Codeveloping a Novel Intervention for People With Post-COVID Condition: The Balance-ACT Study

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2025-06-08 DOI:10.1111/hex.70320

Lily Felton, Michail Kalfas, Debbie Brewin, Carole Beckwith, Tasbiha Khan, Caroline Jolley, Nicholas Hart, Emma L. Duncan, Timothy Nicholson, Oliver Witard, Julie Moore, Alan Metcalfe, Gerrard F Rafferty, Trudie Chalder

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Abstract

Introduction

Some people experience persistent symptoms, such as fatigue, brain fog and breathlessness, long after the onset of COVID-19 infection. This is known as the post-COVID syndrome (PCS). We developed a unique and holistic psycho-physiological intervention that integrates Acceptance and Commitment Therapy (ACT), a structured talking therapy, with principles of homeostasis. This aims to provide targeted support and treatment strategies for effectively managing the long-term repercussions of the condition and improve patient outcomes.

Methods

This empirical study was informed by theory and other research strands. These strands included a qualitative study of people with lived experience, a scoping review of interventions for fatigue (including rehabilitation) and insights from a patient and public involvement (PPI) group. The PPI group were actively involved in the development of the intervention, manuals and overall study management, ensuring it was relevant, ethical and aligned with patient preferences and needs.

Results

The qualitative study uncovered the tangible contexts in which the intervention would be implemented, and the attraction of Balance-ACT for those living with PCS. People living with PCS (n = 19) and health care professionals (HCPs; n = 12) provided overall endorsement for the intervention. Through an iterative process, their feedback, alongside input from the PPI group, informed the development of key materials, including a therapist manual, participant handbook, mindfulness recordings and an animation. Therapists were trained, and a novel fidelity measure was developed to ensure adherence to Balance-ACT principles.

Conclusion

We used an iterative approach to develop the Balance-ACT intervention, which was acceptable to patients and HCPs. Subsequent research will examine the efficacy of Balance-ACT.

Patient and Public Contribution

This article represents work conducted as part of the Balance-ACT project. People with the post-COVID condition (PCC) were involved throughout all aspects of this study, in line with the National Institute for Health and Care Research framework, and contributed in several key ways. It ensured the research captured a diverse range of illness experiences. The study design was refined and addressed potential barriers to engagement. Patient-friendly language was used to improve accessibility, making the study more inclusive. Additionally, the outcome measures were informed by patient input to enhance their relevance. Finally, dissemination was guided to ensure that the findings were both useful and accessible, using clear language in reporting and incorporating feedback from patient representatives on drafts to ensure clarity.

C.B. recorded the mindfulness exercises and was a core part of the management team throughout.

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共同开发一种针对后冠状病毒感染者的新型干预措施：Balance-ACT研究

有些人在感染COVID-19很久之后仍会出现持续的症状，如疲劳、脑雾和呼吸困难。这被称为“后covid综合征”。我们开发了一种独特而全面的心理生理干预，将接受和承诺疗法（ACT），一种结构化的谈话疗法，与体内平衡原则相结合。其目的是提供有针对性的支持和治疗策略，以有效地管理病情的长期影响并改善患者的预后。方法运用理论和其他研究方法进行实证研究。这些部分包括对有生活经验的人的定性研究，对疲劳干预（包括康复）的范围审查，以及来自患者和公众参与（PPI）小组的见解。PPI组积极参与干预、手册和整体研究管理的制定，确保其相关、合乎道德并符合患者的偏好和需求。结果定性研究揭示了实施干预的具体环境，以及Balance-ACT对PCS患者的吸引力。PCS患者（n = 19）和卫生保健专业人员(HCPs；N = 12)为干预提供了总体支持。通过一个反复的过程，他们的反馈与PPI组的输入一起，为关键材料的开发提供了信息，包括治疗师手册、参与者手册、正念录音和动画。治疗师接受了培训，并开发了一种新的保真度测量方法，以确保遵守Balance-ACT原则。结论：我们采用迭代方法开发Balance-ACT干预，该干预为患者和HCPs所接受。后续研究将检验Balance-ACT的功效。本文是Balance-ACT项目的一部分。根据国家卫生与护理研究所的框架，患有后冠状病毒病（PCC）的人参与了本研究的各个方面，并以几个关键方式做出了贡献。它确保了研究捕捉到各种各样的疾病经历。研究设计得到了改进，并解决了参与的潜在障碍。使用患者友好的语言来提高可及性，使研究更具包容性。此外，结果测量通过患者输入来增强其相关性。最后，指导传播工作，以确保调查结果既有用又易于获取，在报告中使用明确的语言，并纳入患者代表对草案的反馈，以确保清晰。C.B.记录了正念练习，自始至终都是管理团队的核心成员。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.