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荷兰全科医疗中“新冠后综合征”患者的护理需求:患者和全科医生的访谈研究。

Care needs of patients with the post-COVID syndrome in Dutch general practice: an interview study among patients and general practitioners.

机构信息

Nivel, Netherlands Institute for Health Services Research, Otterstraat 118, Utrecht, 3513CR, The Netherlands.

Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands.

出版信息

BMC Prim Care. 2024 Sep 28;25(1):355. doi: 10.1186/s12875-024-02597-w.

Abstract

BACKGROUND

The post-COVID syndrome (PCS) has a large impact on an individual's daily life. The wide variety of symptoms in PCS patients and the fact that it is still relatively new makes it difficult for general practitioners (GPs) to recognize, diagnose and treat patients with PCS, leading to difficulties in assessing and fulfilling healthcare needs. It is largely unknown what the experiences of Dutch patients and GPs are with PCS and, therefore, we gained insight into the different aspects of living with PCS and the associated healthcare needs.

METHODS

Semi-structured interviews were performed with 13 self-reported PCS patients (varying in sex, age, education, and health literacy) and 6 GPs (varying in gender, age, and type of practice) between January-July 2022. Patients and GPs were most likely unrelated (not in the same practices). The data have been analysed using the Thematic Analysis method.

RESULTS

Experiences appeared to vary between two types of PCS patients that emerged during the interviews: (1) individuals with good pre-existing health status (PEHS) who are severely affected by PCS and have difficulty recovering and (2) individuals with poorer PEHS whose health became even poorer after COVID-19 infection. The interviews with PCS patients and GPs revealed two main themes, in which the types of patients differed: (1) aspects of living with PCS; individuals with good PEHS mainly experience symptoms when overstimulated, while individuals with poorer PEHS generally feel exhausted continuously. (2) Healthcare experiences; GPs emphasized that individuals with good PEHS seem to benefit from support in distributing their energy by careful planning of daily activities, whereas individuals with poorer PEHS require support in activation. Patients and GPs emphasised the importance of taking patients seriously and acknowledging their symptoms. Finally, the patients interviewed indicated that some GPs doubted the existence of PCS, resulting in insufficient recognition.

CONCLUSION

Awareness of the differences in needs and experiences of the two types of PCS patients could contribute to more appropriate care. Acknowledgement of PCS by GPs as a real syndrome is important for patients and plays an important role in coping with or recovering from PCS. A multidisciplinary person-centred approach is important and can be coordinated by a GP.

摘要

背景

新冠后综合征(PCS)对个体的日常生活有很大影响。PCS 患者症状多样,且该病相对较新,这使得全科医生(GP)难以识别、诊断和治疗 PCS 患者,导致难以评估和满足其医疗保健需求。目前尚不清楚荷兰患者和 GP 对 PCS 的体验如何,因此,我们深入了解了与 PCS 相关的生活的不同方面及其相关的医疗保健需求。

方法

2022 年 1 月至 7 月期间,对 13 名自我报告的 PCS 患者(性别、年龄、教育程度和健康素养各不相同)和 6 名 GP(性别、年龄和执业类型各不相同)进行了半结构化访谈。患者和 GP 很可能没有关系(不在同一家诊所)。使用主题分析方法对数据进行了分析。

结果

访谈中出现了两种类型的 PCS 患者,他们的体验似乎有所不同:(1) 先前健康状况良好(PEHS)的个体受 PCS 严重影响,难以康复;(2)PEHS 较差的个体在 COVID-19 感染后健康状况甚至更差。对 PCS 患者和 GP 的访谈揭示了两个主要主题,其中患者类型有所不同:(1)PCS 患者的生活方面;PEHS 较好的个体主要在过度刺激时出现症状,而 PEHS 较差的个体则普遍持续感到疲惫。(2)医疗保健体验;GP 强调,PEHS 较好的个体似乎通过仔细规划日常活动来分配精力,从而从支持中受益,而 PEHS 较差的个体则需要在激活方面的支持。患者和 GP 强调了认真对待患者并承认其症状的重要性。最后,接受访谈的患者表示,一些 GP 怀疑 PCS 的存在,导致对其认识不足。

结论

认识到两种类型的 PCS 患者的需求和体验差异,可以为提供更合适的护理做出贡献。GP 承认 PCS 是一种真正的综合征,对患者很重要,并在应对或从 PCS 中恢复方面发挥重要作用。多学科以患者为中心的方法很重要,可以由 GP 协调。

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