Back to life: Is it possible to be myself again? A qualitative study with persons initially hospitalised due to COVID-19.

OBJECTIVE: To gain a deeper understanding of the lived experiences of patients with COVID-19, regarding rehabilitation, work and social life 6 months after hospital discharge. DESIGN: An explorative qualitative study with individual interviews. SUBJECTS: Patients of working age with persistent self-reported symptoms at a 3-month follow-up who had received inpatient hospital care with discharge approximately 6 months previously were purposively sampled. METHODS: Semi-structured interviews were performed with 10 men and 5 women. The interviews were transcribed verbatim and analysed with inductive thematic analysis. RESULTS: Four themes were identified: "Social support - crucial, but decreased over time", "Varying needs of, and access to, rehabilitation", "Returning to work after COVID-19 - crucial for future prospects" and "An overwhelming experience that essentially changed one's personality". CONCLUSION: Rehabilitation provided participants with the valuable tools for recovery, giving them hope for future recovery. Support from next of kin was highly valued, creating stronger family bonds. A new meaning and greater appreciation of life was expressed.

Recovering from COVID-19 - A Process Characterised by Uncertainty: A Qualitative study.

OBJECTIVE: To obtain a deeper understanding of the lived experiences of patients with COVID-19, the recovery process and consequences for everyday life 6 months after hospital discharge. DESIGN: An explorative qualitative study using individual interviews. SUBJECTS: A purposive sampling was applied to recruit persons who had received inpatient hospital care, were discharged approximately 6 months previously, were of working age and had persistent self-reported symptoms at a 3-month follow-up appointment. METHODS: Semi-structured interviews were conducted with 15 participants (10 men, 5 women), which were then transcribed and analysed with inductive thematic analysis. RESULTS: Three themes were identified: "Status of recovery - two steps forward, one step back", "Remaining symptoms caused limitations in everyday life" and "Strategies for recovery". Participants indicated the recovery process through 6 months after discharge was a challenging road, often involving setbacks. A wide range of persistent, fluctuating, or new symptoms negatively impacted many areas of daily life, with fatigue and lack of energy being especially prominent. Participants used a variety of strategies to cope and recover. CONCLUSION: This study increases our knowledge of the lived experiences of COVID-19 based individual experiences. Unexpected symptoms in the recovery process were described and not always possible to forecast.

Self-Assessed Aspects of Health 3 Months after COVID-19 Hospitalization-A Swedish Cross-Sectional Study.

It is not yet fully understood how the patients self-assess their overall health in the early recovery after COVID-19 and if certain patient groups are more prominent in perceived long-time effects of COVID-19. The aim of this study was to describe self-assessed aspects of health in body function, activity and participation 3 months after hospitalization due to COVID-19 and identify difference between groups depending in age, sex and level of hospital care. This cross-sectional study consists of self-assessed aspects of health and recovery in 168 participants (mean age 64 years old, 69% men) previously hospitalized patients due to COVID-19. We have previously published data, from hospital discharge, on this cohort were predominantly the older patients and previous ICU-treated participants were affected. In this study there were differences in between groups. Of the study population 72% perceived fatigue, 64% respiratory difficulties, 37% perceived symptoms of anxiety. Three-months after COVID-19 this cohort was overall still affected. The recovery process is multifaced and the cohort heterogeneous, hence the rehabilitation needs to be highly individualized, and the follow-up of this patient group is of importance regardless of age, sex and previous level of hospital care.

Patients' Self-Reported Recovery After an Environmental Intervention Aimed to Support Patient's Circadian Rhythm in Intensive Care.

BACKGROUND: Patients in intensive care units (ICUs) are among the most vulnerable, and they require support to start their recovery. The design of the patient area in the ICU can play a prominent role in both the quality of care and patients' recovery. The lighting environment has the opportunity to restore and strengthen the natural human circadian rhythm and health. AIM: To evaluate patients' self-reported recovery after being cared for in an ICU room rebuilt according to evidence-based design principles that promote recovery. METHOD: An intervention was set up in a two-bed patient room including a cycled lighting system. Self-reported recovery was reported at 6 and 12 months after discharge. Data were analyzed using a 2(mechanically ventilated, nonmechanically ventilated) × 2(intervention room, ordinary room) analysis of covariance (ANCOVA) and 2(male, women) × 2(intervention room, ordinary room) ANCOVA. RESULTS: Data from the different rooms showed no significant main effects for recovery after 6 months, p = .21; however, after 12 months, it become significant, p. < .05. This indicated that patient recovery was positively influenced for patients cared for in the intervention room (M = 8.88, SD = 4.07) compared to the ordinary room (M = 10.90, SD = 4.26). There were no interaction effects for gender or if the patients had been mechanically ventilated either at 6 or 12 months' postdischarge. CONCLUSIONS: A cycled lighting system may improve patient self-reported recovery after ICU care; however, more research on the topic is needed.

The effect of cycled lighting in the intensive care unit on sleep, activity and physiological parameters: A pilot study.

Patients in intensive care suffer from severe illnesses or injuries and from symptoms related to care and treatments. Environmental factors, such as lighting at night, can disturb patients' circadian rhythms. The aim was to investigate whether patients displayed circadian rhythms and whether a cycled lighting intervention would impact it. In this pilot study (N=60), a cycled lighting intervention in a two-bed patient room was conducted. An ordinary hospital room functioned as the control. Patient activity, heart rate, mean arterial pressure and body temperature were recorded. All data were collected during the patients' final 24h in the intensive care unit. There was a significant difference between day and night patient activity within but not between conditions. Heart rates differed between day and night significantly for patients in the ordinary room but not in the intervention room or between conditions. Body temperature was lowest at night for all patients with no significant difference between conditions. Patients in both conditions had a natural circadian rhythm; and the cycled lighting intervention showed no significant impact. As the sample size was small, a larger repeated measures study should be conducted to determine if other types of lighting or environmental factors can impact patients' well-being.

Lighting, sleep and circadian rhythm: An intervention study in the intensive care unit.

Patients in an intensive care unit (ICU) may risk disruption of their circadian rhythm. In an intervention research project a cycled lighting system was set up in an ICU room to support patients' circadian rhythm. Part I aimed to compare experiences of the lighting environment in two rooms with different lighting environments by lighting experiences questionnaire. The results indicated differences in advantage for the patients in the intervention room (n=48), in perception of daytime brightness (p=0.004). In nighttime, greater lighting variation (p=0.005) was found in the ordinary room (n=52). Part II aimed to describe experiences of lighting in the room equipped with the cycled lighting environment. Patients (n=19) were interviewed and the results were presented in categories: "A dynamic lighting environment", "Impact of lighting on patients' sleep", "The impact of lighting/lights on circadian rhythm" and "The lighting calms". Most had experiences from sleep disorders and half had nightmares/sights and circadian rhythm disruption. Nearly all were pleased with the cycled lighting environment, which together with daylight supported their circadian rhythm. In night's actual lighting levels helped patients and staff to connect which engendered feelings of calm.

Let there be light and darkness: findings from a prestudy concerning cycled light in the intensive care unit environment.

The present study reports findings concerning light in an intensive care unit setting presented from 3 aspects, giving a wide view. The first part is a systematic review of intervention studies concerning cycled light compared with dim light/noncycled light. The findings showed that cycled light may be beneficial to preterm infant health. Second, a lighting intervention in the intensive care unit is presented, comparing and assessing experience of this lighting environment with that of an ordinary room. Significant differences were shown in hedonic tone, favoring the intervention environment. In the third part, measured illuminance, luminance, and irradiance values achieved in the lighting intervention room and ordinary room lighting are reported.