Occupational therapy and work: challenges and perspectives of an emerging practice during and after the Covid-19 pandemic

This essay discusses the intervention possibilities of occupational therapy in the field of work in the pandemic period, as well as points out the challenges and perspectives of post-pandemic actions. Interventions were discussed from three stages: i) pre -pandemic preparation;ii) pandemic preparedness strategies;iii) post-pandemic recovery, considering the micro, meso and macrostructural levels, from the perspective of a practice centered on the person and the work environment. Attention to work (in)capacities and acting in the process of returning to work were considered the main interventions of the occupational therapist, articulated with the various actors, institutions, services and class entities, in order to expand actions and promote a network integrated care. The new configurations of work resulting from technological innovation have expanded the interdisciplinary dialogue between occupational therapy and the field of work. It is expected to contribute with theoretical reflections about professional practice and the strengthening of this field in contemporary times.

ICU follow-up clinic provides the opportunity to recognise and address symptoms post critical illness, which may otherwise have been missed

Introduction: It is well documented that survivors of ICU admissions struggle to return to pre-admission level of function because of both physical and psychological burden. Current guidance therefore recommends a follow-up service to review patients 2-3 months post discharge [NICE 2009]. Prior to 2020 University Hospitals Bristol and Weston had no such service. With the increase in patient numbers seen during the COVID-19 pandemic, funding was received to provide a follow-up clinic to COVID-19 survivors. Objective(s): To provide a service that supports and empowers patients with their recovery from critical illness. Improving quality of life, speed of recovery and reducing longer term health care needs. Method(s): Referral criteria for the clinic included COVID-19 patients who received advanced respiratory support within intensive care and the high dependence unit. 8 weeks post discharge patients had a telephone appointment where ongoing symptoms could be identified. Advice around recovery, signposting to resources and onward referrals to appropriate specialities were provided. At 10 weeks post discharge patients had lung function tests and a chest X-ray which were reviewed by respiratory consultants. Based on the combination of these assessments, patients would be discharged or referred into the multidisciplinary team (MDT) follow-up clinic. The face to face clinic consisted of appointments with an intensivist, clinical psychologist, physiotherapist, and occupational therapist. Where needed patients would also be seen by a speech and language therapist or dietitian. Patients were seen only once in follow up clinic but again would be referred onto appropriate services within trust or the community, including but not exclusively community therapy services, secondary care services, SALT, dietetic or psychology clinics. Result(s): One of the key outcomes was the need for 147 onward referrals (an average of 1.13 referrals per patient). This included, 31 referrals to musculoskeletal physiotherapy outpatients for problems originating or made worse by their admission. 20 referrals to secondary care, including cardiology and ENT. 16 referrals to community occupational therapy, for provision of equipment, home adaptations and support in accessing the community. Subjectively, patient feedback was excellent. When asked what they felt was the most valuable thing they had taken from the clinic they reported: "Reassurance";"To know I'm not alone, others feel like this";"They listened to me and gave advice";"The ability to ask anything I wanted and the obvious kindness and support from all the clinicians I saw". Conclusion(s): Onward referral rates made by the follow-up clinic highlight the many issues faced by patients following discharge from ICU and hospital. With timely recognition and management, we can prevent a majority of these symptoms manifesting into chronic problems. This has the potential to lower the long-term burden on health care and improve quality of life for patients in both the short and long term. Without the follow-up clinic, these issues may have been missed or delayed. This reinforces the importance of the follow-up clinic and the need for ongoing investment.

An Examination of Occupational Therapy Telehealth Service Delivery Among Novice Users During the COVID-19 Pandemic

The COVID-19 pandemic allowed for widespread implementation of telehealth as a delivery method for occupational therapy (OT) services. The purpose of this study was to investigate the perceptions of novice telehealth OT practitioners regarding telehealth as a delivery method for OT services. Quantitative data was collected through a modified version of the Telehealth Usability Questionnaire and analyzed via descriptive statistics. Qualitative data was collected by open-ended questions and analyzed via thematic analysis. OT practitioners' responses revealed four major themes: logistics of telehealth practice, role of client champions, capacity of the OT practitioner, and styles and approaches. The study revealed that OT sessions delivered via telehealth increased access to clients and continuity of services. Client champion engagement, effective coaching strategies, and practitioner flexibility supported the success of OT telehealth sessions. © 2023, University Library System, University of Pittsburgh. All rights reserved.

Rehabilitation of a Child with Neonatal Brachial Plexus Palsy: Case Report Described by Parents.

This paper presents a case report of a child with Neonatal Brachial Plexus Palsy on the right arm, with C5, C6, and C7 nerve injuries. The symptoms presented at birth and at the time of diagnosis were absence of movement in the right arm but with mobility of the fingers; internal rotation of the injured limb with elbow extension; active flexion of the wrist and fingers; and ulnar deviation of the hand. The rehabilitation plan followed the conservative approach and included different intervention strategies (passive and active mobilisation, kinesio tape, use of splints, bimanual stimulation, etc.) carried out by the occupational therapist and the physical therapist. The rehabilitation allowed the child to have a functional limb for daily activities, with bimanual motor integration and coordination; passive and active range of motion in the different joints except for pronation, sensibility, and maintained strength. In conclusion, it can be said that this case report describes a set of rehabilitation strategies that were used in the conservative treatment of a child with NBPP and the functional gains they allowed. Early intervention, parental involvement in the rehabilitation process, and continuous follow-up of the child favoured the prognosis and allowed the prevention of functional sequelae of the limb.

Effectiveness of an Online Dementia Prevention Program on Cognitive Function and Depression in Community-Dwelling Older Adults during the COVID-19 Pandemic in Korea.

(1) Background: Continuous participation in a comprehensive dementia prevention program is important for community-dwelling older adults during the coronavirus disease (COVID-19) pandemic, as limitations on their communities and social participation have increased and participation in daily tasks has decreased. These factors can negatively affect their cognitive function and symptoms of depression. This study aimed to introduce an evidence-based online dementia prevention program in the South Korean context and to identify its effect on cognitive function and symptoms of depression in community-dwelling older adults during the COVID-19 pandemic. (2) Methods: One hundred and one community-dwelling older adults without dementia participated in twelve sessions of an online dementia prevention program designed by occupational therapists. Cognitive function and symptoms of depression were assessed before and after the program. Cognitive function was tested using the Cognitive Impairment Screening Test and symptoms of depression were assessed using the Korean version of the Short Geriatric Depression Scale. The participants' opinions were gathered using open-ended questions. (3) Results: After the program, according to the raw score, orientation was maintained and attention, visuospatial function, executive function, memory, and language function increased. The memory and total cognitive score was improved significantly. Symptoms of depression significantly decreased. The program's benefits according to the participants were participation in new activities, boredom reduction, online communication, and reminiscence. (4) Conclusions: An online dementia prevention program is effective in maintaining and increasing cognitive function and preventing depression in community-dwelling older adults. An online dementia prevention program is a useful method in providing opportunities to participate in cognitive training and continuous daily activities during the COVID-19 pandemic.

Impact of COVID-19 on Clinical Education for Occupational Therapy Students: A 3-Year Longitudinal Study on Fall Risk Prediction Ability.

This study aimed to examine if there were disadvantages to student learning and application when clinical education is canceled due to factors such as COVID-19 pandemic that occurred between 2020-2021. Forty occupational therapy students participated in the study, and they were classified into two groups: those with clinical education (clinical education group) and those without clinical education (inexperienced group). TP-KYT, which assesses a client's ability to predict risk related to falls, was administered in the first and final year. The inexperienced group showed less ability to predict risk related to client falls than the clinical education group.

Exploring the Influence of the Coronavirus Disease 2019 Pandemic on the Accessibility of Rehabilitation Services Provided to Children with Disabilities: A Cross-Sectional Study.

Background and Objectives: Children with disabilities (such as cerebral palsy, autistic spectrum disorder, and Down syndrome) are the most vulnerable and marginalized subset of the population, representing 2.7% of the total population of Saudi Arabia. The COVID-19 outbreak might have disproportionately affected children with disabilities, augmented their isolation, and induced severe disruptions to the services on which these children rely. Limited research has been conducted in Saudi Arabia to understand the impact of the COVID-19 pandemic on the rehabilitation services provided to children with disabilities and barriers. This study aimed to investigate the effect of the lockdown implemented as a result of the coronavirus disease-2019 (COVID-19) pandemic on the accessibility of rehabilitation services, including communication, occupational therapy, and physical therapy, in Riyadh, Kingdom of Saudi Arabia. Materials and Methods: In this cross-sectional study, a survey was conducted between June and September 2020 during the lockdown in Saudi Arabia. A total of 316 caregivers of children with disabilities from Riyadh participated in the study. The accessibility of rehabilitation services provided to children with disabilities was assessed by designing a valid questionnaire. Results: A total of 280 children with disabilities received rehabilitation services before the COVID-19 pandemic and showed improvement following therapeutic sessions. However, during the pandemic, most children stopped receiving therapeutic sessions because of lockdown, which deteriorated their condition. This shows a significant reduction in the accessibility of the rehabilitation services provided during the pandemic. Conclusions: The findings of this study revealed a drastic decline in services provided to children with disabilities. This caused a notable deterioration in the abilities of these children.

Role of Oral Intake, Mobility, and Activity Measures in Informing Discharge Recommendations for Hospitalized Inmate and Noninmate Patients With COVID-19: Retrospective Analysis.

BACKGROUND: Patients who were incarcerated were disproportionately affected by COVID-19 compared with the general public. Furthermore, the impact of multidisciplinary rehabilitation assessments and interventions on the outcomes of patients admitted to the hospital with COVID-19 is limited. OBJECTIVE: We aimed to compare the functional outcomes of oral intake, mobility, and activity between inmates and noninmates diagnosed with COVID-19 and examine the relationships among these functional measures and discharge destination. METHODS: A retrospective analysis was performed on patients admitted to the hospital for COVID-19 at a large academic medical center. Scores on functional measures including the Functional Oral Intake Scale and Activity Measure for Postacute Care (AM-PAC) were collected and compared between inmates and noninmates. Binary logistic regression models were used to evaluate the odds of whether patients were discharged to the same place they were admitted from and whether patients were being discharged with a total oral diet with no restrictions. Independent variables were considered significant if the 95% CIs of the odds ratios (ORs) did not include 1.0. RESULTS: A total of 83 patients (inmates: n=38; noninmates: n=45) were included in the final analysis. There were no differences between inmates and noninmates in the initial (P=.39) and final Functional Oral Intake Scale scores (P=.35) or in the initial (P=.06 and P=.46), final (P=.43 and P=.79), or change scores (P=.97 and P=.45) on the AM-PAC mobility and activity subscales, respectively. When examining separate regression models using AM-PAC mobility or AM-PAC activity scores as independent variables, greater age upon admission decreased the odds (OR 0.922, 95% CI 0.875-0.972 and OR 0.918, 95% CI 0.871-0.968) of patients being discharged with a total oral diet with no restrictions. The following factors increased the odds of patients being discharged to the same place they were admitted from: being an inmate (OR 5.285, 95% CI 1.334-20.931 and OR 6.083, 95% CI 1.548-23.912), "Other" race (OR 7.596, 95% CI 1.203-47.968 and OR 8.515, 95% CI 1.311-55.291), and female sex (OR 4.671, 95% CI 1.086-20.092 and OR 4.977, 95% CI 1.146-21.615). CONCLUSIONS: The results of this study provide an opportunity to learn how functional measures may be used to better understand discharge outcomes in both inmate and noninmate patients admitted to the hospital with COVID-19 during the initial period of the pandemic.

Partnering for Occupational Therapy Telehealth Services: Collaboratively developing telehealth and hybrid occupational therapy student placements

In 2020, in Ireland, challenges associated with the COVID-19 pandemic disrupted occupational therapy student practice education placements availability. New innovative placements were required. A collaboration between University of Limerick (UL), Ireland, and Dyspraxia/DCD Ireland (DDCD Ireland) has to date enabled 30 occupational therapy students to undertake practice education placements via telehealth. Originally, this placement was designed to allow students to meet learning objectives remotely. This case report outlines how an area of innovative practice at an Irish occupational therapy student education programme evolved, during the crisis associated with Covid-19, culminating in the establishment of the Partnering for Occupational Therapy Telehealth Services (POTTS), which is now a hybrid service (telehealth and face-to-face service).

Reflections on the role of occupational therapy programmes on the mental health of stakeholders' transition to e-learning during the COVID-19 pandemic

The rise in COVID-19 cases has resulted in the suspension of face-to-face classes in the Philippines. Educational programmes are suddenly expected to shift to e-learning strategies in the delivery of educational instructions. This case report provides a critical reflection on an occupational therapy (OT) programme's e-learning preparedness survey of its stakeholders. Implications on the stakeholders' readiness and confidence in e-learning as it relates to their mental health are discussed. The paper concludes with a recommendation for OT programmes to use its str in supporting its stakeholders' transition to an - learning environment to mitigate any associated mental health-related issues and promote full participation within this new environment.

Occupational therapists' Perspectives of Using Telehealth for Youth with Autism Amidst the COVID-19 Pandemic in the UK: A Pilot Qualitative Study

The COVID-19 national emergency led to a surging demand for telehealth expansion within pediatric occupational therapy. Despite the growing literature on telehealth as a response to COVID-19, few studies explore the use of telehealth for children and young people with autism spectrum disorder (ASD). This pilot study aimed to understand the experiences of occupational therapists adapting to a virtual delivery service model amidst COVID-19 to support youth with ASD. The researchers used a qualitative research design. Semi-structured, video-based interviews were used to collect data. Interviews were analyzed using thematic analysis. This study included 3 UK registered occupational therapists. Four themes emerged from the data: 1. "Telehealth is Reducing Social Anxiety" 2. "Parents End Up Becoming Your Therapy Assistants" 3. "Nothing Will Replace Face to Face for Assessments" 4. "You Definitely Have to Be More Creative." The themes report that telehealth can reduce social anxiety, increase skill transferability, and improve family involvement. Participants indicated that shorter sessions, movement-based interventions, planning and adapting to home-based resources were strategies that overcame the limitations of virtual therapy. The findings contrast with some previous research that found that telehealth may inhibit engagement and may strain the therapeutic rapport. This study supports existing literature that telehealth can enhance engagement, family involvement and generalization of skills. Findings from this study support the use of telehealth to deliver occupational therapy services for children and young people with ASD, but it is recommended that telehealth should not be a one size fits all service delivery model. Further larger-scale research is needed to confirm the study findings and to explore the family and young person's perspectives of using telehealth.

Rehabilitation

Many patients hospitalized due to COVID-19 presented with varying degrees of impairments and disabilities mostly attributed to prolonged ICU stay. The consequences of severe respiratory illness and longer duration of ICU stay can lead to long-term physical, emotional, and cognitive dysfunction. The rehabilitation department at SBH Health System had its own set of challenges and had to quickly adapt to constant changes and needs of the patients. This chapter focuses on the important role of rehabilitation in pandemic response, restoring function, and recovery of COVID-19 survivors. It outlines the effectiveness of prone positioning and early mobilization that can make a significant difference in the patients' long-term quality of life. The integrated approach to discharge planning with multidisciplinary involvement facilitated a smooth transition from the hospital to their home. This helped as demands for post-acute care needs increased whether it was skilled nursing facilities for short-term rehabilitation, home care services, or outpatient services, including virtual rehabilitation or telehealth. © SBH Health System 2022.

The contribution of participation in meaningful activities on mental health during the COVID-19 lockdown in the Spanish population

Introduction: During the lockdown caused by COVID-19 in Spain, citizens had to stop performing activities in the usual way, which could have had an impact on mental health. The aim of this study was to determine the contribution of participating in meaningful activities on mental health in the Spanish population during the COVID-19 lockdown. Method: A cross-sectional online survey was developed and administered, where mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), participation in meaningful activities (Engage-ment in Meaningful Activities Survey) and socio-demographic data were assessed. A hierarchical-linear-regression was used to identify key correla-tions. Results: The participants (N = 311) reported low mental health (M = 16.12/36) and a lower level of resilience (M = 25.48). The results of the re-gression revealed that 32.6% of the variance of the GHQ was significantly explained by the living space, including an outdoor space, resilience and participation in meaningful activities. The loss of meaningful activities was significantly related to mental health, with a significant contribution when controlling for the other variables (β = -.12). Conclusion: Although experi-mental studies are needed to determine causality, this study highlights the relationship between participation in meaningful activities and mental health during the lockdown. © 2023, Universidad de Murcia Servicio de Publicaciones. All rights reserved.

Allied health clinical placements with a remote supervision model: Students' and clinical educators' perceptions

COVID-19 restrictions prompted change to clinical placements for students, including a move to a remote supervision model where students, clinical educators, and patients were geographically remote from each other but connected via videoconferencing technology. A total of seven students and 11 clinical educators from occupational therapy and speech pathology participated in focus groups, reflecting on their experiences and perceptions of the rapid transition to remote supervision. Qualitative data were analyzed using a thematic analysis approach. No participants had experience with remote supervision prior to COVID-19. Three key themes were generated from the data: (a) key considerations, processes, and suggestions for remote supervision, (b) impact of remote supervision on relationship development, and (c) development of student professional competencies within the model. This study provides insights and practical considerations for implementing remote supervision and confirms this model can effectively meet students' supervision needs and support the development of professional competencies. [ FROM AUTHOR] Copyright of Distance Education is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Life during Covid-19: An Explorative Qualitative Study of Occupational Therapists in South Africa

This article explores the experiences of fifteen occupational therapists during the Covid-19 pandemic. Participants from rural and urban areas in KwaZulu-Natal, South Africa, were recruited using snowball sampling. Semi-structured interviews and personal narratives were used to collect data on occupational engagement during the pandemic. Inductive thematic analysis was used. The impact of Covid-19 on occupational engagement, occupational adaptations, factors that negatively influenced occupational engagement and enablers to occupational engagement emerged as themes. Participants experienced role changes at work and home, as well as feelings of isolation. It is essential to advocate for the role of occupation therapy during a pandemic.Ethical Clearance Number: BREC/00002587/2021

Acute inpatient rehabilitation for COVID-19 survivors: A retrospective case series.

BACKGROUND: Patients with Coronavirus Disease 2019 (COVID-19) who required mechanical ventilation and had prolonged hospital stay present with medical instability and functional impairments after the acute hospitalization. OBJECTIVE: To present the rehabilitation outcome of three patients with COVID-19 admitted to an inpatient rehabilitation unit using a case series method. METHODS: Subjects included three consecutive male patients admitted to the rehabilitation unit with a diagnosis of deconditioning and critical illness myopathy. On admission, patients were evaluated by a multidisciplinary team using outcome measures such as 6-min walk test (6 MWT), 10-m walk test (10 MWT), berg balance scale (BBS), and dynamometry. Each patient received daily therapy with a minimum of 900 min per week during their rehabilitation stay. Treatment strategies included fatigue management, training of mobility and activities for daily living tasks, muscle strengthening, and cognitive retraining. RESULTS: All patients showed significant improvements across all the outcome measures, specifically, the 6MWT (minimal clinically identifiable difference (MCID) range: 14-30.5 m) and the 10MWT (MCID range: 0.10-0.20 m/s) which exceeded the MCID for all three patients. The BBS also demonstrated significant improvement, surpassing the minimum detectable change of 5-7 points. Of the three patients, two were able to be discharged at an independent level, while one required supervision for safety. CONCLUSION: Patients with COVID-19, who experienced prolonged hospital stay present with severe impairments in muscle strength, functional mobility, and participation in daily living tasks. Inpatient rehabilitation may have the potential to reduce impairments and accelerate the recovery process while managing ongoing medical issues.

The era of technology in healthcare: an evaluation of telerehabilitation on patient outcomes-a systematic review and meta-analysis protocol.

BACKGROUND: The World Health Organization announced the outbreak of the Coronavirus disease as a global pandemic on March 11, 2020. Since then, rapid implementation of telehealth approaches into the healthcare system have been evident. The pandemic has drastically impacted the lives of many around the globe and has detrimentally affected our healthcare systems, specifically with the delivery of healthcare. This has had many implications on rehabilitation services such as, occupational therapy, physiotherapy, and speech therapy. The delivery of mental health services remotely may be referred to as teletherapy, telemental health, telepsychiatry, and telepsychology. Telerehabilitation has become a necessity over the course of the pandemic due to safety concerns with COVID-19 transmission. The primary aim of this systematic review protocol is to evaluate the literature on the effect of telerehabilitation on patient outcomes and propose directives for future research based on the evidence reviewed. METHODS: A systematic review and meta-analysis will be conducted to examine the literature on the effect of telerehabilitation on patient outcomes following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PRISMA, 2015). The systematic review will use the following databases to examine the literature on telerehabilitation and patient outcomes: APA PsychINFO, Embase (Ovid), MEDLINE (Ovid), CINAHL, and Scopus. DISCUSSION: The utilization of telerehabilitation and similar telehealth treatments has increased throughout the COVID-19 pandemic. However, much is still unclear regarding the effectiveness of these methods in the delivery and service of healthcare, and their effect on health outcomes. This review will identify and address the knowledge gaps in the literature, which will provide further directions for future research. TRIAL REGISTRATION: This systematic review has been registered with PROSPERO under registration number CRD42022297849.

An investigation into the effects of Omicron and winter pressures on stroke rehabilitation services across the East of England

Introduction: A service impact assessment was undertaken to understand the influence of winter pressures and omicron on stroke rehabilitation service delivery in November and December 2021. This followed concerns regarding rehabilitation provision raised by clinicians and stroke service managers including acute providers, community in patient teams and early supported discharge (ESD) teams across the East of England. Method(s): Questionnaires were distributed to all acute, community and ESD stroke services within the North and South Integrated Stroke Delivery Networks (ISDN), covering physiotherapy, occupational therapy, speech and language therapy and psychology disciplines. Ratings were made against the key themes that had been raised anecdotally as concerns to service delivery. (0=no impact, 1=some impact 2=significant impact) Follow up meetings were arranged for each Integrated Care System (ICS) to provide narrative around the rated themes. Allied Health Professional (AHP) representatives from each stroke service within the ICS were invited to these meetings. Finally, the ratings and narrative were taken back to the Rehabilitation Clinical Advisory Group (CAG) for solutionbased discussions to formulate a potential action plan to report to the Clinical Reference Group (CRG). In total 61 responses were received from professional leads across the four disciplines. Result(s): Issues, themes and recommendations have been established relating to: * Workforce. * Increased referral rates and caseloads. * Rehabilitation Intensity. * Access to care packages and equipment. * Visiting arrangements and the direct impact on discharge planning. * Perceived patient and family experience. Conclusion(s): Analysis is ongoing;however, ten recommendations are being prepared to enable increased robustness of service delivery in preparation for next winter.

Physical Activity Solutions to Decrease Occupational Stress

Occupational stress impacts employees, organizations, and potential customers. Physical activity as a coping mechanism can help to mitigate the adverse outcomes of occupational stress. Physical activity solutions for employees allow employees to initiate and maintain a physically active lifestyle, potentially mitigating the adverse outcomes of occupational stress. Apply It!: After reading this article, fitness professionals will be able to: • Understand the impact of occupational stress on employees. • Understand how physical activity impacts occupational stress. • Implement suggestions for on-site physical activity solutions and off-site physical activity promotion to impact occupational stress.

Transverse myelitis 48 hours after the administration of an mRNA COVID 19 vaccine

Background Vaccinations against SARS-CoV-2 have been a topic of political, social, and medical intrigue since the declaration of the COVID-19 pandemic in early 2020. The vaccine side effects have been relatively mild to date, with few observed systemic effects. Case presentation A 69-year-old previously healthy female presented with symptoms of asymmetric bilateral lower and upper extremity weakness 2 days after vaccination with the Pfizer-BioNTech mRNA vaccine. MRI of the cervical spine revealed a non-compressive myelitis extending from C3-4 to T2-3. Common known causes of transverse myelitis were ruled out by diagnostic techniques. Conclusions Transverse myelitis is a rare autoimmune disorder that has been shown to have a temporal association with vaccination in the past. With a progressively partisan societal view on vaccinations, it is important for clinicians to remain vigilant on documenting potential associations without encouraging fear of causation.Copyright © 2021 The Author(s)