Association Between Outpatient Service Reduction and Mental Health Among Rehabilitation Specialists during the COVID-19 Pandemic in Taiwan

Abstract

Background: The COVID-19 pandemic has disrupted rehabilitation services, with potential implications for the well-being of rehabilitation specialists. This study investigates the impact of service volume reduction during the pandemic on the mental health, general health, and quality of life of these professionals. Methods: A national survey conducted in November 2021 sampled 293 rehabilitation specialists in Taiwan. The survey inquired about work hours, workload, and changes in outpatient service volume relative to pre-pandemic levels. Mental health status was gauged using the Patient Health Questionnaire-2 (PHQ-2), complemented by self-rated general health and quality of life measurements. Multiple logistic regression evaluated the association between service volume changes, work hours, workload, and indicators of well-being. Results: Accounting for gender, age, and workplace, specialists experiencing outpatient volumes below 60% and 60-69% of pre-pandemic figures showed increased odds of poorer mental health, with adjusted odds ratios (AORs) of 6.11 (95% CI: 1.43, 26.10) and 7.15 (95% CI: 1.52, 33.57), respectively, versus those above 80%. Yet, outpatient volumes under 60% were linked to a decreased likelihood of worse self-rated health (AOR: 0.35, 95% CI: 0.16, 0.82). Furthermore, work hours exceeding 48/week correlated with deteriorated mental health (AOR: 4.95, 95% CI: 1.04, 23.64) and quality of life (AOR: 9.57, 95% CI: 2.96, 30.96). Perceived work overload was also associated with poorer mental health (AOR: 2.93, 95% CI: 1.14, 7.49), self-rated health (AOR: 2.84, 95% CI: 1.52, 5.33), and quality of life (AOR: 5.74, 95% CI: 2.87, 11.48). Conclusions: Rehabilitation specialists experiencing significant reductions in service volume during the pandemic faced an elevated risk of mental health issues. It is essential to implement supportive mental health strategies for these professionals to address these challenges.