Consolidating an Integrative Healthcare Delivery Service

According to the World Health Organization (2023), as of 10 May 2023, 765,903,278 cases of COVID-19 and 6,927,378 COVID-19-related deaths have been confirmed worldwide. Although a majority of COVID-19 cases recover, clinical recovery does not mean full recovery. Many COVID-19 survivors have reported post-COVID symptoms persisting for over 4 weeks after the acute stage. Bull-Otterson et al. (2022) reported that 1/4 ~ 1/5 of COVID-19 survivors experienced a post-COVID incident condition. Moreover, Guo et al. (2022) found not only physiological problems but also psychological stresses, including depression, psychological trauma, and social stigma, after hospital discharge. Thus, guidance for physical rehabilitation, psychological growth, social support, and protection from social stigmatization are recommended.

The high mortality rate of COVID-19 has raised another concern. As people generally believe that a loved one is safe from harm and assume that accidents and illnesses will bypass them, their sudden death due to COVID-19 often send their families, friends, and colleagues into “shock” mode. This is most noted when, due to prevalent quarantine requirements, families and friends are requested / mandated to cease direct contact with patients with COVID-19, even in the days and hours before their death. This may result in less-real feelings of pain about the death of these loved ones. When grief goes unrecognized or denied, people may experience helplessness and feel powerless due to disenfranchised grief. Respect and cultural rituals from family members, friends, and health professionals for grieving families are considered to be of critical importance (Center for the Study of Traumatic Stress, 2023).

Based on these observed COVID-19 issues, a more holistic approach to health services must be incorporated into care approaches for both COVID-19 survivors and family members of the deceased. Also of importance is that many chronic diseases result in higher rates of mortality and disabilities among the elderly. Realizing a person-centered, comprehensive, and continuous care system that is able to respond flexibly and effectively to current service needs is a major concern of healthcare today. A healthcare system with an integrative delivery chain is indispensable because a lack of collaboration among health care providers may affect the safe transition of patients from the hospital to long-term care facilities. Discharge planning and/or post-acute care are situational transitions requiring the participation of clients, primary caregivers, clinical professionals and even family members in some situations. Constant coordination and communication during all phases of acute, post-acute and long-term care are required to meet clients’ needs and efficiently use medical care resources.

The focus of the studies in this issue of The Journal of Nursing Research is on continuity of care, with articles addressing such issues as transitional care, chronic care, and sudden death experiences. Hamdan Mansour et al. investigated how recovered individuals with COVID-19 adapt to related psychological and social stressors during the infection period. Siga Tage et al. elucidated the experiences of nurses who had experienced the loss of a colleague during the COVID-19 pandemic. Po et al. examined the factors affecting discharge planning effectiveness. Yen et al. discussed the supportive care needs trajectories in patients with advanced non-small cell lung cancer who receive chemotherapy. We hope that our readers obtain up-to-date, innovative information from these articles that can be employed to consolidate different healthcare providers across all phases of the health-illness continuum.

Bull-Otterson L., Baca S., Saydah S., Boehmer T. K., Adjei S., Gray S., Harris A. M. (2022). Post-COVID conditions among adult COVID-19 survivors aged 18-64 and ≥ 65 years―Unites States, March 2020-Novemvber 2021. Morbidity and Mortality Weekly Report, 71(21), 713–717. https://doi.org/10.15585/mmwr.mm7121e1 Guo M., Kong M., Shi W., Wang M., Yang H. (2022). Listening to COVID-19 survivors: What they need after early discharge form hospital―A qualitative study. International Journal of Qualitative Studies on Health and Well-being, 17(1), Article 2030001. https://doi.org/10.1080/17482631.2022.2030001 World Health Organization. (2023). WHO Coronavirus (COVID-19) dashboard. Retrieved 11 May, 2023, from https://covid19.who.int/

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