TY - JOUR

T1 - Understanding the impact of the Covid-19 pandemic on delivery of rehabilitation in specialist palliative care services

T2 - An analysis of the CovPall-Rehab survey data

AU - Bayly, Jo

AU - Bradshaw, Andy

AU - Fettes, Lucy

AU - Omarjee, Muhammed

AU - Talbot-Rice, Helena

AU - Walshe, Catherine

AU - Sleeman, Katherine

AU - Bajwah, Sabrina

AU - Dunleavy, Lesley

AU - Hocaoglu, Mevhibe

AU - Oluyase, Adejoke

AU - Garner, Ian

AU - Cripps, Rachel

AU - Preston, Nancy

AU - Fraser, Lorna

AU - Murtagh, Fliss

AU - Irene, Higginson

AU - Maddocks, Matthew

PY - 2022/2/28

Y1 - 2022/2/28

N2 - Background: Palliative rehabilitation involves multi-professional processes and interventions aimed at optimising patients’ symptom self-management, independence, and social participation throughout advanced illness. Rehabilitation services were highly disrupted during the Covid-19 pandemic.Aim: To understand rehabilitation provision in palliative care services during the Covid-19 pandemic,identifying and reflecting on adaptative and innovative practice to inform ongoing provision.Design: Cross-sectional national online survey.Setting/participants: Rehabilitation leads for specialist palliative care services across hospice, hospital,or community settings, conducted from 30/07/20 to 21/09/2020.Findings: 61 completed responses (England, n=55; Scotland, n=4; Wales, n=1; and Northern Ireland, n=1) most frequently from services based in hospices (56/61, 92%) providing adult rehabilitation. Most services (55/61, 90%) reported rehabilitation provision becoming remote during Covid-19 and half reported reduced caseloads. Rehabilitation teams frequently had staff members on sick-leave with suspected/confirmed Covid-19 (27/61, 44%), redeployed to other services/organisations (25/61, 41%) or furloughed (15/61, 26%). Free text responses were constructed into four themes: (i) fluctuating shared spaces; (ii) remote and digitised rehabilitation offer; (iii) capacity to provide and participate in rehabilitation; (iv) Covid-19 as a springboard for positive change. These represent how rehabilitation services contracted, reconfigured, and were redirected to more remote modes of delivery, and how this affected the capacity of clinicians and patients to participate in rehabilitation.Conclusion: This study demonstrates how changes in provision of rehabilitation during the pandemic could act as a springboard for positive changes. Hybrid models of rehabilitation have the potential to expand the equity of access and reach of rehabilitation within specialist palliative care.

AB - Background: Palliative rehabilitation involves multi-professional processes and interventions aimed at optimising patients’ symptom self-management, independence, and social participation throughout advanced illness. Rehabilitation services were highly disrupted during the Covid-19 pandemic.Aim: To understand rehabilitation provision in palliative care services during the Covid-19 pandemic,identifying and reflecting on adaptative and innovative practice to inform ongoing provision.Design: Cross-sectional national online survey.Setting/participants: Rehabilitation leads for specialist palliative care services across hospice, hospital,or community settings, conducted from 30/07/20 to 21/09/2020.Findings: 61 completed responses (England, n=55; Scotland, n=4; Wales, n=1; and Northern Ireland, n=1) most frequently from services based in hospices (56/61, 92%) providing adult rehabilitation. Most services (55/61, 90%) reported rehabilitation provision becoming remote during Covid-19 and half reported reduced caseloads. Rehabilitation teams frequently had staff members on sick-leave with suspected/confirmed Covid-19 (27/61, 44%), redeployed to other services/organisations (25/61, 41%) or furloughed (15/61, 26%). Free text responses were constructed into four themes: (i) fluctuating shared spaces; (ii) remote and digitised rehabilitation offer; (iii) capacity to provide and participate in rehabilitation; (iv) Covid-19 as a springboard for positive change. These represent how rehabilitation services contracted, reconfigured, and were redirected to more remote modes of delivery, and how this affected the capacity of clinicians and patients to participate in rehabilitation.Conclusion: This study demonstrates how changes in provision of rehabilitation during the pandemic could act as a springboard for positive changes. Hybrid models of rehabilitation have the potential to expand the equity of access and reach of rehabilitation within specialist palliative care.

KW - Rehabilitation

KW - Palliative Care, Hospices

KW - Physical Therapy Modalities

KW - Occupational Therapy

KW - Surveys and Questionnaires

KW - Covid-19

U2 - 10.1101/2021.04.13.21255380

DO - 10.1101/2021.04.13.21255380

M3 - Journal article

VL - 36

SP - 216

EP - 218

JO - Palliative Medicine

JF - Palliative Medicine

SN - 0269-2163

IS - 2

ER -