COVID-19 has hugely impacted the everyday lives of every person globally and it added insurmountable pressure to our healthcare system which was already barely keeping afloat with huge waiting lists and enormous stress to both staff and patients. As the pandemic developed in March 2020, there was growing concern as to how to protect the most vulnerable in our society. Suddenly outpatient care in Ireland changed drastically to telemedicine - where you have a phone or video consultation with a medical/nursing healthcare professional that would have previously been held in an outpatient’s clinic. It suddenly become the norm to have an appointment by phone or video without physically attending the hospital. While this undoubtedly protected patients lives, I was eager to unearth what implications this sudden change in patient care would have and how patients felt about the experience.
After obtaining ethical approval from the School of Nursing and Midwifery Ethics Committee in Trinity I was delighted to begin my survey. I focused on examining the experiences of patients with three main chronic illnesses; Arthritis, Asthma and Diabetes. With around 1.5 million people in Ireland having at least one of these chronic illnesses I knew it was an interesting topic that related to a vast number of people. To advertise the survey I collaborated with three patient representative groups in Ireland; the Asthma Society of Ireland, Diabetes Ireland and Arthritis Ireland. While this was slightly daunting initially ringing up the charities and explaining what I was doing, there were all eager to help in any way they could. It was so satisfying seeing my survey finally launched and the accumulation of all the hard work that had gone into the creation, ethical approval and advertisement. I was ecstatic as I watched the responses come in over the ten days the survey was live.
Once I had the data collected, I began analysing it. I used the Press Ganley Patient Satisfaction Scale to measure how satisfied patients were with their care during the pandemic based on their responses to a series of questions. I was very surprised to discover that on average, patients felt their care was better during the pandemic than before. From analysing the qualitative data I collected, using thematic analysis I discovered a number of respondents felt the fact they didn’t have to travel to the hospital saved them valuable time which ultimately resulted in their preference for a hybrid model going forward. This discovery has really made me realise that I shouldn’t make assumptions based on my own views as contrary to what I would have thought, a number of respondents felt that the pandemic has changed the healthcare system for the better.
However, upon analysing certain socio-demographic and behavioural characteristics in relation to how satisfied patients were with their care I discovered that 73% of young people aged between 18 and 25 felt their care was worse during the pandemic. This was a shocking statistic and, in my opinion, really shows that young people need extra support going forward to counteract this. I also found it interesting to compare the type of appointment patients had and their care. 57% of people who had telephone consultation felt their care was worse. This highlighted people who had telephone consultation in particular felt their care was disproportionally worse than others who had video or in person. Comparing across chronic illness, I was interested to learn 50% of patients with Diabetes felt their care was worse compared to 43.5% of people with Asthma and 16.7% of people with Arthritis. This shows people with Diabetes were most adversely affected during the pandemic and additional supports need to be implemented to ensure their health isn’t adversely affected in the future. From my thematic analysis of the qualitative data a number of respondents commented on an increase in wait times, cancellation of appointments, lack of vital signs such as blood pressure, increased communication difficulties and a lack of support in their chronic illness management. These are very valid concerns that patients had and some patients even wrote that they had no form of hospital appointment since March 2020. These concerns raised have led me to realise that more supports are needed for particular cohorts of patients to ensure that the consequences of their care during the pandemic are rectified. However, I think it is a credit to all the hospital staff who have persevered wave after wave of COVID-19 and on average patients found that their care improved during the pandemic.
I have learned so much from completing my research, not only has it opened my eyes to how the pandemic has impacted numerous patients in Ireland and changed healthcare ultimately for the better but I have learned a plethora of new skills such as data analysis, time management and collaboration. I look forward to further building on these skills throughout the rest of my journey as a Laidlaw Scholar.