The impact of the COVID-19 pandemic on mental health and well-being of people living with a long-term physical health condition: a qualitative study

  1. A. Fisher
  2. A. Roberts
  3. A. R. McKinlay
  4. D. Fancourt
  5. A. Burton

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Abstract

Background

The COVID-19 pandemic and associated restrictions caused major global disruption. Individuals with long-term physical health conditions (LTCs) are at higher risk of severe illness and often subject to the strictest pandemic guidance, so may be disproportionally affected. The aim of this study was to qualitatively explore how living with a LTC during the COVID-19 pandemic affected people’s mental health and wellbeing.

Methods

Participants were people living with LTCs who participated in telephone/video call interviews based on a semi-structured topic guide. Key themes and subthemes were determined using deductive and inductive thematic analysis.

Results

The sample included 32 participants with LTCs (most commonly cancer, respiratory conditions or cardiovascular diseases), mean age 57 (SD 13) years, 66% female and 72% white British. There were four overarching themes specific to living with a LTC. These were 1) high levels of fear and anxiety related to perceived consequences of catching COVID-19, 2) impact of shielding/isolation on mental health and wellbeing, 3) experience of healthcare during the pandemic and 4) anxiety created by uncertainty about the future. Fourteen subthemes were identified, including concerns about accessing essential supplies and the importance of social support. Individuals who lived alone and were advised to shield could be profoundly negatively affected.

Conclusions

This study found that there were a number of aspects of living with a LTC during the pandemic that had a significant impact on mental health and well-being. There should be focus on how best to provide practical and social support to people with LTCs during a pandemic, particularly if they have to shield or isolate.

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  1. Version published to 10.1186/s12889-021-11751-3
  2. ScreenIT

    SciScore for 10.1101/2020.12.03.20243246: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethical approval was provided by UCL Ethics Committee (Project ID 14895/005) and all participants provided informed written consent prior to interview.
    Consent: Ethical approval was provided by UCL Ethics Committee (Project ID 14895/005) and all participants provided informed written consent prior to interview.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableInterviews were conducted via telephone or video call by four female Health Psychology/Social Science postdoctoral researchers experienced in qualitative interviewing (AR, AM, RC, SE).

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and limitations: To the best of our knowledge, this was the first study to qualitatively explore the impact of the COVID-19 pandemic and associated restrictions in the UK on the mental health and well-being of people with LTCs. In this paper we focussed on the emergent themes that were specific to living with an LTC. However, there were other more general themes discussed so this study alone may not reflect the full experience of living through the pandemic. However, since this work was conducted in parallel with studies in older adults, people with mental health conditions, parents of young children and many others, the more general overlapping themes will be presented in future papers. Our findings support large-scale quantitative surveys, but build on these by providing valuable depth and context, as well as factors that could potentially mitigate some of the negative impacts. The strength of qualitative research is that is can provide rich insights into people’s lived experience not attainable through quantitative methods. Interviews were conducted via video call or telephone, so could have missed some of the non-verbal cues and ability to build rapport and trust between participant and interviewer in person (Knox & Burkard, 2009). However, pandemic restrictions meant that in-person interviewing was not feasible, participants could choose telephone or video and the length and content of interviews suggest that participants still felt able to have an authentic di...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.12.03.20243246v2 on medRxiv
  4. Version published to 10.1101/2020.12.03.20243246v1 on medRxiv