Disrupted candidacy: a longitudinal examination of the constrained healthcare-access journeys of National Health Service workers in Scotland seeking supports for Long COVID illness.

Adams, Nicholas Norman; MacIver, Emma; Douglas, Flora; Kennedy, Catriona; Skåtun, Diane; Hernandez Santiago, Virginia; Torrance, Nicola; Grant, Aileen

Abstract

Evidence examines how persons experiencing Long COVID (LC) struggle to secure healthcare for symptoms; however, few studies examine healthcare workers experiencing LC, nor the complex and multiple difficulties faced when seeking and receiving healthcare. This study is based upon two phases of longitudinally conducted qualitative interviews, six-months apart, with NHS (National Health Service) workers experiencing LC, from different occupational roles at NHS locales in Scotland (first interviews n=50, second interviews n=44). Multiple factors restricted healthcare-access, including worries of pressuring the NHS and concerns over LC being legitimised. When healthcare was sought, workers struggled to secure supports, referrals and treatment. Reasons included: 1) Context - the restrictive pandemic healthcare context; 2) Illness Climate - low GP knowledge surrounding LC and how this could be treated, trends for ascribing symptoms to other causes, and reluctance to diagnose LC; 3) Sense-making of LC, healthcare availability linked to occupational role-identity. To visualise and examine healthcare barriers, candidacy theory is applied, drawing inferences between healthcare context, illness climate, sense-making and identities. The study concluded that NHS workers' complex journeys represent Disrupted Candidacy: intersecting challenges across candidacy domains, restricting seeking and receive LC healthcare. Findings provide insights into why NHS workers resisted and withdrew from healthcare-seeking, and barriers faced when later attempting to secure LC supports. A pathway for future LC illness research to make use of a modified candidacy theory framework is presented. This research focusses on amplifying and learning from lived experiences; the voices of NHS workers in Scotland experiencing Long COVID. Interviews represent primary data for this study, therefore participants and their healthcare journeys are centred in this research and all aspects of production, reporting and output. Explicit discussions of stakeholder group involvement are highlighted in the methods section.

Citation

ADAMS, N.N., MACIVER, E., DOUGLAS, F., KENNEDY, C., SKÅTUN, D., HERNANDEZ SANTIAGO, V., TORRANCE, N. and GRANT, A. 2024. Disrupted candidacy: a longitudinal examination of the constrained healthcare-access journeys of National Health Service workers in Scotland seeking supports for Long COVID illness. Health expectations [online], 27(5), article number e70050. Available from: https://doi.org/10.1111/hex.70050

• Journal Article Type: Article
• Acceptance Date: Sep 17, 2024
• Online Publication Date: Oct 2, 2024
• Publication Date: Oct 31, 2024
• Deposit Date: Oct 2, 2024
• Publicly Available Date: Oct 2, 2024
• Journal: Health expectations
• Print ISSN: 1369-6513
• Electronic ISSN: 1369-7625
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 5
• Article Number: e70050
• DOI: https://doi.org/10.1111/hex.70050
• Keywords: Long COVID; COVID-19; Healthcare workers; Health service workers; Scotland
• Public URL: https://rgu-repository.worktribe.com/output/2344774