Therapist perceptions of barriers to telehealth uptake in children's occupational therapy.

INTRODUCTION: The COVID-19 pandemic resulted in a rapid shift to telehealth implementation across paediatric occupational therapy services. Although telehealth can be an appealing option, access is conditional, and the delivery of a telehealth service differs from face-to-face. If telehealth is to be a viable and equitable option for families, insight is needed into why the service might be declined. The purpose of our study was to explore barriers to paediatric occupational therapy telehealth services from client and therapist perspectives in a Greater Sydney local health district. METHOD: A mixed method approach was used, including (i) retrospective review of clinical records for 250 clients seeking occupational therapy who declined the service and (ii) a focus group with four therapists providing the service. Client demographic information was summarised using descriptive statistics. Open-text responses about reasons for declining telehealth were analysed using qualitative content analysis, whereas thematic analysis was used to explore focus group data. FINDINGS: Key findings from the mixed methods analysis identified barriers and issues to consider when working to ensure equitable access to telehealth for children and families. These issues included child engagement, family complexity, the nature of assessments, interventions, and overarching service characteristics as well as the family's digital inclusion. Digital inclusion comprises affordable access to the internet, data, and devices and the capacity of a child and/or family to engage online. CONCLUSION: Our findings suggest that telehealth is not a panacea when face-to-face services are not available. Multiple barriers confounded uptake of telehealth prompting a call to action to ensure equitable access to occupational therapy services for all children.

A systematic review that is ``rapid'' and ``living'': A specific answer to the COVID-19 pandemic.

OBJECTIVE: This study aims to describe "rapid living" systematic reviews, an innovative methodological design used to systematically synthesize emerging evidence in the field of rehabilitation during the COVID-19 pandemic. STUDY DESIGN AND SETTING: A methodological paper, with a formative approach to rapid living systematic reviews. RESULTS: Based on our experience, we propose the following definition of rapid living SR: ``A dynamic method of knowledge synthesis that allows for the constant updating of new emerging evidence and refinement of its methodological quality.'' This method has the benefit of accelerating the conduct of traditional systematic reviews and allows for a synergistic adaptation of methodology based on the quality of the evidence with a flexibility to update results, methods and collaborations. CONCLUSION: Our proposed methodology has been helpful to synthesize the rapidly evolving evidence in the field of rehabilitation during the pandemic. Similarly, it may be useful when a rapid answer is urgently needed to make informed decisions. The COVID-19 disease has shown that modern medical science has the ability to produce new knowledge at a rate never seen before. Therefore, our proposed rapid living systematic reviews provide the scientific community with a method to rapidly synthesize evidence when facing health emergencies.

Nursing Diagnoses for Coronavirus Disease, COVID-19: Identification by Taxonomic Triangulation.

PURPOSE: To identify the nursing care problems related to the clinical process of disease by COVID-19. METHOD: The study applied the taxonomic triangulation technique on a clinical management guide to coronavirus disease, COVID-19, from the World Health Organization. The technique is divided into the phases: extraction of knowledge in natural language about assessment, planning and intervention, translation into standard language NOC and NIC, linking to NANDA-I diagnoses, triangulation looking for diagnostic matches in the three sets, and, finally, validation by a panel of experts from a hospital and a university. FINDINGS: The extraction identified 159 terms in natural language that were translated into 173 variables: 34 NOC for assessment, 19 NOC for planning, and 120 NIC for intervention. The relationships to NANDA-I diagnoses recorded 2,182 links and the triangulation returned 109 diagnoses, 54 of them for a critical situation. The panel of experts unanimously validated the 29 diagnoses with the highest number of links. CONCLUSION: Coronavirus disease, COVID-19, involves a complex situation with multiple associated care problems that can be identified using the taxonomic triangulation technique. IMPLICATIONS FOR NURSING PRACTICE: The links between taxonomies and the taxonomic triangulation technique are an important tool for generating knowledge. The results of this study may guide the diagnosis and treatment of coronavirus disease, COVID-19, as well as similar processes that occur with acute respiratory distress syndrome.