The impact of COVID-19 on Occupational Therapy services in Gauteng Province, South Africa: a qualitative study

Abstract

The impact of COVID-19 on healthcare services has been widely reported, but limited information is available on its impact on rehabilitation services in South Africa. This article reports on the impact of COVID-19 on Occupational Therapy services and programmes in public and private health care as delivered by occupational therapists. A qualitative case study design was selected to explore the perceptions of occupational therapists in private and public healthcare settings regarding the impact of COVID-19 on rehabilitation services. Asynchronous on-line focus group interviews were conducted by a team of researchers. The data were thematically analysed. Three themes emerged from the data. Theme 1, the ‘impact on the practice context’, revealed that infection prevention and control protocols were a barrier to achieving rehabilitation goals. An enabler was the therapists’ creativity and new ways of practice. Theme 2 described the ‘impact on the service-users’ where isolation and physical distancing curbed access to rehabilitation services. The struggle of vulnerable populations and socio-economic disparities in healthcare was evident in these data. Theme 3 referred to changes in the ‘professional and personal self’ of the occupational therapists. Challenges to ethical practices − for example, the uncertainty of the benefit of adapted services − resulted in stress and anxiety among therapists. Constantly adapting to changes in Regulations caused compassion fatigue, but therapists also reported healthy coping strategies and resilience. Occupational Therapy rehabilitation services should be listed as essential in times of a pandemic. Better health and social support to vulnerable populations should be established, as their challenges escalated during COVID-19. Research is required to determine practice guidelines and effectiveness of novel rehabilitation practices that were identified during the COVID-19 pandemic.