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Experiencing COVID-19, home isolation and primary health care: A mixed-methods study.
Parisi, Sandra; Lehner, Nina; Schrader, Hanna; Kierer, Leonard; Fleischer, Anna; Miljukov, Olga; Borgulya, Gabor; Rüter, Gernot; Viniol, Annika; Gágyor, Ildikó.
  • Parisi S; Department of General Practice, University Hospital Würzburg, Würzburg, Germany.
  • Lehner N; Department of General Practice, University Hospital Würzburg, Würzburg, Germany.
  • Schrader H; Department of General Practice, University Hospital Würzburg, Würzburg, Germany.
  • Kierer L; Department of General Practice, University Hospital Würzburg, Würzburg, Germany.
  • Fleischer A; Division of Medical Psychosomatics, University Hospital Würzburg, Würzburg, Germany.
  • Miljukov O; Institute of Clinical Epidemiology and Biometry, Julius Maximilian University of Würzburg, Würzburg, Germany.
  • Borgulya G; Department of General Practice, University Hospital Würzburg, Würzburg, Germany.
  • Rüter G; Academic Teaching Practice, Mentoring Team of the Competence-Based Continuing Education Baden-Württemberg Kompetenzzentrum Weiterbildung Baden-Württemberg (KWBW), University of Tübingen, Tübingen, Germany.
  • Viniol A; Department of General Practice, University of Marburg, Marburg, Germany.
  • Gágyor I; Department of General Practice, University Hospital Würzburg, Würzburg, Germany.
Front Public Health ; 10: 1023431, 2022.
Artigo em Inglês | MEDLINE | ID: covidwho-2234174
ABSTRACT

Objectives:

Although the vast majority of COVID-19 cases are treated in primary care, patients' experiences during home isolation have been little studied. This study aimed to explore the experiences of patients with acute COVID-19 and to identify challenges after the initial adaptation of the German health system to the pandemic (after first infection wave from February to June 2020).

Methods:

A mixed-method convergent design was used to gain a holistic insight into patients experience. The study consisted of a cross-sectional survey, open survey answers and semi-structured telephone interviews. Descriptive analysis was performed on quantitative survey answers. Between group differences were calculated to explore changes after the first infection wave. Qualitative thematic analysis was conducted on open survey answers and interviews. The results were then compared within a triangulation protocol.

Results:

A total of 1100 participants from all German states were recruited by 145 general practitioners from August 2020 to April 2021, 42 additionally took part in qualitative interviews. Disease onset varied from February 2020 to April 2021. After the first infection wave, more participants were tested positive during the acute disease (88.8%; 95.2%; P < 0.001). Waiting times for tests (mean 4.5 days, SD 4.1; 2.7days, SD 2.6, P < 0.001) and test results (mean 2.4 days, SD 1.9; 1.8 days, SD 1.3, P < 0.001) decreased. Qualitative results indicated that the availability of repeated testing and antigen tests reduced insecurities, transmission and related guilt. Although personal consultations at general practices increased (6.8%; 15.5%, P < 0.001), telephone consultation remained the main mode of consultation (78.5%) and video remained insignificant (1.9%). The course of disease, the living situation and social surroundings during isolation, access to health care, personal resilience, spirituality and feelings of guilt and worries emerged as themes influencing the illness experience. Challenges were contact management and adequate provision of care during home isolation. A constant contact person within the health system helped against feelings of care deprivation, uncertainty and fear.

Conclusions:

Our study highlights that home isolation of individuals with COVID-19 requires a holistic approach that considers all aspects of patient care and effective coordination between different care providers.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Isolamento de Pacientes / COVID-19 Tipo de estudo: Estudo observacional / Estudo prognóstico / Pesquisa qualitativa / Ensaios controlados aleatorizados Limite: Humanos Idioma: Inglês Revista: Front Public Health Ano de publicação: 2022 Tipo de documento: Artigo País de afiliação: Fpubh.2022.1023431

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Isolamento de Pacientes / COVID-19 Tipo de estudo: Estudo observacional / Estudo prognóstico / Pesquisa qualitativa / Ensaios controlados aleatorizados Limite: Humanos Idioma: Inglês Revista: Front Public Health Ano de publicação: 2022 Tipo de documento: Artigo País de afiliação: Fpubh.2022.1023431