University of Alberta, Edmonton, Canada.
Université Laval, Quebec City, Canada.
BMC Health Serv Res. 2023 Dec 12;23(1):1396. doi: 10.1186/s12913-023-10288-y.
Understanding of Long COVID has advanced through patient-led initiatives. However, research about barriers to accessing Long COVID services is limited. This study aimed to better understand the need for, access to, and quality of, Long COVID services. We explored health needs and experiences of services, including ability of services to address needs.
Our study was informed by the Levesque et al.'s (2013) "conceptual framework of access to health care." We used Interpretive Description, a qualitative approach partly aimed at informing clinical decisions. We recruited participants across five settings. Participants engaged in one-time, semi-structured, virtual interviews. Interviews were transcribed verbatim. We used reflexive thematic analysis. Best practice to ensure methodological rigour was employed.
Three key themes were generated from 56 interviews. The first theme illustrated the rollercoaster-like nature of participants' Long COVID symptoms and the resulting impact on function and health. The second theme highlighted participants' attempts to access Long COVID services. Guidance received from healthcare professionals and self-advocacy impacted initial access. When navigating Long COVID services within the broader system, participants encountered barriers to access around stigma; appointment logistics; testing and 'normal' results; and financial precarity and affordability of services. The third theme illuminated common factors participants liked and disliked about Long COVID services. We framed each sub-theme as the key lesson (stemming from all likes and dislikes) that, if acted upon, the health system can use to improve the quality of Long COVID services. This provides tangible ways to improve the system based directly on what we heard from participants.
With Long COVID services continuously evolving, our findings can inform decision makers within the health system to better understand the lived experiences of Long COVID and tailor services and policies appropriately.
通过患者主导的倡议，人们对长新冠有了更多的了解。然而，关于获取长新冠服务的障碍的研究有限。本研究旨在更好地了解长新冠服务的需求、获取途径和质量，并探讨服务的健康需求和体验，包括服务满足需求的能力。
本研究以莱韦斯克等人（2013 年）的“获取医疗保健概念框架”为指导。我们采用解释性描述法，这是一种定性方法，部分旨在为临床决策提供信息。我们在五个地点招募参与者。参与者进行了一次性、半结构化的虚拟访谈。访谈内容逐字记录。我们使用了反思性主题分析。采用了最佳实践方法以确保方法的严谨性。
从 56 次访谈中生成了三个关键主题。第一个主题描述了参与者长新冠症状的过山车式性质，以及这些症状对功能和健康的影响。第二个主题突出了参与者尝试获取长新冠服务的情况。医疗保健专业人员提供的指导和自我倡导对初始获取服务产生了影响。当在更广泛的系统中导航长新冠服务时，参与者遇到了与污名、预约后勤、测试和“正常”结果、财务不稳定以及服务的可负担性相关的获取障碍。第三个主题阐明了参与者对长新冠服务喜欢和不喜欢的常见因素。我们将每个子主题框定为关键教训（源于所有的喜欢和不喜欢），如果付诸实施，医疗系统可以利用这些教训来提高长新冠服务的质量。这为根据参与者的反馈直接改进系统提供了切实可行的方法。
随着长新冠服务的不断发展，我们的研究结果可以为医疗系统内的决策者提供信息，以更好地了解长新冠的生活体验，并适当地调整服务和政策。
