接受长期 COVID 治疗所面临的挑战:对初级保健患者期望和经历的定性访谈研究。

IF 4.4 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Elena Gardner, Alex Lockrey, Kirsten L Stoesser, Jennifer P Leiser, Jeanette Brown, Bernadette Kiraly, Dominik J Ose
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引用次数: 0

摘要

背景:对于许多患有后 COVID-19 病症(长 COVID)的患者来说,初级保健是他们与医疗保健系统的第一个互动点。原则上,初级医疗机构完全有能力管理长期 COVID。然而,除了表达无能为力之外,患者对长程 COVID 护理质量的看法并不乐观。因此,本研究旨在分析寻求长期 COVID 治疗的初级保健患者的期望和经历:方法:采用现象学方法进行分析。通过有目的的抽样,我们对讲英语的成年初级保健患者进行了半结构化访谈,让他们描述长期 COVID 的症状。我们对访谈录音进行了去身份化和转录。我们采用归纳式定性内容分析法对访谈记录进行了分析:本文报告了 19 次访谈(53% 为女性,平均年龄为 54 岁)的结果。患者希望他们的初级保健医生(PCP)了解长效 COVID 的相关知识,关注他们的个人状况,并参与合作治疗过程。患者描述了两个方面的经历。首先,患者认为与临床医生的互动是积极的,因为临床医生是诚实的、认可的,而当患者感到被忽视或气馁时,则是消极的。其次,患者描述了在协调护理、治疗和检查以及付款时,在美国分散的医疗保健系统中遇到的挑战:结论:初级保健患者寻求长期 COVID 治疗的经历与他们的期望不一致。患者必须克服医疗保健系统各个层面的障碍,并对持续不断的挑战感到沮丧。初级保健医生和其他医疗保健专业人员可以通过倾听、确认和宣传长期慢性阻塞性肺病患者的经历,提高他们的期望和经历的一致性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Challenges in Receiving Care for Long COVID: A Qualitative Interview Study Among Primary Care Patients About Expectations and Experiences.

Background: For many patients with post-COVID-19 condition (long COVID), primary care is the first point of interaction with the health care system. In principle, primary care is well situated to manage long COVID. Beyond expressions of disempowerment, however, the patient's perspective regarding the quality of long COVID care is lacking. Therefore, this study aimed to analyze the expectations and experiences of primary care patients seeking treatment for long COVID.

Methods: A phenomenological approach guided this analysis. Using purposive sampling, we conducted semistructured interviews with English-speaking, adult primary care patients describing symptoms of long COVID. We deidentified and transcribed the recorded interviews. Transcripts were analyzed using inductive qualitative content analysis.

Results: This article reports results from 19 interviews (53% female, mean age = 54 years). Patients expected their primary care practitioners (PCPs) to be knowledgeable about long COVID, attentive to their individual condition, and to engage in collaborative processes for treatment. Patients described 2 areas of experiences. First, interactions with clinicians were perceived as positive when clinicians were honest and validating, and negative when patients felt dismissed or discouraged. Second, patients described challenges navigating the fragmented US health care system when coordinating care, treatment and testing, and payment.

Conclusion: Primary care patients' experiences seeking care for long COVID are incongruent with their expectations. Patients must overcome barriers at each level of the health care system and are frustrated by the constant challenges. PCPs and other health care professionals might increase congruence with expectations and experiences through listening, validating, and advocating for patients with long COVID.Annals Early Access article.

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来源期刊
Annals of Family Medicine
Annals of Family Medicine 医学-医学:内科
CiteScore
3.70
自引率
4.50%
发文量
142
审稿时长
6-12 weeks
期刊介绍: The Annals of Family Medicine is a peer-reviewed research journal to meet the needs of scientists, practitioners, policymakers, and the patients and communities they serve.
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