SARS-CoV-2–Related Adaptation Mechanisms of Rehabilitation Clinics Affecting Patient-Centered Care: Qualitative Study of Online Patient Reports

BACKGROUND The SARS-CoV-2 pandemic impacted the access to inpatient rehabilitation services. At the current state of research, it is unclear to what extent the adaptation of rehabilitation services to infection-protective standards affected patient-centred care in Germany. OBJECTIVE This study aimed to explore which aspects of patient-centred care were relevant for patients in inpatient rehabilitation clinics under early-phase pandemic conditions. METHODS A deductive-inductive framework analysis of online patient reports posted on a leading German hospital rating website was conducted (www.klinikbewertungen.de). The selected hospital rating website is a third party, patient-centred commercial platform which operates independently of governmental entities. Following a theoretical sampling approach, online reports of rehabilitation stays in two federal states of Germany (Brandenburg, Saarland) uploaded between March 2020 and September 2021 were included. Independently of medical specialty groups, all reports were included. Keywords addressing framework domains were analysed descriptively. RESULTS In total, 649 online reports reflecting inpatient rehabilitation services of 31 clinics (Brandenburg N = 23; Saarland N = 8) were analysed. Keywords addressing the care environment were most frequently reported (59.9%) followed by staff prerequisites (33.0%), patient-centred processes (4.5%) and expected outcomes (2.6%). Qualitative in depth-analysis revealed SARS-CoV-2 related reports to be associated with domains of patient-centred processes and staff prerequisites. Discontinuous communication of infection protection standards was perceived to threaten patient autonomy. This was amplified by a tangible gratification crisis of medical staff. Established and emotional supportive relationships to clinicians and peer-groups offered the potential to mitigate adverse effects of infection protection standards. CONCLUSIONS Patients predominantly reported feedback associated with the care environment. SARS-CoV-2 related reports were strongly affected by increased staff workloads as well as patient-centred processes addressing discontinuous communication and organizationally demanding implementation of infection protection standards which were perceived to threaten patient autonomy. Peer-relationships formed during inpatient rehabilitation had the potential to mitigate these mechanisms. CLINICALTRIAL Not applicable.