Citation: Jackes, A.; Malfesi, M.; Curnow, E.; Tyagi, V.; Bulley, C. Living with and Breaking a Cycle of Illness: A Secondary Qualitative Data Analysis of Women’s Experiences with Long COVID. Women 2022, 2, 161–175. https://doi.org/10.3390/ women2020017 Academic Editor: Mary V. Seeman Received: 27 April 2022 Accepted: 13 June 2022 Published: 17 June 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). Article Living with and Breaking a Cycle of Illness: A Secondary Qualitative Data Analysis of Women’s Experiences with Long COVID Alison Jackes *, Michael Malfesi, Eleanor Curnow , Vaibhav Tyagi and Cathy Bulley School of Health Sciences, Queen Margaret University (at Time of Study), Queen Margaret Drive, East Lothian, Musselburgh EH21 6UU, UK; miker.malfesi@gmail.com (M.M.); ecurnow@qmu.ac.uk (E.C.); vtyagi@qmu.ac.uk (V.T.); cbulley@qmu.ac.uk (C.B.) * Correspondence: aejackes@gmail.com; Tel.: +1-250-254-4284 Abstract: Long COVID is an emerging condition, with early evidence suggesting it impacts women at a greater rate than men. As we seek to understand long COVID, it is important to consider the holistic impacts of this condition. Therefore, a qualitative perspective was used to explore the experience of those living with long COVID. Eight people from Scotland, who presented as women and Caucasian, participated in this study. A thematic analysis, from a phenomenological perspective, was conducted on data collected during two semi-structured focus groups. Five central themes emerged including: (1) a prolonged, varied, and debilitating illness; (2) barriers to care; (3) predominantly negative experiences of care; (4) fighting to carry the burden; and (5) looking to the future. These themes are linked through an explanatory theory describing a cycle of illness, the work required to break the cycle, and participant’s aims to regain their health and advocate for their condition. The thematic results are consistent with two prior qualitative studies on long COVID, creating a relatively consistent picture of individuals’ experiences during the pandemic. Additionally, the developed theory shares commonalities with individuals living with chronic illness, providing further insight into participants’ experiences. Keywords: health; women; qualitative; long COVID; experiences; long-term condition 1. Introduction As the global pandemic caused by SARS-CoV-2 (the novel coronavirus responsible for the disease COVID-19) enters its third year, it has become apparent that some individuals who contract the virus experience persisting illness. This is consistent with the two prior 21st century coronavirus epidemics (SARS and MERS), where some endured physical and mental sequelae for months or years after illness onset [1]. In May 2020, the first anecdotal report of prolonged COVID-19 was published, and by June, online communities of people experiencing this were forming [2]. These groups suggested that focusing on case numbers and deaths was creating an incomplete picture of COVID-19; it omitted this chronic condition, which these groups named long COVID [3]. International definitions for long COVID have only recently been developed. The World Health Organization conducted a Delphi consensus study to establish a clinical case definition: “Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others which generally have an impact on everyday functioning. Symptoms may be new onset, following initial recovery from an acute COVID19 episode, or persist from the initial illness. Symptoms may also fluctuate or relapse over time. A separate definition Women 2022, 2, 161–175. https://doi.org/10.3390/women2020017 https://www.mdpi.com/journal/women