Department of Mental Health, Nnamdi Azikwe University, Nnewi, Anambra State, Nigeria.
Department of Internal Medicine, College of Medicine, University of Lagos, Lagos, Nigeria.
BMC Health Serv Res. 2024 Apr 29;24(1):549. doi: 10.1186/s12913-024-11032-w.
Despite modest efforts to study and document the complications that arise after acute treatment of patients with coronavirus disease, its ramifications and regional variations are yet to be clearly understood. Progress in sub-Saharan Africa, notably Nigeria, has been impeded by patient disengagement from care and insufficient or non-existent follow-up arrangements. The aim of this study was to describe the barriers and enablers for follow-up services after discharge from COVID-19 care pathway in Nigeria.
Seventeen experts involved directly in the care of patients with COVID-19 participated in brainstorming using the nominal group technique during a national workshop to review the new guidelines for COVID-19 case management in Nigeria. Participants discussed the barriers and facilitators of post-acute care follow-up of patients discharged from COVID-19 pathway and ranked their recommendations to arrive at three major factors per question.
Participants were mostly middle aged and predominantly clinicians. The top three barriers were patients' perception of their symptom severity, lack of organizational clarity/structure/policies on follow-up care after discharge, and financial constraints. Similarly, participants identified providers' initiated education on the reasons for follow-up at discharge, written organizational policies/structure and clarity and free follow-up services as the top three facilitators.
This study has enumerated barriers to follow-up care after discharge patients with coronavirus disease and highlighted providers, institutional and governmental responses that will facilitator follow-up care after discharge of patients with COVID-19. The implication is that, there is need for clear institutional guidelines for tracking and documenting post-COVID condition. In the future, it would be necessary to assess the achievements and shortcomings of post-COVID condition tracking in Nigeria through the use of implementation science outcomes.
尽管人们努力研究和记录冠状病毒病患者急性治疗后出现的并发症，但这些并发症的影响及其地域差异仍未得到清晰了解。撒哈拉以南非洲，尤其是尼日利亚，在该疾病的后续护理方面进展缓慢，主要原因是患者不配合治疗以及后续护理安排不足或不存在。本研究旨在描述尼日利亚冠状病毒病患者出院后随访服务的障碍和促进因素。
17 名直接参与冠状病毒病患者护理的专家在全国研讨会上使用名义群体技术进行头脑风暴，以审查尼日利亚冠状病毒病病例管理新指南。参与者讨论了冠状病毒病患者出院后急性后护理随访的障碍和促进因素，并对其建议进行排名，每个问题分为三个主要因素。
参与者主要为中年，以临床医生为主。排名前三的障碍是患者对自身症状严重程度的认知、出院后随访缺乏组织明确性/结构/政策以及经济限制。同样，参与者确定了三个促进因素，包括提供者在出院时对随访原因进行教育、书面组织政策/结构和清晰性以及免费随访服务。
本研究列举了冠状病毒病患者出院后随访护理的障碍，并强调了提供者、机构和政府的应对措施，这些措施将促进冠状病毒病患者出院后的随访护理。这意味着，需要制定明确的机构指南来跟踪和记录新冠病毒后状况。未来，有必要通过实施科学成果来评估尼日利亚新冠病毒后状况跟踪的成就和不足。
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