Occupational therapy and work: challenges and perspectives of an emerging practice during and after the Covid-19 pandemic

Rodrigues, Daniela da Silva

doi:10.1590/2526-8910.ctoEN255833372

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Reflection Article/Essay • Cad. Bras. Ter. Ocup. 31 • 2023 • https://doi.org/10.1590/2526-8910.ctoEN255833372 copy

Occupational therapy and work: challenges and perspectives of an emerging practice during and after the Covid-19 pandemic

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This essay discusses the intervention possibilities of occupational therapy in the field of work in the pandemic period, as well as points out the challenges and perspectives of post-pandemic actions. Interventions were discussed from three stages: i) pre-pandemic preparation; ii) pandemic preparedness strategies; iii) post-pandemic recovery, considering the micro, meso and macrostructural levels, from the perspective of a practice centered on the person and the work environment. Attention to work (in)capacities and acting in the process of returning to work were considered the main interventions of the occupational therapist, articulated with the various actors, institutions, services and class entities, in order to expand actions and promote a network integrated care. The new configurations of work resulting from technological innovation have expanded the interdisciplinary dialogue between occupational therapy and the field of work. It is expected to contribute with theoretical reflections about professional practice and the strengthening of this field in contemporary times.

Keywords:
Occupational Therapy; Occupational Health; Disaster; Management; Inventions; Covid-19

Intervention levels	Examples of intervention
Intervention levels	Person-centered (worker)	Centered on the environment (processes and work organization)
Phase 1: pre-pandemic preparation
Micro (individual)	1. Promote worker health education actions on risks in pandemic situations.	1. Organize ongoing training and courses to deal with adverse situations in the workplace.
		2. Encourage workers to participate in the first aid courses.
	2. Help with the organization of the daily routine, occupational balance and use of time.	3. Create a pre-checklist to continually assess workplace safety.
Meso (family, environment, community, everyday life)	1. Elaborate a plan of actions centered on the workers, considering the exposure to risk in each work sector.	1. Update information about the adverse event and necessary adaptations in the workplace to promote safety.
Meso (family, environment, community, everyday life)	2. Provide information on the network and support for workers linked to the community.	2. Place notices in the work environment with important guidelines for coping with the adverse situation considering the work activity performed.
Macro (institutional, public policies - social and health)	1. Inform about assistance policies (health and social) prior to welcoming the worker.	1. Present the epidemiological situation of the pandemic context at Ergonomics Committee meetings.
Phase 2: Preparedness strategies during the pandemic
Micro (individual)	1. Accept and manage feelings of psychological, physical or social suffering related to work.	1. Make listening channels available to workers, such as call center.
	2. Carry out a clinical-occupational assessment to understand work capacity.	2. Carry out an ergonomic analysis of the work activity in a real situation.
	3. Identify the compatibility between health and functionality with work.	3. Analyze risk factors in the workplace, such as physical, chemical, biological, ergonomic or accident hazards.
	4. Guidance on self-protection, such as the use of Personal Protective Equipment (PPE).	4. Depending on the context, promote biosafety actions.
Meso (family, environment, community, everyday life)	1. Develop actions for health and quality of life at work, such as relaxation techniques, stress management and workplace gymnastics.	1. Adapt the work environment, when appropriate, using Assistive Technology.
	2. Assist in the reorganization of the worker's work routine and encourage telework practices, when appropriate.	2. Recommend changes to workstation layout to maintain safety.
	3. Assist in the elaboration of the causal link of the illness or accident at work.	3. Assist in the reorganization of the work routine of the institution, service or company, such as shift schedule changes, implementation of rotations and breaks.
	4. Articulate with worker care systems and/or equipment for physical and/or psychosocial rehabilitation.	4. Carry out an epidemiological mapping of the adverse situation to identify the existence of new cases of work-related suffering.
	5. Provide peer support networks, such as support groups, for times of crisis.	5. Support inspections in work environments, favoring the creation of risk maps.
	6. Establish community care and resilience strategies considering adverse situations.	6. Promote worker health surveillance, such as notification of work-related injuries, to develop prevention measures on site.
Macro (public policies – social and health)	1. Participate in building booklets, bulletins, etc., for guidelines and preventive measures for exposure to risks associated with the work context.	1. Teleconsulting or consulting in partnership with Class Entities to support workers during the pandemic period.
	1. Disseminate, in partnership with Class Entities, the importance of being involved in occupations, highlighting the meaning of work.	2. Virtual or face-to-face space to share experiences as a form of collective work defense strategy (Dejours et al., 2016Dejours, C., Barros, J. O., & Lancman, S. (2016). A centralidade do trabalho para a construção da saúde. Revista de Terapia Ocupacional da Universidade de São Paulo, 27(2), 228-235. http://dx.doi.org/10.11606/issn.2238-6149.v27i2p228-235. http://dx.doi.org/10.11606/issn.2238-614... ).
	3. Call center policies occupational therapy during the pandemic period.	3. Foster employment and social support policies for unemployed workers.
		4. Articulate with social control to discuss social protection and health and safety management for the working class in pandemic situations.
Phase 3: Post-pandemic recovery
Micro (individual)	1. Accommodate workers' physical, emotional and social demands.	1. Combat the weakening of labor ties.
	2. Seek occupational balance between professional and personal life in telecommuting	2. Promote the protection of workers in their workplaces, such as through preventive actions against diseases and accidents in this period of post-pandemic adaptation.
	3. Keep up-to-date records of work-related illnesses and accidents.	3. Monitor work environments to prevent exposure to risks and stratify their severity.
		4. Provide information about ergonomic risks during telecommuting, remote work and face-to-face work.
Meso (family, environment, community, everyday life)	1. Promote effective return to work based on the assessment of work capacity and ergonomic analysis (eligibility).	1. Promote and coordinate return to work programs in a procedural, staggered and flexible manner.
	2. Make a return-to-work flow considering exposure risk levels and workers with comorbidities.	2. Assist in the identification and management of risks in the face-to-face and telework environment.
	2. Organize and participate in Workplace Health and Safety Weeks, prioritizing prevention measures, quality of life at work actions, training and information.	3. Help in building a safe and healthy organizational culture for all workers aiming at health and productivity.
	3. Develop quality of life at work programs aimed at facing the difficulties generated by isolation.	4. Organize security protocols with the service team, company or institution.
		5. Encourage and participate in the development of constant surveillance systems in the workplace.
Macro (institutional, public policies – social and health)	1. Discuss the incorporation of professionals' preparation for pandemic situations in workers' health policies.	1. Articulate with union entities to ensure the protection and rights of workers, especially in telework.
Macro (institutional, public policies – social and health)	2. Debate with Councils and Entities about the need for spaces for “Worker Care” that prioritize the performance of health professionals in comprehensive care for workers, in accordance with their real demands.

Universidade Federal de São Carlos, Departamento de Terapia Ocupacional Rodovia Washington Luis, Km 235, Caixa Postal 676, CEP: , 13565-905, São Carlos, SP - Brasil, Tel.: 55-16-3361-8749 - São Carlos - SP - Brazil
E-mail: cadto@ufscar.br

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[1] Daniela da Silva Rodrigues e-mail: danirodrigues.to@gmail.com