The GP can't help me, there's no point bothering them: exploring the complex healthcare journeys of NHS workers in Scotland suffering from long COVID: a longitudinal study.

Abstract

Globally, Long COVID (LC) affects around 40% of people infected with COVID-19 (Chen et al, 2022). Despite high prevalence, symptoms are variable, and no clear healthcare pathway models exist for diagnosis and treatment. The Candidacy Framework describes how individuals conceptualise their eligibility for accessing healthcare services and legitimise service engagement (Dixon-Woods et al., 2006). Anticipation of poor communication with healthcare professionals, and poor expectations of knowledge and advice, deter healthcare engagement. Conversely, positive beliefs regarding accessing clear illness information facilitate healthcare interactions. Determining factors are complicated in the context of LC, where candidacy domains such as Professional Adjudication are conflated with the high demand for NHS services and lack of knowledge surrounding diagnosis, classification and management of LC symptoms. We apply the Candidacy Framework to make sense of the often difficult and challenging healthcare journeys of NHS workers suffering from LC as they negotiate access to healthcare services. Online qualitative interviews were conducted with 50 NHS workers who reported symptoms of LC and came from a range of healthcare disciplines. Analysis identified themes of uncertainty regarding available healthcare supports, self-management and feeling abandoned. GP access was often difficult, with mixed responses surrounding LC legitimacy and diagnosis. Referrals were negotiated (i.e. cardiology consult) but often addressed single fluctuating symptoms, which impacted candidacy. Findings are used to advance three existing Candidacy Framework domains in new directions, highlighting how uncertainties surrounding LC, illness presentation, legitimacy and available recovery pathways systemically constrain health seeking behaviours in healthcare workers suffering LC in Scotland.

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https://creativecommons.org/licenses/by/4.0/

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https://rgu-repository.worktribe.com/output/1763987