Healthcare use during COVID-19 and the effect on psychological distress in patients with chronic cardiopulmonary disorders in the Netherlands: a cross-sectional study

Abstract

ObjectivesThe COVID-19 pandemic caused a massive shift in the focus of healthcare. Such changes could have affected health status and mental health in vulnerable patient groups. We aimed to investigate whether patients with chronic pulmonary and cardiac diseases had experienced high levels of psychological distress during the COVID-19 pandemic in the Netherlands.DesignA cross-sectional study.SettingCOVID-19 pandemic-related changes in healthcare use, health status and psychological distress were investigated among patients with chronic obstructive pulmonary disease (COPD), pulmonary fibrosis (PF) and congestive heart failure (CHF), using an online nationwide survey.Participants680 patients completed the survey. COPD was the most often reported diagnosis 334 (49%), followed by congestive heart failure 219 (32%) and PF 44 (7%). There were 79 (12%) patients with primary diagnosis ‘other’ than chronic cardiopulmonary disease, who also completed this survey.InterventionsPsychological distress was assessed via the DASS-21 score (Depression Anxiety Stress Scale). Moreover, specific worries and anxieties regarding COVID-19 were explored.ResultsThe frequency of contact with healthcare professionals changed in 52%. Changes in treatment were reported in 52%. Deterioration in health status was self-reported in 39%. Moderate to extremely severe levels of depression, anxiety and stress was observed in 25.8%, 28.5% and 14%, respectively. Over 70% reported specific worries and anxieties, such as about their own health and fear of being alone. Both the deterioration in health status and increased levels of anxiety were significantly (p<0.001, p<0.006) associated with changes in treatment. Exploratory analyses indicated that lack of social support may further increase anxiety.ConclusionHealthcare use changed during the COVID-19 pandemic in the Netherlands. It was associated with a decrease in health status, and increased psychological stress among patients with chronic cardiopulmonary disorders. Provision of healthcare should be more sensitive to the mental health needs of these patients during subsequent COVID-19 waves.

Determinants of Outpatient Physician Visits in the General Adult German Population during Later Stages of the COVID-19 Pandemic

“…With regard to psychosocial factors, a higher coronavirus anxiety was associated with a lower number of specialist visits in our study. This is very plausible, as individuals with a high coronavirus anxiety may be afraid of a COVID-19 infection while on their way to the specialist’s office [ 1 ]. It is difficult to compare our findings regarding the association between higher coronavirus anxiety and outpatient physician visits with previous studies due to a lack of previous quantitative studies.…”

“…Outpatient physician services (GP or specialist visits) reflect an integral part of HCU. We particularly assume that individuals avoid using outpatient physician services since they may fear an infection with COVID-19 (e.g., while travelling to the doctor or during the waiting time in the practice) [ 1 ].…”

Common Infections and Antibiotic Prescribing during the First Year of the COVID-19 Pandemic: A Primary Care-Based Observational Cohort Study

“…Although primary care services remained accessible throughout the first pandemic year, health care delivery and consultation behavior changed significantly for infectious as well as non-infectious illnesses [ 4 , 5 , 6 , 7 ]. After the first wave of the pandemic, we evaluated primary care presentation and antibiotic prescribing for common infection episodes in the Netherlands, and found a sharp decrease in respiratory and ear infections (after a sudden initial peak), with a concomitant decrease in antibiotic use [ 8 ].…”

A Nursing Philosophy of Chronic Disease Services-Based Palliative Care Nursing During Covid-19

“…Many cancer patients during the COVID-19 pandemic reported symptoms of anxiety and depression and used antidepressant drugs to treat these symptoms (Rodriguez et al, 2022). The contact of chronic disease sufferers with health workers is also reduced, resulting in increased stress (Pouwels and Send mail to Pouwels B.D.C. ;Simons, Sami Ob;Theunissen, Mauricec;Peters, Madelon Ld;Schoenmaekers, Janna Je;Bekkers, Sebastiaan Cf;Van Den Beuken-Van Everdingen, 2021).…”