Work - Volume 79, issue 3

Authors: Bianchi, Renzo | Swingler, Gail | Schonfeld, Irvin Sam

Article Type: Article Commentary

Abstract: For decades, the Maslach Burnout Inventory (MBI) has been regarded as the “gold standard” for the assessment of burnout. The present paper demonstrates that the MBI fails to measure the construct it is purported to measure. On a deeper level, the problems affecting the MBI question the very idea of burnout. These problems may be unsurprising in light of the genesis of the burnout construct. Burnout emerged in the mid-1970s as a largely predefined entity. Burnout’s definition was not predicated on robust empirical investigations or sound theorizing, nor was it anchored in a systematic review of the literature on stress …and health. Interestingly, other measures deemed to assess burnout, such as the Oldenburg Burnout Inventory, similarly fail to measure what they are claimed to measure. Despite far-reaching implications for our ability to study and promote occupational health, the flaws that undermine the conceptualization and measurement of burnout remain widely underappreciated. We hope this paper will help raise awareness of these flaws and correct current practices in research on job-related distress. Alternatives to burnout do exist and may enable us to support our workforce more effectively. Show more

Keywords: Burnout, construct validity, diagnosis, job stress, measurement, occupational health

DOI: 10.3233/WOR-240095

Citation: Work, vol. 79, no. 3, pp. 1525-1527, 2024

Authors: Hassanzadeh, Gholamreza | Anastasio, Albert T. | Tamrin, Shamsul Bahri Mohd | Shariat, Ardalan

Article Type: Editorial

DOI: 10.3233/WOR-246019

Citation: Work, vol. 79, no. 3, pp. 1529-1530, 2024

Authors: Davenport, Todd E. | Lee, Alan C. | Raja, Bhavana | Stark, Matthew L. | Reed, Christopher | Magnusson, Dawn M.

Article Type: Research Article

Abstract: BACKGROUND: Telehealth is becoming more prevalent in physical therapy, involving a whole host of clinical services. These services are often provided without structured training in telehealth, and no formal curricula currently exist for this purpose. OBJECTIVE: To develop a set of educational competencies (ECs) to guide instruction of telehealth-related skills in entry-level programs (i.e., Doctor of Physical Therapy), existing programs (i.e., residencies and fellowships), and potential future post-graduate programs specific to telehealth physical therapy. METHODS: Physical therapists and physical therapist assistants from diverse geographic locations and practice areas were invited to participate on …an expert panel. A modified Delphi process was then used to evaluate the acceptability of draft ECs gathered from the extant literature by a steering group. Draft ECs were presented to the expert panel on a questionnaire, which asked expert participants to rate each draft EC according to applicability and clarity. Draft ECs were accepted if they met a priori established criteria for acceptability and clarity. Unendorsed ECs were revised by the steering group according to open-ended comments from respondents and presented during a subsequent round. Three rounds of surveys were undertaken. RESULTS: Thirty-eight participants formed the expert panel; 38 participants completed the Round 1 survey, 28 participants completed the Round 2 survey, and 24 participants completed the Round 3 survey. Delphi group members approved 48 ECs in the first round, 23 ECs in the second round, and 2 ECs in the third round. There were 4 ECs that remained unendorsed after the modified Delphi process. Endorsed ECs spanned 7 conceptual areas. Distinct sets of ECs characterized expected end points of first professional degree, existing residency and fellowship, and potential future telehealth physical therapy post-graduate program. CONCLUSIONS: Consensus-based ECs identified in this study may guide instruction in knowledge and skills relevant to physical therapy telehealth. Show more

Keywords: Mobile health, virtual medicine, ehealth, telecare, competency based education, education, delphi study, consensus development

DOI: 10.3233/WOR-230618

Citation: Work, vol. 79, no. 3, pp. 1531-1549, 2024

Authors: Wu, Kevin A. | Anastasio, Albert T. | Kim, Joshua K. | Choudhury, Ankit | Adams, Samuel B.

Article Type: Research Article

Abstract: BACKGROUND: The COVID-19 pandemic caused notable shifts in healthcare behavior, influenced by remote work policies. This study examines the impact of Work from Home (WFH) policies on public interest in ankle-related orthopaedic surgeries, utilizing Google search trends. Understanding these trends is crucial for healthcare providers, enabling them to adapt services and communication to evolving patient needs during challenging times. OBJECTIVE: To comprehend variations in search volume and trends for ankle-related queries due to WFH policies during the COVID-19 pandemic. METHODS: Ankle-related terms accessible to laypersons were analyzed using Google Trends data from March 2018 to March …2022 in the United States. Data were divided into pre-pandemic (March 2018-March 2020) and post-pandemic (March 2020-March 2022) periods. Weekly search interest data for 20 terms were analyzed using a Mann-Whitney U test. The study aimed to identify significant changes in search interest, providing insights into public information-seeking behavior concerning ankle surgeries. RESULTS: Among the 20 terms analyzed, 11 exhibited significant changes. Ankle arthritis and ankle bursitis showed increased interest, suggesting heightened concern during the pandemic. Conversely, post-pandemic interest decreased for terms 9 terms, including ankle pain and ankle tendonitis, indicating reduced worry. Moderate declines were noted for ankle gout, Achilles tendonitis, and heel bursitis, reflecting shifting patient priorities. Some terms, including ankle fracture and ankle arthroplasty, showed stable information-seeking behavior despite the pandemic. CONCLUSIONS: The study underscores the nuanced impact of WFH policies on public interest in ankle-related orthopaedic surgeries. Varied search trends highlight changing patient concerns. Healthcare providers can use these insights to tailor services effectively, meeting evolving patient needs and enhancing communication strategies. Show more

Keywords: Orthopaedic, ankle surgery, work from home, pandemic, COVID-19, telemedicine

DOI: 10.3233/WOR-230621

Citation: Work, vol. 79, no. 3, pp. 1551-1556, 2024

Authors: Purushothaman, Vinosh Kumar | Ramalingam, Vinodhkumar | Subbarayalu, Arun Vijay | Raman, Vinoth | Prabaharan, Sivasankar | Subramaniam, Ambusam | Vijayakumar, Selvakumary | Krishnan Vasanthi, Rajkumar

Article Type: Research Article

Abstract: BACKGROUND: The global implementation of full-time telework became widespread during the new normal conditions following the pandemic, resulting in reduced physical activity (PA) among teleworkers and young adults. It is vital to comprehend how telehealth interventions favorably impact PA levels and overall well-being of young adults who face increasingly blurred boundaries between work and home life. OBJECTIVES: The aim of this study is to examine the effect of telerehabilitation (TR) on PA levels and quality of life (QoL) in young adult teleworkers. METHODS: A quasi-experimental study was conducted on 82 teleworkers (54 females and 28 males). …Levels of PA and QoL were assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Health-Related Quality of Life (HRQOL-14) questionnaire. TR was provided to all participants for four weeks, three times a week, for 40 minutes per session. Levels of PA and QoL were evaluated at baseline and after four weeks of the intervention. Data were analyzed using descriptive and inferential statistics. RESULTS: After four weeks of TR, there has been a significant improvement in the scores of IPAQ and HRQOL-14 (p  < 0.05). In regards to IPAQ-SF results, TR had a significant effect on the sitting or sedentary behavior of the teleworkers. CONCLUSION: The results showed that a short-term TR intervention improved both the level of PA and QoL in young adult teleworkers. Therefore, TR may be an effective treatment approach to improve PA and QoL and promote a healthy lifestyle in teleworkers. Show more

Keywords: Tele commuter, remote rehabilitation, exercise, healthy lifestyle, health risk, public health

DOI: 10.3233/WOR-230745

Citation: Work, vol. 79, no. 3, pp. 1557-1565, 2024

Authors: Gustavson, Allison M. | Rauzi, Michelle R. | Rasmussen, Alana | Raja, Bhavana | Kim, June | Davenport, Todd E.

Article Type: Article Commentary

Abstract: BACKGROUND: Telerehabilitation, or the delivery of rehabilitation services through telehealth platforms, has existed since the late 1990 s. Telerehabilitation was characterized by unprecedented, exponential growth at the beginning of the novel coronavirus-2019 (COVID-19) pandemic. Medical systems sought to reduce the likelihood of disease transmission by using telerehabilitation to limit physical proximity during routine care. This dramatic change in how medical care was delivered forced many professions to adapt processes and practices. Following the change, debates sparked regarding the best path to move forward for the betterment of patients, clinicians, systems, and society. Long COVID has emerged as a complex chronic health …condition arising from COVID-19. The unique needs and dynamic disease process of Long COVID has incentivized medical systems to create equitable ways for patients to safely access interdisciplinary care. OBJECTIVES: The purpose of this commentary is to describe what medical systems must consider when deploying high-quality telerehabilitation to deliver rehabilitation through asynchronous (e.g., text, portal) and synchronous modalities (e.g., phone or video). We highlight lessons learned to help guide decision-makers on key actions to support their patients and clinicians. METHODS: Not applicable. RESULTS: Not applicable. CONCLUSIONS: Key action steps from our lessons learned may be used to address complex chronic health conditions such as Long COVID and prepare for future challenges that may disrupt medical systems. Show more

Keywords: Telehealth, virtual care, rehabilitation, post-COVID conditions, care delivery, chronic disease

DOI: 10.3233/WOR-230731

Citation: Work, vol. 79, no. 3, pp. 1567-1571, 2024

Authors: Moghadam, Zahra Behboodi | Bahramnezhad, Fatemeh

Article Type: Letter

Keywords: Stroke, pregnant women, telehealth, rehabilitation, prevention, telemedicine

DOI: 10.3233/WOR-230586

Citation: Work, vol. 79, no. 3, pp. 1573-1576, 2024

Authors: Karaibrahimoglu, Adnan | İnce, Fuat | Hassanzadeh, Gholamreza | Alizadeh, Ali | Bagheri, Kian | Yucel, Irem | Shariat, Ardalan

Article Type: Research Article

Abstract: BACKGROUND: Artificial Intelligence (AI) refers to the simulation of human intelligence in machines that are programmed to perform tasks that typically require human intelligence. The integration of AI and telehealth applications in healthcare raises ethical concerns such as bias, transparency, data privacy, and accountability for errors. Several studies have assessed this topic, particularly with regard to musculoskeletal disorders, which will be the focus of this manuscript. OBJECTIVE: We will examine key ethical concepts including informed consent, data protection, confidentiality, physician malpractice, liability, and telemedicine regulations. METHODS: Ethical issues pertaining to the topic were explored through a …review paper. The primary objective of this scoping review was to map and synthesize the existing literature concerning ethical considerations in telehealth and AI for work-related musculoskeletal disorders. RESULTS: Research demonstrates that medication effectiveness, patient and physician satisfaction, and accessibility costs are higher with telemedicine and AI methods compared to in-person approaches, particularly for work-related musculoskeletal disorders. Therefore, addressing ethical issues, including patient data privacy and security, is crucial in this field. By considering these factors, the adoption of emerging AI and telemedicine applications, especially for work-related musculoskeletal disorders, is likely to increase. CONCLUSION: AI and telemedicine offer significant advantages, particularly in addressing work-related musculoskeletal disorders. However, ethical and legal issues surrounding their practice require standardized rules to ensure equitable access, quality care, sustainable costs, professional liability, patient privacy, data protection, and confidentiality. Further practical research studies are needed to address these considerations more effectively. Show more

Keywords: Ethics, telehealth, digital health, telemedicine, musculoskeletal disease, artificial intelligence, mHealth

DOI: 10.3233/WOR-240187

Citation: Work, vol. 79, no. 3, pp. 1577-1588, 2024

Authors: Talaski, Grayson M. | Baumann, Anthony N. | Kermanshahi, Nazanin | Walley, Kempland C. | Anastasio, Albert T. | de Cesar Netto, Cesar

Article Type: Research Article

Abstract: BACKGROUND: Telemedicine has seen increasing adoption in healthcare over the past two decades, with proven clinical efficacy in several medical specialties. Orthopedics surgery has shown potential benefits from telemedicine implementation. OBJECTIVE: This review aims to evaluate the impact of telemedicine on clinical outcomes and patient and physician preferences in foot and ankle orthopedics, providing insight into the potential role of telemedicine within this subspecialty. METHODS: Multiple databases were searched for relevant articles on telemedicine in foot and ankle orthopedics. Inclusion criteria encompassed articles on telemedicine use and foot and ankle orthopedic care. Data included patient demographics, …reasons for visits, duration of telemedicine, and outcomes. Analysis involved descriptive statistics, and a narrative approach to describe outcomes. RESULTS: Out of 218 articles, 12 met the inclusion criteria, comprising a total of 1,535 patients. Telemedicine visits were used for follow-up care, opinion consultations, monitoring, postoperative care, and treatment of various orthopedic conditions. Clinical outcomes demonstrated equivalence to in-person care. Patients expressed satisfaction with telemedicine but preferred in-person visits for future appointments. Physicians held neutral attitudes towards telemedicine, with concerns about the lack of physical examination. CONCLUSION: This review highlights the benefits of telemedicine in foot and ankle orthopedics. Telemedicine provides an alternative to in-person visits, improving patient access to care and offering cost and time savings. However, patient and physician preferences for in-person visits suggest a need to address concerns related to physical examination limitations. Telemedicine can supplement traditional care, but further research is required to explore its applicability in new patient consultations and optimize physician engagement. Show more

Keywords: Telemedicine, foot and ankle orthopaedic surgery, systematic review, virtual orthopaedic visit

DOI: 10.3233/WOR-230529

Citation: Work, vol. 79, no. 3, pp. 1589-1600, 2024