{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:50:39Z","timestamp":1782845439266,"version":"3.54.5"},"reference-count":39,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Multisystemic complications post\u2013COVID-19 infection are increasingly described in the literature, yet guidance on the management remains limited.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n This study aimed to assess the needs, preferences, challenges, and existing interventions for individuals with post\u2013COVID-19 symptoms. Based on this, we aimed to develop a context-adapted intervention to improve the overall health and well-being of individuals with post\u2013COVID-19 complications.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a cross-sectional mixed-methods situation analysis assessing the needs, preferences, challenges, and existing interventions for patients with post\u2013COVID-19 symptoms. We collected data through questionnaires, semistructured in-depth interviews, and focus group discussions (FGDs) from individuals diagnosed with COVID-19 within the previous 18-month period and health care providers who managed patients with COVID-19 in both inpatient and outpatient settings. Quantitative data were summarized using descriptive statistics, qualitative data were transcribed, and deductive analysis focused on suggestions for future interventions. Findings guided the development of a group intervention.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We conducted 60 questionnaires, 13 interviews, and 3 FGDs. Questionnaires showed limited knowledge of post\u2013COVID-19 complications at 26.7% (16\/60). Of those who received any rehabilitation for COVID-19 (19\/60, 31.7%), 94.7% (18\/19) found it helpful for their recovery. Just over half (23\/41, 56%) of those who did not receive rehabilitation reported that they would have liked to. The majority viewed rehabilitation as an important adjunct to post\u2013COVID-19 care (56\/60, 93.3%) and that support groups would be helpful (53\/60, 88.3%). Qualitative results highlighted the need for mental health support, structured post\u2013COVID-19 follow-up, and financial aid in post\u2013COVID-19 care. Based on the insights from the situation analysis, the theory of change framework, and existing post\u2013COVID-19 evidence, we designed and conducted a pilot support group and rehabilitation intervention for individuals with post\u2013COVID-19 complications. Our main objective was to assess the change in physical and psychological well-being pre- and postintervention. The intervention included 8 weekly themed group sessions supplemented by home tasks. Effectiveness of the intervention was evaluated by questionnaires pre- and postintervention on post\u2013COVID-19 symptoms, quality of life with the EuroQoL 5-Dimension 5-Level, short Warwick-Edinburgh Mental Wellbeing Scale, and physical function by spirometry and 1-minute sit-to-stand test. We also assessed the feasibility and acceptability of the intervention by questionnaires and semistructured in-depth interviews. The intervention outcome analysis is yet to be conducted.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Insights from patients and health care providers on the characteristics of post\u2013COVID-19 complications helped guide the development of a context-adapted intervention program with potential to improve health and well-being post\u2013COVID-19.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/58436","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T14:18:06Z","timestamp":1744294686000},"page":"e58436-e58436","source":"Crossref","is-referenced-by-count":1,"title":["Improving Health and Well-Being of People With Post\u2013COVID-19 Consequences in South Africa: Situation Analysis and Pilot Intervention Design"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1752-1320","authenticated-orcid":false,"given":"Nicole Audrey","family":"Glover","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8296-8554","authenticated-orcid":false,"given":"Farzana","family":"Sathar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0828-0807","authenticated-orcid":false,"given":"Pride","family":"Mokome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2076-0236","authenticated-orcid":false,"given":"Nkululeko","family":"Mathabela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1460-1234","authenticated-orcid":false,"given":"Sipokazi","family":"Taleni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3388-6218","authenticated-orcid":false,"given":"Sarah Alexandra","family":"van Blydenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1483-4781","authenticated-orcid":false,"given":"Anna-Maria","family":"Mekota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7143-1009","authenticated-orcid":false,"given":"Salome","family":"Charalambous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4729-3405","authenticated-orcid":false,"given":"Andrea","family":"Rachow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8276-7891","authenticated-orcid":false,"given":"Olena","family":"Ivanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"issue":"10","key":"R1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.28568","article-title":"Short-term and long-term rates of postacute sequelae of SARS-CoV-2 infection: a systematic review","volume":"4","author":"Groff","journal-title":"JAMA Netw Open"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101762","article-title":"The prevalence and long-term health effects of long COVID among hospitalised and non-hospitalised populations: a systematic review and meta-analysis","volume":"55","author":"O\u2019Mahoney","journal-title":"EClinicalMedicine"},{"key":"R3","unstructured":"A clinical case definition of post COVID-19 condition by a Delphi consensus. World Health Organization. URL: https:\/\/iris.who.int\/bitstream\/handle\/10665\/345824\/WHO-2019-nCoV-Post-COVID-19-condition-Clinical-case-definition-2021.1-eng.pdf?sequence=1&isAllowed=y [Accessed 22-08-2023]"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-95565-8","article-title":"More than 50 long-term effects of COVID-19: a systematic review and meta-analysis","volume":"11","author":"Lopez-Leon","journal-title":"Sci Rep"},{"issue":"16","key":"R5","doi-asserted-by":"publisher","first-page":"1604","DOI":"10.1001\/jama.2022.18931","article-title":"Estimated global proportions of individuals with persistent fatigue, cognitive, and respiratory symptom clusters following symptomatic COVID-19 in 2020 and 2021","volume":"328","author":"Global Burden of Disease Long COVID Collaborators","journal-title":"JAMA"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-023-02250-0","article-title":"A systematic review and meta-analysis of long COVID symptoms","volume":"12","author":"Natarajan","journal-title":"Syst Rev"},{"issue":"11","key":"R7","doi-asserted-by":"publisher","first-page":"102947","DOI":"10.1016\/j.autrev.2021.102947","article-title":"Post-COVID syndrome. A case series and comprehensive review","volume":"20","author":"Anaya","journal-title":"Autoimmun Rev"},{"issue":"8","key":"R8","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1016\/S2213-2600(23)00239-4","article-title":"Post-acute sequelae of COVID-19: understanding and addressing the burden of multisystem manifestations","volume":"11","author":"Parotto","journal-title":"Lancet Respir Med"},{"issue":"5","key":"R9","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-055989","article-title":"Patient experience of symptoms and impacts of COVID-19: a qualitative investigation with symptomatic outpatients","volume":"12","author":"Rofail","journal-title":"BMJ Open"},{"issue":"2","key":"R10","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1093\/cid\/ciab352","article-title":"Development and validation of the long coronavirus disease (COVID) symptom and impact tools: a set of patient-reported instruments constructed from patients\u2019 lived experience","volume":"74","author":"Tran","journal-title":"Clin Infect Dis"},{"issue":"9","key":"R11","doi-asserted-by":"publisher","first-page":"e1247","DOI":"10.1016\/S2214-109X(22)00286-8","article-title":"Post-COVID-19 condition 3 months after hospitalisation with SARS-CoV-2 in South Africa: a prospective cohort study","volume":"10","author":"Dryden","journal-title":"Lancet Glob Health"},{"issue":"9","key":"R12","doi-asserted-by":"publisher","first-page":"e554","DOI":"10.1016\/S2352-3018(21)00151-X","article-title":"Risk factors for COVID-19-related in-hospital mortality in a high HIV and tuberculosis prevalence setting in South Africa: a cohort study","volume":"8","author":"Jassat","journal-title":"Lancet HIV"},{"key":"R13","unstructured":"Glover N Sathar F Charalambous S Ivanova O Riess F Shambhu RR et al. Respiratory outcomes post-hospitalisation for symptomatic covid-19 disease in patients from a tertiary facility, South Africa. Presented at: Proceedings of the 7th South African TB Conference; Sep 13-16, 2022; Durban, South Africa."},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.1186\/s43168-020-00049-4","article-title":"Determinants of persistent post-COVID-19 symptoms: value of a novel COVID-19 symptom score","volume":"15","author":"Galal","journal-title":"Egypt J Bronchol"},{"issue":"7","key":"R15","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1016\/S2213-2600(22)00169-2","article-title":"A core outcome set for post-COVID-19 condition in adults for use in clinical practice and research: an international Delphi consensus study","volume":"10","author":"Munblit","journal-title":"Lancet Respir Med"},{"issue":"10252","key":"R16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31823-7","article-title":"Surveillance is underestimating the burden of the COVID-19 pandemic","volume":"396","author":"Alwan","journal-title":"Lancet"},{"issue":"8","key":"R17","doi-asserted-by":"publisher","first-page":"300060520948382","DOI":"10.1177\/0300060520948382","article-title":"Rehabilitation of patients post-COVID-19 infection: A literature review","volume":"48","author":"Demeco","journal-title":"J Int Med Res"},{"key":"R18","unstructured":"COVID-19 rapid guideline: managing the long-term effects of COVID-19. National Institute for Health and Care Excellence. 2024. URL: https:\/\/www.nice.org.uk\/guidance\/ng188\/chapter\/5-Management [Accessed 08-02-2024]"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctcp.2020.101166","article-title":"Respiratory rehabilitation in elderly patients with COVID-19: a randomized controlled study","volume":"39","author":"Liu","journal-title":"Complement Ther Clin Pract"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1177\/02692155211036956","article-title":"Comparative effectiveness study of low versus high-intensity aerobic training with resistance training in community-dwelling older men with post-COVID 19 sarcopenia: a randomized controlled trial","volume":"36","author":"Nambi","journal-title":"Clin Rehabil"},{"issue":"10","key":"R21","doi-asserted-by":"publisher","DOI":"10.2196\/41410","article-title":"Digital peer-supported self-management intervention codesigned by people with long COVID: mixed methods proof-of-concept study","volume":"6","author":"Wright","journal-title":"JMIR Form Res"},{"issue":"5","key":"R22","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1097\/HCR.0000000000000436","article-title":"Adherence to pulmonary rehabilitation in COPD: a qualitative exploration of patient perspectives on barriers and facilitators","volume":"39","author":"Oates","journal-title":"J Cardiopulm Rehabil Prev"},{"issue":"9","key":"R23","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1111\/resp.13582","article-title":"Rehabilitation in lung diseases: \u201cEducation\u201d component of pulmonary rehabilitation","volume":"24","author":"Blackstock","journal-title":"Respirology"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2020-000862","article-title":"\u201cIt\u2019s not one size fits all\u201d: a qualitative study of patients\u2019 and healthcare professionals\u2019 views of self-management for bronchiectasis","volume":"8","author":"Kelly","journal-title":"BMJ Open Respir Res"},{"issue":"10408","key":"R25","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1016\/S0140-6736(23)01685-9","article-title":"Long COVID in low-income and middle-income countries: the hidden public health crisis","volume":"402","author":"Jassat","journal-title":"Lancet"},{"issue":"7","key":"R26","doi-asserted-by":"publisher","first-page":"e961","DOI":"10.1016\/S2214-109X(22)00114-0","article-title":"Clinical severity of COVID-19 in patients admitted to hospital during the omicron wave in South Africa: a retrospective observational study","volume":"10","author":"Jassat","journal-title":"Lancet Glob Health"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-10-800","article-title":"Group interventions to improve health outcomes: a framework for their design and delivery","volume":"10","author":"Hoddinott","journal-title":"BMC Public Health"},{"issue":"4","key":"R28","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1016\/j.jrp.2007.11.003","article-title":"The role of gratitude in the development of social support, stress, and depression: two longitudinal studies","volume":"42","author":"Wood","journal-title":"J Res Pers"},{"issue":"2","key":"R29","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1080\/09515070.2015.1007444","article-title":"Hope in a strengths-based group activity for individuals with chronic pain","volume":"28","author":"Larsen","journal-title":"Couns Psychol Q"},{"issue":"1","key":"R30","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1097\/MLR.0000000000001664","article-title":"Guidelines for Designing and Evaluating Feasibility Pilot Studies","volume":"60","author":"Teresi","journal-title":"Med Care"},{"key":"R31","unstructured":"Support for rehabilitation self-management after COVID-19-related illness. World Health Organization Regional Office for Europe; 2021. URL: https:\/\/www.who.int\/publications\/m\/item\/support-for-rehabilitation-self-management-after-covid-19-related-illness [Accessed 01-03-2023]"},{"key":"R32","doi-asserted-by":"crossref","unstructured":"Shahid A Wilkinson K Marcu S Shapiro CM . Fatigue severity scale (FSS). In: In: STOP, THAT and One Hundred Other Sleep Scales. Springer; 2011:167-168. [doi: 10.1007\/978-1-4419-9893-4_35]","DOI":"10.1007\/978-1-4419-9893-4_35"},{"key":"R33","unstructured":"Johns M . About the ESS. The Epworth Sleepiness Scale. URL: https:\/\/epworthsleepinessscale.com\/about-the-ess\/ [Accessed 09-11-2023]"},{"key":"R34","unstructured":"EQ-5D-5L. EuroQoL. 2024. URL: https:\/\/euroqol.org\/information-and-support\/euroqol-instruments\/eq-5d-5l\/ [Accessed 10-06-2023]"},{"key":"R35","unstructured":"The Warwick-Edinburgh Mental Wellbeing Scales - WEMWBS. Warwick Medical School. 2021. URL: https:\/\/warwick.ac.uk\/fac\/sci\/med\/research\/platform\/wemwbs [Accessed 20-06-2023]"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2017.05.003","article-title":"Sit-to-stand tests for COPD: a literature review","volume":"128","author":"Vaidya","journal-title":"Respir Med"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1258","article-title":"Process evaluation of complex interventions: Medical Research Council guidance","volume":"350","author":"Moore","journal-title":"BMJ"},{"issue":"7","key":"R38","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1080\/09540121.2012.729808","article-title":"Barriers to care among people living with HIV in South Africa: contrasts between patient and healthcare provider perspectives","volume":"25","author":"Bogart","journal-title":"AIDS Care"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2021.38.129.26311","article-title":"A report on the development of COVID-19 guidelines for rehabilitation professionals in African settings","volume":"38","author":"Ngeh","journal-title":"Pan Afr Med J"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e58436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:50:15Z","timestamp":1782841815000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e58436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,10]]},"references-count":39,"URL":"https:\/\/doi.org\/10.2196\/58436","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,10]]},"article-number":"v9i10e58436"}}