|
MINISTRY OF HEALTH
-------
|
SOCIALIST REPUBLIC
OF VIETNAM
Independence – Freedom – Happiness
----------------
|
|
No. 1242/QD-BYT
|
Hanoi, May 18, 2022
|
DECISION
GUIDELINES
ON POST COVID-19 REHABLITATION AND SELF-MANAGEMENT OF RELATED ILLNESSES
MINISTER OF HEALTH
Pursuant to Law on Prevention and Control of
Infectious Diseases in 2007;
Pursuant to the Law on Medical Examination
and Treatment in 2009;
Pursuant to Decree No. 75/2017/ND-CP dated
June 20, 2017 of the Government on functions, tasks, powers, and organizational
structure of the Ministry of Health;
Pursuant to Resolution No. 38/NQ-CP dated
March 17, 2022 of the Government on COVID-19 Control Program;
At request of Director of Department of
Medical Service Administration, Ministry of Health.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Article 1. The
Guidelines on post COVID-19 rehabilitation and self-management of related
illnesses are attached hereto.
Article 2. The
Guidelines on post COVID-19 rehabilitation and self-management of related
illnesses apply to people recovering from COVID-19 infection at home and
grassroots health personnel.
Article 3. Assign
Health Departments of provinces and central-affiliated cities, and health
authorities to direct implementation hereof for the general public and medical
establishments assigned to manage and advise on the general public's health
following a recovery from COVID-19.
Article 4. This
Decision comes into effect from the day of signing.
Article 5. Chief
of Ministry Office, Chief of Ministry Inspectorate, Directors of Departments
affiliated to Ministry of Health; Chairpersons of Steering Committees for
COVID-19 Control of provinces and cities; directors of hospitals and institutes
affiliated to Ministry of Health; directors of Health Departments of provinces
and central-affiliated cities; heads of medical sector are responsible for
implementation of this Decision./.
PP. MINISTER
DEPUTY MINISTER
Nguyen Truong Son
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
(Attached to Decision
No. 1242/QD-BYT dated May 18, 2022 of Minister of Health)
Compilation director:
Assoc. Prof. PhD Nguyen Truong Son
Deputy Minister of Health
Chief editor:
Assoc. Prof. PhD Luong Ngoc Khue
Director of Department of Medical Service
Administration, Ministry of Health
Participants in compilation and appraisal:
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Vice Director of Department of Medical
Service Administration, Ministry of Health
Assoc. Prof. PhD Tran Trong Hai
Chairperson of the Vietnam Rehabilitation
Association
Prof. PhD. Cao Minh Chau
General Secretary of Vietnam Rehabilitation
Association
Specialist Level 2 MD. Nguyen Trung Cap
Vice Director of National Hospital of
Tropical Diseases
Assoc. Prof. PhD Truong Tuyet Mai
Vice Director of National Institute of
Nutrition
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Vice Director of the Central Rehabilitation
Hospital
PhD. Tran Ngoc Nghi
Director of Division of Rehabilitation and
Expertise, Department of Medical Service Administration
Specialist Level 1 MD. Nguyen Thi Thanh
Lich
Vice Director of Division of Rehabilitation
and Expertise, Department of Medical Service Administration
Assoc. Prof. PhD Luong Tuan Khanh
Director of Rehabilitation Center, Bach Mai
Hospital
Assoc. Prof. PhD Do Dao Vu
Vice Director of Rehabilitation Center,
Bach Mai Hospital
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Head of Emergency Department, Bach Mai
Hospital
PhD. Pham Thi Cam Hung
Vice Principal of Hai Duong Medical
Technical University
BMed. Specialist Level 2 MD. Tran Quoc Dat
Head of Rehabilitation Department,
Friendship Hospital
PhD. Nguyen Trong Hung
Director of Department of Adult Nutrition
Counseling - National Institute of Nutrition
Specialist Level 2 MD. Vu Thi Thu Huong
Director of Department of Examination and
Treatment, National Hospital of Tropical Diseases
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Director of Rehabilitation Department, Cho
Ray Hospital
BMed. Le Huy Cuong
Director of Rehabilitation Department,
Central Rehabilitation Hospital
BMed. Nguyen Thu Phuong Anh
Director of Department of Exploration -
Rehabilitation, National Lung Hospital
BMed. Nguyen Minh Hanh
Principal Official, Department of
Rehabilitation and Expertise, Department of Medical Service Administration
Specialist Level 1 MD. Ho Quang Hung
Vice Director of Rehabilitation Department,
Cho Ray Hospital
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Head of C6 Department - Heart Institute -
Bach Mai Hospital
MD. Pham Thi Le Quyen
Respiratory Center, Bach Mai Hospital
MD. Bui Van Loi
Institute of Mental Health, Bach Mai
Hospital
Editor secretaries:
BMed. Nguyen Thu Phuong Anh
Director of Department of Exploration -
Rehabilitation, National Lung Hospital
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Principal Official, Department of
Rehabilitation and Expertise, Department of Medical Service Administration
MD. Nguyen Thi Dung
Principal Official of Department of
Rehabilitation and Expertise, Department of Medical Service Administration
BMed. Nguyen Thanh Hoa
Principal Official of Department of
Rehabilitation and Expertise, Department of Medical Service Administration
MD. Do Duc Tuan
Principal Official of Department of
Rehabilitation and Expertise, Department of Medical Service Administration
GUIDELINES
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Who is this document for?
This document provides guidelines on post
COVID-19 rehabilitation and self-management of related illnesses for adults. This
document can be used in combination with guidance of health workers.
This document is compiled by care, treatment,
rehabilitation experts after consulting recovered COVID-19 patients on the
basis of documents of World Health Organization (WHO). Despite being
indigestible, advice given under reference documents is based on evidence. There
are a lot of details regarding post COVID-19 recovery that remain obscure and
more and more evidence will come to light.
COVID-19 can cause health problems and
long-term symptoms that impact daily activities. In some cases, these symptoms
may last more than 12 weeks and have now been referred to as post COVID-19
conditions, also known as long COVID-19 or post COVID-19 conditions. Regular
symptoms will improve over time. This document provides practical
recommendations to allow readers to manage these regular symptoms. If these
symptoms worsen or do not improve over time, physical examination by health
workers is required.
You can read this document in each section,
starting with sections related to symptoms that you wish to improve the most.
In addition, health workers can make
adjustments to advice given under the document to best suit your situations. Advice
under this document does not replace personal rehabilitation program or advice
which you personally receive from health workers.
Your family and friends can help you recover
so it’s in your best interests to share this document with them.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
“Warning sign". When to contact a
health worker for emergency aid
Managing breathlessness
Exercising
Conserving energy and managing fatigue
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Managing problems relating to swallowing
Nutrition and problems relating to sense of
smell and sense of taste
Managing problems with attention, memory,
and thinking clearly
Managing problems with stress, mood,
depression, and sleep
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Returning to work
Symptom diary
“Warning sign". When to contact a
health worker for emergency aid
Medical complications may occur during post
COVID-19 recovery and require emergency medical care. You must immediately
contact health workers when:
- You have difficulty breathing when performing
light activities and the condition does not improve with positions described in
pages 2-3; or
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
- You fee chest pain, fast heart rate, or
dizziness in some positions or throughout the exercise or physical activities,
or
- Confusion worsens or you have difficulty
talking or understanding speech; or
- You feel changes to feeing and motion on your
face or limb(s), especially when these symptoms are unilateral and/or anxiety
or mood worsens, or you are having self-harm thoughts.
Managing breathlessness
Managing breathlessness
- Cause of breathlessness: damage to lungs,
heart, or muscle weakness.
- Breathlessness usually occurs as a result of
physical exertion
- Upon experiencing breathlessness: Remain
calm, cease all physical exertion, take appropriate positions to ease
breathlessness, practice diaphragmatic breathing: inhale before physically
exerting, exhale while physically exerting.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Positions to ease breathlessness: combine
breathing practices with these positions to ease breathlessness.
Taking a prone position
Lying on your side propped up by pillows,
supporting your head and neck, with your knees slightly bent
Forward lean sitting
Forward lean sitting (no table in front)
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
While standing, lean forwards onto a
windowsill or other stable surface.
Lean with your back against a wall and your
hands by your side. Have your feet about 30 cm away from the wall and
slightly apart.
Breathing techniques
* Diaphragmatic breathing or belly
breathing helps relax and ease breathlessness
- Lie or sit in a comfortable position, put
one hand on your stomach, relax and focus on your breathing.
- Slowly breathe in through your nose, your
stomach will rise along with your hand.
- Hold your breath for 1-2 seconds. Later
repetitions will require you to hold your breath for as long as possible.
- Breathe out through your mouth while
sinking your stomach.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
* Paced breathing
Think about breaking the activity down into
smaller parts to make it easier to carry out without getting so tired or
breathless at the end Example when taking the stairs.
- Breathe in through the nose and take one
step up the stairs
- Breathe out through the mouth and take
another step up.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Staying indoors or in hospital as a result of
COVID-19 infection for a long time will reduce physical strength and muscle. Exercising
helps improve physical strength and muscle. However, exercising must be safe
and monitored for other symptoms of COVID-19 infection.
You may feel tired or “exhausted” or
“laborious” despite little effort. This phenomenon is called “post-exertional
malaise”. This symptom typically occurs for several hours following physical
and mental exertion. It commonly takes at least 24 hours to physically recover,
reenergize, and regain focus, sleep, and memory.
If you experience “post-exertional malaise”,
avoid physical exercises or exerting activities while maintaining energy. If
you do not experience exertional malaise, you can increase exercise intensity
gradually. You can refer to the Borg - CR 10 scale to increase exercise
intensity.
This scale is an objective tool for assessing
the perception of intensity that you will feel when exercising, from 0 (no
exertion) to 10 (most exertion).
Borg - CR 10 rating varies from person to
person and from time to time for the same activity. For example, by walking,
you may experience a rating of 1 (very light) while another person may
experience a rating of 4 (little exertion) or you may experience another rating
on another day. You will write down your daily activities and give Borg - CR 10
ratings for those activities in order to monitor your situations and gradually
increase your intensity.
Stages of exercise
Exercises shall be divided into 5 stages with
each stage must be maintained for at least 7 days before moving onto a higher
intensity stage. If you feel increasing fatigue after exercising, reduce
intensity and/or move back to a lighter intensity stage.
If you experience chest pain or dizziness,
stop immediately and contact health workers.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Preparation activities (Borg - CR 10 rating
from 0 - 1)
Perform breath control exercises, walking,
muscle stretching exercises, and balancing exercises.
You can stretch muscle while standing or
sitting. Each stretch should be done slowly and kept in position for 15-20
seconds.
If your Borg - CR 10 rating of the
exercises increases by 1, you must stop exercising at this stage.
Reach your right arm up to the ceiling and
then lean over to the left slightly; you should feel a stretch along the
right side of your body. Repeat for the other side.
Put your arm out in front of you, keep your
arm straight, and bring it across your body at shoulder height, using your
other hand to squeeze your arm to your chest so you feel a stretch around
your shoulder. Repeat on the opposite side.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Stand with your feet apart and leaning
forwards onto a wall or something sturdy. Keep your body upright and step one
leg behind you. With both feet facing forwards, bend your front knee, keeping
your back leg straight and your heel on the floor. You should feel a stretch
in the back of your lower leg. Repeat on the opposite side.
Stand up and hold onto a chair. Bend one
leg up behind you, and if you can reach it, use the hand on the same side to
hold your ankle or the back of your leg. Take your foot up towards your
bottom. Repeat on the opposite side.
Stage 2
Low-intensity activities (Borg - CR 10 rating
of 2-3)
Walking, chores, or light gardening.
If you complete the exercises with ease (Borg
- CR 10 rating of 2-3), you can increase daily exercise duration by 10 - 15
minutes. You will have to maintain this exercising stage for 7 days without
feeling exhausted before moving onto the next stage. If your Borg - CR 10
rating of the exercises is higher than 3, you should stop exercising at this
stage.
Stage 3
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Jogging, going up and down the stairs,
running, bowing, resistance training, and focusing on upper body. If your Borg
- CR 10 rating of the exercises is higher than 5, you should stop exercising at
this stage.
Strengthening exercises for your ARMS
Biceps exercise
Hold a weight or water bottle in each hand
with your palms facing forwards. Gently lift the forearms, bringing the
weights up and down. You can do this exercise sitting or standing.
Wall push off
Stand 20 cm away from the wall and face the
wall, place your one hand flat against the wall at shoulder height. Slowly
lower your body towards the wall by bending your elbows, then gently push
away from the wall again, until your arms are straight. Repeat for the other
side.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Hold a weight in each hand, with your arms
by your sides and your palms facing inwards, raise both arms out to the side,
up to your shoulder level (but not higher), and slowly lower back down.
Strengthening exercises for your LEGS
Sit to stand
Sit with your feet hip-width apart. With
your arms by your side or crossed over your chest, slowly stand up, hold the
position for the count of 3, and slowly sit back down onto the chair
Knee straightening
Sit in a chair with your feet together.
Straighten one knee and hold your leg out
straight for a moment, then slowly lower it. Repeat with your other leg.
Increase the time holding your leg out straight to a count of 3.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Squats
Stand with your back against a wall or
other stable surface and your feet slightly apart. Move your feet about 30 cm
away from the wall. Slowly bend your knees a short distance; your back will
slide down the wall. Keep your hips higher than your knees
Pause for a moment before slowly
straightening your knees again.
Heel raises
Rest your hands on a stable surface to
support your balance, but do not lean on them. Slowly rise up on to your
toes, and slowly lower back down again.
Stage 4
Moderate-intensity activities for motor and
coordination functions (Borg - CR 10 rating of 5 - 7)
Running, cycling, swimming, dancing.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Stage 5
Returning to regular exercising (Borg - CR 10
rating of 8 - 10)
You can resume your regular sports and
activities.
Do not exercise if you feel pain If you feel
pain such as chest pain or nausea or dizzy during exercise, stop immediately
until you have consulted health workers.
Conserving energy and managing fatigue
Fatigue is one of the most commonly seen
symptoms during recovery from COVID-19 and described as a feeling of being
overwhelmed or physically and mentally exhausted.
Physical fatigue: if you feel physical
fatigue, you will find your body heavy and light physical exercises to be
energy-consuming.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Fatigue causes you to feel exhausted after
completing daily tasks. You may wake up feeling as fatigued as before you go to
sleep. The level of fatigue you experience can change on a weekly, daily, or
hourly basis. You do not feel motivated to do anything and/or feel exhausted
even with the simplest tasks and find it difficult to explain your exhaustion
to your family, friends, and colleagues.
Help other people understand your fatigue and
how it affects you can create a huge difference in how you deal with and manage
your fatigue.
Pacing
Pacing is a key strategy to help you avoid
injury while managing your activities without worsening current symptoms. You
should develop a flexible plan which allows you to stay within your current capacity
and avoid being overloaded. After which, your level of activity can be
gradually increased in a controlled manner as soon as your energy level and
symptoms improve.
By adjusting the pace of your activities
yourself, you can make sure that:
- You are controlling the parameters set forth
for yourself.
- These parameters fit your current capacity.
- You are exposing your physical and mental
attributes to these demands on a regular basis and in a controlled manner in
order to assist your gradual recovery.
The first step is to think of how many
activities can you perform without being exhausted or relapsing. It is
important not to compare yourself to other people or your previous self. Thereby
you can create a basic number of tasks or activities which you can carry out
safely on a daily basis.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
If you feel low on energy, you should save
energy for the most important tasks. You should identify necessary tasks in
your day - meaning you should define tasks that you “must” do, tasks that you
“want” to do, tasks that you can do at a later time, and tasks that you can ask
for help from other people.
Planning
When planning for your day or week, it is
best to evenly distribute activities instead of cramming everything in one day.
Carry out energy-consuming activities whenever your energy level is at the
highest. Can any activity be rearranged so that you do not have to complete
everything at the same time? For example, can you just clean one room instead
of the whole house at once?
Planning for rest and relaxation to help you
“recharge” is as important as planning for your activities. Plan for multiple
rests in a day if necessary.
Keeping an activity diary or daily timetables
will help you adjust your pace and prioritize what you must do and want to do. You
may have to try several times in order to find the best direction. As soon as
you find your correct pace, it is important that you must keep your pace
consistent for a definite amount of time before increasing your activity
intensity.
Examining and counseling fatigue management
If fatigue persists after you have adjusted
your pace and prioritized activities, clearly affects your health and daily
tasks, and is accompanied by symptoms such as (1) Fatigue after exertion
lasting longer than 24 hours; (2) Difficulty staying asleep; (3) Reduced memory
or concentration capacity; (4) Muscle pain, multiple joint pain without
inflammation, soreness; Sore throat or mouth ulcer; headache, you should seek
appropriate specialist consultation for diagnosis and treatment. In addition,
if you feel persistent fatigue after COVID-19 infection while having chronic
diseases relating to cardiovascular (coronary artery disease, heart failure,
etc.), internal diseases (diabetes, chronic kidney disease, chronic obstructive
pulmonary disease, etc.) or cardiovascular, pulmonary, etc. complications
during COVID-19 infection, you should immediately seek appropriate specialist
consultation for examination.
Managing problems with your voice
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
COVID-19 may cause sore throat, coughing, and
feeling of mucus in your throat thus you feel the need to frequently clear your
throat. Your voice may also be weak, out of breath, or hoarse, especially when
you were previously ventilated (having a breathing tube) in the hospital. You
may feel that your throat/upper respiratory tract is more sensitive to the
environment than it was before the infection. For example: you may cough or
feel throat tightness or breathless if you are exposed to a strong scent. If
your symptoms do not relieve over time, please consult healthcare specialists.
Advice for voice problems
- Stay well hydrated. Sip water throughout the
day to keep your vocal cord flexible and functional.
- Straining your voice, raising your voice, or
screaming may strain your vocal cord. Whispering may cause your vocal cord to slack.
- Steam inhalation for 10 - 15 minutes helps
moisturize the vocal tract.
- Gastroesophageal reflux disease may cause
your throat to sore or irritate and thereby affecting your vocal cord and
altering your voice, so you should avoid certain food and eating late at night.
- Quit smoking and imbibing.
- Use other forms of communication, such as
writing, texting, or gestures if talking is difficult or uncomfortable.
Advice for persistent coughing
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
- Try sucking on low-sugar boiled sweets
- Practice “Coughing relief exercises”. Whenever
you feel like coughing, close your mouth and cover your mouth with your hands (TO
EASE the coughing). At the same time, SWALLOW with effort. HOLD your
breath - stop momentarily. Once you start breathing again, breathe in and
breathe out through your nose GENTLY.
- If you cough at night due to gastroesophageal
reflux, lie on one side or prop your head (neck) up with pillows.
Managing problems relating to swallowing
You have difficulty swallowing food and
beverages. This condition occurs because the muscles involved in the swallowing
process have been weakened. For people who were previously ventilated in
hospital, breathing tubes may cause bruises and swelling of the tongue, throat,
vocal cord, epiglottis. You should be careful to avoid choking which can lead
to aspiration pneumonia. Aspiration occurs if food/beverages go down "the
wrong pipe” and into your airway or lungs.
If you have difficulty swallowing, the
following advice may come in handy:
- Sit straight up
whenever you eat or drink. Do not eat or drink while lying.
- Keep a straight
(sitting, standing, walking) posture for at least 30 minutes after eating.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
- Focus on your meal,
have your meal in a quiet place Refrain from talking while eating or drinking
to prevent the opening of airway or choking or food and drink from going down
the wrong pipe into bronchus and lungs.
- Make sure that your
mouth cavity is empty before taking another bite or another sip. If necessary,
swallow one more time.
- Have many small meals
in the day if
you feel tired when you are full.
- If you cough or choke
while
eating or drinking, seek advice from a medical professional since the food or
drink may go down your airway.
- Keep your mouth
cavity clean by
brushing your teeth and drinking enough water.
Nutrition and problems relating to sense of
smell and sense of taste
COVID-19 can affect appetite and nutrition
and cause some people to lose weight due to skipping meals or gain weight due
to inactivity. Thus, a balanced, reasonable, and healthy diet is required in
order to improve and recover health.
- Make sure that you have enough food, have all
3 primary meals, eat even when you feel tired and do not want to eat. If your
intake amount is small, divide into smaller meals in order to have sufficient
nutrition.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
- If you feel tired or do not feel like eating
or do not eat enough, you should drink milk and energy-rich, protein-rich
supplements for 1-3 times/day. Vulnerable individuals such as the elderly,
people with underlying medical conditions, pregnant women, breastfeeding women,
small children, etc. must eat properly to prevent malnutrition.
- For people with underlying medical
conditions, adhere to prescription drug and advised diet suitable for their
conditions and nutrition situation.
- Drink a lot of water, 6-8 glasses every day
on average. Refrain from drinking soft drinks, alcoholic beverages, stimulants,
etc.
- Restrict salty food, fat, and sugar:
+ Have less than 5g of salt every day
(equivalent to 1 teaspoon)
+ Have less than 50g of sugar every day
(equivalent to 12 teaspoons).
+ Total fat should be less than 30% of total
food intake. Opt for unsaturated fat in fish, avocado, peas, and vegetable oil
instead of saturated fat (fat, butter, etc.) and trans fat (confectionery,
fried oil, etc.).
- Ensure food safety, only consume cooked food
and drink. Read food label carefully before use.
- Receive nutrition advice from health workers.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
- Brush your teeth twice every day.
- Sniff fragrant herbs (lime, rose, clove,
eucalyptus, etc.) for 20 seconds every time for 2 times per day.
- Use herbs and spices such as chili, lime
juice, and other kinds to enhance the flavor. However, these components should
be used with care as they can worsen gastroesophageal reflux in some people.
Managing problems with attention, memory,
and thinking clearly
While recovering from COVID-19, you may
suffer from a series of difficulties relating to your thinking capacity
(hereinafter referred to as “cognition”). These difficulties may include
problems with memory, attention, information processing, planning, and organization.
These conditions are also referred to as “brain fog” phenomenon. The brain fog
phenomenon usually worsens due to fatigue, meaning the more fatigue you feel,
the more difficulty you will have with your thinking capacity.
The important thing is you and your family
should be aware of whether or not you encounter these difficulties since they
can affect your relationship, daily activities, your return to work or
education. If you face any of difficulties above, the following advice might be
helpful:
- Reduce distraction: try working in a
peaceful environment without distractions. You can use earplugs if necessary. If
you feel distracted while reading text, mark sections of the text with paper or
your fingers.
- Complete activities
whenever you feel less tired: Whenever your tasks require thinking
capacity, save these tasks for when you feel less tired. For example, if you
feel tired as the day goes on, finish your work in the morning.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
- Set reasonable goals
and objectives: Something
clear and attainable will help you stay motivated. Set realistic and attainable
goals for yourself. For example: Read 5 pages each day.
- Prepare timetable: Establish your daily
and weekly timetables. It might come in handy if you make plans in advance. It
might also come in handy if you record or divide tasks into manageable parts.
- Reward yourself: Whenever you achieve
your goals, reward yourself - starting with something simple, having a cup of
tea or coffee, watching television, or going on a walk.
- Do one activity at a
time: Do
not feel the urge or try to receive too much information at the same time, as
doing so can lead to errors in information processing.
- Prompt yourself: Use lists, notes,
diaries, and calendars to help your memory and habits.
- Brain exercise: try new hobbies,
solve puzzles, crossword puzzles, memory exercises, or read to help you think.
Start with challenging but manageable brain exercises and increase the
difficulty whenever you can. Doing so is important as it helps keep you
motivated.
- In addition, some solutions for
improving physical conditions and strategies for reducing stress can improve
brain fog condition such as: taking sufficient and quality sleep, exercising,
relaxing; thinking positively, having reasonable diet, avoiding psychotropic
substances such as alcohol, stimulants, etc.
Managing problems with stress, mood,
depression, and sleep
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Relaxing
Relaxing helps you conserve the limited
energy that you have during recovery from COVID-19. This helps you control
anxiety and improve your mood. Examples regarding relaxing techniques are
mentioned below.
Grounding technique
Breathe gently and ask yourself:
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
What are the 4 things I can touch?
What are the 3 things I can hear?
What are the 2 things I can smell?
What is the one thing I can taste?
Think and answer these questions to yourself
slowly, one question at a time, and spend at least 10 seconds to focus on each
question.
The important thing to remember is that your
symptoms are a part of the recovery process. Anxiety and thoughts about your
symptoms can make you feel worse. For example, if you focus on your headache,
you may feel your headache worsen.
Relaxation techniques
Find a quiet place, gentle lighting but not
too bright, lie flat with your limps stretched out and in a complete relaxed
state. Whisper and think to yourself “completely still” while paying attention
to your breath. You can repeat until you feel comfortable or enter a sleep
state.
In addition, an important thing to remember
is that symptoms are usually related: the increase of one symptom can lead to
the increase of another. If you feel tired, your ability to focus will be
affected, and then your memory will be affected followed by more anxiety and
you will feel more tired. As you can see, it becomes a loop. You only have to
improve one symptom to improve another.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
- Sleep quality
+ Try to return to a regular sleeping and
waking time, using alarms to remind you;
+ You or your family/caregivers can ensure
that your environment is free from things that might disturb you, such as too
much light or noise.
+ Try to stop using electronic devices such
as mobile phones and tablets one hour before you go to sleep;
+ Do not use or minimize the use of
substances that effect your sleep such as: alcohol, coffee, tobacco, or other
psychotropic substances;
+ Try to use relaxation technique to sleep.
- Alternative
relaxation techniques: Examples on relaxation techniques include meditation,
focusing on images, herbal bath therapy, Tai chi, Yoga, and music.
- Staying socially
connected is
important for your mental wellbeing. Talking with others can help to reduce the
stress.
- Eating healthily and
gradually returning to your daily activities or hobbies are the best ways to
improve your mood.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
- Spend more time to relax, you can choose
tasks that you feel excited (listening to music, gardening, etc.)
- Spend time exercising, play sports, and doing
appropriate physical training. If you do not exercise, you should start forming
the habit of doing so.
- Remain calm about health information and
select credible information sources.
- Share with relatives and seek help from
mental health professionals upon experiencing prolonged fatigue, anxiety, or
excessive boredom, or lose interest to everything, or experience extended
period of poor sleep quality, or have negative thoughts.
Managing pain
Pain is a common symptom of people recovering
from COVID-19. The pain may occur in localized area (joint pain, muscle pain,
headache, or abdominal pain) or in a generalized area or spread across the
body. Prolonged pain (that lasts longer than 3 months) may affect your sleep,
lead to insomnia, various degrees of fatigue, mood, reduced ability to focus or
work. If you experience localized pain, such as chest pain with pain severity
increases when you work, you can consult health workers.
Advice on pain management
- For joint pain, muscle pain, or body pain,
you can take over-the-counter pain relief such as paracetamol or ibuprofen
after meal.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
- It might be difficult to completely remove
persistent pain. Aiming towards controlling the pain will allow you to operate
and sleep better and potentially engage in daily essential activities.
- A good sleep will help relieve the pain. Time
your use of pain relief together with sleeping time will help if the pain
affects your sleep.
- Listening to relaxing music or meditating
can help reducing pain.
Arranging daily activities is an effective
tool in managing your pain. Light exercises help the body to release a
substance called endorphin which relieves pain.
- Be assured that pain is a common symptoms
and overcoming the pain is analogous to breaking the loop of pain. You can
overcome light pain but you should not exert yourself, as doing so will cause
you to feel more pain and fatigue (post-exertional malaise).
Returning to work
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
What you need to pay attention to upon
returning to work:
- Take time off until you feel strong enough.
- Discuss your health conditions with your
employers.
- If you feel strong enough to return to work,
consult health workers and occupational health workers where you work for
permission.
- Review your work responsibilities and assess
whether you can handle everything or just a part of the work.
- Discuss plans for returning to work to
employers, including the gradual increase of workload in a definite period
(also known as “phased return to work”) and regularly revise these plans. This
helps prevent repetition of symptoms and reduces the need for paid leave. Once
you have returned to work, you may adjust your work pace such as starting time
and finishing time, work from home or light tasks.
- Employers should assist employees’ phased
return to work as it may take several weeks or months, depending on employees’
symptoms and nature of the work.
- If you cannot meet your work demands,
consider changing tasks or work.
- If you think your health conditions may
affect your work in the long term, consult health workers and employers in
order to make necessary adjustments based on policies of the government and
legal demands.
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Symptom diary
Please specify whether the symptom occurs
before or after COVID-19 in the first column
In the subsequent columns, give a rating of
0-3 for each symptom (with 0 being no problem, 1 being mild
problem, 2 being moderate problem, 3 being serious or life-changing problem)
Put your rating on a weekly basis in order
to determine whether your symptoms are improving or worsening.
Symptoms
Do the symptoms
occur after COVID-19?
Yes/No
Day
Day
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Day
Day
Day
Rating
0-3
Rating
0-3
Rating
0-3
Rating
0-3
Rating
0-3
Rating
0-3
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you have cough/throat
irritation/voice problems?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you feel any change to your sense of
smell or sense of taste?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you have difficulty swallowing
soft or hard food?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you feel tired during the day?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Are you in pain (joint pain/muscle
pain/headache/abdominal pain)?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you feel your heart beating rapidly
whenever you move or do activities?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you feel dizzy whenever you move
or do activities?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you have difficulty sleeping?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you feel anxious?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you feel frustrated?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you have difficulty communicating
(in terms of looking for appropriate words)?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you have difficulty performing daily
personal tasks such as showering or dressing up?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Do you have difficulty taking care of family
members or communicating with friends?
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Other symptoms (specify)-
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Other symptoms (specify)-
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Other symptoms (specify)-
...
...
...
Hãy đăng nhập hoặc đăng ký Thành viên
Pro tại đây để xem toàn bộ văn bản tiếng Anh.
Reference:
1. Ministry of Health, 2020, Guidelines on
rehabilitation for severe acute respiratory syndrome caused by SARS-CoV-2
(COVID-19) (Attached to Decision No. 1719/QD-BYT dated April 15, 2020 of
Minister of Health).
2. Ministry of Health, 2021, Decision No.
5904/BYT-KCB dated December 29, 2021 on commissioning and promulgating videos
guiding rehabilitation for severe acute respiratory syndrome caused by
SARS-CoV-2 (COVID-19).
3. “Support for rehabilitation:
self-management after COVID-19-related illness, second edition; 2021. License: CC
BY-NC-SA 3.0 IGO”.