Person-Centered Healthcare Practice in a Pandemic Context: An Exploration of People's Experience of Seeking Healthcare Support

Abstract

Background: The recent COVID-19 pandemic increased pressure upon healthcare resources resulting in compromised health services. Enforced national lockdown led to people being unable to access essential services in addition to limiting contact with social support networks. The novel coronavirus, and subsequent condition known as long covid were not well-understood and clinicians were not supported by existing guidelines or pathways. Our study explored people's experiences of healthcare during this period with a person-centered “lens.”Methods: Ninety-seven people participated in our online survey about their experiences of the pandemic, particularly while socially isolated and their experiences of healthcare. Following completion of the survey, 11 of these participants agreed to further semi-structured interviews to explore this further in their own words. Interview conversations were transcribed, checked; together with the responses to open questions in the survey. The data were then analyzed thematically by members of the research team. We conducted framework analysis from a post-positivist perspective, using the Person-centered Practice Framework to explore participants' experiences.Results: There were few examples of people describing person-centered care. People experienced barriers to accessing support, and negative experiences of care that represented complexities enacting person-centered care at each level of the framework (processes, practice environment, prerequisites, and macro context). These barriers were influenced greatly by the pandemic, for example, with health professionals being harder to access. Some experiences related to the ways in which health professionals responded to the context, for example, positive examples included active listening, recognition of people's experiences, seeking to find out more, and engaging in collaborative problem-solving.Discussion: People want to feel heard, supported to navigate healthcare systems, source trustworthy information, find appropriate services, and collaborate in learning and problem-solving with healthcare professionals. There have been enormous challenges to the provision of healthcare throughout the pandemic. Moving forward is crucial with emphasis on overcoming barriers to person-centered healthcare. This should focus on steps now and also in planning for the possibility of further rapid changes in the demand for and provision of healthcare.

Barriers and enablers to delivering opportunistic behaviour change interventions during the COVID‐19 pandemic: A qualitative study in healthcare professionals

“…Similarly, pharmacists used innovative ways to engage with patients during mandatory post-vaccination wait. While many of the findings, such as a lack of time and workload pressures, are echoed in the literature as barriers to the implementation of opportunistic health behaviour change interventions pre-pandemic (Keyworth et al, 2019(Keyworth et al, , 2020bParchment et al, 2021), the current results add to the evidence that the health service overall, in its response to the pandemic, became less holistic and patient-centred (Curnow et al, 2021). Thus, it is paramount that the NHS is equipped with the resources and tools to ensure that the prevention and management of long-term health conditions is a focus of routine healthcare consultations in the months to come.…”

Global Healthcare Needs Related to COVID-19: An Evidence Map of the First Year of the Pandemic

“…The saturation of the health systems led to a decrease in the quality of services [ 19 , 20 ] and person-centered care [ 21 ]. Patients encountered barriers to accessing health services [ 21 , 22 ], communication difficulties with healthcare providers [ 23 ], and lack of social support, among other difficulties [ 22 , 24 ].…”

“…The saturation of the health systems led to a decrease in the quality of services [ 19 , 20 ] and person-centered care [ 21 ]. Patients encountered barriers to accessing health services [ 21 , 22 ], communication difficulties with healthcare providers [ 23 ], and lack of social support, among other difficulties [ 22 , 24 ]. COVID-19 patients have had pronounced healthcare needs, with approximately half of them needing physical, cognitive, and psychological follow-up care post-acute symptoms’ resolution [ 25 , 26 , 27 ].…”

"There is no one who helps you with it." Experiences of people with long COVID regarding medical care, therapeutic measures, and barriers in the German healthcare system: results of a qualitative study with four focus groups

“…First studies have shown that many people with long COVID perceive their medical care as inadequate [22], [23]. They describe a lack of acceptance of their symptoms by health professionals, which leads to uncertainty and the feeling of being left alone [22], [24], [25]. This represents an obstacle to needs-based medical care.…”