gms | German Medical Science

Background and state of research: Due to the COVID-19 pandemic, various measures have been taken in healthcare settings to prevent the spread of SARS-CoV-2, affecting for both caregivers and patients. Medical rehabilitation facilities face numerous challenges in how to ensure patient-centered rehabilitation while simultaneously minimizing the risk of infection. To address the challenges, flexible strategies must be employed to meet the needs of various stakeholders.

Question and objective: By means of a scoping review, the objective of the present study was to identify strategies, guidelines and recommendations on how medical rehabilitation facilities can adapt to the challenges of the pandemic.

Method: Due to the dynamic development, two scoping reviews were scheduled to be conducted at two different times during the pandemic using Pubmed, CINAHL, Web of Science, PsycInfo, Livivo, Google Search and Google Scholar. In the initial review a total of 2,188 relevant articles were identified. After removing duplicates and reviewing the publications based on their titles, abstracts and full texts, articles were excluded when they were considered not relevant to the research question or only addressed challenges of the COVID-19 pandemic and did not provide strategies to address them. 17 publications were included into the analysis.

Results: Many facilities have newly established infection control measures such as daily monitoring of body temperature and identification of symptoms among clinical staff and rehabilitation patients. A large number of articles report changes in structural measures, e.g., dividing staff into sub-teams and isolating patients found to be infected during their stay. The use of digital communication tools and education of staff and patients on the proper use of personal protective equipment or about hygiene measures are also mentioned. Only a small number of the included publications address strategies for psychosocial support. Experiences with the implementation of existing recommendations are reported only very sporadically.

Discussion: So far, limited research is available on strategies, guidelines or recommendations on how to address COVID-19 in the field of rehabilitation. The publications included into the present review indicate that infection control measures and structural strategies are the dominating approaches. Critically, only few articles provide recommendations on psychological assistance for staff and patients, which would be necessary to prevent staff from becoming overwhelmed and to counteract the social isolation of patients.

Practical implications: Both research and rehabilitation providers should develop and evaluate strategies allowing to provide patient-centered rehabilitative measures in times of pandemics and other public health crises.

Appeal to practice: Health care research and practice need to evaluate existing measures and strategies to address the challenges posed by the COVID-19 pandemic in order to provide patient-centered rehabilitative care now and in future crisis situations.