Department of Infection and Inflammation Research, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
These authors contributed equally to this work.
Eur Respir Rev. 2023 Jul 26;32(169). doi: 10.1183/16000617.0031-2023. Print 2023 Sep 30.
To determine the lived experiences of people with COPD who isolated at home during the coronavirus disease 2019 (COVID-19) pandemic, and explore how these experiences affected health and patient-reported outcomes.
Keyword searches were performed in five bibliographic databases. Critical interpretative synthesis (CIS) methods were used to interrogate and understand patterns across studies.
23 studies were identified; three employed qualitative methods and 20 quantitative methods. Application of CIS methods highlighted a core synthetic concept that appeared to underpin experiences and outcomes, that of a heightened perception of risk. Using the Risk Perception Model as a framework, we found that cognitive factors such as knowledge of underlying health status and the transmissibility of COVID-19; experiential factors including previous episodes of breathlessness and hospitalisation; and sociocultural factors such as access to trusted sources of information, influenced perceptions of risk. In turn, this influenced behaviour, which translated to outcomes such as reduced hospitalisations, deconditioning and social isolation as people avoided "high-risk" situations and settings.
Patients with COPD who isolated at home during the COVID-19 pandemic had a heightened perception of risk which was influenced by cognitive, experiential and sociocultural factors. The consequences of this were varied and included both positive (reduced exacerbations and hospitalisations) and negative (social isolation, deconditioning, diminished capacity for self-care) outcomes. Understanding risk and the impacts it can have could help clinicians to support people with COPD return to their pre-pandemic way of living and enable better communication of ongoing risk from respiratory viral illness.
确定在 2019 年冠状病毒病（COVID-19）大流行期间在家中隔离的慢性阻塞性肺疾病（COPD）患者的生活体验，并探讨这些体验如何影响健康和患者报告的结果。
在五个文献数据库中进行了关键词搜索。采用批判解释性综合（CIS）方法来询问和理解研究之间的模式。
确定了 23 项研究；其中三项采用了定性方法，二十项采用了定量方法。CIS 方法的应用突出了一个核心综合概念，该概念似乎是体验和结果的基础，即风险感知增强。我们发现，使用风险感知模型作为框架，认知因素（如对潜在健康状况和 COVID-19 传染性的了解）、经验因素（如以前的呼吸困难和住院经历）以及社会文化因素（如获取可信信息来源）等因素影响了风险感知。反过来，这又影响了行为，从而导致了住院、去适应和社会隔离等结果，因为人们避免了“高风险”情况和环境。
在 COVID-19 大流行期间在家中隔离的 COPD 患者对风险的感知增强，这受到认知、经验和社会文化因素的影响。其结果是多方面的，包括积极的（减少恶化和住院）和消极的（社会隔离、去适应、自我护理能力下降）结果。了解风险及其影响可以帮助临床医生支持 COPD 患者恢复到大流行前的生活方式，并能够更好地沟通呼吸道病毒疾病的持续风险。
