EXPERIENCES OF PHYSICAL THERAPISTS WORKING IN NEUROLOGICAL REHABILITATION DURING COVID-19

Abstract

Purpose: The study aimed to identify the experiences of physical therapists working in neurological rehabilitation during the COVID-19 process. Methods: The draft survey was created by two physical therapists working in the field of neurological rehabilitation, and Lawshe method was used to assess its content validity. The survey included demographic information and questions regarding clinical practice, and psychological states. The final survey was administered via Google forms. Only physical therapists working in the field of neurology were involved in the study. Results: The content validity ratio of the draft survey was found to be 0.745. According to this survey, the number of patients per week decreased significantly during the first 3 months and normalization process (p<0.01). Usage of tele-health applications significantly increased during the pandemic/normalization period (p<0.01). The mean score of physical therapists’ anxiety about their family's health was 7.72±2.39 (min=0, max=10). The study showed that working conditions changed, number of patients decreased (p<0.01), some precautions were taken, and the use of tele-health applications increased in clinics during pandemic period (p<0.01). Conclusion: The COVID-19 pandemic has had a significant impact on neurological rehabilitation services according to this study. As a result, methods to provide the most appropriate treatment without endangering patients and physiotherapists and policies to be followed in extraordinary situations need to be developed.

Keywords

• COVID-19
• Experience
• Neurorehabilitation
• Pandemic
• Physical Therapy

NÖROLOJİK REHABİLİTASYON ALANINDA ÇALIŞAN FİZYOTERAPİSTLERİN COVİD-19 SÜRECİNDEKİ DENEYİMLERİ

Öz

Amaç: Bu çalışma, nörolojik rehabilitasyon alanında çalışan fizyoterapistlerin COVID-19 sürecindeki deneyimlerini belirlemek amacıyla yapılmıştır. Yöntemler: Taslak anket nörolojik rehabilitasyon alanında çalışan iki fizyoterapist tarafından oluşturuldu ve bu oluşturulan taslak anketin kapsam geçerliliğini değerlendirmek için Lawshe yöntemi kullanıldı. Anket, demografik bilgi, klinik uygulama ve psikolojik durumları talep eden soruları içeriyordu. Son olarak oluşturulan anket Google formlar aracılığıyla uygulandı. Çalışmaya sadece nöroloji alanında çalışan fizyoterapistler dahil edildi. Sonuç: Taslak anketin kapsam geçerlilik oranı 0,745 olarak bulundu. Anket sonuçlarına göre haftalık hasta sayısı ilk 3 ayda ve normalleşme sürecinde istatistiksel olarak anlamlı şekilde azaldı (p<0,01). Pandemi/normalleşme döneminde tele-sağlık uygulamalarının kullanımı önemli ölçüde arttı (p<0,01). Ailelerinin sağlığı ile ilgili ortalama kaygı puanı 7,72±2,39 (min=0, maks=10) idi. Çalışma, pandemi döneminde çalışma koşullarının değiştiğini, hasta sayısının azaldığını, bazı önlemlerin alındığını ve tele-sağlık uygulamalarının kullanımının arttığını gösterdi. Tartışma: Bu çalışmaya göre COVID-19 pandemisinin nörolojik rehabilitasyon hizmetleri üzerinde önemli bir etkisi olmuştur. Sonuç olarak, hastaları ve fizyoterapistleri tehlikeye atmadan en doğru tedaviyi sunma yöntemlerinin ve olağan dışı durumlarda izlenecek politikaların geliştirilmesi gerekmektedir.

Anahtar Kelimeler

• COVID-19
• Deneyim
• Nörorehabilitasyon
• Pandemi
• Fizyoterapi

References

1. Lai CC, Shih TP, Ko WC, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924.
2. World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
3. Bao L, Gao H, Deng W, et al. Transmission of severe acute respiratory syndrome coronavirus 2 via close contact and respiratory droplets among human angiotensin-converting enzyme 2 mice. J Infect Dis. 2020;222(4):551-5.
4. Ankaralı H, & Ankaralı, S. Forecasting of the number of intensive care beds and hospital capacity for COVID-19 outbreak in Turkey until the end of april. J Turk Soc Intens Care. 2020; 18(1): 24-32.
5. Sağlık Hizmetleri Genel Müdürlüğü Hasta Hakları ve Tıbbi Sosyal Hizmetler Dairesi Başkanlığı. Elektif işlemlerin ertelenmesi ve diger tedbirler 2020. Available from: https://dosyamerkez.saglik.gov.tr/Eklenti/36865/0/elektif-islemlerin-ertelenmesi-ve-diger-tedbirlerpdf.pdf
6. İnce Dİ, Yağlı NV, Sağlam M, el al. Covid-19 enfeksiyonunda akut ve post-akut fizyoterapi ve rehabilitasyon. Turk J Physiother Rehabil. 2020;31(1):81-93.
7. Ferreira CHJ, Driusso P, Haddad JM, et al. A guide to physiotherapy in urogynecology for patient care during the COVID-19 pandemic. Int Urogynecol J. 2021;32(1):203-10.
8. Kılınç M, Yıldırım SA. Nörolojik fizyoterapi ve rehabilitasyonda ölçme ve değerlendirme. 1st ed. Ankara:Vize Yayıncılık; 2019.

9. Duncan PW, Zorowitz R, Bates B, et al. Management of adult stroke rehabilitation care: A clinical practice guideline. Stroke. 2005;36(9):e100-43.
10. Bernhardt J, Indredavik B, Dewey H, et al. Mobilisation 'in bed' is not mobilisation. Cerebrovasc Dis. 2007;24(1):157-8; author reply 159.
11. Coleman K, Austin BT, Brach C, et al. Evidence on the Chronic Care Model in the new millennium. Health Aff (Millwood). 2009;28(1):75-85.
12. Bernhardt J, Dewey H, Thrift A, et al. Inactive and alone: physical activity within the first 14 days of acute stroke unit care. Stroke. 2004;35(4):1005-9.
13. Mackey K, Parchman ML, Leykum LK, et al. Impact of the Chronic Care Model on medication adherence when patients perceive cost as a barrier. Prim Care Diabetes. 2012;6(2):137-42.
14. Thomas P, Baldwin C, Bissett B, et al. Physiotherapy management for COVID-19 in the acute hospital setting: clinical practice recommendations. J Physiother. 2020;66(2):73-82.
15. Kurtaiş Aytür Y, Füsun Köseoglu B, Özyemişci Taşkıran Ö, et al. Pulmonary rehabilitation principles in SARS-COV-2 infection (COVID-19): The revised guideline for the acute, subacute, and post-COVID-19 rehabilitation. Turk J Phys Med Rehabil. 2021; 67(2):129-145.
16. Lawshe, C. H. A quantitative approach to content validity. Pers. Psychol. 1975;28(4), 563-575.
17. Ayre C, Scally A. Critical values for Lawshe’s content validity ratio. Meas. Eval. Couns. Dev. 2013;47:79-86.
18. Metzl JM, Maybank A, De Maio F. Responding to the COVID-19 pandemic: the need for a structurally competent health care system. Jama. 2020;324(3):231-2.
19. Yang Y, Zhou Y, Liu X, et al. Health services provision of 48 public tertiary dental hospitals during the COVID-19 epidemic in China. Clin Oral Investig. 2020;24(5):1861-4.
20. Birkmeyer J, Barnato A, Birkmeyer N, et al. The impact of the COVID-19 pandemic on hospital admissions in the United States. Health Aff. (Millwood). 2020;39:101377hlthaff202000980.
21. Cankurtaran D, Tezel N. COVID-19 pandemisi döneminde fiziksel tıp ve rehabilitasyon polikliniğine başvuran hastaların başvuru tanılarının incelenmesi. J PMR Sci. 2021;24(1):27-32.
22. Bersano A, Kraemer M, Touzé E, et al. Stroke care during the COVID-19 pandemic: experience from three large European countries. Eur J Neurol. 2020;27(9):1794-800.
23. Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19): emerging and future challenges for dental and oral medicine. J Dent Res. 2020;99(5):481-7.
24. Guan W-j, Ni Z-y, Hu Y, et al. Clinical characteristics of 2019 novel coronavirus infection in China. MedRxiv. 2020;382(18):1708-20.
25. World Health Organization. Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19): interim guidance, 19 March 2020. Avaible from: https://iris.who.int/bitstream/handle/10665/338033/WHO-2019-nCoV-IPC_PPE_use-2020.4-eng.pdf?sequence=1
26. Chakravorty I, Daga S, Dave S, et al. An online survey of healthcare professionals in the COVID-19 Pandemic in the UK. Sushruta. 2020;13(2) ePub 23.04.2020 (pre-print v1).
27. Centers for Disease Control and Prevention – CDC. Coronavirus disease 2019 (COVID-19): Social distancing.; 29 Nov. 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html
28. Zampolini M, Todeschini E, Bernabeu Guitart M, et al. Tele-rehabilitation: present and future. Ann Ist Super Sanita. 2008;44(2):125-34.
29. Kahraman T. Koronavirüs hastalığı (COVID-19) pandemisi ve telerehabilitasyon. İKÇÜSBFD. 2020;5(2):87-92.
30. Suso-Martí L, La Touche R, Herranz-Gómez A, et al. Effectiveness of telerehabilitation in physical therapist practice: An umbrella and mapping review with meta–meta-analysis. Phys Ther. 2021;101(5):pzab075.
31. Lohse KR, Lang CE, Boyd LA. Is more better? Using metadata to explore dose-response relationships in stroke rehabilitation. Stroke. 2014;45(7):2053-8.
32. Bezuidenhout, L., Joseph, C., Thurston, C. et al. Telerehabilitation during the COVID-19 pandemic in Sweden: a survey of use and perceptions among physiotherapists treating people with neurological diseases or older adults. BMC Health Serv Res. 2022; 22(1):555.
33. Greenberg N, Docherty M, Gnanapragasam S, et al. Managing mental health challenges faced by healthcare workers during covid-19 pandemic. BMJ. 2020;368:m1211.
34. Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review. Asian J Psychiatr. 2020;51:102119.
35. Walton M, Murray E, Christian MD. Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic. Eur Heart J Acute Cardiovasc Care. 2020;9(3):241-7.
36. Igwesi-Chidobe CN, Anyaene C, Akinfeleye A, et al. Experiences of physiotherapists involved in front-line management of patients with COVID-19 in Nigeria: a qualitative study. BMJ Open. 2022;12(4):e060012.
37. Cui S, Jiang Y, Shi Q, et al. Impact of COVID-19 on anxiety, stress, and coping styles in nurses in emergency departments and fever Clinics: A cross-sectional survey. Risk Manag Healthc Policy. 2021;14:585.
38. Ornell F, Schuch JB, Sordi AO, et al. “Pandemic fear” and COVID-19: mental health burden and strategies. Braz J Psychiatry. 2020;42(3):232-5.
39. Chirico F, Nucera G, Magnavita N. Protecting the mental health of healthcare workers during the COVID-19 emergency. BJPsych Int. 2021;18(1):1-2.