Constellation, le dépôt institutionnel de l'Université du Québec à Chicoutimi

Résumé

Purpose. During the COVID-19 pandemic, the Québec Public Health Agency asked Family Medicine Groups (FMGs) to prioritize telehealth interventions over face-to-face consultations. Telehealth interventions may increase stress and anxiety among patients with physical and/or mental chronic diseases (PCDs) and have a negative impact on patient-centered care. This study aimed to explore how PCDs coped with their healthcare needs through the use of telehealth services provided by FMGs during the first wave of the COVID-19 pandemic, between march and august 2020.

Methods. We conducted a qualitative descriptive study in FMGs in three regions of the province of Québec, Canada (metropolitan, semi-urban and rural). Forty-nine PCDs participated in this study. We carried out semi-structured interviews with 40 of these patients. We explored their satisfaction with telehealth services received in FMGs, their healthcare needs and emerging coping strategies related to self-care. We also investigated frequency of appointments in primary care. We used the transactional theory of stress and coping to inform our data collection and analysis, according to the COREQ appraisal grid.

Results. All PCDs were satisfied with their telehealth experience. They reported quick and easy access to their family physician or other healthcare providers. Participants thought telehealth was less appropriate for follow-ups with social workers or with any healthcare provider with whom no trust relationship had been established. Furthermore, several PCDs mentioned having visited primary care settings less frequently during the pandemic than before, as most of them tried to cope on their own before making an appointment for an in-person consultation. PCDs developed coping strategies primarily aimed at maintaining their health status, others aimed at reducing their stress. Consistent with the transactional model, many participants demonstrated the use of strategies that promote resilience in a pandemic context.

Conclusion. PCDs appreciated the telehealth interventions received but believe follow-ups could be improved. PCDs developed coping strategies to face the pandemic but they were not all optimal for their health. Combined with pandemic side effects, this could lead to a negative impact on PCDs’ health and self-management abilities.