The COVID-19 experience and rehabilitation insights from formerly hospitalised individuals and physiotherapists in Malta : a qualitative study

Abstract

This qualitative study investigates the post-COVID-19 experiences of previously hospitalised COVID-19 patients with Post Covid-19 Condition and the perspectives of physiotherapists treating them. The study investigates the impact of post-COVID symptoms, mental health, life satisfaction, hospitalisation, discharge, and the rehabilitation process, as well as the effects on the local healthcare system, as perceived by physiotherapists and patients. Literature Review: A significant gap was identified particularly within the local context, between the emerging rehabilitation needs of individuals with PCC, the current experiences of physiotherapists and the long-term impacts of COVID-19, including hospitalisation and post-discharge experiences. Methodology: The perspective of both the patients and the physiotherapists was explored through qualitative methods. Individual interviews and focus groups, were used for data collection, and thematic analysis was conducted using NVivo software. Results: The study identified ten key themes, including the mastery of breathing control, the seriousness of COVID-19, considerations regarding future major interventions including lung transplants, less intensive rehabilitation post-ITU, the crucial role of relatives, courage and motivation as survival factors, appreciation for healthcare professionals, PTSD resulting from hospitalisation, the burden of caring for COVID-19 patients, and recommendations for healthcare improvement. Discussion: The study underlines the significance of breathing control as a foundation for rehabilitation and highlights shortness of breath as a major limitation for patients, leading to psychological distress, reduced quality of life, and disruptions in daily activities. Physiotherapists had to adapt their sessions due to patient fatigue, emphasising the importance of tailored and manageable approaches to post-extubation. The study also emphasizes the profound impact of COVID-19, both physically and psychologically, including financial burdens, post-intubation effects, and symptoms of PTSD. Patients experienced a shift from independence to dependency during their hospitalisation, with limited psychological support available. Family played a pivotal role in the recovery process, acting as motivators and sources of support for patients. Physiotherapists faced their own challenges, including restricted patient contact, feelings of inadequacy, and the need to adapt to new protocols. However, the majority of participants experienced positive outcomes through pulmonary rehabilitation, highlighting its importance for recovery and socialization. Both positive and negative sentiments were evident when discussing hospitalisation conditions. Notably, patients' narratives frequently highlighted themes of family support, psychological growth, and gratitude towards healthcare professionals as significant aspects of their experiences. Conclusion & Recommendations: Improvement include enhancing mental health services, prioritizing patient communication, ensuring resource availability, promoting accurate information in the media, expanding human resources, collecting more data, improving employee training, respecting patient information rights, continuing research efforts by conducting longitudinal studies on Post Covid-19 Condition specifically targeting non-hospitalised individuals, paediatric populations, and increasing the sample sizes. Overall, this study helps to increase the knowledge on the multifaceted challenges faced by patients and the valuable insights of physiotherapists, offering a comprehensive perspective on the post-COVID-19 experience and highlighting the need for improvements in healthcare services and support systems.