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. 2023 Jan 10:10:1023431.
doi: 10.3389/fpubh.2022.1023431. eCollection 2022.

Experiencing COVID-19, home isolation and primary health care: A mixed-methods study

Sandra Parisi  1 , Nina Lehner  1 , Hanna Schrader  1 , Leonard Kierer  1 , Anna Fleischer  2 , Olga Miljukov  3 , Gabor Borgulya  1 , Gernot Rüter  4 , Annika Viniol  5 , Ildikó Gágyor  1
Affiliations

Experiencing COVID-19, home isolation and primary health care: A mixed-methods study

Sandra Parisi et al. Front Public Health. .

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.

Keywords: COVID-19; Germany; general practice; home isolation; illness experience; mixed methods; patients' experience; telehealth.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Mixed methods convergent design using parallel data collection with an iterative approach.
Figure 2
Figure 2
Flowchart of study recruitment.
Figure 3
Figure 3
Distribution of survey participants per federal state. Adapted by NL from Peter Hermes Furian–shutterstock.com, with permission.
See this image and copyright information in PMC

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