Magwood Gayenell S, Ellis Charles, Hughes Halbert Chanita, Toussaint Ebony Allen, Scott Jewel, Nemeth Lynne S
Department of Biobehavioral Health and Nursing Science, University of South Carolina, Columbia, SC, USA.
College of Nursing, Medical University of South Carolina, Charleston, SC, USA.
Patient Relat Outcome Meas. 2024 Sep 18;15:241-253. doi: 10.2147/PROM.S467743. eCollection 2024.
Many research activities have focused on SARS-CoV-2 infection and subsequent COVID-19 respiratory illness during the pandemic. However, significant racial inequities emerged months after the COVID-19 pandemic began. The similarity between racial/ ethnic disparities in COVID-19 and those for other diseases raised awareness about the context for risk exposure and healthcare access. The purpose of this study is to examine social and structural determinants of health among COVID-19 survivors, carepartners, and the perspectives of healthcare stakeholders who experienced disruption during the early pandemic.
A purposive sample of interviews (n=9) and focus groups (n=10) were used to collect data regarding knowledge of barriers to effective COVID-19 risk mitigation, recovery, and chronic disease self-management. This included nurses, physicians, COVID-19 survivors and their carepartners, public health, and community leaders connected with the healthcare systems in rural counties of South Carolina.
Five major themes were identified across the subgroups. The themes: The COVID-19 Illness Trajectory Added Major Health Challenges and Stressors, Access to Care Is Lacking, Support is Needed for COVID-19 Survivors and Care Partners, Support Must be Distributed Equitably, and Racism and Structural Issues Affect Stress reflect the strengths, opportunities, and inequities perceived within these groups.
This research is the first qualitative study focused on COVID-19 survivor-carepartner dyads that consider the intersectionality of race/ ethnicity, geography, and health that is known to occur when engaging healthcare systems. The themes illustrate the need for infectious disease prevention at all socioecological levels: structural/ systemic, community, organizational/ institutional, interpersonal, and individual.
在疫情大流行期间，许多研究活动都聚焦于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染及随后的冠状病毒病2019（COVID-19）呼吸道疾病。然而，在COVID-19大流行开始数月后，显著的种族不平等现象出现了。COVID-19中的种族/族裔差异与其他疾病的差异相似，这提高了人们对风险暴露背景和医疗保健可及性的认识。本研究的目的是调查COVID-19幸存者、护理伙伴以及在疫情早期经历混乱的医疗保健利益相关者的健康的社会和结构决定因素。
采用有目的抽样的访谈（n = 9）和焦点小组（n = 10）来收集有关有效减轻COVID-19风险、康复和慢性病自我管理障碍的知识的数据。这包括护士、医生、COVID-19幸存者及其护理伙伴、公共卫生人员以及与南卡罗来纳州农村县医疗保健系统相关的社区领袖。
在各亚组中确定了五个主要主题。这些主题：COVID-19疾病轨迹增加了重大健康挑战和压力源、缺乏医疗保健可及性、COVID-19幸存者和护理伙伴需要支持、支持必须公平分配以及种族主义和结构性问题影响压力反映了这些群体中所感知到的优势、机会和不平等。
本研究是第一项针对COVID-19幸存者 - 护理伙伴二元组的定性研究，考虑了在参与医疗保健系统时已知会出现的种族/族裔、地理位置和健康的交叉性。这些主题表明在所有社会生态层面：结构/系统、社区、组织/机构、人际和个体层面进行传染病预防的必要性。
