Beyond the case numbers: Social determinants and contextual factors in patient narratives of recovery from COVID-19

Danielle Hitch; Elle Deféin; Melanie Lloyd; Bodil Rasmussen; Kimberley Haines; Eleanor Garnys; Western Health COVID-19 Recovery Collaboration (WHCOVRE)

doi:10.1016/j.anzjph.2022.100002

Beyond the case numbers: Social determinants and contextual factors in patient narratives of recovery from COVID-19

Aust N Z J Public Health. 2023 Feb;47(1):100002. doi: 10.1016/j.anzjph.2022.100002. Epub 2023 Jan 27.

Authors

Danielle Hitch¹, Elle Deféin², Melanie Lloyd³, Bodil Rasmussen⁴, Kimberley Haines⁵, Eleanor Garnys⁶; Western Health COVID-19 Recovery Collaboration (WHCOVRE)³

Affiliations

¹ Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St. Albans, Victoria 3021, Australia; School of Health and Social Development, Deakin University, Locked Bag 20000, Geelong, Victoria 3200, Australia. Electronic address: Danielle.Hitch@wh.org.au.
² School of Health and Social Development, Deakin University, Locked Bag 20000, Geelong, Victoria 3200, Australia.
³ Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St. Albans, Victoria 3021, Australia.
⁴ Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St. Albans, Victoria 3021, Australia; University of Southern Denmark and Steno Diabetes Center, Odense, Denmark; School of Nursing and Midwifery, Deakin University, Locked Bag 20000, Geelong, Victoria 3200, Australia; Institute of Health Transformation, Deakin University, Locked Bag 20000, Geelong, Victoria 3200, Australia.
⁵ Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St. Albans, Victoria 3021, Australia; Centre for Integrated Critical Care, University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia.
⁶ Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St. Albans, Victoria 3021, Australia; School of Health and Social Development, Deakin University, Locked Bag 20000, Geelong, Victoria 3200, Australia.

Abstract

Objective: This study aimed to describe and contextualise COVID-19 recovery from the perspective of patient-lived experience, to inform the evolving public health response to the pandemic.

Methods: Narrative interviews were completed with 37 adult Australians between six and 10 months following their COVID-19 diagnosis. Verbatim transcripts were analysed thematically and trustworthiness was supported by multiple strategies to ensure rigour.

Results: Three themes were identified: 1) trajectories of recovery, 2) back to 'some sort of normal' and 3) the importance of work. Resumed participation in activities of daily life, the influence of social determinants of health and the impact of contextual factors were prominent features in the recovery narratives.

Conclusions: The COVID-19 pandemic presents both challenges and opportunities for public health systems to formulate appropriate responses and make improvements. Behind the case numbers, patient narratives described the uncertainty, diversity and multiple pathways to recovery that need to inform public health policy.

Implications for public health: Looking beyond the case numbers reveals a complex landscape characterised by uncertainty, diversity and multiple pathways to recovery. The pandemic presents challenges and opportunities for public health in Australia and New Zealand, lived experience expertise is crucial to the formulation of an effective response.

Keywords: COVID-19; lived experience; long Covid; post-acute COVID-19 syndrome; recovery; social determinants.

MeSH terms

Adult
Australia / epidemiology
COVID-19 Testing
COVID-19*
Humans
New Zealand
Pandemics
Post-Acute COVID-19 Syndrome
Social Determinants of Health*