Exploration of Anguish and Sufferings of Critically Ill COVID-19 Patients – A Qualitative Analysis

INTRODUCTION: The COVID-19 pandemic presented unprecedented challenges to healthcare systems worldwide, with critically ill patients facing particularly severe physical and psychological burdens. These patients often required intensive care, including mechanical ventilation and prolonged isolation, which could lead to significant emotional distress and suffering. This study sought to delve deeper into the experiences of these patients, examining the complex interplay of physical symptoms, psychological distress, and social isolation. OBJECTIVES: To qualitatively analyze experiences and reflections of COVID-19 patients about their journey through illness and reflections about anguish and suffering.(1–3) MATERIALS AND METHODS: Setting: The study was carried out at Shree Krishna Hospital, Karamsad- a government-designated Covid tertiary care center in central Gujarat during the second wave of COVID. STUDY DESIGN: An investigator-designed interview guide was prepared to capture experiences and reflections of patients suffering from/those recently recovered from Covid 19 to capture responses to illness and experiences through the journey of illness. In-depth, qualitative interviews were conducted and audio recorded. PARTICIPANTS' SELECTION: Eight patients who were of mild illness and 8 patients who were of moderate or severe illness (Total of 16), who fulfilled inclusion and exclusion criteria were selected by random, convenient sampling method. The interview was recorded. DATA ANALYSIS: To organize data, we used thematic analysis, coupled with a validated conceptual model of clinician-surrogate communication. Qualitative analysis of the audio recordings was carried out as per standard protocols. The steps of Collaizi's phenomenological data analysis were followed.(3,4) RESULTS: 1. Unprecedented illness, unplanned and abrupt hospitalization, and inability to have access to the comforting presence of family members were identified as the most significant experiences reported by all patients. It was observed in patients of all severity and in both genders and at all ages. 2. In the resulting situation, they looked for the needed emotional support from the treating physicians and healthcare team. 3. A number of themes emerged from the interviews. Inferring from a validated conceptual model, we finalized 2 domains for our coding: “inner strength” and “relationship building.”. 4. In the domain of ‘inner strength’, we coded “To have the support of next of kin”, “The wish to go on living”“seen by a doctor” & “health care professionals’ positivity for him/her”. 5. In relationship building, we coded “emotional support”, “trust”, and “consensus” as the key elements. Patients reported that they wanted timely, accurate information about their condition & an interaction with healthcare professional and their keen too. 6. Presence of family members was reported by all patients as a most crucial factor which could make them ‘strong from within” and facilitate overcoming the crisis of his/her own as well as enhance comfort of their family.(5,6.) DISCUSSIONS/CONCLUSIONS: This study provides valuable insights into the complex and multifaceted nature of suffering experienced by critically ill COVID-19 patients. The findings highlight the need for a holistic approach to patient care that addresses not only the physical symptoms of the illness but also the psychological, social, and spiritual needs of patients.