Work - Volume 79, issue 3

Authors: Granberg, Sarah | Widén, Stephen | Gustafsson, Johanna

Article Type: Research Article

Abstract: BACKGROUND: Persons with hearing loss (HL) are a vulnerable group in working life. Studies have shown that they are more likely than the general population to be in part-time work, to be unemployed, receive disability pension, and to be on sick leave. Many workers with HL also experience unhealthy work conditions, such as jobs where they experience high demands combined with low control as well as safety concerns and social isolation. There is a lack of studies that focus on factors that promote a healthy, sustainable work situation for the target group. OBJECTIVE: To investigate health factors that …contribute to a sustainable work situation for employees with HL. METHODS: The current study was a comparative, observational study with a cross-sectional design including a clinical population of adults with HL. Comparisons were made between workers with HL “in work” and workers with HL on “HL-related sick leave”. RESULTS: Seven health factors were identified. Those “in work” experienced a healthier work environment as well as lower levels of mental strain, hearing-related work characteristics and content, cognitively demanding work content, hearing-related symptoms, energy-demanding activities, and bodily aches and pain than those on “HL-related sick leave”. CONCLUSION: The results demonstrate a clear pattern regarding health factors for a sustainable working life. The type of job was not related to whether an individual was on sick leave or working. Rather, the work climate and the content of the work mattered. Show more

Keywords: Hearing loss, working conditions, workplace, health, occupational health, salutogenesis

DOI: 10.3233/WOR-230377

Citation: Work, vol. 79, no. 3, pp. 1391-1406, 2024

Authors: Hurenko, Olha | Suchikova, Yana | Kravchenko, Natalya | Nesterenko, Maryna | Petryk, Kristina

Article Type: Research Article

Abstract: BACKGROUND: This study analyzed the existing global experience of university and labor market partnerships concerning the employment of youth with disabilities. It was found that current cooperation models are implemented locally, in a fragmented manner, and are limited to interactions between universities and large enterprises. OBJECTIVE: The research aimed to explore the current state of meeting the needs of students with disabilities in terms of providing educational services and employment opportunities and to analyze the interaction between universities, municipalities, and the labor market to improve employment opportunities for young people with disabilities. METHODS: The study considered …a survey of three target groups from different regions of Ukraine (105 students with disabilities, 321 university faculty members, and 102 enterprise managers) conducted to study the current state of needs satisfaction in providing educational services and employing people with disabilities. RESULTS: The findings indicated a lack of coordination among stakeholders, an absence of systematization, and organization in addressing the issue of improving the employment of youth with disabilities. The research enabled the identification of existing and desired connections between the subjects of social partnership. A social partnership model between universities, municipalities, and the labor market was developed to improve the employment of youth with disabilities. CONCLUSION: The study results are promising, as implementing the social partnership model will broadly impact society. Show more

Keywords: People with disabilities, employment, social inclusion, social interaction, partnership practice, professional education, workplace environment

DOI: 10.3233/WOR-230351

Citation: Work, vol. 79, no. 3, pp. 1407-1423, 2024

Authors: Honkonen, Niina | Lamminpää, Anne | Liira, Juha

Article Type: Research Article

Abstract: BACKGROUND: Work ability meetings (WAM) are an essential and common tool of disability management in occupational health services in Finland. Meetings are held between an employee, a supervisor, and an occupational physician (OP). The aim is mainly to support work ability. OBJECTIVES: To describe challenges and resolutions in the meetings as described by OPs. METHODS: An internet survey was emailed to the members (n  = 1304) of the Finnish Society of Occupational Health Physicians in August 2014. We asked physicians to describe those WAMs they had attended, especially challenges and resolutions concerning WAM. RESULTS: A …total of 302 (23%) OPs responded to the survey. Most severe of the challenges were personal conflicts and a lack of confidence between the parties at the workplace. Also, the participants’ views may differ about the purpose and goal of the meeting. The respondents noted that the employer might be unable to organize modified work for disabled employees. As a resolution, OPs need to prepare well and maintain their professional and neutral role in WAMs in all cases. OPs also mentioned the need for training in insurance medicine and rehabilitation as well as skills as a mediator. CONCLUSIONS: WAM is a potential tool for return to work and disability management in collaboration between employees, employers, and occupational health when all the participants reach a common goal and become aware of their role in the process. OPs need to recognize possible conflicting interests and contact each party before WAM. Keeping confidentiality in WAMs is a crucial matter. Show more

Keywords: Cooperation within the workplace, occupational health, communication, return to work, supervisor, negotiation

DOI: 10.3233/WOR-230331

Citation: Work, vol. 79, no. 3, pp. 1425-1432, 2024

Authors: Dinelli, Emily J. | Crown, Deborah | Kudla, Angelika | Capraro, Pamela | Sheth, Manasi | Trierweiler, Robert | Munsell, Elizabeth | Heinemann, Allen W.

Article Type: Research Article

Abstract: BACKGROUND: Employment has long been an area of concern for people with disabilities. National samples in the United States are needed to understand the experiences of people with disabilities related to employment. OBJECTIVES: (1) Describe and evaluate associations between personal and health-related factors with employment after disability, and (2) describe and evaluate associations between facilitators, barriers, and work-related external factors with maintaining a longest held job after disability. METHODS: We recruited a national sample of people with physical disabilities from panels assembled by a United States market research organization; by selection, 1309 were working and 491 …were not. We evaluated the likelihood of employment and maintaining employment after disability onset using Poisson regression. Model 1 evaluated factors associated with employment; Model 2 evaluated factors associated with maintained employment. RESULTS: Model 1: Older age, decreased ability to pay bills on time, and assistive device use were associated with decreased likelihood of employment after disability onset. Non-Black minority identification, fatigue, and higher physical function were associated with increased likelihood of employment. For Model 2, the likelihood of maintaining a longest held job was associated with acquiring a disability at work, receipt of job accommodations, valuing opportunities for advancement and health benefits, having a helpful living situation, and helpful human resource attitudes. Decreased likelihood of maintaining a longest held job after disability onset was associated with job dissatisfaction and supervisors’ attitudes. CONCLUSIONS: This work highlights opportunities for employers to focus efforts on job accommodations and support in the maintenance of employment after disability. Show more

Keywords: Vocational rehabilitation, job security, social inequity, disabled persons, return to work, employment

DOI: 10.3233/WOR-240087

Citation: Work, vol. 79, no. 3, pp. 1433-1450, 2024

Authors: Matsuda, Yuko | Hamada, Shoko

Article Type: Research Article

Abstract: BACKGROUND: Japan has a shortage of childcare personnel, and the high levels of stress causing turnover in childcare workers must be urgently resolved. However, there is a lack of knowledge regarding the characteristics and influencing factors of job stress in Japanese childcare workers. OBJECTIVE: This study aimed to evaluate the job stress of childcare workers and explore the influence of demographic factors and the COVID-19 pandemic on such stress. METHODS: The data were collected through an Internet survey from 2,472 respondents. A 23-item version of the Brief Job Stress Questionnaire was used to measure occupational stress …in childcare workers. The instrument is recommended in the stress-check program implemented as a mental health measure in workplaces in Japan. RESULTS: The percentage of childcare workers with high stress exceeded that of general workers. Multiple regression analyses showed that the only factor affecting all job stressors and social support was the fear of contracting COVID-19. Job stressors and the COVID-19 pandemic had a significant large effect on stress responses. Additionally, being married and having children moderated childcare workers’ stress. CONCLUSIONS: This study provided basic data regarding job stress in Japanese childcare workers and compared them with those of other professionals. In the future, it will be necessary to clarify how stress is related to turnover intention and turnover in Japanese childcare workers to promote their career continuity. Show more

Keywords: Childcare, occupational groups, East Asian people, working conditions, occupational stress, demography, COVID-19

DOI: 10.3233/WOR-230658

Citation: Work, vol. 79, no. 3, pp. 1451-1464, 2024

Authors: Eusufzai, Sumaiya Zabin | Then, Bernard Ying Kang | Jamayet, Nafij Bin | Maqbool, Manahil | Noorani, Tahir Yusuf | Ahmad, Wan Muhamad Amir W | Alam, Mohammad Khursheed

Article Type: Research Article

Abstract: BACKGROUND: Obstructive Sleep Apnea (OSA) is a temporary airflow obstruction during periods of sleep. Patients with OSA often suffer from poor work performance, compromised sleep quality, and low quality of life which may lead to a life-threatening event. Adequate knowledge and a positive attitude toward OSA among medical and dental practitioners are crucial to the initial diagnosis and treatment. OBJECTIVE: This study aimed to identify the differences in knowledge and attitude toward OSA between medical and dental practitioners working in North-Eastern Peninsular Malaysia. METHODS: A comparative cross-sectional study was performed from February 2020 to February 2021. …A total of fifty-two medical practitioners and fifty-two dental practitioners working at university-based outpatient clinics, government health clinics, and oral health clinics located in Kelantan State of Malaysia participated in the study, and data were collected by the structured questionnaire including sociodemographic inquiry and OSAKA questionnaire by non-probability stratified random sampling. The Mann-Whitney U test was used to compare knowledge and attitude scores between the two groups. RESULTS: The mean age of the respondents was 34.6 years. The current study shows that 92.3% of medical doctors and 96.1% of dental doctors were able to correctly answer the question “Most of the patients with OSA snore” a significant finding in our study. Only 1% of medical professionals could answer seventeen questions correctly with a median score of 11, and only 1% of dental professionals could answer sixteen questions correctly with a median score of 9. None of them could provide an accurate answer to all the knowledge questions. Medical and dental practitioners exhibited different knowledge levels on OSA (z- statistics=–4.39, U  = 827.00 with p  <  0.05, and effect size, r  = 0.61). However, no significant differences were found in total knowledge score by gender (p -value>0.05), ethnicity (p -value>0.05), total service years (p -value>0.05), and training attended. In addition, significant differences in attitude levels between medical and dental practitioners have been observed (z-statistics=–3.42, U  = 725.00 with p  <  0.05, and effect size, r  = 0.47). Nevertheless, no significant differences have been seen in total attitude score by ethnicity (p -value >  0.05), total service years (p -value >  0.05), attending training on OSA (p -value >  0.05), and professional status (p -value >  0.05) except gender (p -value <  0.05). CONCLUSION: A Significant difference is evident concerning knowledge and attitude toward OSA diagnosis and management between medical and dental practitioners working in North-Eastern Peninsular Malaysia. Medical practitioners in this study recorded a higher knowledge and attitude score compared to dental practitioners. Show more

Keywords: Sleep apnea, sleep-disordered breathing, continuous positive airway pressure, temporomandibular disorders

DOI: 10.3233/WOR-220174

Citation: Work, vol. 79, no. 3, pp. 1465-1475, 2024

Authors: Albakri, Uthman | Smeets, Nick | Drotos, Elizabeth | Kant, IJmert | Gabrio, Andrea | Meertens, Ree

Article Type: Research Article

Abstract: BACKGROUND: Shift work affects the mental and physical health of nurses, yet the effect of working irregular shifts on sleep and its association with the need for recovery is under-explored. OBJECTIVE: The purpose of this study was to investigate the sleep quality of nurses working irregular shifts, including night shifts, and to determine whether sleep quality is associated with the need for recovery. METHODS: This cross-sectional study included 405 nurses working irregular shifts. Data were collected using an online questionnaire that included sociodemographic characteristics, the Sleep-Wake Experience List, sleep problems, sleep duration, and the Need for …Recovery scale. Data analyses included descriptive statistics, chi-square tests, t -tests, logistic and multiple linear regressions. RESULTS: Nurses who worked irregular shifts had poor sleep quality. Those who also worked night shifts, had significantly poorer sleep quality and experienced more difficulties in daily functioning than those who did not work night shifts. Sleep quality was significantly associated with the need for recovery and this remained so after controlling for confounding variables (β = .554, p  = .001). CONCLUSION: The findings indicate that in nurses who work irregular shifts, the sleep quality is low. In this group, the sleep quality in nurses who work night shifts is lower than in nurses who do not work night shifts. Furthermore, better sleep quality was associated with lower need for recovery. These findings suggest that improving sleep quality in nurses working irregular shifts may lower their need for recovery, which may improve health, and reduce burnout and sickness absence. Show more

Keywords: Nurses, hospitals, shift work schedule, circadian rhythm, sleep, fatigue, burnout, need for recovery.

DOI: 10.3233/WOR-230500

Citation: Work, vol. 79, no. 3, pp. 1477-1490, 2024

Authors: Tunç, Ahmet | Yağar, Sema Dökme | Gerçek, Emine | Yağar, Fedayi

Article Type: Research Article

Abstract: BACKGROUND: Adopting an effective leadership style is of critical importance in increasing healthcare efficiency and therefore determining patient satisfaction. For example, although there are many new and effective leadership types today, the paternalistic leadership approach can still play an effective role in developing countries. OBJECTIVE: The aim of this study is to examine the moderating role of paternalistic leadership in the relationship between job satisfaction and job stress. METHODS: A total of 466 healthcare workers completed measures of perceived paternalistic leadership, job stress, and job satisfaction. The research was conducted in the center of Gaziantep, one …of the largest cities in Turkey. Regression analysis was used to evaluate the moderate variable. Dawson slope were used to visualize the results. RESULTS: A negative relationship was found between job satisfaction and job stress. Additionally, it has been determined that the perception of paternalistic leadership has a moderating role. It has been observed that as the perception of paternalistic leadership increases, the negative relationship between job satisfaction and job stress decreases. CONCLUSION: It has been concluded that the paternalistic leadership approach can play a critical role in increasing the productivity of healthcare workers and reducing the negative effect of stress on satisfaction. It has been suggested that policies be developed to develop appropriate strategies for creating work environments that will increase employees’ perceptions of paternalistic leadership. Show more

Keywords: Effective leadership, mental health, work environment, health workers, hospitals, Turkey

DOI: 10.3233/WOR-240026

Citation: Work, vol. 79, no. 3, pp. 1491-1499, 2024

Authors: Asadollahi, Fatemeh | Kouhnavard, Bahram | Daneshmandi, Hadi | Dehghan, Habibollah | Fararouei, Mohammad | Zamanian, Zahra

Article Type: Research Article

Abstract: BACKGROUND: Nurses are among high-risk occupational groups during the outbreak of epidemics. Therefore, these people are required to use personal protective equipment (PPE). Previous studies have shown that the use of personal protective equipment can affect people’s thermal strain and mental workload. OBJECTIVE: The present study was conducted with the aim of objectively and subjectively evaluating the use of protective clothing on the thermal strain and mental workload of nurses during the covid-19 pandemic. METHODS: This cross-sectional study was divided into two groups with a sample size of 300 people who were selected by systematic random …method. In the first group, 120 people were objectively evaluated (use of protective clothing). In the second group, 180 people only completed the questionnaire of mental workload, feeling of heat and sweating and other information related to the type of clothing and the duration of its use, etc. Measurements were done in August and September of 2021 and in the morning shift of hospitals. Data were analyzed using SPSS version 21 software and chi-square, independent T -test and linear regression tests. RESULTS: The average age and average working hours per month of the participants in the study were 33.51±7.88 years, 187.91±35.37 hours, respectively. The results showed that the predicted average vote (PMV) index and the predicted percentage of dissatisfied (PPD), moisture felt on the skin surface, the feeling of desirability and pleasantness of the temperature, the weight of sweat and the humidity inside the clothes between the two groups of people using insulated clothes There is a significant difference between medicine and dressing (P  < 0.05). There was a significant relationship between mental workload and type of clothing, average working hours per month. CONCLUSIONS: The use of medical isolation clothes causes a high heat load on nurses and can increase their mental workload. On the other hand, people using normal gowns suffer from a high mental workload due to the fear of disease due to the uncertainty of high-level protection. In addition, medical isolation clothes increase the humidity of the skin due to their impermeability, which causes skin complications. Show more

Keywords: Nurses, medical isolation clothes, mental workload, heat strain, heat stress, physiological strain

DOI: 10.3233/WOR-230396

Citation: Work, vol. 79, no. 3, pp. 1501-1516, 2024

Authors: Reynders, Sydney S. | Lombardo, Angela M. | Davidson, Emily J. | Guan, Jennifer L. | Pawlowski, Katherine G. | Simons, Nathan Z. | Baumer, Nicole T.

Article Type: Research Article

Abstract: BACKGROUND: Adults with intellectual disabilities have high rates of unemployment and underemployment. Despite benefits to employers and employees, some groups may be hesitant to implement inclusive employment programs due to lack of knowledge, absence of well-defined strategies, and limited exposure to successful examples. OBJECTIVE: To address this gap, the Down Syndrome Program (DSP) in a New England tertiary pediatric hospital established an inclusive employment program that supports and trains young adults with Down syndrome in the development of foundational job skills within a hospital-based clinic. METHODS: This case study examines strategies and lessons learned from the …employment program’s implementation and evolution. RESULTS: Successful implementation required iterative, tailored approaches to meet diverse needs. CONCLUSION: The DSP developed a framework and collection of best practices for other organizations to adopt for successful employment of individuals with disabilities under an inclusive employment model. Show more

Keywords: Intellectual disability, developmental disabilities, healthcare, work, mentoring, supported employment

DOI: 10.3233/WOR-240080

Citation: Work, vol. 79, no. 3, pp. 1517-1523, 2024

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