背景:COVID-19大流行影响了人们如何获得医疗服务,以及他们如何管理2型糖尿病(T2D)等慢性病。社交媒体论坛提供了定性数据的来源,以了解如何从患者的角度进行适应。
目的:我们的目的是通过进行范围界定的文献综述,了解在大流行早期,T2D患者的求医行为和态度是如何受到影响的。第二个目标是将范围审查的结果与流行的社交媒体平台Reddit上显示的结果进行比较。
方法:2021年进行了范围审查。纳入标准为T2D人群,研究以病人为中心,研究目标以健康行为为中心,疾病管理,或COVID-19大流行期间的心理健康结果。排除标准是患有其他非传染性疾病的人群,检查COVID-19与T2D的共病,T2D患者中COVID-19的临床治疗,患有T2D的人群中COVID-19的遗传表达,灰色文学,或者不是用英语发表的研究。通过与其他作者一起审查不确定性,可以减轻偏差。从研究中提取的数据被分为主题类别。根据我们的目标,这些类别反映了本研究的结果。下载了2020年3月至2021年3月初与T2D相关的Reddit论坛的数据,如果在大流行的背景下发布了帖子,则使用支持向量机进行分类。进行了潜在狄利克雷分配主题建模,以收集COVID-19大流行特有的讨论主题。
结果:2020年2月至9月共进行了26项研究,由13,673名参与者组成。包括在这篇范围界定文献综述中。这些研究是定性的,主要依赖于来自调查或问卷的定性数据。从文献综述中发现的主题是“血糖控制较差,\"\"增加不健康食品的消费,“\”体力活动减少,\"\"无法访问医疗预约,\"和\"增加压力和焦虑。“Reddit论坛潜在的Dirichlet分配主题建模的结果是”应对不良的心理健康,\"\"接触医生和药物并控制血糖,\“\”在大流行期间改变饮食习惯,压力对血糖水平的影响,\"\"改变就业和保险状况,“和”COVID并发症的风险。\"
结论:Reddit论坛评估的讨论主题提供了大流行对T2D患者影响的整体观点,这些发现与文献综述的结果相当。这项研究的局限性在于只有一名文献综述者,但是当存在不确定性时,咨询作者可以减轻偏见。Reddit表格的定性分析可以补充传统的T2D患者行为的定性研究。
BACKGROUND: The COVID-19 pandemic impacted how people accessed health services and likely how they managed chronic conditions such as type 2 diabetes (T2D). Social media forums present a source of qualitative data to understand how adaptation might have occurred from the perspective of the patient.
OBJECTIVE: Our objective is to understand how the care-seeking behaviors and attitudes of people living with T2D were impacted during the early part of the pandemic by conducting a scoping literature review. A secondary objective is to compare the findings of the scoping review to those presented on a popular social media platform
Reddit.
METHODS: A scoping review was conducted in 2021. Inclusion criteria were population with T2D, studies are patient-centered, and study objectives are centered around health behaviors, disease management, or mental health outcomes during the COVID-19 pandemic. Exclusion criteria were populations with other noncommunicable diseases, examining COVID-19 as a comorbidity to T2D, clinical treatments for COVID-19 among people living with T2D, genetic expressions of COVID-19 among people living with T2D, gray literature, or studies not published in English. Bias was mitigated by reviewing uncertainties with other authors. Data extracted from the studies were classified into thematic categories. These categories reflect the findings of this study as per our objective. Data from the
Reddit forums related to T2D from March 2020 to early March 2021 were downloaded, and support vector machines were used to classify if a post was published in the context of the pandemic. Latent Dirichlet allocation topic modeling was performed to gather topics of discussion specific to the COVID-19 pandemic.
RESULTS: A total of 26 studies conducted between February and September 2020, consisting of 13,673 participants, were included in this scoping literature review. The studies were qualitative and relied mostly on qualitative data from surveys or questionnaires. Themes found from the literature review were \"poorer glycemic control,\" \"increased consumption of unhealthy foods,\" \"decreased physical activity,\" \"inability to access medical appointments,\" and \"increased stress and anxiety.\" Findings from latent Dirichlet allocation topic modeling of
Reddit forums were \"Coping With Poor Mental Health,\" \"Accessing Doctor & Medications and Controlling Blood Glucose,\" \"Changing Food Habits During Pandemic,\" \"Impact of Stress on Blood Glucose Levels,\" \"Changing Status of Employment & Insurance,\" and \"Risk of COVID Complications.\"
CONCLUSIONS: Topics of discussion gauged from the
Reddit forums provide a holistic perspective of the impact of the pandemic on people living with T2D, which were found to be comparable to the findings of the literature review. The study was limited by only having 1 reviewer for the literature review, but biases were mitigated by consulting authors when there were uncertainties. Qualitative analysis of
Reddit forms can supplement traditional qualitative studies of the behaviors of people living with T2D.