Asia Occupational Therapy Association Exchange Meeting (November 9, 2023)
Post COVID-19 issues particularly in each country

POST COVID-19 ISSUES IN JAPANInternational Director of JAOT, Kitasato University
Higashi Kanagawa Rehabilitation Hospital

Kayoko TAKAHASHI
Masatoshi TAHARAOUTLINE
Post COVID-19 issues as Association (JAOT)

Post COVID-19 issues in OT education
Post COVID-19 issues in clinical settings
Post COVID-19 issues among therapists

POST COVID-19 ISSUES AS
ASSOCIATION (JAOT)CONGRESS✔Congress style has been changed and so the number of participants
YearCongress style

Number of participants

Pre-COVID

on-site only

About 4,0002020

on-demand web conference

3,300

2021

live and on-demand web conference

2,700

2022

onsite (Kyoto) and on-demandOver 2,700✔When only on-site conferences were held, venues were selected only in major cities
to accommodate the size of the conference.
✔With the hybrid format, venues are no longer limited to major cities, giving attendees
more options in both style and location.

CONTINUING EDUCATION✔E-learning has been introduced partially since 2018. Since COVID-19 pandemic in2020, most non-practical courses are now online.
✔Comments from JAOT members:“I can now attend seminars whenever and wherever”“I could take courses at home with small children”“It is good for more experienced (older) generation who feel uncomfortableattending courses with young/novice group”“On-line courses has lowered the bar to take seminars in other areas of interest"

Number of participants for continuing education continues to grow steadily

MANAGEMENT✔Prior to COVID, prefectural association leaders from all over Japan needed togather at the central training program to gather. Now, online meting allows us todeliver information quickly and widely at once.
✔While online meetings allows to exchange ideas among, it is difficult to build aclose relationship to stay in touch afterward.

✔The decline in the organization rate has also become a major concern, and weare reviving face-to-face meetings so that people can feel the benefits ofconnecting with others through the association.

Online meetings is convenient but difficult to feel the benefit to connect

POST COVID-19 ISSUES INOT EDUCATIONPLACEMENT/FIELDWORK
On-site clinical placement is carried out without any problems✔Notification from the Ministry of Health, Labour & Welfare (October 17, 2023)
In the event that an outbreak of infectious diseases at a school training institution
or practical training facility during the period when the practical training is to be
conducted makes it unavoidably difficult to conduct the practical training, it isallowed to substitute on-site placement to on-campus practice (March 31, 2024).
✔Teaching materials (case scenario and videos) created during pandemic are now
distributed and shared among schools.

ONLINE COURSES
What we can do ONLINE has been expanded✔We are now able to hold lectures by lecturers both in Japan and abroad without
having to invite them to campus.
✔Online module (ie. Google classroom) is still used to give handouts, assignment,and feedback. This allows the transparency of class/grading.
✔More opportunities for online international exchange. Interacting online before
studying abroad is now possible, resulting in a smoother international experience.

POST COVID-19 ISSUES IN
CLINICAL SETTINGSPOST COVID-19 ISSUES IN
CLINICAL SETTINGS
Changes in the clinical environment✔Separate training areas for inpatients and outpatients✔Home evaluations, shopping practice, and outdoor training were completely
prohibited at the beginning of the pandemic, but were gradually allowed✔Educational programs that used to be held for patients and their families, with
instructors such as occupational therapists, doctors, and nurses, are now held ondemand on each floor

POST COVID-19 ISSUES IN
CLINICAL SETTINGS
Restrictions on patient and family support✔Family members will be prohibited from visiting the rehabilitation training room
✔There are restrictions on family visits, and depending on the infection situation
within the hospital, there may be cases where the visit is limited to 30 minutes orwhere the visit is prohibited✔Lectures for families will be limited to 30 minutes a day and will be held in a
private lecture room

POST COVID-19 ISSUES IN
CLINICAL SETTINGS
Changes in occupational therapists✔At the beginning of the pandemic, staff members were prohibited from having
meals together and unnecessary going out, but this was gradually allowed✔It is still mandatory to wear a mask when commuting to work

POST COVID-19 ISSUES IN
CLINICAL SETTINGSOur hospital manual for each infection control phase
Phase 1: No COVID-19 infections
Rehabilitation for inpatients continues as usual
Phase 2: Hospitalized patient infected with COVID-19

Infected patients are isolated and trained by therapists wearing PPE
Phase 3: Secondary infection occurs within the hospital
New hospitalizations are restricted and family visits are prohibited

Patients train in the ward and are prohibited from giving lectures to theirfamilies
Therapists are prohibited from training outpatients

POST COVID-19 ISSUES IN
CLINICAL SETTINGS
Impact on Collaborative PracticeCollaboration with out-of-hospital service providers was limited compared to inhospital✔Since care managers who support patients after discharge were restricted frommeeting with patients, we used a web conferencing system (ZOOM) to checkpatient movements and adjust post-discharge services

POST COVID-19 ISSUES IN
CLINICAL SETTINGS
Impact on outside training
Training outside of places where many people gather, such as shops and stations,
was restricted✔We selected a deserted road as a training course and conducted mock shopping
practice inside the hospital

POST COVID-19 ISSUES IN
CLINICAL SETTINGS
Impact on outside training
There were no restrictions on conducting house evaluations before discharge✔Thorough infection control measures were taken, including changing masks anddisinfecting hands upon returning to the hospital

POST COVID-19 ISSUES IN
CLINICAL SETTINGS
Impact on family support
Family members were prohibited from entering the rehabilitation room, andopportunities to observe training progress were limited. Because visitation wasrestricted, gathering and sharing information from family members was restricted

POST COVID-19 ISSUES IN
CLINICAL SETTINGS
Impact on family support✔We filmed the training on a tablet and provided the information to the family
during informed consent✔Family lectures on transfers, diaper changes, etc. were held for 30 minutes a dayin a private room
✔Gathered information from family members and listened to their needs over thephone, and shared goals using a web conferencing system

POST COVID-19 ISSUES IN
CLINICAL SETTINGS✔We filmed the training on a tablet and provided the information to the family
during informed consent

ICの様子の写真

POST COVID-19 ISSUES IN
CLINICAL SETTINGS✔Family lectures on transfers, diaper changes, etc. were held for 30 minutes a dayin a private room

指導の写真

POST COVID-19 ISSUES IN
CLINICAL SETTINGS✔Gathered information from family members and listened to their needs over thephone, and shared goals using a web conferencing system

ZOOM面
接の写真

Mai Koike, Masatoshi Tahara, A clinical experience that encouraged members to participate in goal-setting using ADOC on a web conferencing system，57th Japanese Occupational Therapy Congress, 2023.

POST COVID-19 ISSUESAMONG THERAPISTSPOST COVID-19 ISSUES AMONG
THERAPISTSCOVID-19 impacts the mental health of occupational therapists✔Insufficient information from the workplace and increased workload areassociated with depression, anxiety, and insomnia, and depression is associatedwith poorer quality of care
✔The impact of the pandemic is different in the physical disability area and thepsychological area, with increased workload being a factor associated with anxietyand depression in the physical disability area
✔Providing adequate information significantly reduces the risk of insomnia anddepression
Ito A, Sawamura D, Kajimura S, Miyaguchi H, Nakamura H, Ishioka T. Quality of therapy and mental health among occupational therapists during the COVID-19 pandemic. Front Public Health. 2022 Dec
15;10:1053703.
Sawamura D, Ito A, Miyaguchi H, Nakamura H, Ishioka T. Different Impacts of COVID-19 on Quality of Therapy, Psychological Condition, and Work Life Among Occupational Therapists in Physical andMental Health Fields. Front Public Health. 2022 Jun 3;10:887069.

POST COVID-19 ISSUES AMONG
THERAPISTSThe COVID-19 pandemic is an occupational justice/injustice issue✔The pandemic brings about critical social inequalities and affects people's
occupational justice✔The Occupational Justice Framework (OJF) approach is useful for estimating how
systemic inequalities (limited access to health care, employment opportunities,
government resources) affect work participation and the impact on mental health✔The role of occupational therapists is to advocate for opportunities formeaningful and satisfying occupational participation in a time when isolation andsocial distancing inhibit occupational participation

Lannigan EG, Tyminski Q. Occupational Therapy's Role in Addressing the Psychological and Social Impact of COVID-19. Am J Occup Ther. 2021 Jul-

POST COVID-19 ISSUES AMONG
THERAPISTS
Impact of the COVID-19 on OTs from our research✔Cross-sectional study targeting medical workers during the first state ofemergency declaration from April 30th to May 6th, 2020 (76.2% wereoccupational therapists)✔66.1% had GHQ-12 above the cutoff value and had problems with their mentalhealth✔Risk factors for mental health conditions include women, infrequent
communication with friends, and high anxiety about infection✔Protective factors include good health, high job satisfaction, and high satisfaction
with new activities started since the pandemic
Tahara M, Mashizume Y, Takahashi K. Mental Health Crisis and Stress Coping among Healthcare College Students Momentarily Displaced from Their Campus Community Because of COVID-19
Restrictions in Japan. Int J Environ Res Public Health. 2021 Jul 6;18(14):7245.

POST COVID-19 ISSUES AMONG
THERAPISTS
Impact of the COVID19 on OTs from our research (unpublished)✔Cross-sectional study targeting therapists (OT: 614, PT/ST: 198) during the firststate of emergency from April 30th to May 20th, 2020✔OTs have poorer mental health than PTs/STs, are more anxious about infection,and experience occupational injustice and occupational imbalance.
✔Risk factors for mental health conditions in OTs include living alone, lesscommunication with friends, high anxiety about infection, and being occupational
marginalization✔Protective factors for mental health in OTs include good health and high job
satisfaction

POST COVID-19 ISSUES AMONG
THERAPISTS
Impact of the COVID19 on OTs from our research (unpublished)✔A consecutive cross-sectional study of therapists (OT/PT/ST) comparing thebeginning of the pandemic and one year later✔One year later, anxiety about infection decreased slightly, and satisfaction withleisure, work, and daily life improved (especially with daily activities such asshopping)✔At the beginning of the pandemic, risk factors for mental health were being
female, living alone, less communication with friends, high anxiety about
infection, and low life satisfaction✔The risk factors for mental health conditions have changed one year after thepandemic, with low financial security and low levels of leisure and job satisfaction

POST COVID-19 ISSUES AMONG
THERAPISTS
Impact of the COVID19 on OTs from our research (unpublished)✔A continuous cross-sectional study targeting therapists (OT/PT/ST) surveyed
during the 3rd state of emergency declaration and 6 months before and after.
✔Satisfaction with leisure time decreased during the third state of emergency, anda high percentage of people were in a state of work deprivation.
✔Compared to previous studies prior to the pandemic, they were more likely toexperience work deprivation, work imbalance, and work marginalization during
the pandemic.

SUMMARY✔The clinical environment for occupational therapists has changed due to theCOVID-19 pandemic, and there have been various restrictions.
✔Services were provided using new intervention methods that adapted to changes
and used ICT etc.

✔During the pandemic, occupational therapists' workload increased, and theirmental health declined.
✔Various restrictions during the pandemic raise issues of occupational
justice/injusticePOST COVID-19 ISSUESSUMMARYPOST COVID-19 ISSUES IN JAPAN✔During COVID-19 pandemic, occupational therapists experienced firsthand thatoccupation in society is what makes a person's life unique and well.
✔This experience is reflected in our five-year strategy slogan "Occupational
therapy that supports people's activities and participation and contributes tobuilding a community-based society”.
✔The experience of the COVID-19 pandemic has made us realize once again thatthe role of the association is to support occupational therapists who support
people's activities and participation, no matter what the situation in society is.

THANK YOU