Impact of Post-Acute Sequelae of COVID-19 on Lives of Patients Post ICU Discharge: A Cross-Sectional Study.

OBJECTIVES: Post-acute sequelae of SARS-CoV-2 (PASC) are known for their prolonged and persistent effects on patients. This study aimed to investigate the impact of the PASC on the quality of life (QOL) of patients, their levels of activity participation, and satisfaction with these levels, in addition to exploring whether the duration of post-intensive care unit (ICU) discharge is associated with the effects of PASC. SUBJECT AND METHODS: This cross-sectional study included 134 patients with COVID-19 discharged from an ICU in Kuwait. Data were collected using two validated questionnaires: the World Health Organization Quality of Life-Brief (WHOQOL-BREF) and Satisfaction with Daily Occupations. Additionally, demographic information was collected, and 11 categories of related symptoms were investigated. RESULTS: Most patients reported health issues post-ICU discharge. Furthermore, most PASC-related symptoms decreased over time, whereas a few increased. Notably, we observed a negative association between post-discharge duration and overall improvement in level of participation in activities of daily living. However, patients discharged from the ICU for more than 6 months demonstrated higher satisfaction with functional performance and improved QOL. Additionally, patients who received rehabilitation, and were vaccinated were less likely to have poor QOL. No significant sex differences were observed in the WHOQOL-BREF score. CONCLUSION: PASC adversely affected the daily functioning of patients, especially in leisure, social, and religious aspects. However, these effects lessened over time, with corresponding improvement in QOL. Additionally, patient satisfaction with functional performance increased over time. These findings shed light on the rehabilitation needs of patients with COVID-19.

Profile of paediatric occupational therapy practice in Eastern Mediterranean countries.

BACKGROUND: Paediatric occupational therapy (OT) is considered the largest practice area in OT in several regions, including the Eastern Mediterranean (EM) countries. AIMS/OBJECTIVES: This study aimed to establish a profile of paediatric occupational therapists in EM countries to identify theoretical models, assessments and interventions employed. It also investigated the therapists' usage of evidence-based practice in their practice. MATERIAL AND METHODS: We conducted a cross-sectional survey using a questionnaire which was distributed electronically to occupational therapists working with children. RESULTS: The participants included 118 therapists. Majority of the participants were working at rehabilitation centres. The primary client groups were pre- and school-age children with autism spectrum disorder and cerebral palsy. The most frequently used assessments were sensory-related tools. Activities of daily living and play were the most often targeted interventional area. Participants highlighted some of the challenges faced in implementing evidence in their practice. CONCLUSION: Paediatric occupational therapists are usually exposed to specific age groups and conditions. However, a lack of knowledge practice in some areas and challenges in others exist. SIGNIFICANCE: Within the EM region, knowledge regarding therapists' practices is lacking. Actions should be taken to improve current practice and meet the current needs of clients, and utilise evidence-based practices.

Caregivers' perspectives on the social and physical environmental factors associated with the play of their children with palliative care needs: A Q methodology study.

Children living with palliative care needs are less engaged in play, despite its importance in their lives. The environment may have a crucial role in supporting these children's play. Understanding the importance and impact of environmental factors on children's play is essential to being able to support their participation in play. Data were collected from caregivers (mostly parents) of children living with life-threatening/limiting conditions, who were between 5 and 11 years old. Thirty-nine participants were recruited from two children hospitals and two hospices in Kuwait and in the United Kingdom. The participants' perspectives were explored using Q methodology. By-person factor analysis was used to explore the ranking of each statement. Content analysis was used to analyse the participants' verbal comments. The most important environmental factors were the need for others to share play and get assistance to facilitate play. However, this is not always possible as these conditions, the life-threatening/limiting conditions, may be socially isolating. Children also experience limitations in accessing play resources that match their abilities and meet their play needs. Being aware and responsive to children's play needs is essential for building appropriately supportive play environments for children living with life-threatening/life-limiting conditions.

'Eat, sleep, internet and talk': an exploratory study of play profile for children living with palliative care needs.

Background: Play is central to children's lives. Children living with palliative care needs experience disruption in their play. In this study, we sought to discover the characteristics and patterns of children's play when receiving care in children's hospital wards and hospices in Kuwait and the United Kingdom. Methods: A qualitative nonparticipatory observation design was used. Thirty-one children were observed, between the ages of 5 and 11 years, all diagnosed with life-limiting or life-threatening conditions and receiving palliative care. The data were analysed using content analysis. Results: The children's illnesses were negatively impacting their ability to have typical play for their age and development. The children's interactive play was with grown-ups and very rarely with other children. This was associated with isolation precautions, the child's need for assistance and a lack of play resources that match children's physical and cognitive abilities. This gave rise to their engagement in more sedentary, solitary play. The findings of the study did not indicate significant cultural differences between the two countries. Conclusion: Children living with palliative care needs may be socially isolated due to their illnesses and their play participation can be limited. Understanding the influencing factors that determine these children's play is essential for implementing effective modifications to enhance their play routines.

The social and physical environmental factors associated with the play of children living with life threatening/limiting conditions: A Q methodology study.

BACKGROUND: Living with a life threatening/limiting condition changes and challenges children's play. The environment is known to support participation in play, yet there is a lack of evidence highlighting its specific factors contributing to children's play. In this study, we investigated the perspectives of children living with life threatening/limiting conditions with regard to the environmental factors that are related to their engagement in play whilst receiving inpatient healthcare. METHODS: Twenty-seven children took part in this study. Participants were aged between 5 and 11 years, diagnosed with life threatening/limiting conditions and were receiving care at either a children's hospital or hospice in either Kuwait or the United Kingdom. Children were asked to rank-order a Q set according to their perceived importance. The used Q set composed of social and physical environmental factors. The data were analysed using factor analysis and content analysis. FINDINGS: Two shared viewpoints were identified, which represented children from both countries. For Factor 1, the children's need for social connectivity guided their answers regarding the environmental factors. For Factor 2, although children considered being surrounded by others important, their selections of the play conditions directed their play. For both factors, children had relatively little concern for outdoor and the type of play to engage in, with the exception of arts and crafts play activities, which were deemed important. CONCLUSIONS: Play settings are important to support rich, social play experiences and opportunities that match children's play preferences. Children living with life threatening/limiting conditions in Kuwait and the United Kingdom have relatively similar play needs.

Play in Children With Life-Threatening and Life-Limiting Conditions: A Scoping Review.

IMPORTANCE: Play is essential to children and provides opportunities to promote their health and well-being. Children living with life-threatening and life-limiting conditions experience deprivation in play. OBJECTIVE: To conduct a scoping review of studies that examined play of children with a life-threatening or life-limiting condition to explore their play characteristics and possible factors influencing their participation in play. DATA SOURCES: A search of literature published between 1990 and 2017 was conducted in the health, social care, and built-environment fields. The scoping review included multiple searches in electronic databases, a gray literature search, and manual searches of relevant journals and reference lists of included articles. STUDY SELECTION AND DATA COLLECTION: Defined criteria were used to select articles describing studies that examined the daily play of children ages 5-11 yr with life-threatening and life-limiting conditions; articles that focused on play as therapy or that used parents' accounts of a service were excluded. The identified articles were critically appraised with the Critical Appraisal Skills Programme and the Joanna Briggs Institute Critical Appraisal Tools. FINDINGS: Thirteen articles were reviewed. The findings indicate that children's play is influenced by their health conditions and play opportunities and by the limited availability of appropriate play equipment and spaces allowing play and social interaction. CONCLUSIONS AND RELEVANCE: Available appropriate play opportunities need to be maximized for children living with life-threatening and life-limiting conditions. This goal can be achieved by understanding and considering the needs of these children and by facilitating environmental enablers and limiting barriers. WHAT THIS ARTICLE ADDS: Promoting the participation in play of children who live with life-threatening and life-limiting conditions is important to their health and well-being and can be achieved by targeting the cultural, social, and physical environmental factors that shape the children's play.