Views of healthcare workers to help develop support for people with post-COVID syndrome in Nigeria: a survey study

Abstract

BACKGROUND: Existing pulmonary rehabilitation services have been adapted to accommodate the excess demands for support for people with post-coronavirus disease syndrome. For many low- and middle-income countries, where pulmonary rehabilitation is not routinely available, interventions specific to local contexts are needed. OBJECTIVE: This study aimed to examine the views of healthcare workers in Nigeria on ways to support individuals’ recovery from post-coronavirus disease syndrome. DESIGN: An online survey repeated at two time points during the pandemic via social media. SETTING: Data collection occurred in April–July 2020 and January–July 2021, coordinated from Abuja, Nigeria. PARTICIPANTS: A convenience sample of healthcare workers voluntarily completed the survey without any time constraints. MAIN OUTCOME MEASURES: The survey comprised closed and open-ended questions, in English, with free text boxes for additional comments where necessary. The survey included questions on the key components of post-coronavirus disease support; appropriate location, timing and communication strategies; barriers to healthcare workers referring patients; and perceived barriers to patients accepting a referral. RESULTS: Two hundred and two fully completed responses were received from healthcare workers (52% male, 53% physiotherapists). The majority (88%) recommended support of hospitalised and non-hospitalised patients with home (57%) or community-based (70%) interventions combining video (57%) and telephone (74%) support. Priority components were aerobic exercise (69%), coping with the stigma of infection (68%), advice on nutrition (68%) and integrating back into the community (63%). Healthcare worker-perceived patient barriers to accepting support were cost of treatment (64%), patient stigmatisation (63%) and risk of patient re-infection (53%). The main healthcare worker barrier in referring patients was inadequate personal protective equipment (63%). LIMITATIONS: This exploratory survey study recruited a convenience sample, was available only online and relied on social media for uptake, leading to probable selection bias. Limitations in staffing and resources meant that people with post-coronavirus disease syndrome were not recruited. CONCLUSION: Post-coronavirus disease support was viewed as a high priority by healthcare workers in Nigeria. These results act as a foundation for developing suitable support interventions for post-coronavirus disease survivors with ongoing symptom burden. The suggested structure, content and delivery of post-coronavirus disease support fits well with the conventional structure of pulmonary rehabilitation. FUTURE WORK: The development of post-coronavirus disease support interventions in Nigeria. FUNDING: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Global Health Research programme as award number 17/63/20. A plain language summary of this research article is available on the NIHR Journals Library Website https://doi.org/10.3310/UTNT4760.