Constitution of Long COVID illness, patienthood and recovery: a critical synthesis of qualitative studies

ObjectivesTo investigate the lived experiences of Long COVID.DesignCritical interpretive synthesis of qualitative research.Data sourcesPubMed and Web of Science databases were searched on 14 September 2023.Eligibility criteriaOriginal peer-reviewed qualitative studies describing the experiences of L...

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Published in:	BMJ open Vol. 14; no. 3; p. e083340
Main Authors:	Harrison, Mia, Rhodes, Tim, Lancaster, Kari
Format:	Journal Article
Language:	English
Published:	England British Medical Journal Publishing Group 28.03.2024 BMJ Publishing Group LTD BMJ Publishing Group
Series:	Original research
Subjects:	Chronic fatigue syndrome COVID-19 Focus groups Humans Illnesses Infections Long COVID Patient-centered care Patients Post-Acute COVID-19 Syndrome Qualitative Research Recovery (Medical) Severe acute respiratory syndrome coronavirus 2 United Kingdom > UK United States > US COVID-19 qualitative research patient-centered care patients post-acute COVID-19 syndrome
ISSN:	2044-6055, 2044-6055
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Abstract	ObjectivesTo investigate the lived experiences of Long COVID.DesignCritical interpretive synthesis of qualitative research.Data sourcesPubMed and Web of Science databases were searched on 14 September 2023.Eligibility criteriaOriginal peer-reviewed qualitative studies describing the experiences of Long COVID were eligible for inclusion.Data extraction and synthesisWe used established qualitative synthesis methods to search, screen and manually code the included studies. Critical interpretation methods were used to analyse the data and develop synthetic constructs.Results68 articles were identified in the first phase of sampling, with 16 studies and 879 participants included in the final synthesis. The analysis of these studies was organised into three thematic constructions of Long COVID: (1) the illness, (2) the patient and (3) recovery. Long COVID was diversely characterised across study approaches, designs and findings but was underpinned by shared diagnostic logics, which shaped the identification and measurement of symptoms. The boundaries between different constitutions of Long COVID in qualitative accounts of illness experience were often imprecise. Slippages between different definitions of Long COVID had implications for patient experiences in relation to diagnosis, help-seeking and care, and expectations of recovery.ConclusionsLong COVID is a site of multiple and diverse qualitative interpretation. Accounts of lived experience emphasise the constitutions of illness, patienthood and recovery as situated and emergent. The ongoing context-based negotiation of Long COVID is a defining qualitative feature of the condition. Approaches to researching, diagnosing and developing health interventions must be as adaptive as the varieties of Long COVID lived experience.
AbstractList	Objectives To investigate the lived experiences of Long COVID.Design Critical interpretive synthesis of qualitative research.Data sources PubMed and Web of Science databases were searched on 14 September 2023.Eligibility criteria Original peer-reviewed qualitative studies describing the experiences of Long COVID were eligible for inclusion.Data extraction and synthesis We used established qualitative synthesis methods to search, screen and manually code the included studies. Critical interpretation methods were used to analyse the data and develop synthetic constructs.Results 68 articles were identified in the first phase of sampling, with 16 studies and 879 participants included in the final synthesis. The analysis of these studies was organised into three thematic constructions of Long COVID: (1) the illness, (2) the patient and (3) recovery. Long COVID was diversely characterised across study approaches, designs and findings but was underpinned by shared diagnostic logics, which shaped the identification and measurement of symptoms. The boundaries between different constitutions of Long COVID in qualitative accounts of illness experience were often imprecise. Slippages between different definitions of Long COVID had implications for patient experiences in relation to diagnosis, help-seeking and care, and expectations of recovery.Conclusions Long COVID is a site of multiple and diverse qualitative interpretation. Accounts of lived experience emphasise the constitutions of illness, patienthood and recovery as situated and emergent. The ongoing context-based negotiation of Long COVID is a defining qualitative feature of the condition. Approaches to researching, diagnosing and developing health interventions must be as adaptive as the varieties of Long COVID lived experience. To investigate the lived experiences of Long COVID.OBJECTIVESTo investigate the lived experiences of Long COVID.Critical interpretive synthesis of qualitative research.DESIGNCritical interpretive synthesis of qualitative research.PubMed and Web of Science databases were searched on 14 September 2023.DATA SOURCESPubMed and Web of Science databases were searched on 14 September 2023.Original peer-reviewed qualitative studies describing the experiences of Long COVID were eligible for inclusion.ELIGIBILITY CRITERIAOriginal peer-reviewed qualitative studies describing the experiences of Long COVID were eligible for inclusion.We used established qualitative synthesis methods to search, screen and manually code the included studies. Critical interpretation methods were used to analyse the data and develop synthetic constructs.DATA EXTRACTION AND SYNTHESISWe used established qualitative synthesis methods to search, screen and manually code the included studies. Critical interpretation methods were used to analyse the data and develop synthetic constructs.68 articles were identified in the first phase of sampling, with 16 studies and 879 participants included in the final synthesis. The analysis of these studies was organised into three thematic constructions of Long COVID: (1) the illness, (2) the patient and (3) recovery. Long COVID was diversely characterised across study approaches, designs and findings but was underpinned by shared diagnostic logics, which shaped the identification and measurement of symptoms. The boundaries between different constitutions of Long COVID in qualitative accounts of illness experience were often imprecise. Slippages between different definitions of Long COVID had implications for patient experiences in relation to diagnosis, help-seeking and care, and expectations of recovery.RESULTS68 articles were identified in the first phase of sampling, with 16 studies and 879 participants included in the final synthesis. The analysis of these studies was organised into three thematic constructions of Long COVID: (1) the illness, (2) the patient and (3) recovery. Long COVID was diversely characterised across study approaches, designs and findings but was underpinned by shared diagnostic logics, which shaped the identification and measurement of symptoms. The boundaries between different constitutions of Long COVID in qualitative accounts of illness experience were often imprecise. Slippages between different definitions of Long COVID had implications for patient experiences in relation to diagnosis, help-seeking and care, and expectations of recovery.Long COVID is a site of multiple and diverse qualitative interpretation. Accounts of lived experience emphasise the constitutions of illness, patienthood and recovery as situated and emergent. The ongoing context-based negotiation of Long COVID is a defining qualitative feature of the condition. Approaches to researching, diagnosing and developing health interventions must be as adaptive as the varieties of Long COVID lived experience.CONCLUSIONSLong COVID is a site of multiple and diverse qualitative interpretation. Accounts of lived experience emphasise the constitutions of illness, patienthood and recovery as situated and emergent. The ongoing context-based negotiation of Long COVID is a defining qualitative feature of the condition. Approaches to researching, diagnosing and developing health interventions must be as adaptive as the varieties of Long COVID lived experience. To investigate the lived experiences of Long COVID. Critical interpretive synthesis of qualitative research. PubMed and Web of Science databases were searched on 14 September 2023. Original peer-reviewed qualitative studies describing the experiences of Long COVID were eligible for inclusion. We used established qualitative synthesis methods to search, screen and manually code the included studies. Critical interpretation methods were used to analyse the data and develop synthetic constructs. 68 articles were identified in the first phase of sampling, with 16 studies and 879 participants included in the final synthesis. The analysis of these studies was organised into three thematic constructions of Long COVID: (1) the illness, (2) the patient and (3) recovery. Long COVID was diversely characterised across study approaches, designs and findings but was underpinned by shared diagnostic logics, which shaped the identification and measurement of symptoms. The boundaries between different constitutions of Long COVID in qualitative accounts of illness experience were often imprecise. Slippages between different definitions of Long COVID had implications for patient experiences in relation to diagnosis, help-seeking and care, and expectations of recovery. Long COVID is a site of multiple and diverse qualitative interpretation. Accounts of lived experience emphasise the constitutions of illness, patienthood and recovery as situated and emergent. The ongoing context-based negotiation of Long COVID is a defining qualitative feature of the condition. Approaches to researching, diagnosing and developing health interventions must be as adaptive as the varieties of Long COVID lived experience. ObjectivesTo investigate the lived experiences of Long COVID.DesignCritical interpretive synthesis of qualitative research.Data sourcesPubMed and Web of Science databases were searched on 14 September 2023.Eligibility criteriaOriginal peer-reviewed qualitative studies describing the experiences of Long COVID were eligible for inclusion.Data extraction and synthesisWe used established qualitative synthesis methods to search, screen and manually code the included studies. Critical interpretation methods were used to analyse the data and develop synthetic constructs.Results68 articles were identified in the first phase of sampling, with 16 studies and 879 participants included in the final synthesis. The analysis of these studies was organised into three thematic constructions of Long COVID: (1) the illness, (2) the patient and (3) recovery. Long COVID was diversely characterised across study approaches, designs and findings but was underpinned by shared diagnostic logics, which shaped the identification and measurement of symptoms. The boundaries between different constitutions of Long COVID in qualitative accounts of illness experience were often imprecise. Slippages between different definitions of Long COVID had implications for patient experiences in relation to diagnosis, help-seeking and care, and expectations of recovery.ConclusionsLong COVID is a site of multiple and diverse qualitative interpretation. Accounts of lived experience emphasise the constitutions of illness, patienthood and recovery as situated and emergent. The ongoing context-based negotiation of Long COVID is a defining qualitative feature of the condition. Approaches to researching, diagnosing and developing health interventions must be as adaptive as the varieties of Long COVID lived experience.
Author	Rhodes, Tim Harrison, Mia Lancaster, Kari
AuthorAffiliation	1 Centre for Social Research in Health , University of New South Wales , Sydney , New South Wales , Australia 3 Goldsmiths, University of London , London , UK 2 London School of Hygiene & Tropical Medicine , London , UK
AuthorAffiliation_xml	– name: 3 Goldsmiths, University of London , London , UK – name: 2 London School of Hygiene & Tropical Medicine , London , UK – name: 1 Centre for Social Research in Health , University of New South Wales , Sydney , New South Wales , Australia
Author_xml	– sequence: 1 givenname: Mia orcidid: 0000-0001-8629-9901 surname: Harrison fullname: Harrison, Mia email: mia.harrison@unsw.edu.au organization: Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia – sequence: 2 givenname: Tim surname: Rhodes fullname: Rhodes, Tim organization: London School of Hygiene & Tropical Medicine, London, UK – sequence: 3 givenname: Kari surname: Lancaster fullname: Lancaster, Kari organization: Goldsmiths, University of London, London, UK
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/38548364$$D View this record in MEDLINE/PubMed
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SubjectTerms	Chronic fatigue syndrome COVID-19 Focus groups Humans Illnesses Infections Long COVID Patient-centered care Patients Post-Acute COVID-19 Syndrome Qualitative Research Recovery (Medical) Severe acute respiratory syndrome coronavirus 2
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Title	Constitution of Long COVID illness, patienthood and recovery: a critical synthesis of qualitative studies
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