Risk, vulnerability, and protective factors in living with a tracheostomy in times of Covid-19

The study aimed to explore the experiences of people with neuromuscular and chronic respiratory diseases and their caregivers concerning tracheostomy management at home during the Covid-19 health emergency in Italy. In a multiple case study approach, we sought perspectives through semi-structured interviews of caregivers and patients with neuromuscular or chronic respiratory diseases and tracheostomy. In addition, the following instruments were used: Connor and Davidson Resilience Scale (CD-RISC-25), to detect resilience; Acceptance and Action Questionnaire-II (AAQ-II), to detect flexibility; State-Trait Anxiety Inventory (STAI), to detect trait anxiety; Langer Mindfulness Scale (LMS), to measure dispositional mindfulness; Zarit Burden Interview (ZBI) to detect caregiver’s burden. Qualitative analyses, based on Interpretative Phenomenological Analysis (IPA), were used to identify themes, sub-themes, frequency of words and metaphors. Twenty-two patients [50% female, Mean age=50.2±21.2] and 52 caregivers [62.3% female, Mean age 52.2±1.22] took part in the study. The demonstration of a relationship between resilience, flexibility, anxiety, and dispositional mindfulness offers the opportunity to reinforce the management of tracheostomy at home, even in emergency periods.