The effects of occupational and mental stress among home care rehabilitation professionals working during the COVID-19 pandemic: An exploratory qualitative study.

Home care rehabilitation professionals (hcRPs) provide health services for clients with a broad range of medical conditions. During the COVID-19 pandemic, home care rehabilitation professionals experienced exacerbations of pre-existing work-related stressors, increased risk of transmission of the COVID-19 virus, reduced resource availability, greater workloads, and staffing shortages. The primary aim of this study was to examine the experience and impact of occupational and mental stress on hcRPs working during the COVID-19 pandemic. Semi-structured interviews were conducted with 24 hcRPs working in Ontario, Canada during the COVID-19 pandemic. Inductive thematic analysis was used to interpret and organize the data into conceptualized themes. Interview data was organized into three themes: (a) unique challenges of a home care rehabilitation professional, (b) COVID-19 exacerbations of home care occupational and mental stress, and (c) personal and workplace coping strategies. Many participants reported reducing their hours or taking on adjunctive roles in different clinical settings outside of home care due to work-related stress exacerbated by the COVID-19 pandemic. With a focus on the effects of COVID-19 on the practice of home care, this study provides a unique perspective on the challenges experienced by hcRPs during an emergent and evolving global public health concern. The exploratory nature of this research works towards providing a framework of factors to be addressed when creating sustainable healthcare interventions, as well as recommendations to support hcRPs to benefit both the community and health-care providers.

Factors associated with work performance and mental health of healthcare workers during pandemics: a systematic review and meta-analysis.

Introduction Healthcare workers' work performance and mental health are associated with positive mental health outcomes and directly related to increased productivity and decreased disability costs. Methods We conducted a systematic review to identify factors associated with work performance of healthcare workers during a pandemic and conducted a meta-analysis of the prevalence of mental health outcomes in this context. Primary papers were collected and analysed using the Population/Intervention/Comparison/Outcome framework and using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To critically appraise the studies included in the review, we used the AXIS appraisal tool to assess each cross-sectional study's quality. Results The study identified nine factors associated with the work performance and mental health of healthcare workers, including experiencing feelings of depression, anxiety, having inadequate support, experiencing occupational stress, decreased productivity, lack of workplace preparedness, financial concerns associated with changes in income and daily living, fear of transmission and burnout/fatigue. Conclusion There is a rapidly rising need to address the work performance and mental health of healthcare workers providing timely care to patients. Regular and sustained interventions, including the use of information and communication technologies such as telehealth, are warranted.

Mental and physical health and well-being of canadian employees who were working from home during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has drastically changed various aspects of our lives, including how we work. Since the start of the pandemic, numerous organizations in Canada have mandated their employees to work from home (WFH) on a full-time basis. The rapid rise in the number of remote workers and the possibility for WFH continuing in the future signifies the importance of understanding the health and well-being of employees working from home over the course of the pandemic in Canada. We present the findings of two surveys (initial and 6-month follow-up) to examine the health and well-being of WFH employees during the COVID-19 pandemic in Canada. We analyzed the changes in mental and physical health and well-being of employees who were working from home between two time points during the pandemic. METHODS: Initial survey was completed between October 2020 and December 2020 (n = 1617); follow-up survey was completed between May 2021 and June 2021 (n = 382). We calculated the frequencies for survey questions involving demographics, WFH preferences, workstation setup training, employment situation, provision of hardware technologies, provision and usage of software technologies, and organization's return to work plan. We conducted Wilcoxon signed-rank tests to analyze the within-individual changes in mental and physical health and well-being of the 382 respondents who completed both the initial and follow-up surveys. RESULTS: Our analyses showed significant changes in various aspects of employee mental and physical health and well-being. Burnout, stress, general mental health, and job insecurity levels significantly decreased between the two time periods. Work-related sedentary behaviour reduced over time; however, the average proportion of time spent sitting during work hours was more than 80% in both surveys. Employees received more help and feedback from their colleagues and experienced a better sense of community with their co-workers over time. CONCLUSION: The findings can inform workers and organizations on the changes in mental and physical health and well-being of employees working from home during the pandemic. By understanding the changes in worker health and well-being, employers can develop effective strategies and implement policies that help protect employees' health and well-being.

Factors associated with burnout among medical laboratory professionals in Ontario, Canada: An exploratory study during the second wave of the COVID-19 pandemic.

OBJECTIVE: The objective of this study was to examine factors associated with burnout among medical laboratory technologists (MLT) in Ontario, Canada during the second wave of coronavirus disease 2019 pandemic. METHODS: We employed a cross-sectional design and used a self-reported questionnaire designed for MLT in Ontario, Canada. RESULTS: There were 441 (47.5% response rate) MLT who were included in the analytic sample. Most of the respondents were women, with a mean age of 43.1 and a standard deviation of 11.7. The prevalence of experiencing burnout was 72.3% for MLT. In the adjusted demographic model, those ≥50 (OR = 0.36, 95% CI: 0.22-0.59) were 0.36 or about one third as likely to experience burnout as those under 50. Similarly, those who held a university degree were less likely to experience burnout compared with high school degree (OR = 0.35, 95% CI: 0.15-0.79). In the adjusted occupational model, high quantitative demands (OR = 2.15, 95% CI: 1.21-3.88), high work pace (OR = 2.21, 95% CI: 1.25-3.98), high job insecurity (OR = 2.56, 95% CI: 1.39-4.82), high work life conflict (OR = 5.08, 95% CI: 2.75-9.64) and high job satisfaction (OR = 0.43, 95% CI: 0.20-0.88), high self-rated health (OR = 0.32, 95% CI: 0.17-0.56) were significant. CONCLUSION: This study provides preliminary evidence regarding the factors associated with burnout in MLT. Additional research is needed to understand their relationship with workers health and well-being and in the delivery of health services.

Primary Care Physicians' Learning Needs in Returning Ill or Injured Workers to Work. A Scoping Review.

Primary care physicians are uniquely positioned to assist ill and injured workers to stay-at-work or to return-to-work. Purpose The purpose of this scoping review is to identify primary care physicians' learning needs in returning ill or injured workers to work and to identify gaps to guide future research. Methods We used established methodologies developed by Arksey and O'Malley, Cochrane and adapted by the Systematic Review Program at the Institute for Work & Health. We used Distiller SR©, an online systematic review software to screen for relevance and perform data extraction. We followed the PRISMA for Scoping Reviews checklist for reporting. Results We screened 2106 titles and abstracts, 375 full-text papers for relevance and included 44 studies for qualitative synthesis. The first learning need was related to administrative tasks. These included (1) appropriate record-keeping, (2) time management to review occupational information, (3) communication skills to provide clear, sufficient and relevant factual information, (4) coordination of services between different stakeholders, and (5) collaboration within teams and between different professions. The second learning need was related to attitudes and beliefs and included intrinsic biases, self-confidence, role clarity and culture of blaming the patient. The third learning need was related to specific knowledge and included work capacity assessments and needs for sick leave, environmental exposures, disclosure of information, prognosis of certain conditions and care to certain groups such as adolescents and pregnant workers. The fourth learning need was related to awareness of services and tools. Conclusions There are many opportunities to improve medical education for physicians in training or in continuing medical education to improve care for workers with an illness or injury that affect their work.

Quality of work life of paramedics practicing community paramedicine in northern Ontario, Canada: a mixed-methods sequential explanatory study.

INTRODUCTION: This article aimed to evaluate pilot community paramedicine (CP) programs in northern Ontario from the perspectives of paramedics to gain program recommendations related to both rural and urban settings. METHODS: An online questionnaire was created and distributed to 879 paramedics with and without CP experience employed at eight emergency medical services providers in northern Ontario. An explanatory sequential design was used to analyze and synthesize the results from the quantitative survey items and the open-ended responses. RESULTS: Seventy-five (40.5%) respondents participated in a CP program, and the majority of 75 paramedics who indicated they participated in CP (n=41, 54.4%) were from rural areas. CP was generally well received by both paramedics currently practicing CP and those who were not practicing CP. The majority (86.3%) of paramedics stated paramedics should be practicing CP in the future. Paramedics identified developing professional relationships and improving health promotion as positive aspects of CP. Areas for CP program improvement included better organization and scheduling, improved training and a need for better patient tracking software. CONCLUSION: Engaging and consulting paramedics in the ongoing process of CP development and implementation is important to ensure they feel valued and are part of the change process.

Types of ocular injury and their antecedent factors: A systematic review and meta-analysis.

BACKGROUND: Ocular injuries are an important workplace hazard that can lead to vision loss, decreased functioning, and socioeconomic costs. The aim of this systematic review is to identify types of occupational ocular injuries and examine factors associated with these injuries. METHODS: Four health sciences databases (Ovid Medline, Embase, PsycINFO, and CINAHL) were reviewed to identify evidence pertaining to occupational ocular injuries. This systematic review was registered with PROSPERO (registration number: CRD42018089876) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The PICO (Population/Intervention/Comparison/Outcome) tool was used to support, structure, and improve our search strategy. RESULTS: Overall, 12 studies with quantitative Critical Appraisal Skills Programme grading scores were assessed in a systematic review and meta-analysis of ocular injuries in the workplace. The systematic review identified four main factors associated with occupational ocular injury: (a) use of eye protection at the time of the ocular injury, (b) being male, (c) exposure to biological or chemical occupational hazards, and (d) risk-taking behavior. CONCLUSIONS: Differences in risk between countries of origin, occupational sectors, and dates of publication, suggest likely differences or changes in safety procedures. We recommend that employers ensure that safety equipment is tailored to the protection of their specific occupational hazards, and that employees are adhering to safety protocols.

Work Disability Prevention: A Primer for Occupational Therapists.

An estimated 313 million workplace accidents resulting in injury occur worldwide every year. Therefore, the burden of workplace injury and disability is present at the individual and the societal level and involves several stakeholders. There has been a shift in paradigm from workplace disability and injury treatment to workplace disability prevention. Occupational therapy practitioners are well positioned to address this multifaceted societal issue. Opening communication lines among stakeholders allows for a more holistic, collaborative, and comprehensive approach to disability, injury, and pain management. The positive results researchers have found at the individual level when using a holistic approach translate to benefits for all of the stakeholders involved. Occupational therapy practitioners may espouse a work disability prevention approach to reduce work disability rates and provide timely return-to-work outcomes for clients. The transition to the preventative model requires collaboration among stakeholders but would be beneficial to all stakeholders involved in the workplace.

Relationships between employment status with self-perceived mental and physical health in Canada.

Background: The annual cost of mental illnesses in Canada is estimated to be $50 billion. Research from other countries have suggested that employment status is associated with mental and physical health. Within the Canadian context, there is a dearth of research on the relationship between employment and mental health. Objective: To explore the relationships between age, gender, income, and employment status on mental and physical health. Methods: The 2021 Canadian Digital Health Survey dataset was used for this study. Data records, which included responses for the questions on age, gender, income, employment status, mental, and physical health, were used in the analysis. Ordinal logistics regression was applied to investigate the associations that may exist between mental and physical health with the various sociodemographic factors. Descriptive statistics were also provided for the data. Results: The total sample size included in the analysis was 10,630. When compared to respondents who had full-time employment, those who were unemployed were more likely to have lower self-perceived mental health (OR: 1.91; 95% CI: 1.55-2.34). Retired respondents were less likely to have worse mental health than respondents who were employed full-time (OR: 0.78; 95% CI: 0.68-0.90). Self-perceived physical health was more likely to be lower for those who were unemployed (OR: 1.74; 95% CI: 1.41-2.14) or retired (OR: 1.28; 95% CI: 1.12-1.48) when compared to respondents employed full-time. The likelihood of worsening mental and physical health was also found to be associated with age, gender, and income. Conclusion: Our findings support the evidence that different factors contribute to worsening mental and physical health. Full-time employment may confer some protective effects or attributes leading to an increased likelihood of having improved mental health compared to those who are unemployed. Understanding the complex relationships on how various factors impact mental health will help better inform policymakers, clinicians, and other stakeholders on how to allocate its limited resources.

Systematic review protocol of yoga therapy as a modality in occupational therapy practice for adults experiencing mood disorders.

INTRODUCTION: Mood disorders can have a negative impact on daily functioning because cognitive deficits are exacerbated when individuals experience associated symptoms. Nevertheless, yoga therapy has been found to have enhancing features to well-being and quality of life. Occupational therapists are well positioned to include yoga as a modality to benefit clients experiencing mood disorders. However, literature on yoga interventions for mood disorders is underdeveloped causing an inadequate understanding of the health benefits. Thus, the aim of this study is to gain further knowledge associated with the implications of yoga as an intervention to increase participation in activities of daily living and enhance the quality of life of individuals experiencing mood disorders. This review will answer the following research question: can yoga therapy be used as an effective modality in occupational therapy practice to manage symptomatology related to mood disorders through increasing engagement in daily tasks? METHODS AND ANALYSIS: OVID Medline, Embase as well as CINAHL Plus, Cochrane Library (Wiley), APA PsycINFO and Scopus will be explored to adhere to the following criteria: (1) studies discussing adults diagnosed with mood disorders, specifically bipolar and related disorders or depressive disorders as stated in the Diagnostic Statistical Manual of Mental Disorders-5; (2) studies discussing implementation of yoga therapy; (3) a correlation between mood disorders and effectiveness of yoga therapy. ETHICS AND DISSEMINATION: Ethics approval is not applicable for this study, due to obtaining data from existing research articles. The completed manuscript will be submitted in a peer-reviewed journal for publication. PROSPERO REGISTRATION NUMBER: CRD42021283157.

From Crisis to Opportunity: A Qualitative Study on Rehabilitation Therapists' Experiences and Post-Pandemic Perspectives.

Rehabilitation therapists (RTs) have developed substantial mental health problems since the pandemic. Our study aimed to understand the experience of COVID-19 on occupational therapists and physiotherapists practicing in Canada, how the pandemic may have affected care delivery, and to identify new learnings articulated by RTs. A qualitative descriptive study design guided data collection through one-on-one interviews, dyadic interviews, and focus groups. We recruited active RTs across Canada, advertising on professional practice networks and social media platforms and using snowball sampling. Forty-nine RTs representing seven Canadian provinces participated. The four overarching themes developed using thematic analysis were (1) navigating uncertainty along with ever-changing practices, policies, and attitudes, (2) morphing roles within a constrained system, (3) witnessing patients suffering and experiencing moral distress, and (4) recognizing the personal toll of the pandemic on self and others, as well as lessons learned. Our study demonstrated that many RTs suffered moral distress, poor mental health, and some from challenging financial situations, especially those in the private sector. They also expressed a resilient attitude in response to these stressors. Implications in the future include identifying promising communication strategies that could act as protective factors, addressing workforce constraints and diminishing resources through innovative models of care.

Unmasking the Unrecognized: Exploring Registered Pharmacy Technicians' Stressors During COVID-19 Through a Demands-Resources Inquiry and Looking Ahead.

Canadian registered pharmacy technicians (RPTs) were vital in supporting pharmacy operations during the pandemic. However, they have received little attention during or pre-pandemic. This study aimed to identify and understand the stressors experienced by Canadian RPTs during the pandemic and gain insights on lessons learned to help improve the profession. Through a descriptive qualitative design, virtual semi-structured focus groups were conducted with RPTs who were recruited through various sampling methods across Canada. Data were inductively analyzed and then deductively; themes were categorized using the Job Demands-Resources (JD-R) model. We reached data saturation after 4 focus group sessions with a total of 16 participants. As per the JD-R model, job demands included: (1) increased work volume and hours to meet patient demand; (2) drug shortages and managing prescriptions increased due to influx of orders coinciding with restricted access to medications; (3) fear of the unknown nature of COVID-19 met with frequent change in practices due to protocol changes and ineffective communication; and, (4) the pandemic introduced several factors leading to increased staff shortages. Themes pertaining to resources included: (1) poor incentives and limited access to well-being resources; (2) limited personal protective equipment delaying work operations; (3) and a general lack of knowledge or appreciation of the profession impacting work morale. Lessons learned from the pandemic were also provided. Overall, our findings revealed an imbalance where RPTs experienced high job demands with limited resources. Improved leadership within pharmacies, including improved communication between team members, is required. Furthermore, efforts to highlight and recognize the work of RPTs to the public is important to help improve enrollment, especially with their recent scope of practice expansion.

Physical and Psychosocial Correlates of Occupational Physical Injury in the Global Construction Industry: A Scoping Review.

Purpose: The construction industry is a diverse sector with exposure to multiple psychosocial and environmental workplace hazards that increase the risk of injury. This scoping review aims to consolidate the existing literature on the physical and psychosocial determinants influencing the risk of occupational physical injuries among construction workers globally. Methods: A scoping review was conducted using the PRISMA extension checklist guided. Literature searches were performed between June and October 2023 in electronic academic databases. Results: A total of 77 studies were identified, encompassing various geographical regions, including North America (n = 29), Africa (n = 18), Europe (n = 12), Asia (n = 9), the Middle East (n = 5), and Oceania (n = 4). The review identified physical and psychosocial factors in 3 domains influencing occupational physical injuries: workplace physical environment (eg, exposure to physical hazards, availability and utilization of personal protective equipment, company size, and job type), workplace culture (eg, psychosocial stressors, gender-related barriers, migrant and ethnic disparities, educational background), and physical wellbeing, health and aging (eg, age, obesity, sleep quality, marital stats, and physical health status). Notably, workers from social minority groups (eg, women, ethnic and migrant workers) of young (<25 years old) or older ages (45-55 years old) employed in smaller construction companies are vulnerable to increased injury risk and exposure to physical and psychosocial hazards in the workplace. Conclusion: The review emphasizes a global paucity of research examining the implications of physical and psychosocial factors on injury risk within the construction industry. Future research should prioritize investigating the impact of psychosocial hazards on younger and older workers to detect age-related differences in injury rate, treatment access, and work-related health outcomes.

Remote work transition amidst COVID-19: Impacts on presenteeism, absenteeism, and worker well-being-A scoping review.

BACKGROUND: The COVID-19 pandemic has accelerated the transition to remote work, leading to increased attention on presenteeism and absenteeism among remote workers. Understanding the implications of these phenomena on worker health and productivity is crucial for optimizing remote work arrangements and developing policies to improve employee well-being. OBJECTIVES: This scoping review aims to examine the occurrence of presenteeism and absenteeism among remote workers during the COVID-19 pandemic and the interrelated physical and mental health issues during these periods. METHODS: PsycINFO, Medline, Embase, CINAHL, Eric, Business Source Premier, SCOPUS, and sociological abstracts were searched resulting in 1792 articles. Articles were included if the population of interest was 18+ (i.e., working age), engaged in full or part-time work, and the employees shifted from in-person to remote work due to the COVID-19 pandemic. All study designs, geographical areas, and papers written post-onset of the COVID-19 pandemic were included; however, systematic reviews were excluded. Data was charted into Microsoft Excel by 2 independent reviewers. RESULTS: The literature search identified 10 studies (i.e., seven cross-sectional studies, two qualitative studies, and one observational study). Five major overarching themes were identified specifically (1) telework and mental health (2) telework and physical health (3) worker benefits (4) gender dynamics and (5) difficulty navigating the teleworking environment. While remote work offers flexibility in terms of saved commute time and flexible work schedules, it also exacerbates challenges related to presenteeism, absenteeism, and work-life balance. These challenges include experiencing psychological distress, depression, anxiety, stress, sleep deprivation, musculoskeletal pain, difficulties concentrating at work for both women and working parents, struggles disconnecting after hours, and the inability to delineate between the work and home environment. DISCUSSION: The findings suggest that remote work during the COVID-19 pandemic has both positive and negative implications for worker well-being and productivity. However, future research needs to incorporate the potential effects of telework frequency (full time vs. part time) on employee productivity and its role on presenteeism and absenteeism, to gain a more comprehensive understanding on remote work difficulties. Addressing these challenges requires proactive interventions and support mechanisms to promote worker health and productivity in remote settings.

A systematic review of the literature: Gender-based violence in the construction and natural resources industry.

Gender-based violence (GBV) poses a significant concern in the construction and natural resources industries, where women, due to lower social status and integration, are at heightened risk. This systematic review aimed to identify the prevalence and experience of GBV in the construction and natural resources industries. A systematic search across databases including PubMed, OVID, Scopus, Web of Science, and CINAHL was conducted. The Risk of Bias Instrument for Cross-sectional Surveys of Attitudes and Practices by McMaster University and the Critical Appraisal of Qualitative Studies by the Center for Evidence Based Medicine at the University of Oxford were used to assess the studies included in the review. Six articles were included after full-text analysis. GBV was reported in the construction, mining, urban forestry, and arboriculture sectors. Workplace GBV was measured differently across the studies, and all studies examined more than one form of GBV. The main forms of GBV discussed in these studies were discrimination, sexual harassment, and sexism. The studies provided some insight for demographic factors that may or may not be associated with GBV, such as age, region of work, and number of years working in the industry. The review also suggests that workplace GBV has a negative impact on mental health and well-being outcomes, such as higher levels of stress and lower job satisfaction. The current research has not established the effectiveness of interventions, tools, or policies in these workplaces. Thus, additional research should include intervention studies that aim to minimize or prevent GBV in male-dominated workplaces. The current study can bring awareness and acknowledgement towards GBV in the workplace and highlight the importance of addressing it as this review outlines the negative consequences of GBV on mental health and well-being in these male-dominated industries.

Healthcare providers' perceived acceptability of a warning signs intervention for rural hospital-to-home transitional care: A cross-sectional study.

INTRODUCTION: There is a pressing need for transitional care that prepares rural dwelling medical patients to identify and respond to the signs of worsening health conditions. An evidence-based warning signs intervention has the potential to address this need. While the intervention is predominantly delivered by nurses, other healthcare providers may be required to deliver it in rural communities where human health resources are typically limited. Understanding the perspectives of other healthcare providers likely to be involved in delivering the intervention is a necessary first step to avert consequences of low acceptability, such as poor intervention implementation, uptake, and effectiveness. This study examined and compared nurses' and other healthcare providers' perceived acceptability of an evidence-based warning signs intervention proposed for rural transitional care. METHODS: A cross-sectional design was used. The convenience sample included 45 nurses and 32 other healthcare providers (e.g., physical and occupational therapists, physicians) who self-identified as delivering transitional care to patients in rural Ontario, Canada. In an online survey, participants were presented with a description of the warning signs intervention and completed established measures of intervention acceptability. The measures captured 10 intervention acceptability attributes (effectiveness, appropriateness, risk, convenience, relevance, applicability, usefulness, frequency of current use, likelihood of future use, and confidence in ability to deliver the intervention). Ratings ≥ 2 indicated acceptability. Data analysis included descriptive statistics, independent samples t-tests, as well as effect sizes to quantify the magnitude of any differences in acceptability ratings between nurses and other healthcare providers. RESULTS: Nurses and other healthcare providers rated all intervention attributes > 2, except the attributes of convenience and frequency of current use. Differences between the two groups were found for only three attributes: nurses' ratings were significantly higher than other healthcare providers on perceived applicability, frequency of current use, and the likelihood of future use of the intervention (all p's < .007; effect sizes .58 - .68, respectively). DISCUSSION: The results indicate that both participant groups had positive perspectives of the intervention on most of the attributes and suggest that initiatives to enhance the convenience of the intervention's implementation are warranted to support its widespread adoption in rural transitional care. However, the results also suggest that other healthcare providers may be less receptive to the intervention in practice. Future research is needed to explore and mitigate the possible reasons for low ratings on perceived convenience and frequency of current use of the intervention, as well as the between group differences on perceived applicability, frequency of current use, and the likelihood of future use of the intervention. CONCLUSIONS: The intervention represents a tenable option for rural transitional care in Ontario, Canada, and possibly other jurisdictions emphasizing transitional care.

The Effects of Systemic Lupus-Related Cognitive Impairments on Activities of Daily Living and Life Role Participation: A Qualitative Framework Study.

OBJECTIVE: Cognitive impairment (CI) in systemic lupus erythematosus (SLE) negatively impacts health-related quality of life leading to activity limitations. This qualitative study aimed to (1) explore the effect of SLE-related CI on activities of daily living and life role participation and (2) describe factors influencing activity restriction and life role participation. METHODS: Semistructured, in-depth interviews of lived experience of CI in SLE were conducted with 24 participants with SLE. Sociodemographic and clinical data, and objective and subjective cognitive function, were collected to characterize participants. A qualitative thematic content analysis was undertaken guided by a framework analytical approach. RESULTS: Participants reported problems in multiple cognitive domains, with multiple perceived causes. CI was felt to impact work, social, domestic, and family life, health, and independence. Five overarching themes were represented in the data: (1) characterization of SLE-reported CI, (2) perceived cause of CI, (3) perceived impact of CI on activities of daily living and life role participation, (4) adaptations for managing CI, and (5) influence of CI adaptations on activities of daily living and life role participation. CONCLUSION: This study provides a better understanding of the patient experience of CI in SLE, how it impacts their lives, and what coping strategies they employ. It highlights the long-term challenges those with CI in SLE undergo and provides evidence for the urgent need to implement multidisciplinary treatment options. When managing CI, it may be beneficial to evaluate and understand available psychosocial support resources to help identify and reinforce relevant adaptations to improve health-related quality of life.

OMERACT systemic lupus erythematosus domain survey.

BACKGROUND: Since the development of the OMERACT Systemic Lupus Erythematosus (SLE) Core Outcome Set (COS) in 1998, many new SLE domains have been identified and measures developed, creating a need to update the SLE COS. To revisit the 1998 SLE COS and research agenda domains, and generate new candidate domains, we conducted this study of patients with SLE and collaborators. OBJECTIVE: (1) To evaluate existing candidate SLE domains for inclusion in the SLE COS. (2) To generate additional candidate SLE domains for COS consideration. (3) To engage SLE collaborators, including patients, in developing the updated SLE COS. METHODS: The OMERACT SLE Working Group's steering committee developed a survey to assess the importance of candidate SLE domains and generate additional domains for consideration towards the SLE COS. Patients with SLE followed at the University of Toronto Lupus Clinic (patient group) and members of the OMERACT SLE Working Group (collaborator group) were invited to complete the survey between August 2022 and February 2023. RESULTS: A total of 175 patients were invited and 100 completed the survey. Of 178 collaborators invited, 145 completed the survey. Patients tended to prioritize life-impact domains while collaborators prioritized clinical domains. Both patients and collaborators recommended additional domains to those included in the 1998 SLE COS and research agenda. CONCLUSION: The domain inclusion and importance results demonstrate that patients and collaborators prioritize different domains, so capturing the perspectives of both groups is essential to ensure a holistic assessment of SLE. The results of the study identify domains that already have a high level of agreement for potential inclusion in the SLE COS, domains that require further explanation, and novel domains that warrant consideration.

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.