Occupational Therapy and Covid-19: Most Frequent Environmental Modifications for Returning Home. Multicenter Study

Abstract

Research Objectives: To describe the environmental modifications most frequently suggested by occupational therapists (OT) to post-COVID-19 patients at hospital discharge. Design: Observational, cross-sectional, multicenter survey. Setting: Three inpatient rehabilitation private institutions and three inpatient rehabilitation public hospitals, in Argentina. Participants: A convenience sample was selected. Data were collected from patients with COVID-19 sequelae, over 18 years old, at the time of discharge from inpatient rehabilitation (N= 59). Interventions: Not applicable. Main Outcome Measures: Questionnaire designed for this study. It included items about demographic information, diagnosis, Functional Independence Measure (FIM), support devices for walking, environmental modifications and accessibility. Results: 90% of the sample returned to the same dwelling. Those who did not, was due to the need for assistance (83%) or supervision (50%). Modifications in the social environment had the greatest impact on the decision of the destination after discharge. Physical modifications were mainly related to bathroom safety (52%). One-hundred and forty environmental modifications we suggested, of which 44% weren't carried out and weren't perceived as pending by patients. Conclusions: Changes in the social context had a higher impact than those in the physical context on the choice of destination after hospital discharge. The majority of patients who didn't return to the same dwelling reported that it was due to the need for assistance, supervision or the need for emotional support. Suggested modifications are mainly related to bathroom safety. Even though the advice about home accessibility turned out to be a pertinent OT intervention in all the cases, 44% of the suggestions made weren't carried out nor perceived as pending by patients. Future research is necessary to identify what factors determine the adherence to the suggestions.