Kat Clancy: St James’s Research Profile
13/09/2023
Occupational Therapist Kat Clancy entered St James's Hospital during a very challenging time for healthcare: the beginning of the COVID-19 pandemic in 2020. Since May of the following year, she has been working in the ever-changing field of post-COVID rehabilitation. As part of our series on St James’s researchers, Clancy sat down to tell the Office of the Dean of Research about her experience in both clinical practice and research throughout this time.
Indeed, it’s hard to imagine another field that has evolved so quickly in such a small amount of time. St James’s opened a post-COVID clinic in May of 2020. In April 2021 they were able to use COVID funding to establish a half-time senior Occupational Therapy post, which Clancy took up. Her first project was a collaboration with Trinity, where they conducted research and clinical work side-by-side. Clancy, St James’s OT manager Aoife O’ Gorman and OT Louise McQuaid worked with Professor Deirdre Connolly and Associate Professor Tadhg Stepleton (Discipline of Occupational Therapy, Trinity College Dublin) to develop the intervention and research. They adapted a fatigue and activity management programme for patients with arthritis and other chronic conditions, which had been developed in 2018 by McCormack et al (which includes Prof. Deirdre Connolly), for the newly emerging challenges post-covid patients were facing.
“Our first foray was designing an occupational therapy, fatigue management education program for people with persistent post-COVID fatigue,” she explains. Their first study was quantitative, with a pre-test post-test study design. Now they are in the middle of having that paper reviewed.
The development and impact of the programme has been presented both nationally and internationally at the Association of Occupational Therapists of Ireland conferences (in 2021 and 2022) and at the infectious Diseases Society of Ireland study day in 2022. Findings were also presented at the European Congress of Clinical Microbiology and Infectious Diseases (2022).
Her current research is qualitative, looking at the lived experience of patients with post-COVID fatigue, and their experiences of the fatigue management group. This research aims to better understand the experiences of people with post-COVID fatigue and the impact of the fatigue management group from their perspective. She highlights that it's an area where research is still needed: “There are still people contracting COVID, and at least one in ten people who get it will have post-COVID syndrome. That’s anything from fatigue, brain fog, sleep disturbance, shortness of breath, all of these symptoms which impact on a person's ability to do things day to day.” A high percentage of patients do go on to make a full recovery, but many people are out of work and still experiencing the long term effects of COVID.
Clancy works in St James’s post-COVID clinic. This includes the post acute-service run by respiratory consultants Dr Brian Kent and Dr Parthiban Nadarajan. The long-COVID clinic is led by Dr Ciaran Bannan as the primary infectious diseases consultant. Clancy works on these busy teams with neurologist Dr Aoife Laffan as well as clinical specialist physiotherapist Nicola Keohane, alongside nursing and admin staff.
In her working week, Clancy has a mix of face-to-face appointments and telehealth. A lot of her patients don’t have the energy physically, or cognitively to attend the in person, and others don’t live within commuting distance. They can now access this St James’s Occupational Therapy services from their own home, something a lot of them have found to be a huge benefit. Service development is important to her, and she is currently developing a pathway in relation to employment engagement for this patient group. She also supervises staff from the general medicine occupational therapy team.. On Fridays she sees new patients at the multidisciplinary post COVID clinic.
This is all done alongside her part-time research masters in Trinity. Studying a masters at the same time as full-time work can be quite difficult in terms of balancing one’s time, but it is doable, Clancy observes. It is about “being smart with your time and setting yourself achievable goals.” She highlights the importance of peer support and linking in with your supervisor. It’s important to establish what a normal timeline will look like for you, and to set goals rather than leaving everything to the last minute.
She embarked on her masters thanks to the strong links between St. James's Hospital and Trinity College Dublin. She gets great support from her line manager, Aoife O’Gorman, and from Trinity lecturing staff, including Prof. Deirdre Connelly and Assoc. Prof. Tadgh Stapleton, who is her masters supervisor. And there's the Centre for Learning and Development (CLD) who are able to support with funding. “I don’t know if I would have been able to have done it otherwise.”
“Research is something I've always been interested in, but didn't really know where to start. It’s important to say is that it is a learning process, and that's why it's great to have the Occupational Therapy faculty in Trinity, just over the road. And there's a great level of peer support within the hospital, from the OT department and the team at the post-COVID clinic.”
Looking at Clancy’s work history, she focused on dementia and older adult rehabilitation before turning to post-COVID fatigue. Was there anything that drew her to these areas? She’s always enjoyed working with older adults, she explains, which she has done since working as part of King's College Hospital NHS Foundation Trust in the UK. When she came back to Ireland and worked in a nursing home, she started clinical practice in an acquired brain injury unit, which gave her an interest in cognition. With the start of the pandemic, “we didn't know what post-COVID was going to look like, but it was an opportunity to develop something new, with patients in different age ranges. Symptoms affect everyone differently –physically, mentally and cognitively’
Her team’s approach to rehabilitation is that of co-design. Occupational therapy for this patient group, according to Clancy, is “not just us giving information. It’s about supporting independent self-management It's working on information together with patients, learning from each other and supporting each other.”
Through this approach, they are developing an evidence-base for a self-management approach to post-COVID syndrome, demonstrating how best to implement it and to support people to take it on. “It is difficult to make these changes when someone can run around doing ten things at once, and then suddenly they can't. It's really hard to change that pace and implement strategies like pacing and prioritizing. It’s about looking at achievement in a different way for these patients.”
Clancy has certainly demonstrated, as she herself argues, that healthcare is changing. “’It is now a more collaborative process, supporting independence and empowering people to have autonomy over their healthcare journey” She and her team see the patients as the experts. “And that’s why research is important. It’s about what patients are experiencing, what they think is going to make a difference, and being able to share and publish that, so other people can read and learn from that as well.”
Kat Clancy
Kat Clancy is a Senior Occupational Therapist in St. James’s Hospital specialising in Post COVID. She is currently engaged in a Research Masters (Trinity College Dublin), exploring the impact of post-viral fatigue on the daily lives of people following COVID-19 infection. This research also explores the long-term self-management of this condition following completion of the Occupational Therapy-led Fatigue and Activity Management Education programme for people Post COVID (FAME-PC). Kat has presented on this topic nationally and in 2022 won Best Abstract at the Association of Occupational Therapists of Ireland conference.