Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, USA.
Palliative and Advanced Illness Research (PAIR) Center, the University of Pennsylvania, Philadelphia, PA, USA.
J Gen Intern Med. 2023 Aug;38(10):2374-2382. doi: 10.1007/s11606-023-08246-9. Epub 2023 Jun 2.
Many patients hospitalized for COVID-19 experience prolonged symptoms months after discharge. Little is known abou t patients' personal experiences recovering from COVID-19 in the United States (US), where medically underserved populations are at particular risk of adverse outcomes.
To explore patients' perspectives on the impact of COVID-19 hospitalization and barriers to and facilitators of recovery 1 year after hospital discharge in a predominantly Black American study population with high neighborhood-level socioeconomic disadvantage.
Qualitative study utilizing individual, semi-structured interviews.
Adult patients hospitalized for COVID-19 approximately 1 year after discharge home who were engaged in a COVID-19 longitudinal cohort study.
The interview guide was developed and piloted by a multidisciplinary team. Interviews were audio-recorded and transcribed. Data were coded and organized into discrete themes using qualitative content analysis with constant comparison techniques.
Of 24 participants, 17 (71%) self-identified as Black, and 13 (54%) resided in neighborhoods with the most severe neighborhood-level socioeconomic disadvantage. One year after discharge, participants described persistent deficits in physical, cognitive, or psychological health that impacted their current lives. Repercussions included financial suffering and a loss of identity. Participants reported that clinicians often focused on physical health over cognitive and psychological health, an emphasis that posed a barrier to recovering holistically. Facilitators of recovery included robust financial or social support systems and personal agency in health maintenance. Spirituality and gratitude were common coping mechanisms.
Persistent health deficits after COVID-19 resulted in downstream consequences in participants' lives. Though participants received adequate care to address physical needs, many described persistent unmet cognitive and psychological needs. A more comprehensive understanding of barriers and facilitators for COVID-19 recovery, contextualized by specific healthcare and socioeconomic needs related to socioeconomic disadvantage, is needed to better inform intervention delivery to patients that experience long-term sequelae of COVID-19 hospitalization.
许多因 COVID-19 住院的患者在出院后数月仍持续出现症状。在美国，医疗服务不足的人群尤其面临不良结局的风险，但人们对这些患者在出院后从 COVID-19 中康复的个人经历知之甚少。
在一个以黑人为主、邻里社会经济劣势程度较高的美国研究人群中，探究患者对 COVID-19 住院的影响以及出院后 1 年时康复障碍和促进因素的看法。
利用个体、半结构式访谈进行定性研究。
在 COVID-19 纵向队列研究中，大约在出院 1 年后接受 COVID-19 住院治疗的成年患者。
访谈指南由多学科团队制定和试点。对访谈进行录音并转录。使用定性内容分析和恒定性比较技术，将数据编码并组织为离散主题。
24 名参与者中，17 名（71%）自我认同为黑人，13 名（54%）居住在社会经济劣势最严重的邻里环境中。出院 1 年后，参与者描述了目前对身体、认知或心理健康仍存在持续缺陷，这影响了他们的生活。后果包括经济困难和身份丧失。参与者报告说，临床医生通常更关注身体健康，而不是认知和心理健康，这种重点是全面康复的障碍。康复的促进因素包括强大的财务或社会支持系统以及个人健康维护的自主权。灵性和感恩是常见的应对机制。
COVID-19 后持续存在的健康缺陷导致参与者生活出现下游后果。尽管参与者获得了足够的治疗来满足身体需求，但许多人仍描述存在持续未满足的认知和心理健康需求。需要更全面地了解 COVID-19 康复的障碍和促进因素，具体内容涉及与社会经济劣势相关的特定医疗保健和社会经济需求，以便更好地为经历 COVID-19 住院后长期后遗症的患者提供干预措施。
