The effect of training and workstation adjustability on teleworker discomfort during the COVID-19 pandemic

Best Practices in Telecritical Care: Expert Consensus Recommendations From the Telecritical Care Collaborative Network

OBJECTIVES

Telecritical care (TCC) refers to the delivery of critical care using telehealth technologies. Despite increasing utilization, significant practice variation exists and literature regarding efficacy remains sparse. The Telecritical Care Collaborative Network sought to provide expert, consensus-based best practice recommendations for the design and delivery of TCC.

DESIGN

We used a modified Delphi methodology. Following literature review, an oversight panel identified core domains and developed declarative statements for review by an expert voting panel. During three voting rounds, voters agreed or disagreed with statements and provided open-ended feedback, which the oversight panel used to revise statements. Statements met criteria for consensus when accepted by greater than or equal to 85% of voters.

SETTING/SUBJECTS

The oversight panel included 18 multidisciplinary members of the TCC Collaborative Network, and the voting panel included 32 invited experts in TCC, emphasizing diversity of discipline, care delivery models, and geography.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

We identified ten core domains: definitions/terminology; care delivery models; staffing and coverage models; technological considerations; ergonomics and workplace safety; licensing, credentialing, and certification; trust and relationship building; quality, safety, and efficiency, research agenda; and advocacy, leading to 79 practice statements. Of 79 original statements, 67 were accepted in round 1. After revision, nine were accepted in round 2 and two in round 3 (two statements were merged). In total, 78 practice statements achieved expert consensus.

CONCLUSIONS

These expert consensus recommendations cover a broad range of topics relevant to delivery of TCC. Experts agreed that TCC is most effective when delivered by care teams with specific expertise and by programs with explicit protocols focusing on effective communication, technical reliability, and real-time availability. Interventions should be tailored to local conditions. Although further research is needed to guide future best practice statements, these results provide valuable and actionable recommendations for the delivery of high-quality TCC.

Ergonomics, Health, and Perceptions about Remote Domestic Workposts: Study in Areas of City of João Pessoa, Paraíba, Brazil

Home office (HO) stands out as one of the most promising and popular forms of teleworking, especially after the COVID-19 pandemic. Therefore, many companies want to implement or maintain this working method, given its numerous advantages. However, there are adverse effects that are mainly related to physical and mental health. This article presents ergonomic analyses of HOs in neighborhoods considered heat islands. Temperature levels, extreme low-frequency non-ionizing radiation (ELF-NIR), illuminance, physical layout characteristics, and physiological parameters of teleworkers were measured. The results reveal that 92% of these professionals work 6 to 8 h daily with an ambient temperature between 25 and 30 °C, illumination levels in the range 11.20-290 Lux, and ELF-NIR > 0.4 µT. The majority of teleworkers are overweight (BMI > 24.9), and some of them have blood pressure higher than average values (129 mmHg for systolic and 84 mmHg for diastolic) in addition to a reduction in the number of red blood cells and hematocrits. Symptoms such as burning sensation, dryness, tired eyes, redness, itching, and photophobia (light sensitivity) show a 68.95% similarity. These HOs do not meet the required ergonomic and health standards.

Effectiveness of and preference for a picture-based home office ergonomics assessment compared to a traditional in-person office ergonomics assessment: A case study from a Canadian University during the COVID-19 pandemic

During the COVID-19 pandemic, telework best practices decreased in importance compared to the need for social distancing. It is important that ergonomics assessments for home office workstations are equally as effective as assessment for traditional offices to maintain teleworker wellbeing. The purpose of this case study is to compare a remote, picture-based, home office assessment to a traditional, in-person, office assessment for employees of one Canadian University. Intraclass Correlation Coefficients (ICCs) and Bland-Altman Analyses (BAAs) revealed that the two methods provide repeatable results, with good agreement. Feedback from the participants suggested that picture-based assessments were as effective as in-person assessments; but that picture-based assessments could be improved with video conferencing to discuss findings and ask follow-up questions. Participants found value in remote assessments and, while they preferred in-person assessments, picture-based assessments are suitable when needed as they allow for many assessments to be completed without violating social distancing restrictions.

Chronic pain and associated factors in remote work during the COVID-19 pandemic in Brazil

OBJECTIVE

Estimate the prevalence of chronic pain and its association with symptoms of anxiety, sleep disorders, and aspects of remote work in the context of the COVID-19 pandemic.

METHOD

A cross-sectional and descriptive study conducted with 328 adults engaged in remote work. Data was collected online from February 2021 to January 2022. For pain investigation and evaluations of sleep and anxiety, a structured questionnaire, the Pittsburgh Sleep Quality Index, and the Generalized Anxiety Disorder-7 were used, respectively.

RESULTS

The prevalence of chronic pain was 47.9% (CI 95% = 42.5-53.3). Associations were identified between pain and anxiety, sleep disorders, and sitting time (p<0.01).

CONCLUSION

The prevalence of chronic pain in remote work was found to be high, with pain being of moderate intensity and associated with anxiety, sleep disorders, and prolonged sitting time.

Telework-related risk factors for musculoskeletal disorders

Telework has become considerably more common during the ongoing pandemic. Although working remotely may have numerous advantages, negative impacts on workers' health and safety should also be considered. Telework is a major contributor to the development or aggravation of work-related musculoskeletal disorders where unsuited workstation ergonomics, sedentary behavior, as well as psychosocial and organizational factors play a role. This paper aims to identify telework-related risks and their impact on musculoskeletal health as well as provide recommendations that may be useful in constructing future preventive measures. A comprehensive literature search regarding the topic has been performed. Teleworkers experience musculoskeletal pain and discomfort mostly in low back area, neck, shoulders, arms, and hands. Poor ergonomic solutions when it comes to workstation design resulting in prolonged sitting in non-neutral positions contribute to the development and aggravation of musculoskeletal disorders in teleworkers. Working with inadequately placed screens and laptops and sitting in maladjusted seats without usual functionalities and ergonomic support is associated with musculoskeletal pain and discomfort. Extended working hours with fewer rest periods to meet increased work demands, social isolation, and lack of support from work colleagues and superiors as well as blurred work-home boundaries and omnipresence of work are commonly stated psychosocial and organizational factors associated with musculoskeletal disorders. Environmental factors such as poor lighting and glare, inadequate room temperature, and ventilation or noise, are frequently overlooked remote workstation risk factors. For a certain part of workers, telework will remain a common way of work in the post-pandemic period. Therefore, it is essential to identify telework-related risk factors for musculoskeletal disorders and address them with timely preventive measures tailored to each remote workstation's risks and individual workers' needs.

Best Practices for Technology in Clinical Social Work and Mental Health Professions to Promote Well-being and Prevent Fatigue

The shift to communication technologies during the pandemic has had positive and negative effects on clinical social worker practice. Best practices are identified for clinical social workers to maintain emotional well-being, prevent fatigue, and avoid burnout when using technology. A scoping review from 2000 to 21 of 15 databases focused on communication technologies for mental health care within four areas: (1) behavioral, cognitive, emotional, and physical impact; (2) individual, clinic, hospital, and system/organizational levels; (3) well-being, burnout, and stress; and (4) clinician technology perceptions. Out of 4795 potential literature references, full text review of 201 papers revealed 37 were related to technology impact on engagement, therapeutic alliance, fatigue and well-being. Studies assessed behavioral (67.5%), emotional (43.2%), cognitive (57.8%), and physical (10.8%) impact at the individual (78.4%), clinic (54.1%), hospital (37.8%) and system/organizational (45.9%) levels. Participants were clinicians, social workers, psychologists, and other providers. Clinicians can build a therapeutic alliance via video, but this requires additional skill, effort, and monitoring. Use of video and electronic health records were associated with clinician physical and emotional problems due to barriers, effort, cognitive demands, and additional workflow steps. Studies also found high user ratings on data quality, accuracy, and processing, but low satisfaction with clerical tasks, effort required and interruptions. Studies have overlooked the impact of justice, equity, diversity and inclusion related to technology, fatigue and well-being, for the populations served and the clinicians providing care. Clinical social workers and health care systems must evaluate the impact of technology in order to support well-being and prevent workload burden, fatigue, and burnout. Multi-level evaluation and clinical, human factor, training/professional development and administrative best practices are suggested.

A systems model for the design of occupational health and safety management systems inclusive of work-from-home arrangements

The study addressed an important knowledge gap in the literature by co-designing a model for OHS management systems inclusive of workers who work-from-home, with a focus on psychosocial risks. This qualitative research study utilised a series of co-design focus groups involving Australian regulators, health and safety managers and practitioners, senior managers, middle managers and workers who work-from-home, to better understand the types of measures that organisations can apply to improve their health and safety management systems. Using a systems approach, consideration was given to the organisation of the remote working system, the home-work interface for remote workers, the competencies of managers and employees in regard to their occupation health and safety (OHS) responsibilities, and the complexity of identifying, reporting and monitoring psychosocial hazards for employees working from home. The study identified a need for tools designed to support both managers and workers in promoting psychologically safe working from home.

Telecommuting-related health outcomes during the COVID-19 pandemic in South Korea: a national population-based cross-sectional study

BACKGROUND

Telecommuting has expanded greatly during the COVID-19 pandemic. Since the advent of remote working from home, there has been an ongoing controversy about the positive or negative health-related impact of telecommuting. This study aimed to investigate change in the occupational health risk in South Korean workers involved in telecommuting during the pandemic period compared to daily commuters.

METHODS

A population-based cross-sectional study of South Korean workers using the secondary data from the 6th Korean Working Conditions Survey (2020-2021) was designed. A total of 12,354 white-collar wage employees were selected as the study sample. Telecommuting, depression, anxiety, insomnia, fatigue, musculoskeletal pain, headache-eye strain, absenteeism, and presenteeism were measured by self-reported data. Multiple logistic regression models, including gender stratification analysis, were used to estimate the adjusted odds ratio (AOR) with a 95% confidence interval (CI) for the health outcomes of telecommuters.

RESULTS

Among the study population, 338 males and 318 females were reported to be telecommuters. The entirely adjusted regression model showed a positive association between telecommuting and anxiety (AOR = 2.82; 95% CI, 1.93-4.10), insomnia (AOR = 1.93; 95% CI, 1.27-2.92), fatigue (AOR = 1.76; 95% CI, 1.30-2.37), musculoskeletal pain (AOR = 1,76; 95% CI, 1.33-2.32), headache-eye strain (AOR = 1.94; 95% CI, 1.48-2.54), presenteeism (AOR = 1.66; 95% CI, 1.20-2.28) respectively. Gender difference was identified in that only female telecommuters had a higher risk of depression (AOR = 1.62; 95% CI, 1.04-2.53) and insomnia (AOR = 2.07; 95% CI, 1.26-3.41) than daily commuters in the adjusted model.

CONCLUSION

Telecommuting was significantly associated with an increased risk of various health problems among South Korean workers and females were identified as a more vulnerable group. Although further research is required to ascertain the causal relationship, public health intervention should be considered to prevent the negative effects of telecommuting.

Telework Conditions, Ergonomic and Psychosocial Risks, and Musculoskeletal Problems in the COVID-19 Pandemic

OBJECTIVE

To evaluate the association of telework conditions with ergonomic and psychosocial risks and with the occurrence of musculoskeletal problems among employees of the Brazilian Labor Judiciary during the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted with 934 workers from August to October 2021. The data were collected via Web using a self-administrated questionnaire survey. Nonparametric tests and generalized linear regression analysis were used.

RESULTS

Previous experience in telework was associated with a better evaluation of the home workstation, a lower increase in workload, a greater increase in productivity, and greater preference to continue teleworking after the pandemic. The lack of a place dedicated to telework was specially related to greater ergonomic and psychosocial risks and to the greater occurrence of musculoskeletal problems.

CONCLUSIONS

Companies should monitor telework conditions to reduce health risks among their employees.

Physical activity changes among office workers during the COVID-19 pandemic lockdown and the agreement between objective and subjective physical activity metrics

After the onset of the COVID-19 pandemic, many office workers transitioned to working-from-home (WFH) which altered routine physical activity (PA). To understand how these workers' PA were affected throughout the pandemic, PA data collected in January, April, June, and December 2020 with an activity tracker and a validated survey were analyzed. Between January and December, it was found that step counts during the weekday decreased (p < 0.01), weekday heart rate was higher than weekends (p < 0.01), activity-tracker and self-reported PA decreased (p < 0.01), and sitting time increased (p < 0.01). To understand the agreement between the objective and subjective METs, Bland-Altman analyses were completed and demonstrated an acceptable level of agreement. Findings show decreased level of PA amongst WFH office workers and that the activity tracker and survey are reliable methods of recording WFH PA.

Consequences of COVID-19 on Employees in Remote Working: Challenges, Risks and Opportunities An Evidence-Based Literature Review

The COVID-19 pandemic forced organizations across all sectors and sizes to undertake crucial changes in order to remain productive during the emergency. Among these, the shift towards remote working arrangements is still present in our workplaces, impacting employees' well-being and productivity. This systematic review aims to describe the pandemic's consequences on work organization by analyzing whether and how the shift towards remote or home-working impacted employees' productivity, performance, and well-being. Furthermore, it describes the role of individual and organizational factors in determining employees' adjustment to remote work. Sixty-seven peer-reviewed papers published from 2020 to 2022, written in English, were selected through the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Findings describe how remote working arrangements, the workplace and organizational factors, and the employees' individual traits and skills impacted employees' productivity and well-being. Furthermore, they provide a description of the organizational enforcement actions reported in the literature. Managerial and practical implications, such as enforcement actions, team management strategies, and initiatives to promote employees' physical and mental health, will be discussed in the paper.