Lifestyle implication among patients with selected comorbidities post COVID-19

 

Ms. Jennifer Danieal W.*

Assistant Professor, Medical Surgical Nursing, Tilak Maharashtra Vidyapeeth Trust, INER, Pune, Maharashtra, India

jenny27june@gmail.com

Abstract: While the world was running quickly for the sake of progress and monetary increase, the Novel human Coronavirus has driven the world to stop due to its dangerous result. The disease has shattered every corner of the world and destroyed many families. The Novel Coronavirus has set a respite button on the world. The serious and deadly outcome of the disease has swept many countries to shut their daily activities. COVID-19 had a very piercing impact not only on health factors but also it shattered economy and society, globally. Many countries in the world are affected by the serious pandemic issue which has forced to advise lockdown in order to prevent the transmission. These results have demonstrated the weakness of global networks, severely affecting well-being, food supplies and job stability. Many of the patients has overcome the battle with COVID-19 while many are worst hit by the same. Patient with underlying comorbidity have reportedly increased intensive care unit admissions during the hospital stay for COVID-19. Compared to other patient hit by COVID-19 without any underlying disease, the patient with one or more comorbidities have shown delayed and in most cases no prognosis. Patients with comorbidities were worst hit by COVID-19 with highest rate of mortality. Considering all these severity of COVID-19 with underlying comorbidity, particularly Hypertension and Diabetes Mellitus, this study aims to assess the lifestyle Implications among patients. Additionally the study also focuses to find the association between the lifestyle Implications withdetermined demographic variables and finds the correlation of lifestyle implications with selected comorbidities.

Methodology: A research approach adopted for the study wasNon-Experimental Descriptive approachto assess the lifestyle implication among patients with selected comorbidities post COVID-19 from Pune City. There were total 100 samples who met the inclusion criteria of the study. All the samples accepted to participate in the research and was selected using Non Probability Purposive Sampling Technique.

Result: The analysis depicts that about 14% of total population have shown mild lifestyle implication,83% of the population has shown moderate changes and 3% population have shown severe implication in their lifestyle post COVID-19.

Conclusion: The current study concludes that the patients with selected comorbidities (i.e. Hypertension and Diabetes) post COVID-19 were found to have moderate Lifestyle Implication in overall physical, psychological and socio-economic aspects.

Keyword: Assess, Lifestyle, Implication, Comorbidity, COVID-19

INTRODUCTION AND BACKGROUND

As the Novel Coronavirus keeps on advancing, there are as yet numerous impediments as far as anyone is concerned of who this infection might hit fundamentally. Serious intense respiratory misery condition infection Coronavirus one more from beta COVID is firmly connected with the COVID that was accounted for in 2002. The first case was detected in December from the Wuhan city of China. Older Adults and patients with underlying disease condition are found to have worse prognosis. Given the nature of this virus, there is still much to learn about this virus. We all know that the symptoms of COVID-19 ranges from common cold to severe complications or diseases like Bronchitis, Pneumonia, Multi-Organ failure and even Death. Patients with comorbidity such as Diabetes and Hypertension are been linked to have more admission rates in Intensive care Units.3 Reasons being the underlying comorbidity that the patient is suffering from. It has been examined that the patients with underlying comorbidity has severe impact from that of the normal ones. Additionally, the impaired Immune system because of underlying Diabetes Mellitus could be the contributing determinant for the susceptibility of COVID-19. Patients have shown increased rates of Multi-organ failure and a slow prognosis as a result of the underlying comorbidity. Comparatively patients have reported lifestyle implication after the hospital stay than those of the normally affected COVID-19 without any underlying comorbidity. Complaints such as weakness, pain, breathlessness, etc, even after discharge. Thus, the current study focuses on assessing the lifestyle implication among the patients with selected comorbidity post COVID-19.

A systemic review and meta-analysison 69 publications and 61 studies was conducted to evaluate associations of comorbidities factor with severity of COVID-19. The outcomes recommended the guys had altogether higher sickness seriousness and more prognostic endpoints. More seasoned age was viewed as fundamentally connected with the illness seriousness and six prognostic endpoints. Persistent kidney sickness contributed for the most part for death, constant obstructive pneumonic infection (COPD) for illness seriousness, admission to emergency unit, the composite endpoint, intrusive ventilation, and sickness movement, cerebrovascular infection for intense respiratory pain disorder (ARDS), coronary illness for heart anomaly. Our review featured that the male orientation, more seasoned age and comorbidities possessed solid epidemiological proof of relationship with the seriousness and forecast of COVID-191.Also, Diabetes and Metabolic Syndrome: Clinical research and review article was published in Elsevier journal the results showed diabetes and poor glycemic control are related with expanded seriousness and the rate of mortality in patients with COVID-19. A few clinical situations about hyperglycemia and COVID-19 are distinguished and every one of these requirements explicit administration methodologies.2A study that retrospectively analyzed 961 COVID-19 patients who had a definitive clinical outcome (either death or discharge) was conducted. The prevalent comorbidities found were hypertension (32.8%), diabetes (15.7%), and cardiovascular disease (9.9%). A total of 22 (2.3%) patients reported having asthma, while 21 (2.2%) had COPD. There were no cases of patients having both asthma and COPD simultaneously. Aligning with findings from earlier studies, our group identified hypertension, diabetes, and malignancies as the most common comorbidities present in COVID-19 patients, while COPD and asthma were less frequently seen. Furthermore, consistent with prior research, we observed that COPD was linked to more severe cases of COVID-19. Conversely, asthma was more frequently associated with non-severe cases than with severe cases. In comparison to patients with asthma, those with COPD experienced higher mortality rates.4

Problem Statement:

A study to assess the lifestyle implication among patients with selected comorbidities post COVID-19from selected areas of Pune City.

OBJECTIVES

1.      To assess the lifestyle implication among patients with selected comorbidities post COVID-19.

2.      To find out the association between the lifestyle implication with selected demographic variables.

3.      To find the correlation of lifestyle implications with selected comorbidities.

HYPOTHESIS

H1- There will be correlation between lifestyle implication and comorbidities

H2- There will be significant association between the lifestyle implications of comorbidities with selected socio-demographic variables.

METHODOLOGY

Research Design:The design adopted by the researcher for current study wasNon-Experimental Descriptive Survey.The research was carriedon patients with predetermined comorbidities post COVID-19.

Population: Patients affected with COVID-19 with selected Comorbidities.

Sampling techniques: Sampling technique used for the study wasNonProbabilityPurposive sampling technique and the Patients were selected with comorbidities post COVID-19

Sample Size: 100 samples who met the inclusion criteria of the study. All the samples were pre-informed about the study objectives and were willing to participate in the study.

Tools of data collection: The tool was divided into two sections. Section I comprises 5 questions related to demographic variables of the study. And section II Comprises of 25 questions to assess the lifestyle implications of Physical, psychological and socio-economic aspects

Validity and Reliability of tools: ResearchTool was validated by the 9expertsfrom the field andthe test of Cronbach’s Alpha coefficient was used to test the reliability, it was r=0.86 for assessment of lifestyle implication among the patient with selected comorbidity Post COVID.

CONCEPTUAL FRAMEWORK

According to Robson conceptual framework is defined as the system of concepts assumptions, expectations, beliefs and theories that support and informs your research is a key part of your design. According to Polit and Beck, a study that has its roots in a specified conceptual model is a conceptual framework. Conceptual frameworks or models are worn to give guidance and direct research studies, nursing practice and educational programs, but few researchers have described that the criteria used for selecting a conceptual framework for guiding the design of an educational intervention or intercession enlightenment. According to Bordage conceptual framework represents way of thinking about a problem or a study or way of representing how complex things are. As per Miles and Huberman ,conceptual framework as communication and visual presentation that describes the main things to be considered or studied in either graphically or story form- it includes key factors, concepts, or variables and they assumed relationship among them.

This study is pinned on the Imogene Kings the Theory of Goal Attainment. The theory of goal attainment was developed by Imogene king in the early 1960s. It describes a dynamic, interpersonal relationship in which patient grows and develops to certain life goals. The theory explain that factors which can affect the attainment of goals are roles, stress, space and time. According to king a human being refers to a social being WHO is rational and sentient. He or she has the ability to perceive, think, feel, choose, set goals, select means to achieve goals and make decisions. Imogene King’s hypothesis of Goal Attainment focuses on how objectives of the customer are accomplished through the medical attendant customer exchanges. Nursing objective is to achieve, keep up, and recapture a solid state. Objectives are created through the correspondence and cooperation, and inside a social framework, customer objectives are accomplished featured by commonly set objectives among customers and nursing staff. Lord's model can be utilized as a structure for surveying and keeping a sound social framework that assists customers with accomplishing their expressed objectives (Parker, 2006). The Theory of Goal Attainment gives a way to deal with achieve the objective of access and personal satisfaction. The premise of The Theory of Goal Attainment of Imogene King is her philosophical position, which is, established in General Systems Theory, which manages the investigation of coordinated multifaceted nature as entire frameworks. Consistent advances in innovation and media transmission, and immense measure of data over-burden about the world occasions makes one's life complex. King’s Conceptual Systems consists the following elements that emphasis on Joint Goal Setting by Nurse and Client. In this study the elements that emphasis the joint goal setting is the researcher with adults.

Concept

Definition

Application

Personal: Individual, understand the self-perception own personal growth and development of client.

It refers to affecting by particular person.

Personal-Here is researcher who is conducting study to assess the Lifestyle Implication among patients with selected comorbidities post COVID-19

Interpersonal: interaction between two or more person of group.

It refers to interaction between peoples.

Interpersonal: researcher build an professional interpersonal with Patients by conducting study by administering structured questionnaire to assess the Lifestyle Implication among patients post COVID 19

Perception: person’s representation of reality.

It refers to an ability to see here and become aware

Researcher needs to assess the Lifestyle Implication of patients with Hypertension and Diabetes post COVID-19

Judgment: opinions ,or conclusion

It refers to someone’s opinion or conclusion.

Researcher decides to assess the Physical, Psychological and Socio-Economic aspects of Lifestyle.

Action : steps , activity

It refers to process of doing something

Researchers assess the lifestyle Implication of the patients by administering structured questionnaire

Reaction: done , reply,response

It refers to an action taken in response to something

Researcher evaluate the Implications in the lifestyle of patients with selected comorbidities

Interaction: communication

It refers to direct involvement with someone or something

Researcher communicates the findings

Transaction: purposeful interaction

It refers to purposeful interaction leading to the goal attainment

It refers to purposeful interaction leading to the goal attainment

FINDINGS

The result of the data composedto assess lifestyle implications among the patients with selected comorbidities post COVID-19 was conductedunderstanding the aim of the study in consideration.

1.      To assess the lifestyle implication among patients with selected comorbidities post COVID-19.

2.      To find out the association between the lifestyle implication with selected demographic variables.

3.      To find the correlation of lifestyle implications with selected comorbidities.

The result was divided in V Sections.

SectionI that describesDetails ofDemographic Variables

Section II that describesMean, Median, Mode and Standard Deviation

Section IIIDescription of Lifestyle implications in patients with comorbidity

Section IVShows Association of demographic variables with lifestyle implications among patient with selected comorbidity post COVID-19.

Section VdescribesCorrelation of lifestyle implications with selected comorbidities.

Section I: Demographic Details       n=100

Table 1: Describes demographic details related to assessment of Lifestyle Implications among patients with comorbidity post COVID.

Sr. No

Demographic variables

 

Frequency

Percentage

1.

Age

30-40

21

21%

41-50

28

28%

51-60

28

28%

60-above

23

23%

2

Gender

Male

49

49%

Female

51

51%

3

Education

Uneducated

36

36%

Secondary School

20

20%

Higher Secondary Schooling

16

16%

Graduate Post Graduate

28

28%

4

Occupation

Private Sector

34

32%

Government Sector

22

22%

Self-Employed

22

22%

Home Maker

22

22%

5

Comorbidity

Hypertension

26

26%

Diabetes Mellitus

42

42%

Both

32

32%

6

Family History of Comorbidity

 

Yes

60

60%

No

40

40%

7

Area of admission during COVID

Ward

63

63%

ICU

37

37%

Quarantine Centre

00

00

8

Post COVID period

 

1 Week

00

00

2 Week

00

00

3 Week

35

35%

4 Week and Above

65

65%

 

Section II- Mean, Median, Mode and Standard Deviation

 

N

Range

Maximum

Mean

Std. Deviation

Tool

100

60

104

62.61

11.853

 

Section III- Description of Lifestyle implications in patients with comorbidity

Figure 1: Show the statistical data related to the degree to which lifestyle has been Implicated among the patients with comorbidity.

Section IV:Association of demographic variables with lifestyle implications          N=10

Table 2: Shows the statistical data about association of demographic variables with lifestyle implications among patient with selected comorbidity post COVID-19

Sr. No.

Demographic Variables

Calculated Value

Tabulated Value

Degree Of Freedom

Significance

1.                                                                                                      

Age*Lifestyle Implication

1.828

12.59

6

NS

2.                                                                                                      

Gender* Lifestyle Implication

5.168

5.99

2

NS

3.                                                                                                      

Education* Lifestyle Implication

8.837

12.59

6

NS

4.                                                                                                      

Occupation* Lifestyle Implication

16.900

12.59

6

NS

5.                                                                                                      

Comorbidity* Lifestyle Implication

5.715

9.49

4

NS

6.                                                                                                      

Family History of Comorbidity* Lifestyle Implication

0.195

5.99

2

NS

7.                                                                                                      

Area of admission* Lifestyle Implication

2.803

5.99

2

NS

8.                                                                                                      

Post COVID Period* Lifestyle Implication

2.071

5.99

2

NS

 

Section V: Correlation of lifestyle implications with selected comorbidities.

Table 3: Depicts the data regarding Correlation of lifestyle implications with selected comorbidities.

Variables

Mean

SD

R Value

P Value

Remark

Lifestyle

62.61

11.853

-0.036

>00001

Strong Negative Correlation

Comorbidity

2.06

0.763

 

DISCUSSION

This study aimed to assess the Lifestyle Implication among the patients with selected comorbidity post COVID from the selected areas of Pune city. Thus, the data was collected from the participants and investigation was done to find the result.

DescriptionofLifestyle Implication among the patients with comorbidity post COVID.

Figure 1: Data describes the details related to the degree to which lifestyle has been Implicated among the patients with comorbidity. The parameters measured to assess the lifestyle Implication were: Physical aspects- to understand the physical changes in the patient’s body after recovery from COVID-19 particularly the patients with underlying comorbidity, Psychological Aspects- to assess what are the issues that patient has underwent personally and family vise post COVID, Socio-Economic Aspect- to assess what were the challenges that patient faced after his/her recovery. The analysis says that lifestyle implication towards the above points was mild in 14% patient,moderate in 83% patients and severe in 3% of patients.

Descriptionof Association of demographic variables with lifestyle implications among patient with selected comorbidity post COVID-19

Table 2: Shows the facts and figures about association of demographic variables with lifestyle implications among patient with selected comorbidity post COVID-19. The tabulated value is greater than that of the chi square value of all except Occupation. Hence, Lifestyle Implication was found to have significant association with the occupation of total population and the first hypothesis is accepted.

Findings related toCorrelation of lifestyle implications with selected comorbidities

Table 3: Depicts the data regarding correlation of lifestyle implications with selected comorbidities. It indicates that there is strong negative correlation between lifestyle implication and selected comorbidity. Here, we reject the hypothesis of correlation.

CONCLUSION

The overall study result indicates that there is aModerate changes in lifestyle of a patient after COVID-19 particularly in the patients with selective comorbidity such Hypertension, Diabetes or both. Most of the patient have reported to have increased sign and symptoms of weakness that comparatively makes them incapacitate to perform the activity than earlier. Additionally, patients have also reported socio-economic crisis during and post COVID. The Current study recommends to build proactive measures to overcome and prevent such implication Post COVID in the patients with selective comorbidity.

Conflict of Interest:NA

Source of Funding:There is no other financial support for the study.The study was fully funded by author.

Ethical Clearance:Ethical permissions of the study taken from Symbiosis College of Nursing ethical committee. Consent was taken from the Patients from selected areas of Pune city. Details given to the participants regarding the data collection procedure and the information was only used for study purpose and the confidentiality was maintained.

 

References

1.                  Chopra S, Ranjan P, Singh V, Kumar S, Arora M, Hasan MS, Kasiraj R, Kaur D, Vikram NK, Malhotra A, Kumari A. Impact of COVID-19 on lifestyle-related behaviours-a cross-sectional audit of responses from nine hundred and ninety-five participants from India. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020 Nov 1;14(6):2021-30.

2.                  Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, Li Y, Cheng L, Li W, Jia H, Ma X. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (Albany NY). 2020 Jul 15;12(13):12493.

3.                  Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, Hosein Z, Padda I, Mangat J, Altaf M. Comorbidity and its impact on patients with COVID-19. SN comprehensive clinical medicine. 2020 Jun 25:1-8.

4.                  Song, J., Zeng, M., Wang, H., Qin, C., Hou, H. Y., Sun, Z. Y., ... & Liu, Z. (2021). Distinct effects of asthma and COPD comorbidity on disease expression and outcome in patients with COVID‐19. Allergy, 76(2), 483-496.