The Psychological Experience and Intervention in Post-Acute COVID-19 Inpatients

Abstract

Purpose COVID-19 patients faced first-hand the life-threatening consequences of the disease, oftentimes involving prolonged hospitalization in isolation from family and friends. This study aimed at describing the psychological intervention to address the psychological difficulties and issues encountered by the hospitalized post-acute COVID-19 patients in a rehabilitation setting. Patients and Methods Patients’ demographics, medical diagnosis, and neuro-psychological information were collected from March 2 nd to May 12 th , 2020. The main psychological issues and intervention strategies were collected. Results A total of 181 patients were hospitalized during this period. Among them, the 47.5% underwent psychological assessment (N=86; age: 74.58±13.39; 54.7% females). The most common psychological issues were acute stress disorders (18.6%), anxious and demoralization symptoms (26.7%), depression (10.5%%), and troublesome grief (8.1%). Once recovered from COVID-19, many patients were discharged home (38.4%), some received further rehabilitation in non-COVID-19 wards (41.9%), mostly due to pre-existent diseases (72.2%) rather than to COVID-19 complications (27.8%). Conclusion A great number of the hospitalized post-acute COVID-19 patients showed psychological issues requiring psychological intervention, the most common were anxiety, demoralization, acute stress, depression, and grief. The proposed psychological treatment for hospitalized COVID-19 patients was conducted in a Cognitive Behavioral framework. In particular, during the COVID-19 pandemic, psychological intervention is an important part of rehabilitation in the post-acute phase of the illness to reduce distress symptoms and improve psychological health.

Factors impacting resilience as a result of exposure to COVID-19: The ecological resilience model

“…According to literature (e.g., Bonanno & Diminich, 2013) [ 73 ], age may have a curvilinear relationship with resilience, with the younger and elder individuals at higher risk for psychological issues [ 74 – 76 ]. Thus, particular attention should be dedicated to individuals with unfavourable conditions and the already vulnerable groups, as great elderlies [ 63 , 77 ], patients with pre-existing medical diseases–e.g., cardiac, oncological [ 26 , 75 , 78 – 82 ], and health-care professionals [ 83 , 84 ] for which the COVID-19 may have increased the risk of developing dangerous consequences and detrimental effects on both physical and mental health.…”

From Fear to Hopelessness: The Buffering Effect of Patient-Centered Communication in a Sample of Oncological Patients during COVID-19

“…Second, the social desirability of respondents may have influenced their answers to the structured clinical interview. Additionally, despite the fact that administered structured interview showed good psychometric properties with good "infit" and "outfit" indices, the unfavorable environmental conditions (i.e., hygienic reasons) did not allow the use of any further assessment tool such as self-report questionnaires [8]. Still, the clinical interview allowed one to simultaneously investigate the three basic components for effective communication: verbal (i.e., the content of the message), non-verbal; (i.e., body language such as posture, gesture, facial expression, and spatial distance), and para-verbal (i.e., including tone, pitch, pacing and volume of the voice).…”

“…In line with previous research [8,44,80], due to the impossibility of using routinely paper-and-pencil assessment questionnaires, an ad hoc structured interview was created for this study and administered to oncological outpatients. The use of a structured interview was deemed appropriate to allow the investigation of the patients' thoughts, emotions, and psychological issues using standardized methodological procedures [8].…”

“…Although effective preventive policies were adopted by countries worldwide (i.e., social isolation, social distancing, school closures, reduction or suspension of economic activities, and curfew [8][9][10]), the COVID-19 epidemic continued to demonstrate a growing pattern of community transmission. Italy was one of the most affected countries during the outbreak, initially accounting for over 223.000 individuals infected by COVID-19 and more than 31.000 deaths [11].…”

Psychological Differences Among Healthcare Workers of a Rehabilitation Institute During the COVID-19 Pandemic: A Two-Step Study

“…Although most of the literature highlighted the negative impact of COVID-19 for health professionals (Benfante et al, 2020;Pappa et al, 2020), this study is one of the few trying to also consider the positive and protective factors as esteem, resilient coping, and the positivity of the experience (Rieckert et al, 2021). Recent studies also showed that the COVID-19 pandemic implied a severe psychological burden for health workers, but also COVID-19 patients and caregivers and the general population as well (Bruno et al, 2020;Nese et al, 2020;Panzeri and Rossi Ferrario, 2020;Parola et al, 2020;Que et al, 2020;Rossi Ferrario et al, 2021). Despite this fact, a significant number of people avoided seeking social support and/or professional psychological help (Ratti et al, 2017;Rossi and Mannarini, 2019), probably due to the associated social and personal stigma (Mannarini et al, 2018(Mannarini et al, , 2020Mannarini and Rossi, 2019).…”