Discussion
depression, insomnia, infectious disease, anxiety
INFECTIOUS DISEASE
A time-use intervention can improve the occupational balance of patients isolated due to COVID-19. It also improves QOL and reduces psychological problems such as depression, anxiety, insomnia, boredom, and fear. To our knowledge, this study is the first to evaluate the effectiveness of a time-use intervention in patients with COVID-19.The time-use intervention improved occupational balance in our study. In the time × group analysis, the experimental group showed a significant improvement compared with the control group (The time-use intervention helped reduce patients’ psychological problems, such as depression, anxiety, insomnia, boredom, and fear. An individual’s daily restrictions due to an infectious disease outbreak cause psychological difficulties such as depression, anxiety, and fear [The time-use intervention helped improve patients’ QOL. The total WHOQOL-BREF score of the control group decreased from 86.45±9.52 to 83.82±8.52. The environment of isolation could be a factor that negatively affects patients’ QOL [This study has several limitations. First, it had a small sample size and was conducted at a single center. Therefore, the results cannot be generalized. Further studies should include a larger sample size to validate our findings. However, the results were justified through post hoc analysis and the effect size of each outcome measure. Second, self-reported questionnaires were used as outcome measurements. They rely on participants’ honest answers; thus, the possibility of socially desirable responses, recall bias, and misunderstanding of questions cannot be excluded. Third, follow-up after discharge was not performed. Therefore, it was not possible to confirm whether the effect persisted even after discharge. A follow-up evaluation is necessary to confirm this. Fourth, we considered a single-blinded experiment, but this was not feasible because of manpower shortages and the environment of the isolation ward. The non-blinded trial design could have caused performance bias and detection bias. However, we performed the following efforts to reduce the bias. We assigned patients to separate rooms to prevent group mixing, and the same outcome measurements and methods were used in both groups. In addition, two well-trained clinicians collected the data to reduce bias.Despite these limitations, the time-use intervention was effective in maintaining occupational balance during the isolation period. It also had a positive impact on mental health and QOL. As mental health problems can become serious over time, interventions should begin at the point of isolation. Humans seek satisfaction and lead a happy life by performing occupations [