Psychological distress is affected by fear of COVID-19 via lifestyle disruption and leisure restriction among older adults in Japan: a cross-sectional study.

Introduction: Engaging in social activities is an essential component of a healthy lifestyle for community-dwelling older adults. Critically, as with past disasters, there is concern about the effects of long-term activity restrictions due to the coronavirus disease 2019 (COVID-19) pandemic on health of older adults. However, the precise associations between fear of COVID-19, lifestyle satisfaction, leisure activities, and psychological distress are unclear. Objective: The purpose of this study was to comprehensively determine the associations between fear of COVID-19, lifestyle satisfaction, leisure engagement, and psychological distress among community-dwelling older adults in the context of the ongoing COVID-19 pandemic. Materials and methods: A questionnaire survey administered by mail was conducted from October 1 to October 15, 2021. The questionnaire included the Fear of COVID-19 Scale, the Lifestyle Satisfaction Scale, the Leisure Activity Scale for Contemporary Older Adults, and the Kessler Psychological Distress Scale-6. Based on previous studies, we developed a hypothetical model for the association between fear of COVID-19, lifestyle satisfaction, leisure engagement, and psychological distress and performed structural equation modeling to assess the relationships between these variables. Results: Participants included 301 Japanese citizens (23.6% male, 76.4% female), with a mean age of 76.7 ± 4.58 years. Goodness-of-fit from structural equation modeling was generally good. Analysis of standardized coefficients revealed a significant positive relationship between fear of COVID-19 and psychological distress (ß = 0.33, p < 0.001) and lifestyle satisfaction and leisure activities (ß = 0.35, p < 0.001). We further observed a significant negative relationship between fear of COVID-19 and lifestyle satisfaction (ß = -0.23, p < 0.001) and between leisure activities and psychological distress (ß = -0.33, p < 0.001). Conclusion: Fear of COVID-19 is significantly associated with psychological distress, both directly and via its effects on lifestyle satisfaction and leisure activities. That is, not only did fear of COVID-19 directly impact psychological distress of participants, it also affected psychological distress through lifestyle disruption and leisure restriction. This results may be used to better understand how a national emergency that substantially restricts daily life, such as COVID-19 or an earthquake disaster, can affect the psychological health and wellbeing of older, community-dwelling adults.

Occupational Therapists' Perceptions of Robotics Use for Patients With Chronic Stroke.

IMPORTANCE: The effectiveness of robotic therapy in stroke rehabilitation has been established by many studies, and occupational therapists should consider using robotics in their clinical practice. However, little is known about occupational therapy practitioners' experience using robotics. OBJECTIVE: To explore occupational therapists' perceptions of the mechanisms and outcomes of occupational therapy using robotics with chronic stroke patients. DESIGN: Qualitative study with semistructured focus group interviews. Data were analyzed using thematic analysis. SETTING: Hospitals and institutions in Japan in which occupational therapists used robotics in their clinical practice. PARTICIPANTS: Twenty-seven occupational therapists with experience in using robotics with chronic stroke patients as a self-training method that involved repetitive movements of a paralyzed upper extremity. Participants were interviewed in nine focus groups. RESULTS: Five themes-(1) body function, (2) values, (3) performance skills, (4) occupational performance, and (5) participation-and 12 subthemes were identified on the basis of the Occupational Therapy Practice Framework: Domain and Process (3rd ed.). Participants indicated that robotics improved patients' body function and promoted a desire for independence, which resulted in improved occupational performance and participation in their desired occupations. CONCLUSIONS AND RELEVANCE: Occupational therapists regarded robotics as an adjunct to other therapy, which improved patients' body function and promoted their desire for independence. What This Article Adds: Findings from this research provide insights into using robotics to enhance occupational therapy practice.