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. 2023 Apr 14:18:607-617.
doi: 10.2147/CIA.S393732. eCollection 2023.

Chronic Disease Self-Management of Post-Acute Sequelae of COVID-19 Among Older Adults: A Mixed-Methods Analysis

Kamilah Thomas-Purcell #  1 , Rosemary Davenport #  2 , Victoria Ayala #  2 , Donrie Purcell #  3 , Raymond L Ownby #  2
Affiliations

Chronic Disease Self-Management of Post-Acute Sequelae of COVID-19 Among Older Adults: A Mixed-Methods Analysis

Kamilah Thomas-Purcell et al. Clin Interv Aging. .

Abstract

Introduction: Approximately 20-30% of individuals who contract acute coronavirus disease (COVID-19) infection develop longer term complications of their initial infection, referred to as Post-Acute Sequelae of SARS-CoV-2 infection (PASC). PASC is characterized by chronic, varying symptomatology.

Methods: Using a mixed methods study design, we aimed to gain insight into individuals' experience with PASC, including cognitive issues, fatigue, and sleep disturbances. We explored whether our previously developed application (app), aimed at improving self-management skills among individuals with chronic diseases, is relevant for individuals with PASC and gained information to adapt the app for individuals with PASC. The study included 19 individuals, aged 40 years and older, recruited from our research participant database, Nova Southeastern University clinics, and community locations. We included this age range because older adults are more likely to have comorbid conditions, allowing us to better understand the impact of COVID-19 infection in these individuals. Participants completed seven standardized self-report questionnaires online, and an individual semi-structured interview via videoconferencing. Quantitative data were assessed using descriptive statistics and calculating individuals' scores in relation to norms. Qualitative data were analyzed using a thematic analysis approach. Triangulation of the data was accomplished by calculating correlations between participants' responses on self-report scales and themes found in semi-structured interviews.

Results: Themes included disruption of everyday life, diverse physical symptoms, and cognitive problems including brain fog, fatigue, coping, and emotional upset. Quantitative analysis demonstrated that participants experienced high levels of fatigue, negative mood, cognitive problems, and overall reduction in health-related quality of life (HRQOL). Correlation analyses revealed that individual interview responses were related to participants' self-report of symptoms on standard questionnaires.

Discussion: Findings indicate that self-report questionnaires may reflect the experience of individuals with PASC and its impact. Additionally, further efforts to expand our prior mobile app are warranted among individuals with PASC.

Keywords: COVID-19; SARS-CoV-2 cognitive issues; health-related quality of life; long COVID; post-acute sequelae of SARS-CoV-2 infection; qualitative analysis; self-report questionnaires.

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Conflict of interest statement

Dr Raymond L Ownby is a stockholder of and officer in entity focused on the development of digital therapeutics for Enalan Communications, Inc. In addition, Dr Raymond L Ownby has a patent Assessment of Human Comprehension by an Automate Agent pending to Nova Southeastern University. The authors report no other conflicts of interest in this work.

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