Experiences of COVID-19 patients with person-centred care during cohort isolation: A mixed-method study

Introduction
Quality of care may have been compromised during the exceptionally hectic period of the COVID-19 waves, including isolation precautions.

Aims
Experiences with person-centred care and wellbeing of COVID-19 patients admitted to a cohort isolation nursing ward during the first pandemic wave were explored, including differences between the acute phase (March 2020) and semi-acute phase (April-June 2020).

Methods
A convergent parallel mixed-method design was used. Adult no post-ICU patients visiting the outpatient clinic for COVID-19 aftercare between May and September 2020 six to eight weeks after discharge from the COVID-19 hospital ward were asked to participate. Part 1 comprised Patient Reported Experience Measure (PREM) questionnaires (n=134) and part 2 semi-structured interviews (n=30). Thematic analysis was performed, and themes were linked to the domains of the person-centred care framework.

Results
Part 1: Median scores on all the questions of the PREM were high. The lowest scores on the PREM questionnaire were seen on shared decision-making during the acute phase.

Part 2: In line with this, the interviews also indicated that the majority of patients had positive experiences regarding person-centred care and that patients felt a limited need for interaction in shared decision-making. Additionally, it was learned from the interviews that the domain care environment was affected most by the pandemic: the isolation precautions had an impact on patients’ wellbeing, although they understood the necessity for isolation precautions to protect others. Patients felt lonely, missed physical contact with family and friends, and felt that contact with healthcare professionals was influenced by isolation clothes. Although some still felt isolated, the cohort department contributed to a feeling of engagement with other patients having the same illness.

Conclusion
Delivered care was positively experienced by patients despite the hectic outbreak period. Patients understood and adapted their preferences to the circumstances. However, patients’ wellbeing was influenced by the circumstances in which care was received. To improve patients’ wellbeing during isolation, recognisability of healthcare workers should be stimulated, visits from family and friends should be allowed, and no use of single-room isolation is advised.