主题分析探索长新冠患者的体验:症状和日常生活影响的概念模型。
Thematic analysis to explore patients' experiences with long COVID-19: a conceptual model of symptoms and impacts on daily lives.
机构信息
Regeneron Pharmaceuticals Inc, Tarrytown, New York, USA
Regeneron Pharmaceuticals Inc, Tarrytown, New York, USA.
出版信息
BMJ Open. 2024 Jan 17;14(1):e076992. doi: 10.1136/bmjopen-2023-076992.
OBJECTIVES
There is limited qualitative research on patients' experiences with long COVID-19, and how specific symptoms impact their daily lives. The study aimed to understand patients' lived experiences of long COVID-19 and to develop a conceptual model representing the symptoms and their impact on overall quality of life.
SETTING
Qualitative study consisting of a comprehensive literature review, and in-depth clinician and patient semistructured interviews.
PARTICIPANTS
Forty-one adult patients with long COVID-19, of whom 18 (44%) were recruited through Regeneron Pharmaceuticals's clinical trials and 23 (56%) through recruitment agencies; 85.4% were female and 73.2% were White. Five independent clinicians treating patients with long COVID-19 were interviewed. Concept saturation was also assessed.
PRIMARY AND SECONDARY OUTCOMES
Interview transcripts were analysed thematically to identify concepts of interest spontaneously mentioned by patients, including symptoms and their impacts on daily life, to guide the development of the conceptual model.
RESULTS
Findings from the literature review and clinician and patient interviews resulted in the development of a conceptual model comprising two overarching domains: symptoms (upper respiratory tract, lower respiratory tract, smell and taste, systemic, gastrointestinal, neurocognitive and other) and impacts (activities of daily living, instrumental activities of daily living, physical impacts, emotional, social/leisure activities and professional impacts). Saturation was achieved for the reported impacts. The symptoms reported were heterogenic; neurocognitive symptoms, such as numbness, ringing in ears, haziness, confusion, forgetfulness/memory problems, brain fog, concentration, difficulties finding the right word and challenges with fine motor skills, were particularly pertinent for several months.
CONCLUSION
The conceptual model, developed based on patient experience data of long COVID-19, highlighted numerous symptoms that impact patients' physical and mental well-being, and suggests humanistic unmet needs. Prospective real-world studies are warranted to understand the pattern of long COVID-19 experienced in larger samples over longer periods of time.
目的
关于长新冠患者的体验,以及特定症状如何影响他们的日常生活,目前仅有少量定性研究。本研究旨在了解长新冠患者的生活体验,并构建一个概念模型,展示症状及其对整体生活质量的影响。
设置
定性研究包括全面的文献回顾以及对临床医生和患者的深入半结构化访谈。
参与者
41 名长新冠患者,其中 18 名(44%)通过再生元制药公司的临床试验招募,23 名(56%)通过招募机构招募;85.4%为女性,73.2%为白人。采访了 5 名独立治疗长新冠患者的临床医生。还评估了概念饱和度。
主要和次要结果
对访谈记录进行主题分析,以识别患者自发提及的感兴趣的概念,包括症状及其对日常生活的影响,以指导概念模型的开发。
结果
文献综述以及临床医生和患者访谈的结果得出了一个概念模型,包括两个总体领域:症状(上呼吸道、下呼吸道、嗅觉和味觉、全身、胃肠道、神经认知和其他)和影响(日常生活活动、工具性日常生活活动、身体影响、情绪、社会/休闲活动和职业影响)。报告的影响达到了饱和。所报告的症状具有异质性;神经认知症状,如麻木、耳鸣、模糊、困惑、健忘/记忆问题、脑雾、注意力不集中、难以找到合适的词以及精细运动技能挑战,对几个月的患者尤其相关。
结论
基于长新冠患者的经验数据开发的概念模型突出了许多影响患者身心健康的症状,并表明存在人文关怀方面的未满足需求。需要进行前瞻性的真实世界研究,以了解更大样本、更长时间内的长新冠模式。