Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020

Klamroth-Marganska, Verena; Gemperle, Michael; Ballmer, Thomas; Grylka-Baeschlin, Susanne; Pehlke-Milde, Jessica; Gantschnig, Brigitte Elisabeth (2021). Does therapy always need touch? A cross-sectional study among Switzerland-based occupational therapists and midwives regarding their experience with health care at a distance during the COVID-19 pandemic in spring 2020. BMC health services research, 21(1), p. 578. BioMed Central 10.1186/s12913-021-06527-9

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Background: The COVID-19 pandemic impedes therapy and care activities. Tele-health, i.e., the provision of health care at a distance (HCD), is a promising way to fill the supply gap. However, facilitators and barriers influence the use and experience of HCD for occupational therapists (OTs) and midwives. We identified use of services and appraisal of experiences of Switzerland-based OTs and midwives regarding the provision of HCD during the lockdown as it pertains to the COVID-19 pandemic in spring 2020. 1.

Hypothesis: Profession, age in years, and area of work have a significant and meaningful influence over whether HCD is provided. 2.

Hypothesis: Profession, age in years, area of work, possibility of reimbursement by health insurance, and application used have a significant and meaningful influence on the experience of HCD.

Methods: In a cross-sectional survey, 5755 OTs and midwives were contacted to fill out an online questionnaire with 13 questions regarding demographic information, use of HCD, and experiences while providing the service. Eleven potential facilitators and barriers and areas where there was desire for support were identified.

Results: The questionnaire was completed by 1269 health professionals (response rate 22.5%). 73.4% of responding OTs (n = 431) and midwives (n = 501) provided HCD during the COVID-19 pandemic lockdown. Profession and area of work had a significant influence on whether HCD was provided. Age only had a significant influence on the use of videotelephony, SMS, and chat services. OTs experienced HCD significantly more positively than midwives (log odds = 1.3; p ≤ .01). Video-telephony (log odds = 1.1; p ≤ .01) and use of phone (log odds = 0.8; p = .01) were positive predictors for positive experience, while use of SMS (log odds = - 0.33; p = .02) was a negative predictor. Among OTs, 67.5% experienced HCD as positive or mostly positive, while 27.0% experienced it as negative or mostly negative. Among midwives, 39.5% experienced it as positive or mostly positive, while 57.5% experienced it as negative or mostly negative. Most respondents desired support concerning reimbursement by health insurance (70.8%), followed by law and data protection (60.4%).

Conclusions: HCD during the early COVID-19 pandemic was generally perceived as positive by OTs and midwives. There is need for training opportunities in connection with HCD during the COVID-19 pandemic.

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