, Nova Southeastern University, Ft. Lauderdale, FL, USA.
Department of Psychiatry, Nova Southeastern University, Ft. Lauderdale, FL, USA.
出版信息
Clin Interv Aging. 2023 Apr 14;18:607-617. doi: 10.2147/CIA.S393732. eCollection 2023.
INTRODUCTION
Approximately 20-30% of individuals who contract acute coronavirus disease (COVID-19) infection develop longer term complications of their initial infection, referred to as Post-Acute Sequelae of SARS-CoV-2 infection (PASC). PASC is characterized by chronic, varying symptomatology.
METHODS
Using a mixed methods study design, we aimed to gain insight into individuals' experience with PASC, including cognitive issues, fatigue, and sleep disturbances. We explored whether our previously developed application (app), aimed at improving self-management skills among individuals with chronic diseases, is relevant for individuals with PASC and gained information to adapt the app for individuals with PASC. The study included 19 individuals, aged 40 years and older, recruited from our research participant database, Nova Southeastern University clinics, and community locations. We included this age range because older adults are more likely to have comorbid conditions, allowing us to better understand the impact of COVID-19 infection in these individuals. Participants completed seven standardized self-report questionnaires online, and an individual semi-structured interview via videoconferencing. Quantitative data were assessed using descriptive statistics and calculating individuals' scores in relation to norms. Qualitative data were analyzed using a thematic analysis approach. Triangulation of the data was accomplished by calculating correlations between participants' responses on self-report scales and themes found in semi-structured interviews.
RESULTS
Themes included disruption of everyday life, diverse physical symptoms, and cognitive problems including brain fog, fatigue, coping, and emotional upset. Quantitative analysis demonstrated that participants experienced high levels of fatigue, negative mood, cognitive problems, and overall reduction in health-related quality of life (HRQOL). Correlation analyses revealed that individual interview responses were related to participants' self-report of symptoms on standard questionnaires.
DISCUSSION
Findings indicate that self-report questionnaires may reflect the experience of individuals with PASC and its impact. Additionally, further efforts to expand our prior mobile app are warranted among individuals with PASC.
简介
大约 20-30%感染急性冠状病毒病(COVID-19)的个体出现初始感染的长期并发症,称为 SARS-CoV-2 感染后急性后遗症(PASC)。PASC 的特征是慢性、多变的症状。
方法
我们使用混合方法研究设计,旨在深入了解个体的 PASC 体验,包括认知问题、疲劳和睡眠障碍。我们探讨了我们之前开发的应用程序(app)是否与 PASC 个体相关,该应用程序旨在提高慢性病个体的自我管理技能,并获得有关为 PASC 个体调整应用程序的信息。该研究纳入了 19 名年龄在 40 岁及以上的个体,他们是从我们的研究参与者数据库、诺瓦东南大学诊所和社区地点招募的。我们纳入这个年龄范围是因为老年人更有可能患有合并症,这使我们能够更好地了解 COVID-19 感染对这些个体的影响。参与者在线完成了七个标准化的自我报告问卷,并通过视频会议进行了个体半结构化访谈。定量数据使用描述性统计和计算个体与常模的得分进行评估。定性数据使用主题分析方法进行分析。通过计算参与者在自我报告量表上的反应与半结构化访谈中发现的主题之间的相关性,实现数据的三角验证。
结果
主题包括日常生活的中断、各种身体症状以及认知问题,包括脑雾、疲劳、应对和情绪困扰。定量分析表明,参与者经历了高水平的疲劳、负面情绪、认知问题以及整体健康相关生活质量(HRQOL)下降。相关分析显示,个体访谈的反应与参与者在标准问卷上自我报告的症状相关。
讨论
研究结果表明,自我报告问卷可能反映了 PASC 个体的体验及其影响。此外,需要进一步努力扩大我们针对 PASC 个体的移动应用程序。
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