Themes and subthemes.

Background
The catastrophe caused by the Coronavirus disease has affected all services worldwide. A range of policies were introduced to slow the virus spread, which in turn, affected the accessibility and quality of healthcare services. This was a problematic and concerning for patients with chronic diseases, such as patients with diabetes mellitus (DM) and chronic respiratory diseases (CRD), due to their sustained need for ongoing health care. The aims of the study were: 1) assessing the level of both accessibility and quality of healthcare services during the Covid-19 pandemic from the DM and CRD patients’ perspectives, 2) assessing the association between the patients’ socio-demographics and their perspectives on health services accessibility and quality, and 3) exploring the perspectives of DM and CRD patients on barriers and facilitators of health services accessibility and quality during the era of COVID -19.
Method
Design. A sequential explanatory mixed-method was used in this study. In the quantitative part, a self -administered questionnaire was used to collect data from 300 patients with DM and/or CRD. In the qualitative part, focus group approach was used to collect data from 25 patients.
Setting. Public, private and teaching hospitals were involved.
Analysis. SPSS Version 25 was used to analyze the quantitative data. Thematic analysis was used to analyze the qualitative data.
Results
The quantitative findings indicated that almost 99% of the participating patients perceived barriers, ranging from low to high, to accessing health services during COVID-19. Additionally, more than half of the sample perceived low to moderate level of quality of health services. Four themes and nine subthemes related to barriers and facilitators were identified in the qualitative part of the study.
Conclusion
The study revealed that both quality and accessibility of healthcare services for DM and CRD patients were impacted during the era of COVID -19. The findings lay the ground for developing future health programs and establishing or revising policies with the goal of improving healthcare services quality and accessibility for the target population.

背景
新型冠状病毒肺炎（Coronavirus disease）引发的疫情灾难已对全球各行各业造成冲击。各国陆续出台多项政策以减缓病毒传播，此举却间接影响了医疗服务的可及性与质量。由于糖尿病（Diabetes Mellitus, DM）患者与慢性呼吸道疾病（Chronic Respiratory Diseases, CRD）等慢性病患者需要长期持续的医疗照护，疫情对他们而言无疑是极具挑战且令人担忧的状况。本研究的研究目的如下：① 从糖尿病与慢性呼吸道疾病患者的视角，评估新冠疫情期间医疗服务的可及性与质量水平；② 分析患者社会人口学特征与其对医疗服务可及性、质量的认知之间的关联；③ 探讨新冠疫情期间糖尿病与慢性呼吸道疾病患者眼中影响医疗服务可及性与质量的阻碍因素与促进因素。

方法
研究设计：本研究采用序贯解释性混合研究方法。定量研究阶段，通过自填式问卷向300名糖尿病和/或慢性呼吸道疾病患者收集研究数据；定性研究阶段，则采用焦点小组法对25名患者进行数据采集。
研究场景：本研究纳入了公立、私立及教学医院。
数据分析：定量数据采用SPSS 25版本软件进行分析；定性数据则采用主题分析法进行编码与分析。

结果
定量研究结果显示，近99%的参与患者表示在新冠疫情期间就医存在不同程度（从轻度到重度）的阻碍。此外，超过半数的研究对象认为医疗服务质量处于低至中等水平。本研究定性阶段共识别出与阻碍因素及促进因素相关的4个主主题与9个亚主题。

结论
本研究表明，新冠疫情期间糖尿病与慢性呼吸道疾病患者所获得的医疗服务质量与可及性均受到了影响。本研究结果可为后续制定医疗照护方案、出台或修订相关政策提供依据，旨在提升目标人群的医疗服务质量与可及性。