Perceptions of Rehabilitation Access After SARS-CoV-2 Infection in Romanian Patients with Chronic Diseases: A Mixed-Methods Exploratory Study.

Publication date: Jun 27, 2025

Background/Objectives: The COVID-19 pandemic exposed critical vulnerabilities in healthcare systems, especially in ensuring continuity of care for patients with chronic diseases. Rehabilitation services, essential for recovery following SARS-CoV-2 infection, were among the most disrupted. This exploratory study aimed to assess Romanian patients’ perceptions of the accessibility and quality of post-COVID-19 rehabilitation services, focusing on individuals with chronic conditions. Methods: This exploratory cross-sectional study was conducted over a 12-month period in 2024. Data were collected from 76 adult patients diagnosed with at least one chronic condition (hypertension, diabetes mellitus, ischemic heart disease, cancer, or chronic obstructive pulmonary disease) and with confirmed prior SARS-CoV-2 infection. Most participants were recruited during outpatient specialty consultations, with a smaller number included from hospital settings, all located in Bucharest. A structured questionnaire was administered by the principal investigator after obtaining informed consent. Quantitative data were analyzed using non-parametric methods following confirmation of non-normal distribution via the Shapiro-Wilk test (p < 0. 05). Satisfaction scores were reported as medians with interquartile ranges (IQR), and group comparisons were performed using the Mann-Whitney U test. A mixed-methods approach was employed, including thematic analysis of open-ended responses. Results: Patient satisfaction with rehabilitation services was consistently low. The median satisfaction scores [IQR] were accessibility 1. 0 [0. 0-2. 0], quality of services 0. 0 [0. 0-4. 0], staff empathy 0. 0 [0. 0-5. 0], and perceived effectiveness 0. 0 [0. 0-5. 0]. The median score for perceived difficulties in access was 1. 0 [1. 0-2. 0], indicating widespread barriers. No statistically significant differences were observed between urban and rural participants or across chronic disease categories. Thematic analysis (n = 65) revealed key concerns including lack of publicly funded services, cost barriers, limited physician referral, service scarcity in rural areas, and demand for home-based rehabilitation options. Conclusions: Romanian patients with chronic illnesses and previous SARS-CoV-2 infection continue to face substantial barriers in accessing post-COVID-19 rehabilitation services. These findings highlight the need for more equitable and integrated recovery programs, especially for vulnerable populations in underserved settings.

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Concepts Keywords
Bucharest chronic diseases
Diabetes COVID-19
Home healthcare access
Pandemic mixed methods
Physician patient satisfaction
rehabilitation services
Romania
SARS-CoV-2

Semantics

Type Source Name
disease MESH SARS-CoV-2 Infection
pathway REACTOME SARS-CoV-2 Infection
disease MESH Chronic Diseases
disease IDO quality
disease MESH hypertension
disease MESH diabetes mellitus
disease MESH ischemic heart disease
disease MESH cancer
disease MESH chronic obstructive pulmonary disease
drug DRUGBANK Etoperidone
disease MESH Emergency
disease MESH infection
disease MESH cardiovascular diseases
disease IDO country
disease MESH Syndrome
disease MESH asymptomatic infections
disease MESH functional status
disease MESH long COVID
disease MESH coinfection
disease MESH clinical relevance
disease MESH cognitive impairment
disease MESH mental illness
disease IDO process
drug DRUGBANK Methionine
drug DRUGBANK Serine
disease MESH comorbidity
disease IDO history
disease MESH critical illness
drug DRUGBANK Hyaluronic acid
drug DRUGBANK Coenzyme M
drug DRUGBANK Trestolone
drug DRUGBANK Huperzine B
drug DRUGBANK D-Proline

Original Article

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