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Publications of 2024
Evaluating the Efficacy of Telehealth-Based Treatments for Depression in Adults: A Rapid Review and Meta-Analysis
Behdin Nowrouzi-Kia, Ali Bani-Fatemi, Tanya D. Jackson, Anson Kwok Choi Li, Vijay Kumar Chatty, Ellina Lytvyak, Danika Deibert, Liz Dennett, Martin Ferguson-Pell, Reidar Hagtvedt, Charl Els, Quentin Durand-Moreau, Douglas P. Gross & Sebastian Straube
This Rapid Review and Meta-Analysis aims to investigate the effectiveness of telehealth interventions, including CBT, for adults diagnosed with Major Depressive Disorder (MDD). A comprehensive search was conducted across databases, including Medline, PsycINFO, and CINAHL. Results displayed significant positive improvements in depression symptoms for individuals with MDD who received CBT delivered by telehealth. This study will aid in the development of effective policies that support mental health
Effectiveness of Occupational Therapy Mental Health Interventions in a Return-to-Work Context: A Scoping Review
Bao-Zhu Stephanie Long, Kishana Balakrishnar, Michael Drobenko, Batoul Awada, Kaila Jodoin, Alicia McDougall & Behdin Nowrouzi-Kia
Literature on the effectiveness of occupational therapy mental health interventions in return-to-work (RTW) is limited, presenting challenges in implementing appropriate strategies. This scoping review aims to synthesize empirical evidence on the effectiveness of mental health interventions on RTW. The search strategy across databases, including Medline, Embase, CINAHL, Web of Science, APA PsycINFO, and Cochrane Library, yielded over 1430 articles, of which seven met the eligibility criteria. Three main intervention types were identified from the review: work performance/function intervention, vocational rehabilitation, and nature-based rehabilitation. This study will help select effective interventions for RTW and expand on the existing knowledge base
Exploring the readiness to practice of underrepresented healthcare workers: A scoping review
Sara Hussein, Liam Ishaky, Behdin Nowrouzi-Kia, Sarah Laughton & Basem Gohar
Background:
Studies across the extant literature suggest that less-experienced healthcare workers are more likely to experience adverse outcomes such as burnout, sick leaves, or intend to leave the profession. Thus, one’s readiness to practice is an important element that requires more attention. While extensive research exists on the readiness of certain professions like nurses, a notable gap remains concerning other healthcare workers.
Purpose:
This study sought to explore studies examining readiness to practice among various underrepresented healthcare workers.
Methods:
We conducted a scoping review to determine the available research related to clinical and nonclinical areas related to the readiness to practice of healthcare workers, excluding physicians and nurses. We examined three databases, MEDLINE, CINAHL, and PsycINFO, from 1 January 2000 to 31 December 2023. Our search focused on readiness to practice among various healthcare professions, whether clinically focused or broadly related to professionalism.
Results:
Our search identified 41 articles meeting the inclusion criteria from several professions, including but not limited to physiotherapists and occupational therapists, pharmacists, osteopaths/chiropractors, and social workers. Overall, studies differed in assessing readiness to practice with a broad range of identified clinical competencies that varied between professions and regions. Nonclinical skills, such as communication, conflict management, and cultural competence, were common barriers across professions.
Conclusion:
Despite the heterogeneity in job roles, work settings, and geographical reasons, there is evidence to suggest that new healthcare professionals may be clinically adept but may be lacking in other nonclinical skills that could affect their work and well-being. With early-career healthcare workers particularly vulnerable to adverse outcomes in the workplace, future research should standardize core competencies, including nonclinical skills and well-being-related activities, as a prevention method across various health groups.
Evidence-Based Recommendations for Improving the Mental Health and Wellbeing of Ontario Mining Workers
Caroline Dignard, Michel Larivière, Nancy Lightfoot, Behdin Nowrouzi-Kia, Line Tremblay & Zsuzsanna Kerekes
Mental health problems negatively impact workplaces. Poor mental health in the workplace contributes to higher turnover, poor worker engagement, and job dissatisfaction. The health and safety implications can be especially serious: poor mental health in the workplace increases the risk of accidents and injuries. This risk is notably elevated in industrial settings, such as in the mining industry, where accidents can be fatal. This is relevant in the Canadian context because mining employs hundreds of thousands of workers in Canada. Despite the known implications of poor mental health in the workplace, and the possible severity of its ramifications in industrial settings, research specific to mental health in the mining industry is limited. However, existing literature has revealed concerning findings: mining workers appear to experience higher rates of mental-ill health. Therefore, the need for further research to better understand the mental health implications of employment in the mining industry in Canada is clear. Our research team conducted a study to better understand the mental health of mining industry workers in Ontario, Canada. As part of this study, the authors of this paper sought to examine the prevalence and determinants (e.g., demographic, health-related, and psychosocial factors, including work and non-work-related factors) of stress, anxiety, and depression for this workforce. While the methods and quantitative findings are reported elsewhere, the current paper proposes eight evidence-based recommendations for improving mental health and wellbeing of Ontario mining workers. These recommendations are based on our research findings and are supported by the literature.
A qualitative study of patient and healthcare provider experience with rheumatoid arthritis in Northern Ontario
Nancy Lightfoot, David Marsh, Sherry Mongeau, Susan Boyko, Behdin Nowrouzi-Kia, Lucio Fabris
Background
Rheumatoid arthritis (RA) is a disabling common chronic inflammatory joint disease. In Ontario, the burden is higher in those aged 65 and older, in females, and in northern communities. This study examined patient disease impact and healthcare provider access and satisfaction as well as provider satisfaction, patient experience and educational suggestions.
Methods
Semi-structured interviews and reflexive thematic analysis were used.
Results
Interviews occurred with: (1) 18 Northern (N) Ontario patients, (2) 6 N Ontario family physicians, (3) 6 N Ontario pharmacists and (4) a rheumatologist and 4 advanced clinical practitioners in arthritis care (ACPACs) who treat N Ontario patients. Patients emphasised the need to: (1) act on early symptoms, (2) self-advocate, (3) attract more N Ontario rheumatologists, (4) educate the public, (5) recognise that medication can change over time and (6) pace physical tasks. Satisfaction was expressed with providers. Family physicians mentioned the need to: (1) be front-line educators, (2) commence initial treatment, (3) enhance undergraduate medical curricula and (4) require rheumatology rotations. Pharmacists expressed: (1) acting as patient educators, (2) assisting with insurance plans, (3) encouraging family physicians to commence treatment, (4) monitoring medication interactions and (5) professional collaboration. The ACPACs and rheumatologist stressed the value of: (1) patient advocates, (2) family physicians initiating treatment, (3) pharmacists monitoring for drug interactions, (4) expanding undergraduate medical school rheumatology curricula and (5) accessing local care.
Conclusion
Additional patient and public education are needed. Enhancing undergraduate and graduate medical school rheumatology curricula, rotations, continuing rheumatology education and interprofessional collaboration were recommended.
Impacts of Arthritis on Work Performance, Functioning and Activities of Daily Living Using the Canadian Community Health Survey
Shane Avila, Yifan Hao, Ali Bani-Fatemi, Aaron Howe & Behdin Nowrouzi-Kia
Background:
Individuals with arthritis often face significant challenges in their activities of daily living and work performance, resulting in substantial effects on both their personal and professional lives.
Objective:
This study aims to determine whether workers with arthritis within the Canadian working-age population are more or less likely to miss work, sustain injuries, or experience activity limitations compared to those without arthritis.
Methods: The analysis utilized data from the Canadian Community Health Survey, focusing on employed individuals over 20 from two datasets: 2015-2016 (n=107,705) and 2017-2018 (n=112,947). Logistic regression examined occupational health factors, while bivariate analyses via chi-squared tests (p < 0.01) and Tukey's HSD post hoc analysis (p
Breathing Under Pressure: Examining Stressors Among Respiratory Therapists in Ontario Amidst the COVID-19 Pandemic
Marianna Saragosa, Farwa Goraya, Behdin Nowrouzi-Kia & Basem Gohar
Health care systems were subjected to an unprecedented surge of critically ill patients with the coronavirus disease 2019 (COVID-19), which required management by Respiratory Therapists (RTs). Despite the high level of burnout reported in this health care professional group, we have limited knowledge about the lived experience of RTs during the pandemic. This study aims to examine the impact of COVID-19 on RTs in Ontario, Canada. We conducted a qualitative exploratory, descriptive study by conducting virtual semi-structured interviews and focus groups with RTs between March 2023 and June 2023. Two coders analyzed the data using thematic analysis. Twenty-seven RTs participated in the study, with the majority being female (n = 25), averaging 16.4 years of practice (range 4 to 36 years), primarily in acute care settings (n = 23). We identified four themes and lessons learned from the perspective of RTs: (1) Working in the shadow and suffering in silence reflecting varying perceptions of recognition; (2) Flying blind amidst the buzz reflecting the rapid pace of changing policies and practices as COVID-19 gained global attention; (3) Putting out fires in the face of overflowing hospitals reflecting increased workload and staffing issues; and (4) Managing tensions, both external and internal reflecting how RTs coped with distressing workplace situations and their mental well-being. Finally, lessons learned from the RTs include 1) Mobilizing early and consistently during an emergency, which addresses staff concerns; 2) Prioritizing and investing in the mental health and well-being of RTs; 3) Implementing strategies to retain experienced staff in healthcare; and 4) Involving RTs in leadership discussions. The COVID-19 stressors of RTs have illuminated the detrimental impact of the pandemic on this understudied health care profession. With this knowledge, targeted interventions can be developed to address RT recognition and staff retention and provide mental health support.
ECHO OEM virtual community of learning for primary care
A D Furlan, C Severin, S Harbin, E Irvin, Nancy Carnide, Behdin Nowrouzi-Kia, Sara Macdonald, Aaron Thompson, Qing Liao, Peter SmithAnil Adisesh
Background
Health issues caused and/or exacerbated by work are common in patients seeking primary health care. Yet, primary care providers generally receive little or no training in the assessment and management of occupational injuries and illnesses.
Aims
To conduct a pilot project to develop, implement and evaluate a programme to teach occupational and environmental medicine to primary healthcare providers.
Methods
We followed the Extensions for Community Healthcare Outcomes (ECHO) model to connect primary healthcare providers with experts in Occupational and Environmental Medicine (OEM). We employed an observational pre–post study design to assess changes in self-efficacy, knowledge, attitudes and beliefs towards OEM.
Results
From September 2021 to June 2022, we offered two cycles of 12 sessions each. Participants came from medicine, nursing, psychology, occupational and physical therapy, chiropractic, kinesiology, social work, and pharmacy. Sixty-seven participants completed both pre- and post-ECHO questionnaires. Self-efficacy and knowledge ratings significantly increased after attendance at ECHO compared to the pre-ECHO responses. Attitudes and beliefs were unchanged in most of the items assessed. Participants rated their satisfaction with ECHO between 59% and 97%.
Conclusions
Our pilot study demonstrated the challenges in implementing the first ECHO OEM in Canada. Findings show acceptability and satisfaction, improved self-efficacy, and small increases in knowledge, but not overall attitudes and beliefs. There is a need to understand barriers to participation and to target participants with less knowledge and experience in occupational and environmental medicine.
Occupational hazards and population-based prevention strategies for pharmacy workers in Canada
Edris Formuli, Basem Gohar & Behdin Nowrouzi-Kia
Pharmacy settings pose various and unpredictable dangers to workers, including biological, chemical, psychosocial hazards. Pharmacy technicians and assistants are a vulnerable and at-risk population. Workers are exposed to unique workplace hazards that impact their physical, mental, and social wellbeing, such as exposure to hazardous medication, violent robberies, and challenges with occupational identity. In this paper, five key areas of hazard are explored: hazardous drug exposure, infections, violence, mental health issues, and social challenges. Each hazard area explored is accompanied with evidence-based recommendations that can be implemented at the population-level to support the wellbeing of pharmacy personnel. Overall, the paper calls for the better protection of pharmacy technicians and assistants from occupational hazards. The population health impact framework is utilized as a guide to create evidence-based recommendations that can benefit whole populations of pharmacy workers at local, provincial, and national scales in Canada, thereby ensuring long-lasting protective interventions that support this vulnerable occupation group. The study concludes by providing future direction for research efforts in this area.
Role of Occupational Therapy Assessment and Office Ergonomics to Support Students with Accommodations in Higher Learning: A Narrative Review
Behdin Nowrouzi-Kia, Christi Tam, Raabia Khan, Bushra Alam, Sujatha Alla, Vijay Kumar Chattu
Postsecondary students with disabilities (SWDs) face significant challenges to their academic and personal well-being. There is a demand for more supportive strategies to facilitate fulfilling and equitable academic experiences for SWDs. This review aimed to (1) determine the effectiveness of various interventions, programs, and accommodations for enhancing the overall well-being of postsecondary SWDs and (2) evaluate the implications of these support strategies for disability service providers at postsecondary institutions. A narrative review was conducted, examining 13 studies aimed at enhancing the well-being of postsecondary SWDs. Studies were classified using the International Classification of Functioning, Disability and Health (ICF) Model. Ergonomics, assistive technology, and counselling programs had positive improvements on the academic success of SWDs. In SWDs, health status was associated with higher community participation, and physical interventions were beneficial to reducing pain over time. Coaching and mentoring opportunities were beneficial for successful goal fulfilment. However, there remains a risk of digital eye strain when using technology to support postsecondary SWDs. The findings indicate that a range of support strategies can benefit several different components of SWDs experiences. This review identifies research gaps and opportunities to examine support strategies to improve the physical and mental well-being of SWDs.
The Era of Technology in Healthcare - An Evaluation of Telerehabilitation on Client Outcomes: A Systematic Review and Meta-analysis
Sharan Jaswal, Joyce Lo, Aaron Howe, Yifan Hao, Shangkai Zhu, Gobika Sithamparanathan & Behdin Nowrouzi-Kia
Purpose: This systematic review and meta-analysis aimed to synthesize the evidence and examine the effect of telerehabilitation interventions compared to face-to-face rehabilitation interventions on physical functioning, mental health, and pain reduction among employed individuals, 18 years old and older. Methods: Following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search syntax was created and inputted into Ovid Medline, APA PsycINFO, Ovid Embase, CINAHL, and Scopus. Critical appraisal of the included studies was conducted by two researchers to assess the risk of bias. A meta-analysis was completed for the randomized controlled trials and GRADE was used to determine the certainty of the evidence. Results: A total of 16 out of 4319 articles were included in this review. This systematic review and meta-analysis found no significant differences between telerehabilitation interventions for physical functioning, mental health, and pain reduction outcomes compared to traditional rehabilitation interventions. Conclusion: The study findings indicate that telerehabilitation is less effective than in-person care for occupational therapy and physical therapy services. Future research may look at addressing the limitations of the current study to produce more conclusive results, such as exploring the length of the intervention, knowledge and confidence of intervention application, and follow-ups.
Examining the Prevalence and Effects of Gender-based Violence in Academic Settings: A Systematic Review and Meta-analyses
Behdin Nowrouzi-Kia, Hong Yi Chan, Shangkai Zhu, Sharada Nandan, Ali Bani-Fatemi, Aaron Howe, Douglas P. Gross, Basem Gohar, Amin Yazdani & Vijay Kumar Chattu
Gender-based violence (GBV) in the academic job sector is a critical issue that intersects with broader systemic and structural inequities, but research is limited. To study the prevalence, effects, and prevention measures of interpersonal GBV within the academic job sector, a meta-analysis and systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. Rigorous searches were conducted across the databases PubMed, OVID, Scopus, Web of Science, and CINAHL, using specific keywords related to GBV, workplace, and virtual work environments, identifying papers published between January 2013 and February 2023. Studies were evaluated based on the Population, Intervention, Comparison, Outcomes framework. Data from papers were extracted and grouped by reported instances, and prevalence data for interpersonal GBV were reported in university settings, including in-person, hybrid, and virtual environments, and among men, women, and those who identify as 2SLGBTQ+. A random effects meta-analysis of proportions was conducted to evaluate the reported point prevalence rates of interpersonal GBV in academia between 2012 and 2015. Subgroup analyses were performed for university staff only, females only, and males only. Out of the 1,290 records, 16 studies met the inclusion criteria. The types of violence identified include sexual harassment, workplace bullying and online harassment, which affects career advancement, and employee well-being. The meta-analyses, conducted with a 95% confidence interval [CI], identified that 51.4% (95% CI [39.9%, 63.0%]) of university staff members experience GBV, with females, 59.3% [38.1%, 80.5%], experiencing greater rates than males, 44% [28.1%, 44.1%]. The findings underscore the need for institutional interventions to address interpersonal GBV in academic workplaces.
A quantitative examination of sleep quality, burnout, psychological distress, and social support availability of electrical workers in Ontario, Canada
Aaron S. Howe, Ali Bani-Fatemi, Evan Tjahayadi, Alexia Haritos, Yifan Hao, Shangkai Zhu, Edris Formuli & Behdin Nowrouzi-Kia
Electrical workers experience difficult psychosocial working conditions that may expose them to poor mental health outcomes. This study aims to explore the relationships between psychological distress, access to social support, burnout, and sleep quality in Canadian electrical workers. A 30-item cross-sectional survey including the Pittsburgh Sleep Quality Index, Kessler’s Psychological Distress Scale, Copenhagen Burnout Inventory, and social support questions from the WHO-QoL-BREF were completed by 118 electrical workers. Data was analyzed to determine differences between groups, correlations between variables, and to identify predictors of poor sleep quality. No significant differences were found in burnout scores and subjective sleep quality between apprentices, electricians, and contractors. Apprentices reported being more psychologically distressed than electricians (p = 0.005) and contractors (p
Remote work transition amidst COVID-19: Impacts on presenteeism, absenteeism, and worker well-being - A scoping review
Nowrouzi-Kia, B., Haritos, A. M., Long, B.-Z. S., Atikian, C., Fiorini, L. A., Gohar, B., Howe, A., Li, Y., & Bani-Fatemi, A
Background: The COVID-19 pandemic has accelerated the transition to remote work, leading to increased attention on presenteeism and absenteeism among remote workers. Understanding the implications of these phenomena on worker health and productivity is crucial for optimizing remote work arrangements and developing policies to improve employee well-being. Objectives: This scoping review aims to examine the occurrence of presenteeism and absenteeism among remote workers during the COVID-19 pandemic and the interrelated physical and mental health issues during these periods. Methods: PsycINFO, Medline, Embase, CINAHL, Eric, Business Source Premier, SCOPUS, and sociological abstracts were searched resulting in 1792 articles. Articles were included if the population of interest was 18+ (i.e., working age), engaged in full or part-time work, and the employees shifted from in-person to remote work due to the COVID-19 pandemic. All study designs, geographical areas, and papers written post-onset of the COVID-19 pandemic were included; however, systematic reviews were excluded. Data was charted into Microsoft Excel by 2 independent reviewers. Results: The literature search identified 10 studies (i.e., seven cross-sectional studies, two qualitative studies, and one observational study). Five major overarching themes were identified specifically (1) telework and mental health (2) telework and physical health (3) worker benefits (4) gender dynamics and (5) difficulty navigating the teleworking environment. While remote work offers flexibility in terms of saved commute time and flexible work schedules, it also exacerbates challenges related to presenteeism, absenteeism, and work-life balance. These challenges include experiencing psychological distress, depression, anxiety, stress, sleep deprivation, musculoskeletal pain, difficulties concentrating at work for both women and working parents, struggles disconnecting after hours, and the inability to delineate between the work and home environment. Discussion: The findings suggest that remote work during the COVID-19 pandemic has both positive and negative implications for worker well-being and productivity. However, future research needs to incorporate the potential effects of telework frequency (full time vs. part time) on employee productivity and its role on presenteeism and absenteeism, to gain a more comprehensive understanding on remote work difficulties. Addressing these challenges requires proactive interventions and support mechanisms to promote worker health and productivity in remote settings.
Examining the antecedents and conceptualisations of presenteeism and absenteeism in the workplace and its impact on teleworkers: a scoping review protocol
Behdin Nowrouzi-Kia, Luke Fiorini, Shane Avila, Chantal Atikian
Presenteeism and absenteeism impact an individual’s ability to work efficiently. The onset of the COVID-19 pandemic has exacerbated their effect on teleworkers. The current literature regarding presenteeism and absenteeism is broad, with various definitions of both phenomena making it difficult for researchers to measure accurately. This scoping review protocol aims to examine existing definitions of presenteeism and absenteeism in the workplace and focus on the antecedents for why they occur among teleworkers. The scoping review protocol has been pre-registered on Open Science Framework (osf.io/ur5a6). Online databases MEDLINE, CINAHL, PsycINFO, ABI Inform Global, SCOPUS, Web of Science and Business Source Premier will be searched to identify studies investigating presenteeism and absenteeism. Inclusion criteria will include individuals 18 or older who are part of the working population and currently employed in a teleworking environment for at least 50% of the working hours. The findings of this review will be of interest to companies and health professionals who seek to develop more practical policies and guidelines to assist those who engage in presenteeism and absenteeism.
Burnout and occupational stress of home care rehabilitation professionals transitioning out of the COVID-19 pandemic in Ontario, Canada
Behdin Nowrouzi-Kia, Emily King, Brydne Edwards, Sonia Nizzer, Amin Yazdani, Basem Gohar, Ali Bani-Fatemi, Aaron Howe, Yusra Fayyaz, Bushra Alam, Raabia Khan, Vijay Kumar Chattu
Introduction: The COVID-19 pandemic has significantly impacted the home healthcare industry, with increased rates of burnout and stress among homecare rehabilitation professionals (hcRPs). This study aimed to (1) examine the nature of burnout and occupational stress among homecare rehabilitation professionals at a large home care organization in Ontario, Canada, transitioning out of the pandemic, and (2) assess its impact on work participation and engagement. Methods: We conducted a cross-sectional survey using the National Institute for Occupational Safety and Health Generic Job Stress Questionnaire and Copenhagen Burnout Inventory to examine burnout and job stress. Results: One hundred thirty-nine participants identified that work stress and burnout are more likely to occur when one struggles to cope, experiences unexpected circumstances, and feels a lack of control, which can lead to anger and emotional exhaustion. The adjusted odds ratio for emotional exhaustion was 5.46, indicating that the probability of experiencing work stress among homecare rehabilitation professionals increases as emotional exhaustion increases. Significant associations were found between coping with daily tasks and levels of burnout. Conclusion: Work stress and burnout influence coping, unexpected circumstances in homecare rehabilitation professionals work–life. Furthermore, highlighting the need to provide organizational support and policies that specifically address these issues in the home care sector.
Physical and Psychosocial Correlates of Occupational Physical Injury in the Global Construction Industry: A Scoping Review
Aaron Howe, Jeremy Tan, Beatrice Yuen, Harseerat Saini, Natalia Saade-Cleves, Donia Obeidat, Maryam Shahzad, Vijay Kumar Chattu, Ali-Bani Fatemi, Behdin Nowrouzi-Kia
The construction industry is a diverse sector with exposure to multiple psychosocial and environmental workplace hazards that increase the risk of injury. This scoping review aims to consolidate the existing literature on the physical and psychosocial determinants influencing the risk of occupational physical injuries among construction workers globally.
Methods: A scoping review was conducted using the PRISMA extension checklist guided. Literature searches were performed between June and October 2023 in electronic academic databases.
Results: A total of 77 studies were identified, encompassing various geographical regions, including North America (n = 29), Africa (n = 18), Europe (n = 12), Asia (n = 9), the Middle East (n = 5), and Oceania (n = 4). The review identified physical and psychosocial factors in 3 domains influencing occupational physical injuries: workplace physical environment (eg, exposure to physical hazards, availability and utilization of personal protective equipment, company size, and job type), workplace culture (eg, psychosocial stressors, gender-related barriers, migrant and ethnic disparities, educational background), and physical wellbeing, health and aging (eg, age, obesity, sleep quality, marital stats, and physical health status). Notably, workers from social minority groups (eg, women, ethnic and migrant workers) of young (
From Crisis to Opportunity: A Qualitative Study on Rehabilitation Therapists’ Experiences and Post-Pandemic Perspectives
Marianne Saragosa, Farwa Goraya, Frances Serrano, Behdin Nowrouzi-Kia, Sara Guilcher, Yasmin Abdul Aziz, Basem Gohar
Rehabilitation therapists (RTs) have developed substantial mental health problems since the pandemic. Our study aimed to understand the experience of COVID-19 on occupational therapists and physiotherapists practicing in Canada, how the pandemic may have affected care delivery, and to identify new learnings articulated by RTs. A qualitative descriptive study design guided data collection through one-on-one interviews, dyadic interviews, and focus groups. We recruited active RTs across Canada, advertising on professional practice networks and social media platforms and using snowball sampling. Forty-nine RTs representing seven Canadian provinces participated. The four overarching themes developed using thematic analysis were (1) navigating uncertainty along with ever-changing practices, policies, and attitudes, (2) morphing roles within a constrained system, (3) witnessing patients suffering and experiencing moral distress, and (4) recognizing the personal toll of the pandemic on self and others, as well as lessons learned. Our study demonstrated that many RTs suffered moral distress, poor mental health, and some from challenging financial situations, especially those in the private sector. They also expressed a resilient attitude in response to these stressors. Implications in the future include identifying promising communication strategies that could act as protective factors, addressing workforce constraints and diminishing resources through innovative models of care.
A systematic review of the literature: Gender-based violence in the construction and natural resources industry
Joyce Lo, Sharan Jaswal, Matthew Yeung, Vijay Kumar Chattu, Ali Bani-Fatemi, Aaron Howe, Amin Yazdani, Basem Gohar, Douglas P. Gross, Behdin Nowrouzi-Kia
Gender-based violence (GBV) poses a significant concern in the construction and natural resources industries, where women, due to lower social status and integration, are at heightened risk. This systematic review aimed to identify the prevalence and experience of GBV in the construction and natural resources industries. A systematic search across databases including PubMed, OVID, Scopus, Web of Science, and CINAHL was conducted. The Risk of Bias Instrument for Cross-sectional Surveys of Attitudes and Practices by McMaster University and the Critical Appraisal of Qualitative Studies by the Center for Evidence Based Medicine at the University of Oxford were used to assess the studies included in the review. Six articles were included after full-text analysis. GBV was reported in the construction, mining, urban forestry, and arboriculture sectors. Workplace GBV was measured differently across the studies, and all studies examined more than one form of GBV. The main forms of GBV discussed in these studies were discrimination, sexual harassment, and sexism. The studies provided some insight for demographic factors that may or may not be associated with GBV, such as age, region of work, and number of years working in the industry. The review also suggests that workplace GBV has a negative impact on mental health and well-being outcomes, such as higher levels of stress and lower job satisfaction. The current research has not established the effectiveness of interventions, tools, or policies in these workplaces. Thus, additional research should include intervention studies that aim to minimize or prevent GBV in male-dominated workplaces. The current study can bring awareness and acknowledgement towards GBV in the workplace and highlight the importance of addressing it as this review outlines the negative consequences of GBV on mental health and well-being in these male-dominated industries.
Autism spectrum disorder in the workplace: a position paper to support an inclusive and neurodivergent approach to work participation and engagement
Kathy Zhou, Bushra Alam, Ali Bani-Fatemi, Aaron Howe, Vijay Kumar Chattu & Behdin Nowrouzi-Kia
Autistic individuals often experience a wide range of barriers and challenges with employment across their lifetime. Despite their strengths and abilities to contribute to the workforce, many individuals experience unemployment, underemployment and malemployment. However, current supports and services are often inadequate to meet their needs. To allow autistic people to achieve vocational success, we explore four contributors to employment and expand upon the issues and potential solutions to each. These positions include the importance of family support and its consideration in the application of vocational support interventions, addressing transitional needs for autistic youth, building employer capacity, and conducting research that advises the development of meaningful programs and policies. By advocating for these positions, we aim to foster greater inclusivity and support for individuals with ASD in the workplace.
Exploring vocational outcomes, quality of life, and social inclusion in patients with spinal cord injuries following vocational rehabilitation in India
Alan Li, Ziru Wang, Raabia Khan, Ramasubramanian Ponnusamy, Dinesh Krishna & Behdin Nowrouzi-Kia
Study design
We conducted a mixed-methods sequential explanatory study. In India, most spinal cord injuries (SCI) occur within low socioeconomic status populations, typically resulting in poor vocational outcomes post-injury and difficulty reintegrating into the community. This study will increase our understanding of how vocational rehabilitation affects patients with SCI.
Objectives
This study aims to understand the factors affecting vocational outcomes, quality of life and social inclusion for patients who have completed the Amar Seva Sangam (ASSA’s) rehabilitation program, by examining both quantitative and qualitative measures.
Methods
Conducted at the University of Toronto, we used self-administered questionnaires via REDCap for quantitative data collection and semi-structured interviews for qualitative data collection to capture aspects of lived SCI experience for five participants.
Results
Thirty-two participants completed the quantitative phone questionnaire of which 17 were paraplegic and 15 were quadriplegic. Four themes emerged including physical barriers to employment, social inclusion of SCI patients, low income, and state of mental health.
Conclusion
This study provided a detailed examination of demographic information and lived experiences of ASSA participants. The findings will be relevant and applicable to both clinical and public health sectors in SCI rehabilitation in India and other low- and middle-income countries by directing rehabilitation programs to better address areas of function that allow patients to find success following rehabilitation.
OMERACT 2023 Systemic Lupus Erythematosus Workshop: Synopsis.
Wils Nielsen, Vibeke Strand, Lee S Simon, Ioannis Parodis, Alfred H J Kim, Maya Desai, Yvonne Enman, Daniel Wallace, Yashaar Chaichian, Sandra Navarra, Cynthia Aranow, Meggan MacKay, Kimberly Trotter, Oshrat E Tayer-Shifman, Ali Duarte-Garcia, Lai Shan Tam, Manuel F Ugarte-Gil, Guillermo J PonsEstel, John A Reynolds, Mandana Nikpour, Alberta Hoi, Juanita Romero-Diaz, Danaë Papachristos, Amita Aggarwal, Chi Chiu Mok, Keishi Fujio, Rosalind Ramsey-Goldman, Aaron Howe, Behdin Nowrouzi Kia, Dennisse Bonilla, Julian Thumboo, Marta Mosca, Martin Aringer, Sindhu R Johnson, Aaron M Drucker, Eric Morand, Ian Bruce, Zahi Touma
Background: The Outcome Measures in Rheumatology (OMERACT) Systemic Lupus Erythematosus (SLE) Working Group held a Special Interest Group (SIG) at the OMERACT 2023 conference in Colorado Springs where SLE collaborators reviewed domain sub-themes generated through qualitative research and literature review.
Objective: The objective of the SIG and the subsequent meetings of the SLE Working Group was to begin the winnowing and binning of candidate domain sub-themes into a preliminary list of candidate domains that will proceed to the consensus Delphi exercise for the SLE COS.
Methods: Four breakout groups at the SLE SIG in Colorado Springs winnowed and binned 132 domain sub-themes into candidate domains, which was continued with a series of virtual meetings by an advisory group of SLE patient research partners (PRPs), members of the OMERACT SLE Working Group Steering Committee, and other collaborators.
Results: The 132 domain sub-themes were reduced to a preliminary list of 20 candidate domains based on their clinical and research relevance for clinical trials and research studies.
Conclusion: A meaningful and substantial winnowing and binning of candidate domains for the SLE COS was achieved resulting in a preliminary list of 20 candidate domains.
Relationships between employment status with self-perceived mental and physical health in Canada
Anson Kwok Choi Li, Behdin Nowrouzi-Kia
To evaluate the effectiveness of Employee Assistance Program (EAP) interventions, the Workplace Outcome Suite (WOS) was developed. This study aims to determine if the new WOS 5-item version can be used to approximate the WOS 25-item version without excessive loss of reliability, validity, or sensitivity. A quantitative psychometric evaluation study design was employed. Secondary data analysis of the WOS 25-item questionnaire was conducted before and after EAP services were delivered to participants. This analysis used 2046 data responses from 1023 participants. Quantitative data analysis included descriptive statistics, Cohen’s d, paired t-test, the Wilcoxon signed-rank (non-parametric test), and bivariate factor analysis. Findings demonstrate that the WOS 5-item version can successfully detect changes in workplace functioning. Within all five constructs, users’ scores improved after EAP interventions, indicating improvement in mental health. Significant changes were detected for absenteeism, presenteeism, work engagement, and workplace distress. Bivariate correlation results indicate the WOS 5-item is a good representation of the 25-item version. There are strong correlations between each item on the WOS-5 and the corresponding items in each construct on the WOS-25. This evidence suggests the WOS 5-item version can be used to approximate the WOS 25-item version without excessive loss of reliability, validity, or sensitivity.
Healthcare providers’ perceived acceptability of a warning signs intervention for rural hospital-to-home transitional care: A cross-sectional study
Mary T. Fox, Jeffrey I. Butler, Adam M. B. Day, Evelyne Durocher, Behdin Nowrouzi-Kia, Souraya Sidani, Ilo-Katryn Maimets, Sherry Dahlke, Janet Yamada
Introduction: There is a pressing need for transitional care that prepares rural dwelling medical patients to identify and respond to the signs of worsening health conditions. An evidence-based warning signs intervention has the potential to address this need. While the intervention is predominantly delivered by nurses, other healthcare providers may be required to deliver it in rural communities where human health resources are typically limited. Understanding the perspectives of other healthcare providers likely to be involved in delivering the intervention is a necessary first step to avert consequences of low acceptability, such as poor intervention implementation, uptake, and effectiveness. This study examined and compared nurses’ and other healthcare providers’ perceived acceptability of an evidence-based warning signs intervention proposed for rural transitional care. Methods: A cross-sectional design was used. The convenience sample included 45 nurses and 32 other healthcare providers (e.g., physical and occupational therapists, physicians) who self-identified as delivering transitional care to patients in rural Ontario, Canada. In an online survey, participants were presented with a description of the warning signs intervention and completed established measures of intervention acceptability. The measures captured 10 intervention acceptability attributes (effectiveness, appropriateness, risk, convenience, relevance, applicability, usefulness, frequency of current use, likelihood of future use, and confidence in ability to deliver the intervention). Ratings ≥ 2 indicated acceptability. Data analysis included descriptive statistics, independent samples t-tests, as well as effect sizes to quantify the magnitude of any differences in acceptability ratings between nurses and other healthcare providers.
Results: Nurses and other healthcare providers rated all intervention attributes > 2, except the attributes of convenience and frequency of current use. Differences between the two groups were found for only three attributes: nurses’ ratings were significantly higher than other healthcare providers on perceived applicability, frequency of current use, and the likelihood of future use of the intervention (all p’s
Validation of the 5-item Workplace Outcome Suite on Employee Assistant Programs for Office Workers.
Behdin Nowrouzi-Kia, Sarah Sirek, Grace Granofsky, Mitchel Morrison & Ivan Steenstra
Background: The annual cost of mental illnesses in Canada is estimated to be $50 billion. Research from other countries have suggested that employment status is associated with mental and physical health. Within the Canadian context, there is a dearth of research on the relationship between employment and mental health. Objective: To explore the relationships between age, gender, income, and employment status on mental and physical health. Methods: The 2021 Canadian Digital Health Survey dataset was used for this study. Data records, which included responses for the questions on age, gender, income, employment status, mental, and physical health, were used in the analysis. Ordinal logistics regression was applied to investigate the associations that may exist between mental and physical health with the various sociodemographic factors. Descriptive statistics were also provided for the data. Results: The total sample size included in the analysis was 10,630. When compared to respondents who had full-time employment, those who were unemployed were more likely to have lower self-perceived mental health (OR: 1.91; 95% CI: 1.55–2.34). Retired respondents were less likely to have worse mental health than respondents who were employed full-time (OR: 0.78; 95% CI: 0.68–0.90). Self-perceived physical health was more likely to be lower for those who were unemployed (OR: 1.74; 95% CI: 1.41–2.14) or retired (OR: 1.28; 95% CI: 1.12–1.48) when compared to respondents employed full-time. The likelihood of worsening mental and physical health was also found to be associated with age, gender, and income.Conclusion: Our findings support the evidence that different factors contribute to worsening mental and physical health. Full-time employment may confer some protective effects or attributes leading to an increased likelihood of having improved mental health compared to those who are unemployed. Understanding the complex relationships on how various factors impact mental health will help better inform policymakers, clinicians, and other stakeholders on how to allocate its limited resources.
The effects of occupational and mental stress among home care rehabilitation professionals working during the COVID-19 pandemic: An exploratory qualitative study.
Aaron S. Howe, Kevon Jules, Jeremy KCD Tan, Raabia Khan, Anson KC Li, Brydne Edwards, Emily C King, Sonia Nizzer, Basem Gohar, Amin Yazdani, Ali- Bani-Fatemi, Vijay Kumar Chattu, Lindsay Sinclair, Mhairi Kay, Behdin Nowrouzi-Kia
Home care rehabilitation professionals (hcRPs) provide health services for clients with a broad range of medical conditions. During the COVID-19 pandemic, home care rehabilitation professionals experienced exacerbations of pre-existing work-related stressors, increased risk of transmission of the COVID-19 virus, reduced resource availability, greater workloads, and staffing shortages. The primary aim of this study was to examine the experience and impact of occupational and mental stress on hcRPs working during the COVID-19 pandemic. Semi-structured interviews were conducted with 24 hcRPs working in Ontario, Canada during the COVID-19 pandemic. Inductive thematic analysis was used to interpret and organize the data into conceptualized themes. Interview data was organized into three themes: (a) unique challenges of a home care rehabilitation professional, (b) COVID-19 exacerbations of home care occupational and mental stress, and (c) personal and workplace coping strategies. Many participants reported reducing their hours or taking on adjunctive roles in different clinical settings outside of home care due to work-related stress exacerbated by the COVID-19 pandemic. With a focus on the effects of COVID-19 on the practice of home care, this study provides a unique perspective on the challenges experienced by hcRPs during an emergent and evolving global public health concern. The exploratory nature of this research works towards providing a framework of factors to be addressed when creating sustainable healthcare interventions, as well as recommendations to support hcRPs to benefit both the community and health-care providers.
A systematic review protocol of yoga therapy as a modality in occupational therapy practice for adults experiencing mood disorders.
Candice Crooks, Helena Toolsiedas, Alicia McDougall, Behdin Nowrouzi-Kia
Introduction: Mood disorders can have a negative impact on daily functioning because cognitive deficits are exacerbated when individuals experience associated symptoms. Nevertheless, yoga therapy has been found to have enhancing features to well-being and quality of life. Occupational therapists are well positioned to include yoga as a modality to benefit clients experiencing mood disorders. However, literature on yoga interventions for mood disorders is underdeveloped causing an inadequate understanding of the health benefits. Thus, the aim of this study is to gain further knowledge associated with the implications of yoga as an intervention to increase participation in activities of daily living and enhance the quality of life of individuals experiencing mood disorders. This review will answer the following research question: can yoga therapy be used as an effective modality in occupational therapy practice to manage symptomatology related to mood disorders through increasing engagement in daily tasks?
Methods and analysis: OVID Medline, Embase as well as CINAHL Plus, Cochrane Library (Wiley), APA PsycINFO and Scopus will be explored to adhere to the following criteria: (1) studies discussing adults diagnosed with mood disorders, specifically bipolar and related disorders or depressive disorders as stated in the Diagnostic Statistical Manual of Mental Disorders-5; (2) studies discussing implementation of yoga therapy; (3) a correlation between mood disorders and effectiveness of yoga therapy.
Ethics and dissemination: Ethics approval is not applicable for this study, due to obtaining data from existing research articles. The completed manuscript will be submitted in a peer-reviewed journal for publication.
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