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

Abstract

BackgroundThe 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.Sample and methods32 participants, mean age 57 (SD 13) years, 66% female and 72% white British, who reported having LTCS (most commonly cancer, respiratory conditions or cardiovascular diseases), 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.ResultsThere 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.ConclusionsThis 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.

Covid-19 Coping Survey: an In-depth Qualitative Analysis of Free-Text Responses from People With and Without Existing Health Conditions in the UK

“…Similarly to Fisher et al [27], this study indicates that people with EHCs may be fearful of reintegrating into society following prolonged social isolation. This is concerning as fear responses could fuel avoidance coping strategies and reinforces calls for increasing psychological support for high-risk individuals [36].…”

“…These studies show that the pandemic had a mainly negative impact on psychological and social wellbeing and daily functioning, but were specific to people with existing mental health difficulties [25] and respiratory conditions [26]. Another study reported a range of impacts of the global pandemic on the mental health and well-being of people with long-term conditions (LTCs) in the UK, particularly social isolation and healthcare access and delivery, but did not address implications on coping behaviour [27].…”

‘Stressed, uncomfortable, vulnerable, neglected’: a qualitative study of the psychological and social impact of the COVID-19 pandemic on UK frontline keyworkers

“…3 Being at increased risk of COVID-19 susceptibility is likely to have a detrimental impact on mental health and well-being due to the perceived negative consequences of infection, as documented in studies with older adults 17 and those with long-term health conditions. 18 Second, many keyworkers, particularly those from low-income, service or elementary occupations, may face financial challenges that increase susceptibility to COVID-19. 2 For example, although the Coronavirus Act 2020 extended Statutory Sick Pay (SSP) to all UK employees, the scheme is based on contractual hours.…”

The impact of the COVID-19 pandemic on adult mental health in the UK: A rapid systematic review

“…COVID-19 related anxiety also led to reduced well-being and increased depression and anxiety [12, 81, 82, 83]. In some cases, this has led to acute stress presentations to hospital [84].…”

“…Having to self-isolate [57] and shield [66, 82, 89, 90] have led to poorer mental health. Indeed, feelings of loneliness and isolation were a key risk factor for poorer mental health [53, 91; 61, 57].…”