How People with a Chronic Health Condition Have Promoted their Health during COVID-19

RESEARCH OBJECTIVES: To interview individuals with long-standing Multiple Sclerosis about their perceptions of COVID-19 restrictions on health, health care access, and health promotion. DESIGN: A descriptive qualitative approach with maximum variation sampling was used to facilitate low inference interpretation. After coming to consensus on the codes, the researchers clustered the codes and used them to identify emerging themes, consistent with analytic techniques suggested by Miles and Huberman. SETTING: Telephone interviews were conducted with individuals with multiple sclerosis living in the community who were recruited from the mailing list of the National MS Society. PARTICIPANTS: The 24 individuals interviewed had an average age of 66 years, and had been diagnosed an average of 32 years. Half were married, and 75% were female. Many had college degrees; six were employed. INTERVENTIONS: This is a qualitative study with no intervention. MAIN OUTCOME MEASURES: Self-reported health, health care access, and health promoting behaviors. RESULTS: Four interconnected themes emerged from the analysis: negative effects on health and health promotion, being isolated, loss of spontaneity in daily life, and resilience. Although most individuals initially reported no effect of COVID-19 on their health, additional probing revealed that some felt weaker and had more balance problems. Normal exercise regimens had been disrupted for approximately half of them. Several also described decreased social interactions; 80% expressed negative emotional impacts. Many utilized previously developed coping mechanisms, such as cognitive reframing, and support from family as they adapted to COVID-19. Most individuals reported no MS exacerbations and were able to have some contact with providers, usually through telehealth. CONCLUSIONS: Providers and researchers should monitor the on-going impact of the COVID-19 pandemic on physical functioning and emotional well-being among individuals with MS. Higher levels of depression have been previously reported among those with MS. For those needing mental health supports, rapid advancements in telehealth enable providers to refer them to psychological services provided through access from their homes. AUTHOR(S) DISCLOSURES: The authors have no conflicts of interest to declare.