Occupational Therapy service inpost-COVID era, from hospital to community~ Sharing from Hong Kong
Asia Occupational Therapy Exchange Meeting
Nov, 2023
Sanne Fong
Vice-Chairperson
Hong Kong Occupational Therapy Association

Sharing include:• Patients’ conditions of elderly, mental and children;• Local studies and program evaluation to illustrate
how the OT services can help those survive fromCOVID-19;• New modalities of treatment used in the community
to hasten normalization of life

Problems encountered by patients
1. More than 30% of patients referred to OT in Integrated Community Discharge Service (ICDS) program weresuffered from chronic lung disease.
2. The COVID-19 pandemic induced social isolation, anxiety and mental stress individually and globally.
Patients recovered from COVID-19 reported numerous ongoing health effects. A post COVID-19 recovery
program was developed for psychiatric in-patients to support their recovery.
3. In the wake of the COVID-19 pandemic and social restriction, the mental health of individuals in Hong Kong
has been severely impacted.
4. Long COVID-19 syndrome has been increasingly reported by patient after infection of COVID-19, of which
cognitive complaints are commonly observed.
5. Dysphagia is a crucial problem in post-stroke care in an elderly residential home. The face-to-face training
sessions for dysphagia were risky and were affected by the COVID-19 pandemic in HK.
6. The fifth wave of COVID-19 in Hong Kong had led to an unprecedented surge in hospital admission. Elderly
COVID-19 patients were suffered from significant decline in self-care ability which led to discharge problem.
Therefore, Occupational Therapy (OT) service was introduced to HKICC in March 2022 to provide in-patient
rehabilitation service for COVID-19 patients.

Problems encountered by patients
7. During the 5th wave of COVID-19 pandemic, local COVID-19 service framework and case management
approach by occupational therapist (OT) were adopted according to the needs of COVID-19 patients.
8. The emergence of COVID-19 in 2020 led to 2.74M people being infected and over 12,000 deaths. Poor
management of the Long COVID symptoms, including fatigue, brain fog, emotional distress, exertional
dyspnea and musculoskeletal discomforts, may lead to an increased number of unplanned medical
consultations and healthcare burdens. Excessive health stress would lead to serious health problems.
Occupational Therapists are dedicated promoting occupational justice, health and welling. A pilot
outpatient service for patients with Long COVID was developed, underpinning the Social Cognitive Theory
and the electronic health-enhanced chronic care model, which integrates telehealth to enhance access ofcare and rehabilitation.
9. Growing evidence indicates that many residents in residential homes experience cognitive impairmentsafter recovery from COVID-19. Occupational Therapists designed a tailored multi-component rehabilitation
program to alleviate the long-term cognitive impairments of residents in residential homes.
10. Both parents and children with mild grade ID comorbid ASD and/or ADHD face developmental challenges infunctional occupations. After 3 years of COVID during which they had received scarce face to face training
in educational or rehabilitation setting, parents are in distress to cope with children’s transition to primaryschoolStudies/ program evaluation
1. The application of smart remote monitoring devices provide good visual cues with immediate feedback on
SpO2, which allow OTs to effectively analyze the data and formulate prompt and individualized intervention
for patients.

2. Post-COVID OT lead program is effective in enhancing hopefulness, well-being, emotional state & cognitive
function for psychiatric patients. Further program development on longer-term COVID-19 disease
management for psychiatric patients is essential.
3. A pilot study of mindfulness-based lifestyle redesign program has demonstrated potential benefits inimproving the mental health of patients with mood disorders. Participants reported positive changes inemotional awareness, mood, and enjoyment of the program. Significant reductions in symptoms ofdepression and anxiety were also observed.
4. A study of 30 participants demonstrated that health Qigong LiuZiJue can increase the frontal oxyhemoglobin
concentration and cognitive function of adults.
5. During COVID-19, the computerized biofeedback game-base swallowing training (BGBST) was proved effective
in situation with reduced face-to-face training in elderly residential homes.
6. OT demonstrated a vital role in improving the ADL performance and the safe discharge of the COVID-19
elderly patients. However, the relatively short course of in-patient rehabilitation was not sufficient to optimize
patient’s ADL performance and decrease their frailty. Post-discharge follow-up by out-patient sector andhome rehabilitation program were largely indicated for optimal benefit.

Studies/ program evaluation
7. Based on our preliminary COVID-19 service review during the in-patient and the community phase, it provided
direction and insight for our service enhancement to prepare for the rebound of the COVID-19 pandemic.
8. Integrating telehealth to enhance access to rehabilitation in Occupational Therapy outpatient service:
Asynchronous telehealth content fostered patient compliance with the home program. Patients with chronic
respiratory diseases showed fair cognitive function recovery after attending OT Long COVID Rehabilitation
Programme. Other factors, including gender, age, smoking, and exercise habits, should be explored. Patients who
received two or more COVID vaccines demonstrated less cognitive impairment and better recovery, as measured
by CTT. Further study will be conducted to explore the long-term functional improvement after patients attend
the training, including emotion, functional balance, fatigue and dyspnea, ADL, Quality of Life, and Self-efficacy inmanaging Long COVID symptoms.
9. The multi-component rehabilitation program applied in 44 patients, results indicated that it might have a positiveeffect on the recovery of cognitive function in elderly COVID-19 survivors. However, the effectiveness oftreatment might be different in elderly with dementia. Future studies should recruit more participants, adopt a
randomized-control trail design, and have a longer follow-up period.
10. Parents experienced burden in raising children with ID, training programand parent support are in need toalleviate their stress in handling children and promote development. An effective parent-child OT program for
mild grade intellectual disability(ID) comorbid ASD and/or ADHD illustrated that Occupational Therapy service
embracing various treatment strategies to provide related areas of training is effective and crucial, especially inthe transitional period of developmental life stages.