期刊
JOURNAL OF GENERAL INTERNAL MEDICINE
卷 38, 期 10, 页码 2374-2382出版社
SPRINGER
DOI: 10.1007/s11606-023-08246-9
关键词
COVID-19; outcomes; recovery; qualitative research; health disparities
This study explores the recovery experiences of COVID-19 patients in the US, particularly focusing on medically underserved populations. Findings show that patients experienced persistent health deficits in physical, cognitive, and psychological aspects, leading to financial suffering and loss of identity. Clinicians' emphasis on physical health hindered holistic recovery, while facilitators included strong support systems and personal agency in health maintenance. Coping mechanisms involved spirituality and gratitude.
BackgroundMany patients hospitalized for COVID-19 experience prolonged symptoms months after discharge. Little is known abou t patients' personal experiences recovering from COVID-19 in the United States (US), where medically underserved populations are at particular risk of adverse outcomes.ObjectiveTo explore patients' perspectives on the impact of COVID-19 hospitalization and barriers to and facilitators of recovery 1 year after hospital discharge in a predominantly Black American study population with high neighborhood-level socioeconomic disadvantage.DesignQualitative study utilizing individual, semi-structured interviews.ParticipantsAdult patients hospitalized for COVID-19 approximately 1 year after discharge home who were engaged in a COVID-19 longitudinal cohort study.ApproachThe interview guide was developed and piloted by a multidisciplinary team. Interviews were audio-recorded and transcribed. Data were coded and organized into discrete themes using qualitative content analysis with constant comparison techniques.Key ResultsOf 24 participants, 17 (71%) self-identified as Black, and 13 (54%) resided in neighborhoods with the most severe neighborhood-level socioeconomic disadvantage. One year after discharge, participants described persistent deficits in physical, cognitive, or psychological health that impacted their current lives. Repercussions included financial suffering and a loss of identity. Participants reported that clinicians often focused on physical health over cognitive and psychological health, an emphasis that posed a barrier to recovering holistically. Facilitators of recovery included robust financial or social support systems and personal agency in health maintenance. Spirituality and gratitude were common coping mechanisms.ConclusionsPersistent health deficits after COVID-19 resulted in downstream consequences in participants' lives. Though participants received adequate care to address physical needs, many described persistent unmet cognitive and psychological needs. A more comprehensive understanding of barriers and facilitators for COVID-19 recovery, contextualized by specific healthcare and socioeconomic needs related to socioeconomic disadvantage, is needed to better inform intervention delivery to patients that experience long-term sequelae of COVID-19 hospitalization.
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