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RESEARCH ARTICLE
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Feasibility of an allied health led, workplace delivered Long COVID service for hospital staff: a mixed-methods study

Aruska N. D’Souza https://orcid.org/0000-0002-2510-109X A * , Catherine L. Granger A , Zoe Calulo Rivera A , Aisling Burke A , Riley Ngwenya A , Carly Struck A , Myvanwy Merrett A , Timothy N. Fazio B C D , Genevieve Juj A and Casey L. Peiris A E
+ Author Affiliations
- Author Affiliations

A Allied Health, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Vic 3050, Australia.

B Health Intelligence Unit, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Vic 3050, Australia.

C Electronic Medical Records Team, The Royal Melbourne Hospital, 300 Grattan Street, Parkville, Vic 3050, Australia.

D Melbourne Medical School, The University of Melbourne, Parkville, Vic 3050, Australia.

E Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, Vic 3086, Australia.

* Correspondence to: Aruska.D’Souza@mh.org.au

Australian Health Review https://doi.org/10.1071/AH24146
Submitted: 27 February 2024  Accepted: 13 September 2024  Published: 8 October 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

This study aimed to evaluate the feasibility of a workplace-delivered outpatient multidisciplinary service (ReCOV) for staff experiencing post COVID-19 condition (‘Long COVID’).

Methods

A mixed-methods study of staff at a large, tertiary hospital with Long COVID who attended the service was conducted. Participants completed questionnaires to determine baseline symptoms and were offered allied health appointments for up to 12 weeks each based on clinical indication. Acceptability, implementation, practicality and limited efficacy were evaluated via one-on-one semi-structured interviews and analysed using inductive thematic analysis. Limited efficacy was evaluated via pre- and post-questionnaires and demand via multidisciplinary utilisation.

Results

Twenty-three (median age 37 [interquartile range 30–45] years, 52% female) participants were included. Participants had appointments with a median of 4 [3–5] different professions; most commonly exercise physiology (n = 19, 83%), occupational therapy (n = 17, 74%) and neuropsychology (n = 15, 65%). Median time spent on the ReCOV service was 15 [9–19] weeks. Thirteen semi-structured interviews were completed and analysed. Participants valued ReCOV for being a COVID-19 specific, convenient, flexible and multidisciplinary service at their workplace. Participants preferred the service to have been available for longer than 12 weeks to achieve further benefits as many participants perceived little change in physical health.

Conclusions

Attending a multidisciplinary service located at their workplace was feasible for staff to manage post COVID-19 symptoms. Further research is required to confirm the efficacy on patient outcomes.

Keywords: COVID-19, feasibility studies, interviews, mixed-methods, outpatient, post acute COVID-19 syndrome, tertiary care centres, workplace.

References

1  Australian Institute of Health and Welfare. Long COVID in Australia – a review of the literature. Australian Government; 2022.

2  World Health Organization. Coronavirus disease (COVID-19): Post COVID-19 condition WHO Headquarters; 2023. Available at https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-(covid-19)-post-covid-19-condition

3  Marra AR, Sampaio VS, Ozahata MC, Lopes R, Brito AF, Bragatte M, et al. Risk factors for long coronavirus disease 2019 (long COVID) among healthcare personnel, Brazil, 2020–2022. Infect Control Hosp Epidemiol 2022; 44: 1972-8.
| Crossref | Google Scholar | PubMed |

4  Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re’em Y, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 2021; 38: 101019.
| Crossref | Google Scholar | PubMed |

5  Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep 2021; 11(1): 16144.
| Crossref | Google Scholar | PubMed |

6  Menges D, Ballouz T, Anagnostopoulos A, Aschmann HE, Domenghino A, Fehr JS, Puhan MA. Burden of post-COVID-19 syndrome and implications for healthcare service planning: A population-based cohort study. PLoS One 2021; 16(7): e0254523.
| Crossref | Google Scholar | PubMed |

7  Bower WF, D’Souza AN, Barson E, Marston C, Granger CL, Beach L, et al. Previously health unvaccinated adults have significant functional limitations in the medium and long term after mild COVID-19. Aust J Gen Pract 2024; 53(7): 491-7.
| Crossref | Google Scholar | PubMed |

8  Global Burden of Disease Long COVID Collaborators.. Estimated global proportions of individuals with persistent fatigue, cognitive, and respiratory symptom clusters following symptomatic COVID-19 in 2020 and 2021. JAMA 2022; 328(16): 1604-15.
| Crossref | Google Scholar | PubMed |

9  Liu B, Jayasundara D, Pye V, Dobbins T, Dore GJ, Matthews G, et al. Whole of population-based cohort study of recovery time from COVID-19 in New South Wales Australia. Lancet Reg Health West Pac 2021; 12: 100193.
| Crossref | Google Scholar | PubMed |

10  Carazo S, Skowronski DM, Laforce R, Jr, Talbot D, Falcone EL, Laliberté D, et al. Physical, Psychological, and Cognitive Profile of Post-COVID Conditions in Healthcare Workers, Quebec, Canada. Open Forum Infect Dis 2022; 9(8): ofac386.
| Crossref | Google Scholar | PubMed |

11  National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Royal College of General Practitioners (RCGP). COVID-19 rapid guideline: managing the long-term effects of COVID-19. 2022. Available at https://www.nice.org.uk/guidance/ng188/resources/covid19-rapid-guideline-managing-the-longterm-effects-of-covid19-pdf-66142028400325

12  D’Souza AN, Merrett M, Griffin H, Tran-Duy A, Struck C, Fazio TN, et al. Recovering from COVID-19 (ReCOV): Feasibility of an Allied-Health-Led Multidisciplinary Outpatient Rehabilitation Service for People with Long COVID. Int J Environ Res Public Health 2024; 21(7): 958.
| Crossref | Google Scholar | PubMed |

13  Compagno S, Palermi S, Pescatore V, Brugin E, Sarto M, Marin R, et al. Physical and psychological reconditioning in long COVID syndrome: Results of an out-of-hospital exercise and psychological-based rehabilitation program. Int J Cardiol Heart Vasc 2022; 41: 101080.
| Crossref | Google Scholar | PubMed |

14  Hawke LD, Nguyen ATP, Ski CF, Thompson DR, Ma C, Castle D. Interventions for mental health, cognition, and psychological wellbeing in long COVID: a systematic review of registered trials. Psychol Med 2022; 52: 2426-40.
| Crossref | Google Scholar | PubMed |

15  Andrew A, Cutter K, Lang L, Li H, Lyon R, Wang Z, et al. How COVID-19 has affected Mortality and Morbidity in 2020 & 2021. Sydney: Actuaries Institute; 2022.

16  Svantesson M, Carlsson E, Prenkert M, Anderzén-Carlsson A. ‘Just so you know, the patient is staff’: healthcare professionals’ perceptions of caring for healthcare professional–patients. BMJ Open 2016; 6(1): e008507.
| Crossref | Google Scholar | PubMed |

17  Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007; 19: 349-57.
| Crossref | Google Scholar | PubMed |

18  Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370(9596): 1453-7.
| Crossref | Google Scholar | PubMed |

19  Bowen DJ, Kreuter M, Spring B, Cofta-Woerpel L, Linnan L, Weiner D, et al. How we design feasibility studies. Am J Prev Med 2009; 36(5): 452-7.
| Crossref | Google Scholar | PubMed |

20  Schoonenboom J, Johnson RB. How to construct a mixed methods research design. Köln Z Soziol 2017; 69: 107-31.
| Crossref | Google Scholar | PubMed |

21  State Government of Victoria. Victorian COVID-19 Data. 2023. Available at https://www.coronavirus.vic.gov.au/victorian-coronavirus-covid-19-data.

22  Rhon DI, Fritz JM, Kerns RD, McGeary DD, Coleman BC, Farrokhi S, et al. TIDieR-telehealth: precision in reporting of telehealth interventions used in clinical trials-unique considerations for the Template for the Intervention Description and Replication (TIDieR) checklist. BMC Med Res Methodol 2022; 22(1): 161.
| Crossref | Google Scholar | PubMed |

23  Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3(2): 77-101.
| Crossref | Google Scholar |

24  Ashra F, Jen HJ, Liu D, Lee TY, Pien LC, Chen R, et al. Effectiveness of respiratory rehabilitation in patients with COVID‐19: A meta‐analysis. J Clin Nurs 2023; 32: 4972-87.
| Crossref | Google Scholar | PubMed |

25  Scordo KA, Richmond MM, Munro N. Post–COVID-19 syndrome: theoretical basis, identification, and management. AACN Adv Crit Care 2021; 32(2): 188-94.
| Crossref | Google Scholar | PubMed |

26  Martin AK, Green TL, McCarthy AL, Sowa PM, Laakso EL. Allied health transdisciplinary models of care in hospital settings: a scoping review. J Interprof Care 2023; 37(1): 118-30.
| Crossref | Google Scholar | PubMed |

27  Lyckholm LJ, Hackney MH, Smith TJ. Ethics of rural health care. Crit Rev Oncol Hematol 2001; 40(2): 131-8.
| Crossref | Google Scholar | PubMed |

28  Martin AK, Green TL, McCarthy AL, Sowa PM, Laakso EL. Healthcare teams: Terminology, confusion, and ramifications. J Multidiscip Healthc 2022; 15: 765-72.
| Crossref | Google Scholar | PubMed |

29  Gorst SL, Seylanova N, Dodd SR, Harman NL, O’Hara M, Terwee CB, et al. Core outcome measurement instruments for use in clinical and research settings for adults with post-COVID-19 condition: an international Delphi consensus study. Lancet Respir Med 2023; 11(12): 1101-14.
| Crossref | Google Scholar | PubMed |

30  Munblit D, Nicholson T, Akrami A, Apfelbacher C, Chen J, De Groote W, et al. A core outcome set for post-COVID-19 condition in adults for use in clinical practice and research: an international Delphi consensus study. Lancet Respir Med 2022; 10(7): 715-24.
| Crossref | Google Scholar | PubMed |

31  Hughes SE, Haroon S, Subramanian A, McMullan C, Aiyegbusi OL, Turner GM, et al. Development and validation of the symptom burden questionnaire for long covid (SBQ-LC): Rasch analysis. BMJ 2022; 377: e070230.
| Crossref | Google Scholar | PubMed |

32  Kulnik ST, Nikoletou D. WHODAS 2.0 in community rehabilitation: A qualitative investigation into the validity of a generic patient-reported measure of disability. Disabil Rehabil 2014; 36(2): 146-54.
| Crossref | Google Scholar | PubMed |

33  Üstün TB. Measuring health and disability: Manual for WHO disability assessment schedule WHODAS 2.0. World Health Organization; 2010.

34  Herdman M, Gudex C, Lloyd A, Janssen MF, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 2011; 20(10): 1727-36.
| Crossref | Google Scholar | PubMed |

35  Devlin NJ, Shah KK, Feng Y, Mulhern B, Van Hout B. Valuing health‐related quality of life: An EQ‐5 D‐5 L value set for England. Health Econ 2018; 27(1): 7-22.
| Crossref | Google Scholar | PubMed |

36  Kroenke K, Spitzer RL, Williams JB, Löwe B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry 2010; 32(4): 345-59.
| Crossref | Google Scholar | PubMed |

37  Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166(10): 1092-7.
| Crossref | Google Scholar | PubMed |

38  Broadbent E, Wilkes C, Koschwanez H, Weinman J, Norton S, Petrie KJ. A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health 2015; 30(11): 1361-85.
| Crossref | Google Scholar | PubMed |