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Smith LM, McNulty B, Scroggs E, Yorke AM. Collaboration in the midst of chaos: perspectives of inpatient occupational and physical therapists during the COVID-19 pandemic. J Interprof Care 2024; 38:632-641. [PMID: 38743046 DOI: 10.1080/13561820.2024.2351007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
The COVID-19 pandemic has affected over 700 million people globally, straining healthcare systems and highlighting the need for interprofessional collaboration. The aim of this study was to describe interprofessional collaborative practice (IPCP) experiences from the perspectives of occupational therapists (OTs) and physical therapists (PTs) who were employed in a medical center both before and during the COVID-19 pandemic. This qualitative study, conducted from July 2020-November 2021, delved into the lived experiences of occupational and physical therapists in an inpatient setting during the pandemic through analysis of semi-structured interviews and journal entries. The pandemic prompted fear, uncertainty, and ethical dilemmas among therapists, affecting patient-centered care. Roles expanded, and teamwork challenges emerged in defining boundaries, while communication dynamics were transformed by virtual technologies. The pandemic affected therapists' values and ethics, and evolving roles brought expanded tasks. The crisis showcased both collaboration potential and the need to address team disparities. This study highlights the significance of values, roles, teams, and communication for occupational and physical therapists during the COVID-19 pandemic providing valuable insights into interprofessional collaboration's effect on healthcare delivery in times of crisis and beyond.
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Affiliation(s)
- Leslie M Smith
- Physical Therapy, University of Michigan - Flint, Flint, MI, USA
| | - Ben McNulty
- Occupational Therapy, University of Michigan - Flint, Flint, MI, USA
| | - Emily Scroggs
- Physical Therapy, University of Michigan - Flint, Flint, MI, USA
| | - Amy M Yorke
- Physical Therapy, University of Michigan - Flint, Flint, MI, USA
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Bozzolan M, Bighi E, Occhi A, Mottaran S, Simoni G, Valpiani G, Bombardi S, Da Roit M. Professional practice, competence, and education related to COVID-19: A mixed-methods light study of physiotherapists' experiences. Physiother Theory Pract 2024; 40:1215-1231. [PMID: 36369771 DOI: 10.1080/09593985.2022.2142083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/16/2022] [Accepted: 10/16/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) became a significant challenge for the work and personal experience of physiotherapists (PTs). OBJECTIVE To investigate how the work activities of PTs in a region in Italy have changed, describe the reasons for change, perceived competence, and effectiveness of professional education, and explore their personal experience. METHODS We adopted a monocentric convergent mixed-methods light-questionnaire variant study. The questionnaire contains both closed-ended and open-ended questions. Quantitative and qualitative data were combined to interpret the results. RESULTS Among 78 respondents (response rate 24.4%), 87.2% worked during the pandemic, 52.9% treated patients with COVID-19, and 45.6% changed their working activities. Professional competence was perceived as low in intensive and sub-intensive care settings. The major critical aspect of professional education was respiratory rehabilitation. Life-learning education was judged as effective, even if mainly focused on safety. Nine themes emerged from the analysis of the PTs' experiences: 1) Physiotherapy during COVID-19; 2) Fear and negative feelings; 3) Positive aspects; 4) Organization and management; 5) Prevention measures; 6) Patients; 7) Change; 8) Information; and 9) Professional education. CONCLUSIONS PTs who have direct experience with patients with COVID-19 showed great resilience. They overcame the first phase of disorientation and fear, despite a specific lack of competence in the respiratory field.
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Affiliation(s)
- Michela Bozzolan
- Interdepartmental Educational Service, S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Elisa Bighi
- Fondazione "San Salvatore" Via Piave, Ficarolo (RO), Italy
| | - Antonella Occhi
- Rehabilitation Medicine Unit - S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Silvia Mottaran
- Acquired Brain Injuries Unit - S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | | | - Giorgia Valpiani
- Research Innovation Quality and Accreditation Unit, S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Sandra Bombardi
- Research Innovation Quality and Accreditation Unit, S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Marco Da Roit
- Belluno Community Hospital, Azienda AULSS1 Dolomiti via Feltre, Belluno, Italy
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Bemath N, Israel N, Hassem T. Mental health patterns of physiotherapists in South Africa during COVID-19. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2023; 79:1881. [PMID: 37575886 PMCID: PMC10416545 DOI: 10.4102/sajp.v79i1.1881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/24/2023] [Indexed: 08/15/2023] Open
Abstract
Background While attention has been drawn to the impact of the coronavirus disease 2019 (COVID-19) pandemic on the mental health of healthcare workers generally, little is known regarding mental health changes over time in frontline and non-frontline physiotherapists during this period. Objectives Our study aimed to investigate differences in mental health trends among frontline and non-frontline physiotherapists across three time periods during the pandemic. Method Survey-based data were collected from 366 practising physiotherapists across three time periods during the pandemic (Time 1: n = 171; Time 2: n = 101; Time 3: n = 94). Variations in reported mental health of frontline and non-frontline respondents generally and over time were analysed using comparative statistical techniques and trend analysis. Results Frontline physiotherapists reported significantly lower levels of general mental well-being and resilience, and significantly higher levels of burnout and maladaptive strategy use. Only frontline physiotherapists' general mental well-being and resilience decreased over time, whereas depression decreased over time for both groups. Anxiety decreased over time for non-frontline physiotherapists but initially decreased and then increased for frontline physiotherapists. Burnout increased initially and then decreased for non-frontline physiotherapists. Conclusion Varying mental health trends were found between frontline and non-frontline physiotherapists over time. Nuanced mental health interventions that consider the period of the pandemic and degree of exposure are needed. Clinical implications Understandings of the mental health trajectories experienced by physiotherapists across the pandemic can inform long-term, targeted interventions that effectively enhance well-being, retention, and sustainability of practitioners, and thus the care delivered, in the healthcare system.
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Affiliation(s)
- Nabeelah Bemath
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicky Israel
- Department of Psychology, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
| | - Tasneem Hassem
- Department of Psychology, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
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Weathering the Storm. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2023. [DOI: 10.1097/jat.0000000000000213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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Jonsdottir J, Santoyo-Medina C, Kahraman T, Kalron A, Rasova K, Moumdjian L, Coote S, Tacchino A, Grange E, Smedal T, Arntzen EC, Learmonth Y, Pedulla L, Quinn G, Kos D. Changes in physiotherapy services and use of technology for people with multiple sclerosis during the COVID-19 pandemic. Mult Scler Relat Disord 2023; 71:104520. [PMID: 36724646 DOI: 10.1016/j.msard.2023.104520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND The COVID-19 pandemic has led to reorganization or reduction of neurorehabilitation services for people with multiple sclerosis (PwMS). The aim of this study was to explore the changes in the organizational framework and technology usage in physiotherapy services for PwMS during the COVID-19 pandemic. METHODS This international cross-sectional survey study was designed, developed, and disseminated by RIMS European Network for Best Practice and Research in Multiple Sclerosis Rehabilitation. Physiotherapists from nine countries (Australia, Belgium, Czech Republic, Ireland, Israel, Italy, Norway, Spain, Turkey) who provided physiotherapy services to PwMS, were invited to complete an online survey to compare physiotherapy delivery to PwMS prior to and during the pandemic period. RESULTS The survey was completed by 215 physiotherapists. Accessibility, the average number, length and perceived effectiveness of physiotherapy sessions provided to PwMS were significantly reduced during the COVID-19 pandemic (p=0.001). Physiotherapists increased the advice of mobile apps, recorded videos for rehabilitation and exercise websites during the pandemic (p<0.001) while the use of telerehabilitation and virtual reality technology did not change. CONCLUSION There was of a reduction in the number, duration and perceived effectiveness of rehabilitation sessions for people with multiple sclerosis during the COVID-19 pandemic while use of remote technologies for physiotherapy did not change. To ensure the continuity of physiotherapy for PwMS with complex healthcare needs also during pandemics, the provision of guidelines and training in telehealth technologies in professional education becomes crucial.
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Affiliation(s)
| | - Carme Santoyo-Medina
- Neurology-Neuroimmunology Department & Neurorehabilitation Unit, Multiple Sclerosis Centre of Catalonia (Cemcat), Barcelona, Spain; Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, C/ Josep Trueta sn, 08195 Sant Cugat del Vallès, Barcelona, Spain.
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
| | - Alon Kalron
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel-Aviv University, Israel; Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Kamila Rasova
- Department of Rehabilitation, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lousin Moumdjian
- UMSC Hasselt, Pelt, Belgium; REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium.
| | - Susan Coote
- Centre of Physical Activity for Health, Health Research Institute, University of Limerick, Limerick, Ireland; Multiple Sclerosis Society of Ireland and Physical Activity for Health Research Centre, Ireland.
| | - Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genova, Italy.
| | - Erica Grange
- CRRF "Mons. L. Novarese", Moncrivello (VC), Italy
| | - Tori Smedal
- Department of Physiotherapy, Haukeland University Hospital, Helse Bergen, Bergen, Norway,; Department of Neurology, Multiple Sclerosis Competence Centre, Haukeland University Hospital, Helse Bergen, Bergen, Norway.
| | | | - Yvonne Learmonth
- Discipline of Exercise Science, Murdoch University, Murdoch, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Australia; Perron Institute for Neurological and Translational Science, Nedlands, Australia.
| | - Ludovico Pedulla
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy.
| | - Gillian Quinn
- Physiotherapy Department, St. James's Hospital, Dublin, Ireland
| | - Daphne Kos
- Department of Rehabilitation Sciences, KU Leuven, Leuven 1501-3001, Belgium; National MS Center, Melsbroek, Belgium.
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Elliott B, Burt S, Lahr J. Walking into a COVID Petri Dish: Home Care Providers' Experiences during a Pandemic. Home Healthc Now 2023; 41:20-27. [PMID: 36607206 DOI: 10.1097/nhh.0000000000001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
As we approach the third anniversary of the COVID-19 pandemic, the long-term effects on the health and well-being of those caring for patients in their homes, where less control of the environment can be maintained, remain a concern. The purposes of this study were to describe home care providers' experiences caring for patients during the pandemic, barriers and facilitators to the provision of care, and lessons learned for practice during future healthcare crises. A qualitative descriptive study using semistructured interviews was conducted with 13 home care providers. Four themes emerged from the data: Riding an emotional roller coaster, Putting a fire out with a garden hose, Walking into a COVID petri dish, and I'm just trying to do my job. Support for frontline staff should be initiated early in a healthcare crisis or pandemic. Communication needs to be clear, consistent, and made available at regular intervals. Home care leaders need to be visible and transparent to reduce emotional uncertainties that can negatively influence staff and patient outcomes. Education and planning around emergency preparedness are essential in future crises to mitigate the negative consequences on staff and patients.
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Ditwiler RE, Swisher LL, Hardwick DD. Doing things you never imagined: Professional and ethical issues in the U.S. outpatient physical therapy setting during the COVID-19 pandemic. Musculoskelet Sci Pract 2022; 62:102684. [PMID: 36356408 PMCID: PMC9617680 DOI: 10.1016/j.msksp.2022.102684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Despite being the most prevalent physical therapy practice setting in the United States, no literature to date has examined the professional and ethical issues faced by outpatient physical therapists during the COVID-19 pandemic. The purpose of this study was to explore professional and ethical issues experienced by outpatient physical therapists in the United States during the COVID-19 pandemic. DESIGN An explorative semi-structured interview study using reflexive thematic analysis METHODS: Virtual semi-structured interviews explored physical therapists' experiences during COVID-19 in the OP setting. Data was analyzed using reflexive thematic analysis as described by Braun and Clarke. RESULTS Respondents worked predominantly with patients with orthopaedic impairments. Six primary themes and associated subthemes were identified: 1) Disruption of routine professional and personal life. 2) Negative impacts on health and wellbeing (physical, mental, and social). 3) Barriers to relationships, communication, and providing quality care. 4) Telehealth as a safe option to increase access with opportunities and challenges. 5) Discomfort practicing in an environment of misinformation, mistrust, and divisiveness. 6) New & pre-existing ethical issues in the COVID-19 context. CONCLUSIONS Results of this study indicate that physical therapists in the outpatient setting wrestled with critical questions regarding outpatient physical therapy practice during the COVID-19 pandemic: the role of touch in professional identity, challenges to the therapeutic alliance, effect of productivity and fiscal expectations and whether outpatient physical therapy is essential during public emergencies.
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Affiliation(s)
- Rebecca Edgeworth Ditwiler
- School of Physical Therapy and Rehabilitation Sciences, University of South Florida, USF Health Morsani College of Medicine, Tampa, FL, USA.
| | - Laura Lee Swisher
- School of Physical Therapy and Rehabilitation Sciences, University of South Florida, USF Health Morsani College of Medicine, Tampa, FL, USA
| | - Dustin Dean Hardwick
- School of Physical Therapy and Rehabilitation Sciences, University of South Florida, USF Health Morsani College of Medicine, Tampa, FL, USA,School of Physical Therapy, University of the Incarnate Word, San Antonio, TX, USA
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The Impact of COVID-19 on Interprofessional Collaborative Practice Through the Lens of Acute Care Physical Therapists. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2022; 14:93-103. [PMID: 36968179 PMCID: PMC10032220 DOI: 10.1097/jat.0000000000000208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022]
Abstract
This case report describes interprofessional collaborative practice experiences through the viewpoints of 3 acute care physical therapists who worked with patients with coronavirus disease-2019 (COVID-19) during the early months of the pandemic. Methods The cases presented in this case report were selected from a larger longitudinal qualitative multiple-case study investigating interprofessional collaborative practice experiences of physical therapists employed in inpatient settings prior to and during the pandemic. The cases provide detailed narrative descriptions of interprofessional collaborative practice before and during the pandemic from the perspective of 3 physical therapists working in acute care environments. Results The 3 physical therapists reported challenges to and opportunities for interprofessional collaborative practices that align with the 4 interprofessional educational competencies (values/ethics, roles/responsibilities, communication, and teams/teamwork). Conclusions The ability to provide patient-centered care through interprofessional collaborative practices was impacted by the COVID-19 pandemic. The rich narrative descriptions of our participants' experiences as members of interprofessional teams provide additional insight regarding the effect of the COVID-19 pandemic on interprofessional collaborative practice.
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González-Mendoza A, Quiñones-Urióstegui I, Salazar-Cruz S, Perez-Sanpablo AI, López-Gutiérrez R, Lozano R. Design and Implementation of a Rehabilitation Upper-limb Exoskeleton Robot Controlled by Cognitive and Physical Interfaces. JOURNAL OF BIONIC ENGINEERING 2022; 19:1374-1391. [PMID: 35756166 PMCID: PMC9210066 DOI: 10.1007/s42235-022-00214-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 06/15/2023]
Abstract
This paper presents an upper limb exoskeleton that allows cognitive (through electromyography signals) and physical user interaction (through load cells sensors) for passive and active exercises that can activate neuroplasticity in the rehabilitation process of people who suffer from a neurological injury. For the exoskeleton to be easily accepted by patients who suffer from a neurological injury, we used the ISO9241-210:2010 as a methodology design process. As the first steps of the design process, design requirements were collected from previous usability tests and literature. Then, as a second step, a technological solution is proposed, and as a third step, the system was evaluated through performance and user testing. As part of the technological solution and to allow patient participation during the rehabilitation process, we have proposed a hybrid admittance control whose input is load cell or electromyography signals. The hybrid admittance control is intended for active therapy exercises, is easily implemented, and does not need musculoskeletal modeling to work. Furthermore, electromyography signals classification models and features were evaluated to identify the best settings for the cognitive human-robot interaction.
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Affiliation(s)
- Arturo González-Mendoza
- LAFMIA UMI, Center for Research and Advanced, Studies of National Polytechnic Institute, Av. Instituto Politécnico Nacional No. 2508, 07360 Mexico City, Mexico
- Motion Analysis Lab, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Calz. México Xochimilco No. 289, 14389 Mexico City, Mexico
| | - Ivett Quiñones-Urióstegui
- Motion Analysis Lab, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Calz. México Xochimilco No. 289, 14389 Mexico City, Mexico
| | - Sergio Salazar-Cruz
- LAFMIA UMI, Center for Research and Advanced, Studies of National Polytechnic Institute, Av. Instituto Politécnico Nacional No. 2508, 07360 Mexico City, Mexico
| | - Alberto-Isaac Perez-Sanpablo
- Motion Analysis Lab, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Calz. México Xochimilco No. 289, 14389 Mexico City, Mexico
| | | | - Rogelio Lozano
- LAFMIA UMI, Center for Research and Advanced, Studies of National Polytechnic Institute, Av. Instituto Politécnico Nacional No. 2508, 07360 Mexico City, Mexico
- UTC-CNRS UMR, Sorbonne Universités, UTC-CNRS UMR, 7253 Heudiasyc, Compiégne France
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Kahraman T, Rasova K, Jonsdottir J, Medina CS, Kos D, Coote S, Tacchino A, Smedal T, Arntzen EC, Quinn G, Learmonth Y, Pedulla L, Moumdjian L, Kalron A. The impact of the COVID-19 pandemic on physical therapy practice for people with multiple sclerosis: A multicenter survey study of the RIMS network. Mult Scler Relat Disord 2022; 62:103799. [PMID: 35428030 PMCID: PMC8994702 DOI: 10.1016/j.msard.2022.103799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/24/2022] [Accepted: 04/08/2022] [Indexed: 10/24/2022]
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