LONG COVID FEATURE
The survey questions had been written by our AHP professional leadership team and the patient experience team . These were designed to capture any ongoing physical issues , nutritional changes , cognitive and communication difficulties , changes in sleeping patterns and any mental health and wellbeing issues post COVID-19 , while linking these with the impact on the individuals ’ activities of daily living , both at home and work .
We also asked what , if any , further rehabilitation support would be most helpful and which format would be easiest to access it . An open question was also asked about their experience in hospital .
A group of five AHPs began to contact the initial wave of patients five to six weeks after discharge ; these patients had been discharged between 12 March and 29 April 2020 ; 122 telephone calls were completed and a postal survey or email link was also offered .
On average the calls lasted approximately 15 to 20 minutes , however , we gave everyone the opportunity to express their personal experience should they choose to do so .
I then went on to continue to contact patients as they were discharged until August , when the last of our ‘ first wave ’ of patients was discharged home . In total , 435 COVID-19 follow up telephone calls were made as part of this survey .
We had 262 responses in total : 201 patients took part in the telephone survey ; of the 134 postal surveys sent out , 43 responded ; of the 21 email links sent out , 18 responded ; 79 patients verbally declined .
The vast majority of patients were extremely keen to discuss their recovery phase , return to daily activities and the relationship between any ongoing symptoms and the impact on occupational performance .
There were some fascinating narratives , along with some deeply difficult and sad experiences . Participants were reassured to hear that they were not alone in their experience and advice on how to obtain further support or a referral into community services was offered .
The team sent out self-help leaflets , including the RCOT ( 2020 ) ‘ How to conserve your energy ’ and ‘ How to manage post-viral fatigue after COVID-19 ’ leaflets .
The overwhelming deficits patients identified following discharge for the first five to six weeks were fatigue , weakness and breathlessness , or a combination of all three . People found that they were struggling to concentrate and remember things , feeling low , sad and anxious , which had an impact on their self-confidence and participation in day-to-day activities .
The survey data showed that regardless of age , COVID-19 had a profound impact on people ’ s physical and emotional wellbeing .
We now know that these ongoing symptoms , ‘ Long COVID ’, continue to plague a large percentage of people who contract the virus , and the impact on not only their lives , but also on the NHS will continue for some time to come .
Our findings also concurred with results from studies undertaken by Halpin et al ( 2021 ) and Ladds et al ( 2020 ) and a report by Mahase ( 2020 ).
We have all had very different rivers to negotiate , both at work and at home . I have no experience of working on ‘ the front line ’ during this pandemic and have the upmost admiration and respect to all those who have , as I have been shielding for much of the pandemic .
I have personally found that the tool box of skills we are afforded as occupational therapists has assisted me in my own journey . I have accepted that 23 March 2020 was indeed my last shift with the rapid assessment team in the emergency department , but the past year has opened up new doors and given me the chance to embrace new opportunities and develop new skills , for which I am ever thankful .
We , as occupational therapists , are ideally placed to support the research and the rehabilitation agendas , both from COVID-19 and Long COVID ( Drummond and Lannin 2020 ) and we should embrace these new challenges . Grab every opportunity and be kind to yourself .
References
Christiansen and Townsend ( 2004 ) Introduction to occupation : the art and science of living . Prentice Hall
Drummond A and Lannin NA ( 2020 ) Post-COVID-19 : issues and challenges for occupational therapy and the need for clinical trials . British Journal of Occupational Therapy , 83 ( 12 ): 721-722
Halpin SJ , McIvor C , Whyatt G , Adams A , Harvey O , McLean L , Walshaw C , Kemp S , Corrado J , Singh R , Collins T , O ’ Connor RJ , Sivan M ( 2021 ) Post discharge symptoms and rehabilitation needs in survivors of COVID-19 infection : a cross-sectional evaluation . Journal of Medical Virology , 93 ( 2 ), 1013-1022 . doi : 10.1002 / jmv . 26368 . Epub 2020 Aug 17 . PMID : 32729939 .
Ladds E ., Rushforth A ., Wieringa S . et al . ( 2020 ) Persistent symptoms after Covid-19 : qualitative study of 114 “ long Covid ” patients and draft quality principles for services . BMC Health Services Research , 20 , 1144 . https :// doi . org / 10.1186 / s12913-020-06001-y
Mahase E ( 2020 ) COVID-19 : What do we know about ‘ Long COVID ’? BMJ , 2020 , 370 : m2815 . DOI : doi : 10.1136 / bmj . m2815
Royal College of Occupational Therapists ( 2020 ) How to conserve your energy : practical advice for people during and after having COVID-19 . Available online at : www . rcot . co . uk / conserving-energy
Royal College of Occupational Therapists ( 2020 ) How to manage post-viral fatigue after COVID-19 : practical advice for people who have been treated in hospital . Available online at : www . rcot . co . uk / how-managepost-viral-fatigue-after-covid-19
Nicola Slade , senior occupational therapist , York and Scarborough Teaching Hospitals NHS Foundation Trust . With thanks to Ruth Ferguson , interim professional lead for occupational therapy , Vicky Mulvana-Tuohy , deputy chief AHP – lead for AHP professional standards , and Martha Hodge , specialist occupational therapist , for their encouragement , advice and support in writing this article
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