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1.
J Crit Care ; 64: 160-164, 2021 08.
Article in English | MEDLINE | ID: covidwho-1479628

ABSTRACT

PURPOSE: To measure the rate of recall of study participation and study attrition in survivors of acute respiratory distress syndrome(ARDS). MATERIALS/METHODS: In this ancillary study of the Re-evaluation of Systemic Early neuromuscular blockade(ROSE) trial, we measured the rate of study participation recall 3 months following discharge and subsequent study attrition at 6 months. We compared patient and hospital characteristics, and long-term outcomes by recall. As surrogate decision-makers provided initial consent, we measured the rate of patient reconsent and its association with study recall. RESULTS: Of 487 patients evaluated, recall status was determined in 386(82.7%). Among these, 287(74.4%) patients recalled participation in the ROSE trial, while 99(25.6%) did not. There was no significant difference in 6-month attrition among patients who recalled study participation (9.1%) and those who did not (12.1%) (p = 0.38). Patient characteristics were similar between groups, except SOFA scores, ventilator-free days, and length of stay. 330(68%) were reconsented. Compared to those not reconsented, significantly more patients who were reconsented recalled study participation(78% vs. 66%;p = 0.01). CONCLUSIONS: One in 4 ARDS survivors do not recall their participation in a clinical trial during hospitalization 3 months following hospital discharge, which did not influence 6-month attrition. However, more patients recall study participation if reconsent is obtained.


Subject(s)
Respiratory Distress Syndrome , Survivors , Clinical Trials as Topic , Humans , Mental Recall , Patient Discharge , Respiratory Distress Syndrome/therapy , Survivors/psychology
2.
Crit Care Med ; 49(9): 1427-1438, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1434524

ABSTRACT

OBJECTIVE: Determine the characteristics of postintensive care syndrome in the cognitive, physical, and psychiatric domains in coronavirus disease 2019 ICU survivors. DESIGN: Single-center descriptive cohort study from April 21, to July 7, 2020. SETTING: Critical care recovery clinic at The Mount Sinai Hospital in New York City. PATIENTS: Adults who had critical illness due to coronavirus disease 2019 requiring an ICU stay of 7 days or more and who agreed to a telehealth follow-up in the critical care recovery clinic 1-month post hospital discharge. INTERVENTIONS: None. MEASURES AND MAIN RESULTS: Patient-reported outcome measures assessing physical and psychiatric domains were collected electronically, a cognitive test was performed by a clinician, and clinical data were obtained through electronic medical records. Outcome measures assessed postintensive care syndrome symptoms in the physical (Modified Rankin Scale, Dalhousie Clinical Frailty Scale, Neuro-Quality of Life Upper Extremity and Lower Extremity Function, Neuro-Quality of Life Fatigue), psychiatric (Insomnia Severity Scale; Patient Health Questionnaire-9; and Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), and cognitive (Telephone Montreal Cognitive Assessment) domains. The 3-Level Version of Euro-QoL-5D was used to assess the physical and psychiatric domains. A diagnosis of postintensive care syndrome was made in cases with evidence of impairment in at least one postintensive care syndrome domain. We included 45 patients with a mean (sd) age of 54 (13) years, and 73% were male. Ninety-one percent of coronavirus disease 2019 ICU survivors fit diagnostic criteria for postintensive care syndrome. 86.7 % had impairments in the physical domain, 22 (48%) reported impairments in the psychiatric domain, and four (8%) had impairments on cognitive screening. We found that 58% had some degree of mobility impairment. In the psychiatric domain, 38% exhibited at least mild depression, and 18 % moderate to severe depression. Eighteen percent presented Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, scores suggestive of posttraumatic stress syndrome diagnosis. In the Telephone Montreal Cognitive Assessment, 9% had impaired cognition. CONCLUSIONS: Survivors of critical illness related to coronavirus disease 2019 are at high risk of developing postintensive care syndrome. These findings highlight the importance of planning for appropriate post-ICU care to diagnose and treat this population.


Subject(s)
COVID-19/complications , Critical Illness , COVID-19/psychology , COVID-19/therapy , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/etiology , Cohort Studies , Critical Care , Female , Humans , Intensive Care Units , Male , Middle Aged , New York City , Patient Reported Outcome Measures , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Survivors/psychology
3.
Anticancer Res ; 41(6): 2745-2757, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1404214

ABSTRACT

BACKGROUND/AIM: Seventy-six years after Auschwitz Liberation, the Holocaust keeps on persecuting its surviving victims. As witnessed by the psychiatric and medical literature in the last decades, in fact, the Holocaust survivors (HS) appear to suffer from several Shoah-related late-onset diseases impacting their survival, such as internal illnesses and post-traumatic stress disorder (PTSD). Cancer represents a further severe pathology which seems to be connected with the Holocaust experience. Our aim was to review the existing knowledge of Holocaust-related cancer in HS in order to assess its real incidence and clinicoprognostic significance. MATERIALS AND METHODS: We systematically reviewed the literature dealing with Israeli Jewish and non-Jewish non-Israeli HS developing cancer. We also reviewed and analyzed the cancer data of noted Jewish HS not resident or having resided in Israel available as public information. RESULTS: We found 16 and 15 studies on Israeli Jews and non-Jewish non-Israeli survivors, respectively. A statistically significant association between the Holocaust and development of late-onset cancer in HS was seen in most studies with cancer adversely impacting the survival. We also selected 330 noted Jewish non-Israeli HS: genocide-related late-onset cancer resulted to be a significant and independent risk factor of poor prognosis (p<0.0001) imparting shorter survival in affected versus non-cancer subjects (57 versus 64 years, respectively, p=0.0001). CONCLUSION: Although 76 years have passed, our review shows how the Holocaust keeps on burdening its survivors. Moreover, we offered the first analysis of Jewish HS not resident or having resided in Israel in terms of genocide-related late-onset diseases focusing on cancer. Further studies on Jewish non-Israeli HS are needed in order to corroborate our findings on late-onset cancer occurring in this targeted population.


Subject(s)
Holocaust/psychology , Jews , Neoplasms/etiology , Survivors/psychology , Age of Onset , Aged , Humans , Israel , Neoplasms/epidemiology , Neoplasms/pathology , Risk Factors , Survival Analysis
4.
Ann Surg ; 274(6): 913-920, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1337305

ABSTRACT

OBJECTIVE: Determine the proportion and characteristics of traumatic injury survivors who perceive a negative impact of the COVID-19 pandemic on their recovery and to define post-injury outcomes for this cohort. BACKGROUND: The COVID-19 pandemic has precipitated physical, psychological, and social stressors that may create a uniquely difficult recovery and reintegration environment for injured patients. METHODS: Adult (≥18 years) survivors of moderate-to-severe injury completed a survey 6 to 14 months post-injury during the COVID-19 pandemic. This survey queried individuals about the perceived impact of the COVID-19 pandemic on injury recovery and assessed post-injury functional and mental health outcomes. Regression models were built to identify factors associated with a perceived negative impact of the pandemic on injury recovery, and to define the relationship between these perceptions and long-term outcomes. RESULTS: Of 597 eligible trauma survivors who were contacted, 403 (67.5%) completed the survey. Twenty-nine percent reported that the COVID-19 pandemic negatively impacted their recovery and 24% reported difficulty accessing needed healthcare. Younger age, lower perceived-socioeconomic status, extremity injury, and prior psychiatric illness were independently associated with negative perceived impact of the COVID-19 pandemic on injury recovery. In adjusted analyses, patients who reported a negative impact of the pandemic on their recovery were more likely to have new functional limitations, daily pain, lower physical and mental component scores of the Short-Form-12 and to screen positive for PTSD and depression. CONCLUSIONS: The COVID-19 pandemic is negatively impacting the recovery of trauma survivors. It is essential that we recognize the impact of the pandemic on injured patients while focusing on directed efforts to improve the long-term outcomes of this already at-risk population.


Subject(s)
COVID-19/epidemiology , Pandemics , Quality of Life , Recovery of Function , Stress Disorders, Post-Traumatic/epidemiology , Survivors/psychology , Comorbidity , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , SARS-CoV-2 , Stress Disorders, Post-Traumatic/psychology , Surveys and Questionnaires , Time Factors
5.
Chest ; 160(1): 187-198, 2021 07.
Article in English | MEDLINE | ID: covidwho-1290546

ABSTRACT

BACKGROUND: More than 20% of hospitalized patients with COVID-19 demonstrate ARDS requiring ICU admission. The long-term respiratory sequelae in such patients remain unclear. RESEARCH QUESTION: What are the major long-term pulmonary sequelae in critical patients who survive COVID-19? STUDY DESIGN AND METHODS: Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated 3 months after hospitalization discharge. The follow-up comprised symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, exercise test (6-min walking test [6MWT]), and chest CT imaging. RESULTS: One hundred twenty-five patients admitted to the ICU with ARDS secondary to COVID-19 were recruited between March and June 2020. At the 3-month follow-up, 62 patients were available for pulmonary evaluation. The most frequent symptoms were dyspnea (46.7%) and cough (34.4%). Eighty-two percent of patients showed a lung diffusing capacity of less than 80%. The median distance in the 6MWT was 400 m (interquartile range, 362-440 m). CT scans showed abnormal results in 70.2% of patients, demonstrating reticular lesions in 49.1% and fibrotic patterns in 21.1%. Patients with more severe alterations on chest CT scan showed worse pulmonary function and presented more degrees of desaturation in the 6MWT. Factors associated with the severity of lung damage on chest CT scan were age and length of invasive mechanical ventilation during the ICU stay. INTERPRETATION: Three months after hospital discharge, pulmonary structural abnormalities and functional impairment are highly prevalent in patients with ARDS secondary to COVID-19 who required an ICU stay. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months after discharge.


Subject(s)
COVID-19 , Long Term Adverse Effects , Lung/diagnostic imaging , Quality of Life , Respiratory Function Tests/methods , Survivors , Tomography, X-Ray Computed/methods , Aftercare/methods , Aftercare/statistics & numerical data , COVID-19/complications , COVID-19/epidemiology , COVID-19/therapy , Female , Humans , Intensive Care Units/statistics & numerical data , Long Term Adverse Effects/diagnosis , Long Term Adverse Effects/epidemiology , Long Term Adverse Effects/etiology , Long Term Adverse Effects/psychology , Lung/physiopathology , Male , Middle Aged , Outcome Assessment, Health Care , Patient Discharge/statistics & numerical data , Prevalence , SARS-CoV-2 , Spain/epidemiology , Survivors/psychology , Survivors/statistics & numerical data , Walk Test/methods , Walk Test/statistics & numerical data
6.
Health Care Women Int ; 41(11-12): 1294-1312, 2020.
Article in English | MEDLINE | ID: covidwho-1263591

ABSTRACT

Intimate partner violence (IPV) is a significant national and global public health concern, with COVID-19 pandemic increasing IPV and associated health issues. Immigrant women may be disproportionately vulnerable to IPV-related health risks during the pandemic. Using qualitative in-depth interviews, we explored the perspectives of service providers (n = 17) and immigrant survivors of IPV(n = 45) on the impact of COVID-19 on immigrant women, existing services for survivors and strategies needed needed to enhance women's health and safety. Participants reported issues such as increased IPV and suggested strategies (e.g. strengthening virtual platforms). The findings could be informative for providers in national and international settings.


Subject(s)
COVID-19/psychology , Emigrants and Immigrants/psychology , Intimate Partner Violence/psychology , Adult , COVID-19/epidemiology , Female , Humans , Middle Aged , Qualitative Research , Quarantine , SARS-CoV-2 , Spouse Abuse/psychology , Survivors/psychology , Women's Health , Young Adult
8.
Am J Orthopsychiatry ; 91(2): 171-180, 2021.
Article in English | MEDLINE | ID: covidwho-1226414

ABSTRACT

Evidence from multiple samples of trauma-exposed populations across the globe suggests that intergenerational trauma constitutes a biopsychological risk factor which manifests itself throughout the life cycle of offspring of trauma survivors. Prior empirical studies have shown that adult children of Holocaust survivors (OHS, also referred to in select quotes as 2G for "Second Generation") are vulnerable to life-threatening situations. This study aimed to examine the reactions of OHS to the COVID-19 pandemic, which posed a serious threat to the lives of many, in particular to older adults. As they enter middle age, OHS were observed to have more medical health issues and less positive perceptions of their own aging relative to peers. Less positive subjective aging was associated with more negative psychiatric symptoms in relation to Covid-19-related loneliness, further suggesting that OHS are a group of aging adults with particular vulnerabilities to negative mental health effects of the pandemic and of the social distancing and isolation it imposed. This study is a qualitative report of experiences expressed by over 1,200 participants in several web-based interactive webinars for OHS during the period of "shelter at home" in March and April 2020. It is proposed that this format of "web-based, second-best" way of being together, an intervention that emerged spontaneously in response to the coronavirus and social distancing, offers a novel, nonpathologizing, effective form of supportive psychosocial intervention uniquely suited to the unprecedented challenges experienced during times requiring social distancing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
COVID-19/psychology , Holocaust/psychology , Psychotherapy, Group/methods , Survivors/psychology , Adult Children/psychology , Anxiety/etiology , Anxiety/therapy , COVID-19/therapy , Humans , Internet , Siblings/psychology
9.
Crit Care Med ; 49(10): 1726-1738, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1221494

ABSTRACT

OBJECTIVES: We performed a comprehensive health assessment in mechanically ventilated coronavirus disease 2019 survivors to assess the impact of respiratory and skeletal muscle injury sustained during ICU stay on physical performance at 3 months following hospital discharge. DESIGN: Preregistered prospective observational cohort study. SETTING: University hospital ICU. PATIENTS: All mechanically ventilated coronavirus disease 2019 patients admitted to our ICU during the first European pandemic wave. MEASUREMENTS AND MAIN RESULTS: At 3 months after hospital discharge, 46 survivors underwent a comprehensive physical assessment (6-min walking distance, Medical Research Council sum score and handgrip strength), a full pulmonary function test, and a chest CT scan which was used to analyze skeletal muscle architecture. In addition, patient-reported outcomes measures were collected. Physical performance assessed by 6-minute walking distance was below 80% of predicted in 48% of patients. Patients with impaired physical performance had more muscle weakness (Medical Research Council sum score 53 [51-56] vs 59 [56-60]; p < 0.001), lower lung diffusing capacity (54% [44-66%] vs 68% of predicted [61-72% of predicted]; p = 0.002), and higher intermuscular adipose tissue area (p = 0.037). Reduced lung diffusing capacity and increased intermuscular adipose tissue were independently associated with physical performance. CONCLUSIONS: Physical disability is common at 3 months in severe coronavirus disease 2019 survivors. Lung diffusing capacity and intermuscular adipose tissue assessed on CT were independently associated with walking distance, suggesting a key role for pulmonary function and muscle quality in functional disability.


Subject(s)
COVID-19/complications , Recovery of Function/physiology , Respiration, Artificial/adverse effects , Survivors/statistics & numerical data , Aged , COVID-19/therapy , Cohort Studies , Female , Follow-Up Studies , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Outcome Assessment, Health Care/methods , Outcome Assessment, Health Care/statistics & numerical data , Physical Functional Performance , Prospective Studies , Respiration, Artificial/methods , Respiration, Artificial/statistics & numerical data , Survivors/psychology , Time Factors
10.
AACN Adv Crit Care ; 32(2): 188-194, 2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1215521

ABSTRACT

As COVID-19 continues to spread, with the United States surpassing 29 million cases, health care workers are beginning to see patients who have been infected with SARS-CoV-2 return seeking treatment for its longer-term physical and mental effects. The term long-haulers is used to identify patients who have not fully recovered from the illness after weeks or months. Although the acute symptoms of COVID-19 have been widely described, the longer-term effects are less well known because of the relatively short history of the pandemic. Symptoms may be due to persistent chronic inflammation (eg, fatigue), sequelae of organ damage (eg, pulmonary fibrosis, chronic kidney disease), and hospitalization and social isolation (eg, muscle wasting, malnutrition). Health care providers are instrumental in developing a comprehensive plan for identifying and managing post-COVID-19 complications. This article addresses the possible etiology of postviral syndromes and describes reported symptoms and suggested management of post-COVID syndrome.


Subject(s)
COVID-19/complications , Fatigue Syndrome, Chronic/etiology , Fatigue Syndrome, Chronic/nursing , Fatigue Syndrome, Chronic/physiopathology , Practice Guidelines as Topic , Subacute Care/standards , Survivors/psychology , Adult , Aged , Aged, 80 and over , Curriculum , Education, Medical, Continuing , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , United States
11.
Transfus Clin Biol ; 28(3): 254-257, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1199105

ABSTRACT

BACKGROUND: Increasingly, it has been seen that patients recovering from COVID-19 may face a second battle of coping with its mental health ramifications. These psychological issues can even be experienced by patients who were asymptomatic or had mild to moderate symptoms, potentially impacting their quality of life. METHODOLOGY: This was a prospective observational study to analyse the psychological impact of COVID-19 in recovered patients who presented as prospective convalescent plasma (CP) donors. An interview for the psychological assessment of the prospective donors was carried out. Depression and anxiety in the participants were assessed by HAM-A, and HAM-D scores and Quality of Life were assessed using the WHOQOL-BREF scale. RESULTS: A total of 51 prospective donors were assessed, with a mean age of 34.37 (±9.08) years, with the majority being males (46). No clinically significant depression and anxiety were found on the basis of HAM-D and HAM-A scores. The worst affected quality of life parameter, based on the WHOQOL-BREF scale, was physical quality of life followed by environmental, psychological, and social relationships. Moreover, due to infection, social stigma was experienced by 49.02% of the donors, while 21.97% had anxiety related to convalescent plasma donation as a common livid experience. CONCLUSION: Poor quality of life and social stigma during the recovery phase is prevalent in COVID-19 recovered patients, for which formulation of holistic support strategies are the need of the hour.


Subject(s)
Blood Donors/psychology , COVID-19/psychology , COVID-19/therapy , Convalescence/psychology , SARS-CoV-2 , Adult , Altruism , Anxiety/epidemiology , Anxiety/etiology , Attitude to Health , Depression/epidemiology , Depression/etiology , Female , Humans , Immunization, Passive/psychology , India , Interpersonal Relations , Interview, Psychological , Male , Middle Aged , Prospective Studies , Psychological Tests , Quality of Life , Randomized Controlled Trials as Topic , Social Stigma , Survivors/psychology , Young Adult
12.
JMIR Public Health Surveill ; 6(3): e19831, 2020 07 30.
Article in English | MEDLINE | ID: covidwho-1172930

ABSTRACT

Before the coronavirus disease (COVID-19), 1 in 3 women and girls, globally, were victimized by an abusive partner in intimate relationships. However, the current pandemic has amplified cases of domestic violence (DV) against women and girls, with up to thrice the prevalence in DV cases compared to the same time last year. Evidence of the adverse effects of the pandemic on DV is still emerging, even as violence prevention strategies are iteratively being refined by service providers, advocacy agencies, and survivors to meet stay-at-home mandates. Emotional and material support for survivors is a critical resource increasingly delivered using digital and technology-based modalities, which offer several advantages and challenges. This paper rapidly describes current DV mitigation approaches using digital solutions, signaling emerging best practices to support survivors, their children, and abusers during stay-at-home advisories. Some examples of technology-based strategies and solutions are presented. An immediate priority is mapping out current digital solutions in response to COVID-19-related DV and outlining issues with uptake, coverage, and meaningful use of digital solutions.


Subject(s)
Coronavirus Infections/epidemiology , Domestic Violence/prevention & control , Intimate Partner Violence/prevention & control , Pandemics , Pneumonia, Viral/epidemiology , Telemedicine/methods , COVID-19 , Coronavirus Infections/prevention & control , Domestic Violence/statistics & numerical data , Female , Global Health/statistics & numerical data , Humans , Intimate Partner Violence/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Prevalence , Social Support , Survivors/psychology
13.
Psychol Trauma ; 13(4): 438-445, 2021 May.
Article in English | MEDLINE | ID: covidwho-1108885

ABSTRACT

OBJECTIVE: Previous evidence suggests heightened sensitivity to life-threatening challenges among offspring of Holocaust survivors (OHS). Therefore, this study examined the psychological reactions of aging OHS during the COVID-19 pandemic. METHOD: A convenience sample (N = 297, mean age = 66.85) of North American Jews rated posttraumatic stress disorder (PTSD) symptoms for their parents and for themselves. They further rated their psychological distress, COVID-19-related worries, loneliness, and social support. Respondents were divided into four groups: OHS with two parents with probable PTSD, with one such parent, with no such parent, and comparisons whose parents did not undergo the Holocaust. RESULTS: OHS with two parents with PTSD reported the highest levels of PTSD symptoms. Controlling for respondents' own PTSD, OHS with two parents with PTSD reported higher psychological distress relative to comparisons. Moreover, OHS with parental PTSD reported higher loneliness relative to OHS without parental PTSD or comparisons. The groups did not differ in COVID-19-related worries or social support. CONCLUSIONS: The distress experienced by OHS with parental PTSD seems more general, and is possibly related to the multiple coalescing crises that occurred since the pandemic began, rather than to the health risk associated directly with COVID-19. Moreover, while OHS acknowledge having good social support, some of them nevertheless feel lonely. This possibly reflects unique interpersonal difficulties characteristic in Holocaust survivor families. These findings suggest that OHS with parental PTSD (especially when both parents had symptoms) represent a group of older adults who are relatively susceptible to negative psychological effects of the current pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Adult Children/psychology , COVID-19/psychology , Holocaust/psychology , Pandemics , Stress Disorders, Post-Traumatic/psychology , Aged , Anxiety/psychology , Female , Humans , Jews/psychology , Male , Middle Aged , Survivors/psychology
14.
IEEE Pulse ; 12(1): 19-23, 2021.
Article in English | MEDLINE | ID: covidwho-1091097

ABSTRACT

In mid-March 2020, as the novel coronavirus started making its way through the United States, Fiona Lowenstein (they/their) became ill. At that point, there was not yet any public health guidance on social distancing and wearing masks, and certainly no routine or readily accessible testing for COVID-19. Lowenstein was still interacting with others in person, and even led a yoga class. But when they became sick and were hospitalized, they were tested for SARS-CoV2 and received a positive diagnosis.


Subject(s)
COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Survivors , COVID-19/physiopathology , COVID-19/psychology , Chronic Disease , Humans , Mobile Applications , Self-Help Groups , Social Media , Survivors/psychology , Survivors/statistics & numerical data , Time Factors , United States/epidemiology
15.
Stroke ; 52(4): 1407-1414, 2021 04.
Article in English | MEDLINE | ID: covidwho-1085243

ABSTRACT

BACKGROUND AND PURPOSE: The coronavirus disease 2019 (COVID-19) outbreak has led to disruptions in health care service delivery worldwide, inevitably affecting stroke survivors requiring ongoing rehabilitation and chronic illness management. To date, no published research has been found on stroke caregiving during the COVID-19 pandemic. This study aimed to explore Hong Kong stroke caregivers' caregiving experiences in the midst of this difficult time. METHODS: Individual semistructured interviews were conducted with 25 Chinese adult primary stroke caregivers from May to June 2020 via telephone. Interviews were transcribed verbatim and analyzed using an interpretive description approach and constant comparison strategy. RESULTS: Five themes of the stroke caregiving experience during the COVID-19 pandemic emerged: care service adversities, additional caregiving workload and strain, threatened relationship between caregiver and stroke survivors, threats to caregivers' physical and psychological well-being, and needs for continuing caregiving roles. Our findings suggested that caregivers have worsened physical and psychological well-being because of increases in care burden with simultaneously reduced formal and informal support. The relationship between caregiver and stroke survivor was subsequently affected, placing some survivors at heightened risk of abuse. CONCLUSIONS: Our study provides valuable findings about stroke caregiving experiences and needs during the pandemic. Delivery of psychological support, telemedicine, and household hygiene resources would be useful to mitigate caregivers' psychological distress during the COVID-19 pandemic.


Subject(s)
COVID-19/psychology , Caregivers/psychology , Pandemics , Qualitative Research , Stroke Rehabilitation/psychology , Stroke/psychology , Adult , Aged , COVID-19/epidemiology , Caregivers/trends , China/epidemiology , Female , Hong Kong/epidemiology , Humans , Male , Middle Aged , Social Support , Stroke/epidemiology , Stroke/therapy , Stroke Rehabilitation/trends , Survivors/psychology
16.
Soc Sci Med ; 274: 113748, 2021 04.
Article in English | MEDLINE | ID: covidwho-1084590

ABSTRACT

Understanding the health-related quality of life (HrQoL) of hospitalized COVID-19 survivors is an emerging global challenge arising from the current pandemic. A qualitative study of the experiences of sixteen hospitalized COVID-19 survivors from Nanning City, China, was conducted using semi-structured telephone interviews in May 2020. These first-hand accounts were critically and empirically analysed to identify emerging health and social issues, and provide potential solutions to improve survivors' quality of life. This in-depth, qualitative study of HrQoL for hospitalized COVID-19 survivors provides the first empirical evidence and conceptual framework with eight dimensions (physical symptoms, anxiety, trauma, economic loss, place-based identity, self-stigma, health self-interventions, and changing lifestyle) for understanding the physiological, psychological, socio-economic and health behavioral aspects of their daily lives. We argue that local and global governments should provide integrated healthcare, social and digital infrastructure to support this vulnerable group. More comparative and multi-disciplinary studies in this area are needed to generate academic standards of assessing health-related quality of life and produce good practice guidelines for promoting urban resilience in response to public health disasters.


Subject(s)
COVID-19/therapy , Quality of Life/psychology , Survivors/psychology , Adaptation, Psychological , COVID-19/psychology , China , Humans , Interviews as Topic , Qualitative Research , SARS-CoV-2
19.
J Intern Med ; 290(3): 621-631, 2021 09.
Article in English | MEDLINE | ID: covidwho-1061082

ABSTRACT

BACKGROUND: The general medical impacts of coronavirus (COVID-19) are increasingly appreciated. However, its impact on neurocognitive, psychiatric health and quality of life (QoL) in survivors after the acute phase is poorly understood. We aimed to evaluate neurocognitive function, psychiatric symptoms and QoL in COVID-19 survivors shortly after hospital discharge. METHODS: This was a cross-sectional analysis of a prospective study of hospitalized COVID-19 survivors followed up for 2 months after discharge. A battery of standardized instruments evaluating neurocognitive function, psychiatric morbidity and QoL (mental and physical components) was administered by telephone. RESULTS: Of the 229 screened patients, 179 were included in the final analysis. Amongst survivors, the prevalence of moderately impaired immediate verbal memory and learning was 38%, delayed verbal memory (11.8%), verbal fluency (34.6%) and working memory (executive function) (6.1%), respectively. Moreover, 58.7% of patients had neurocognitive impairment in at least one function. Rates of positive screening for anxiety, depression and post-traumatic stress disorder were 29.6%, 26.8% and 25.1%, respectively. In addition, 39.1% of the patients had psychiatric morbidity. Low QoL for physical and mental components was detected in 44.1% and 39.1% of patients respectively. Delirium and psychiatric morbidity were associated with neurocognitive impairment, and female gender was related with psychiatric morbidity. CONCLUSION: Hospitalized COVID-19 survivors showed a considerable prevalence of neurocognitive impairment, psychiatric morbidity and poor QoL in the short term. It is uncertain if these impacts persist over the long term.


Subject(s)
COVID-19/psychology , Cognition Disorders/etiology , Memory Disorders/etiology , Quality of Life , Survivors/psychology , Adult , Aged , Aged, 80 and over , Anxiety/etiology , Cross-Sectional Studies , Depression/etiology , Female , Humans , Male , Memory, Short-Term , Middle Aged , Prospective Studies , SARS-CoV-2 , Sex Factors , Stress Disorders, Post-Traumatic/etiology , Young Adult
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