The Psychosocial Impact of the COVID-19 Pandemic on Chronic Care Patients

Understanding the Lived Experience of Patients With Heart Failure During the COVID-19 Pandemic: A Systematic Review and Meta-synthesis of Qualitative Studies

BACKGROUND

Patients with heart failure face multifaceted challenges, including emotional, social, and psychological burdens, while managing their condition. The COVID-19 pandemic exacerbated these difficulties, amplifying fear, uncertainty, and healthcare complexities, further complicating their experiences.

OBJECTIVE

The objective of this study was to identify and analyze the challenges faced by patients with heart failure during the pandemic.

METHODS

A systematic review and meta-synthesis were conducted to analyze data from qualitative studies. Data were sourced from EMBASE, PubMed, and SCOPUS, spanning from March 11, 2020, when the WHO declared COVID-19 a pandemic, to May 5, 2023, marking the end of COVID-19 as a global public health emergency.

RESULTS

A systematic review and meta-synthesis were conducted, identifying 676 articles through database searches: CINAHL-Complete (n = 130), PubMed (n = 313), SCOPUS (n = 210), hand search (n = 22), and Thai journal online (ThaiJO) (n = 1). After screening and quality assessment using the Critical Appraisal Skills Programme, 17 full-text articles of sufficient quality involving 277 participants with heart failure from East Asia (Taiwan, Japan), Southeast Asia (Thailand, Indonesia), Europe (Denmark, UK, Spain, Italy, Sweden), North America (United States), and the Middle East (Iran) were included in the synthesis. Six primary themes emerged: (1) Emotional Impact-patients reported increased anxiety, fear of disease progression, and heightened feelings of isolation, (2) Limited Physical and Social Activities-restrictions during the pandemic significantly disrupted daily routines, (3) Cultivating Resilience and Meaningful Living-many adapted by finding new coping mechanisms and purpose, (4) Divergent Perspectives on Care Delivery Innovation-although telehealth offered convenience for some, others faced challenges because of the lack of in-person care, (5) Social Support from Family and Friends-family support was critical but often limited by quarantine measures, and (6) Trust in Healthcare Providers-trust emerged as a key factor in managing heart failure during the crisis. Using the GRADE-CERQual approach, the certainty of evidence was evaluated and ranged from moderate to high.

CONCLUSIONS

The findings underscore the urgent need for targeted interventions that address the emotional and practical needs of patients with heart failure during crises. By promoting well-being and enhancing healthcare delivery, these insights can inform healthcare providers and policymakers in developing tailored support strategies aimed at improving patient outcomes and quality of lifePROSPERO registration number: CRD42024526561.

Impact of long COVID-19 on posttraumatic stress disorder as modified by health literacy: an observational study in Vietnam

BACKGROUND

The prevalence of posttraumatic stress disorder (PTSD) has increased, particularly among individuals who have recovered from coronavirus disease 2019 (COVID-19) infection. Health literacy is considered a "social vaccine" that helps people respond effectively to the pandemic. We aimed to investigate the association between long COVID-19 and PTSD, and to examine the modifying role of health literacy in this association.

METHODS

A cross-sectional study was conducted at 18 hospitals and health centers in Vietnam from December 2021 to October 2022. We recruited 4,463 individuals who had recovered from COVID-19 infection for at least 4 weeks. Participants provided information about their sociodemographics, clinical parameters, health-related behaviors, health literacy (using the 12-item short-form health literacy scale), long COVID-19 symptoms and PTSD (Impact Event Scale-Revised score of 33 or higher). Logistic regression models were used to examine associations and interactions.

RESULTS

Out of the study sample, 55.9% had long COVID-19 symptoms, and 49.6% had PTSD. Individuals with long COVID-19 symptoms had a higher likelihood of PTSD (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.63-2.12; p<0.001). Higher health literacy was associated with a lower likelihood of PTSD (OR, 0.98; 95% CI, 0.97-0.99; p=0.001). Compared to those without long COVID-19 symptoms and the lowest health literacy score, those with long COVID-19 symptoms and a 1-point health literacy increment had a 3% lower likelihood of PTSD (OR, 0.97; 95% CI, 0.96-0.99; p=0.001).

CONCLUSION

Health literacy was found to be a protective factor against PTSD and modified the negative impact of long COVID-19 symptoms on PTSD.

Factors disrupting the continuity of care for patients with chronic disease during the pandemics: A systematic review

Background and Aims

Continuous routine care is necessary to prevent long-term complications of chronic diseases and improve patients' health conditions. This review study was conducted to determine the factors disrupting continuity of care for patients with chronic diseases during the pandemic.

Methods

All original articles published on factors disrupting continuity of care for patients with chronic disease during a pandemic between December 2019 and June 28, 2023, in PubMed, Web of Science, Scopus, and ProQuest databases were searched. Selection of articles, data extraction, and qualitative evaluation of articles (through STROBE and COREQ checklist) were done by two researchers separately. Data graphing form was used to extract the data of each study and then the data were classified by thematic analysis method.

Results

Out of 1708 articles reviewed from the databases, 22 were included. The factors disrupting the continuity of care for patients with chronic diseases during the epidemics were classified into two main categories: patient-side factors and health system-side factors. Patient-side factors including psychological, individual and social, disease-related, and health system-side factors including provider access, health system institutional, and infrastructural and financial problems were among the subcategories disrupting the continuity of care for patients with chronic diseases during the pandemic. Based on the studies, psychological factors and access to the provider were among the most frequent factors affecting the continuity of care for patients with chronic diseases in the pandemic.

Conclusion

Considering the factors disrupting the continuity of care and applying appropriate interventions based on them, can guarantee the continuity of providing services to chronic patients in health crises.