gms | German Medical Science

Background: The COVID-19 pandemic brought far-reaching changes to healthcare and other parts of society. The measures required to contain the outbreak, such as contact restrictions and social distancing, have led to numerous challenges for all stakeholders in healthcare, where the protection of patients, in addition to the protection of staff, is of great importance. These challenges are also pronounced in medical rehabilitation facilities when it comes to ensuring patient-centered rehabilitation while minimizing the risk of infection.

Question and objective: To cope with these challenges, providers of rehabilitation have developed different strategies. The aim of the present qualitative study was to investigate how these strategies are perceived by (potential) patients in rehabilitative care.

Methods: 33 telephone interviews, assisted by an interview guide, were conducted with rehabilitation patients and potential applicants. The interviewees were recruited through two cooperation hospitals, social media and a network-based snowballing approach. The interview guide included reasons for or against the decision to apply for rehabilitation, perceived impact of the pandemic on rehabilitation, satisfaction with strategies in rehabilitation hospitals, needs and potential challenges during care at the facility, support from health care staff, and needs and expectations with regard to better support during the pandemic. Interviews were analyzed using Kuckartz qualitative content analysis.

Results: Despite measures and strategies to deal with COVID-19, rehabilitation, in most cases, is perceived as relieving and promoting health. On the one hand, fewer patients, smaller group sizes and fixed group members and therapists lead to positive patient experiences. In addition, wellness opportunities and the social contact with fellow patients or therapists are associated with a feeling of freedom. On the other hand, patients experienced feelings of isolation and loneliness during the rehabilitation due to the cancellation of leisure activities, the closure of public spaces and seating areas within the clinic, and bans on visits. Overall, they found frequent and sometimes incomprehensible changes in rules and measures frustrating.

Discussion: Patients’ perceptions of rehabilitation in times of COVID-19 vary greatly based on their own health status, perceived risk of infection, personal attitudes toward COVID-19, and individual views. Healthcare users demand a balance between infection control measures for their own health protection on the one hand and maintaining social interaction on the other hand.

Practical implications: In order to meet the challenges of the pandemic and to provide patient-centered rehabilitative care now and in future crisis situations, strategies must be developed to consider diverse patients and implement interventions in a way that provides necessary safety precautions but continues to address psychosocial needs.

Appeal to practice (sciene or/and care) in one sentence: Existing measures and strategies for addressing pandemic situations must be evaluated and further developed and should lead to generally applicable guidelines for rehabilitation facilities and their staff.

Funding: Einzelförderung (BMG, DRV, BMBF, DFG, etc); 0421/40-64-50-70