Organizational and occupational health issues with working remotely during the pandemic: a scoping review of remote work and health

Abstract Background: Stay-at-home orders during the COVID-19 global pandemic created unprecedented challenges for workers whose work was transferred to the home setting. Little is presently known about the benefits and the challenges associated with global remote work on well-being and mental health, work-life balance, job satisfaction, productivity, home office adaptability, and gender equality. Methods: A scoping review of PubMed/Medline was undertaken in October 2021 to better understand these broad dimensions associated with remote worker health, well-being, and the home office workspace. The review focused on white-collar workers who undertook remote work during each of the lockdown waves from March 2020 to 2021. Results: A total of 62 studies were included in the review, which spanned Asia, North America, South America, and Europe. Overall, workers seemed to enjoy remote work, but productivity varied. The main setbacks associated with remote work included feelings of isolation and loneliness, which negatively influenced well-being. Social support from management and contact with colleagues mitigated this. Leadership style also influenced remote worker well-being. Overall, women suffered from lower levels of remote work well-being and productivity, especially if they had children. The home office and its adaptability were integral for successful remote work. Work-life balance was affected in some workers who struggled with heavier workloads or family duties. Conclusions: To promote well-being and successful remote work, isolation and loneliness should be reduced through greater contact with colleagues and managers. Managers should promote family friendly policies that may support work-life balance and reduce gender inequities in remote work.


Background
During the unprecedented COVID-19 pandemic, the mental health and well-being of adults around the globe was impacted. 1 systematic review found high rates of depression, anxiety, and stress symptoms in China, Denmark, Sweden, Spain, Italy, Turkey, Iran, and Nepal.Although the prevalence of mental health issues varied by country and assessment method, the prevalence of depressive symptoms was high and ranged from 14% to 48% and 6% to 50% for anxiety symptoms, assessed using validated scales. 1 Workplace mental health is especially relevant, given the sudden changes in workforce dynamics that the pandemic had brought on.Job loss and financial insecurity were just some stressors that employees faced during the pandemic. 2,35][6] According to research in Luxembourg, 1 in 3 employees suffered from a decline in their mental health. 7In addition to this, perceptions of fear, safety, and losing a loved one during COVID were raised as major issues that working adults faced when trying to adjust to the "new normal." 8It is especially timely to better understand how employers around the world worked towards promoting wellbeing, buffering against stress and mental health problems in remote workers during times of uncertainty.
Additionally, more research is needed to better understand the benefits and barriers of remote work for well-being and how they vary by gender.Women have been disproportionately affected by the pandemic and they report lower levels of wellbeing and mental health compared with men, 9,10 although this was the case even before the pandemic.They are also affected by inequitable job loss relative to men; 54% of women lost their jobs during the pandemic when they represented only 39% of the working population. 11There is also evidence that some women were exposed to increased levels of domestic violence during the pandemic, resulting in new occupational hazards when working from home. 12These new work inequities and occupational hazards in the home-office have never been previously studied.
Finally, little is known about the presumed interplay between remote working life, productivity, job satisfaction, work-life balance, and well-being.Table 1.summarizes the various definitions of these constructs, as previously used in the literature.Given that for many people work has moved into the home sphere, the boundary between work and personal life may have become less clear.It is important to understand how remote workers maintained a work-life balance during the pandemic because it is integral for well-being. 13There is meta-analytic evidence that stress and mental well-being are associated with job satisfaction, 14 but it is currently unclear how remote work has impacted global job satisfaction.Additionally, health-related sick leave affects productivity and the economy. 15It is presently unclear how productivity was affected during remote working life, and whether inequities exist between men and women, different countries, and diverse white-collar jobs.
As remote work has become almost ubiquitous in non-servicerelated jobs during the COVID-19 pandemic, it is likely to remain to some extent in the future. 16Murphy 16 theorizes that should remote working remain, it will bring its challenges for managers and create gender inequity for women, but employees may find a general preference for this form of work arrangement overall.Kniffin et al 17 had previously undertaken a scoping review of studies that had been published prior to the pandemic to inform theoretical areas of research including how the pandemic might shape virtual teams, leadership and management, and well-being.A comprehensive updated review is needed that will explore changes in work dynamics, not only in 2020 but also throughout 2021, in order to better understand relationships between remote work, work-life balance, productivity, job satisfaction, and the role leaderships plays.It is also useful for future pandemic preparedness.Gaining a clearer understanding may assist with establishing remote workplace policies that support remote workplace well-being as well as satisfaction with remote work and productivity.Furthermore, interventions may be developed to promote the well-being and success of remote workers by targeting barriers associated with remote work and facilitators.Finally, by better evaluating differences between men and women, future interventions and policies may be better tailored to reduce inequities and promote diverse remote worker well-being.

Aims and objectives
The broad objectives of this review were to summarize the evidence surrounding white-collar employee well-being and remote work.The rationale for focusing on white-collar rather than bluecollar workers is because white-collar jobs could be performed from the "home office" setting during stay-at-home remote work orders when compared with more technical, hands-on jobs, which could only be performed on site by the physical workforce.
The aims of this review were to: 1. Identify the factors affecting employee well-being or acting as buffers against stress while working from home.Determine whether these factors vary by gender and occupation.2. Better understand how remote work affects work-life balance, job productivity, job satisfaction, and the role of management.3. Identify the role of leadership and management to foster employee well-being and work under these circumstances.

Methods
A scoping review of PubMed (Medline) and Google Scholar was undertaken in October 2021 to identify relevant studies to our research questions.The search terms included word variations for "well-being" and "stress" and "remote work" and "work-life balance" and "productivity" and "job satisfaction."The search strings were combined into 1 large search string that is most relevant to our research questions (Table 2).Keywords included medical subject headings (MESH) terms, free text, word variations, and truncation.A medical librarian was consulted with the search strategy.Manual hand searches of references were also undertaken.The PubMed/Medline search strategy example is given in Table 2.

Work-life balance
Work-life balance is defined as harmony between one's personal or private life (eg, leisure, socializing, and family) and one's working life.When there is imbalance, work may take over one's time allocated to pleasure and family 18,19

Productivity
Productivity in the workplace is defined as the output that a person or whole company produces within a period of time during work, sometimes described as the rate at which goods and services are produced. 23,24

Well-being
Well-being is a state of happiness and living well.Broadly defined by the Centers for Disease Control (CDC), it encompasses positive sentiments and general fulfilment, and spans physical, emotional, social, psychological well-being, and overall life satisfaction. 25,26

Workplace well-being
Broad concept that includes occupational health and safety and positive perceptions of the workplace. 27,28

Flourishing
Concept from positive psychology, focused on living one's best life even with limitations (eg, living with an illness or disability).

Data extraction
Data on study characteristics and participant demographics as well as health outcomes and work-related measures were summarized in a tabular format (Table 3).

Results
After title and abstract screening, followed by full-text retrieval, 62 studies were included in this review and are summarized in Table 3. [4][5][6] The studies spanned Europe, North America, South America, Asia, and the Asia Pacific Region. The eployment categories were diverse, but most often included public sector workers such as managers, office workers, administrators, researchers, and teachers.The age of workers varied, but most often covered middle-aged working adults.The search and screening process at each stage based on the key inclusion and exclusion criteria is summarized with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) f lowchart in Figure 1.77

Effects of remote work on well-being and stress
The impact of remote work on well-being, stress, and mental health varied across the studies. 19,21,30,31,33,44,45,55,64,72,73,76ereas some studies reported benefits of working from home on well-being, others found that well-being declined.For example, a study in Australia found that mental health was negatively affected in 40% of remote workers. 30Similar findings were reported in Europe, including in studies in Spain 33 and in Poland. 44 study of university staff found reduced overall well-being and increased stress 73 in the United Kingdom.Higher levels of tele pressure from working online were associated with emotional exhaustion in employees. 45Likewise, studies in Japan found a high 30-day prevalence of stress in teleworkers of 87%, 55 and increases in stress by 47%, when cross-sectionally evaluating perceived changes in stress during the pandemic. 76Nevertheless, some studies also found that working from home was associated with improved overall well-being. 19,21,64,72For instance, 1 study in Japan found that remote work reduced overall stress in employees and promoted mental well-being, 64 which contrasts with the aforementioned studies in Japan.Similarly, research in Austria found that employees were twice as likely to report improved quality of life relative to their non-remote-working counterparts. 72Studies in professors found that many enjoyed working from home, across different countries. 19,21Specifically, a study in academics found that 66% of them supported future remote work for their well-being. 19Thus, working from home was not uniformly associated with poorer well-being and varied according to other contextual factors including employment type.

Social isolation as a barrier to remote workplace well-being
Working from home during the pandemic was associated with isolation and loneliness, which were found to inf luence wellbeing and stress during remote work.Several studies found that social isolation played a role in employee well-being or mental health when working from home.and non-remote workers, a study in university employees who reported that they were isolated were 78% more likely to be vulnerable to poor well-being and higher stress when compared with their counterparts who did not feel isolated. 71Approximately onequarter of university staff experienced depression or anxiety. 71In contrast, a large cross-sectional study in the United States during early lockdown in April 2020 did not find that working from home was associated with higher levels of loneliness. 51Technostress was identified as a predictor of poor mental health outcomes in workers in Finland. 59Nonetheless, the trends point towards vulnerability to feelings of isolation and loneliness when working from home, which inf luence remote workplace well-being, stress, and mental health.

Employee social support as a buffer for remote workplace well-being
Co-workers and employers play a role in providing employees with social support to buffer against the negative effects of isolation and loneliness when working from home and to promote well-being. 26,47,53,57,69,79,80Regular social support was found to be integral for well-being, 81 mitigating the effects of loneliness and isolation associated with remote work.Social connectivity was identified as a main factor for buffering against stress in 1 study in Austria, 79 whereas a study in Spain found that social support was negatively associated with depression. 57Levels of contact with co-workers inf luenced perceptions of loneliness. 53A study found that remote workers were 1.6 times more likely to experience feelings of isolation when compared with non-remote workers and that having co-worker support mitigated this. 53They also found that remote workers with little support from co-workers were 4 times more likely to report feelings of isolation when compared with those with high levels of support. 53Zoom fatigue was found to be inversely related to group belongingness in the workplace, 26 highlighting the need to promote interconnectedness during telework or online remote work.Management played a role in fostering social support and reducing feelings of isolation in the workplace.Organizational support, which is support from the organization in which one works, was found to be a significant determinant of remote workplace well-being 80 and fostered a sense of identify and belonging in the workplace. 47Workers with low levels of managerial support were 2.5 times more likely to report loneliness when compared with those who reported high levels of support. 53Thus, it appears that not only co-worker support, but also managerial support is important for fostering a remote workplace environment that promotes well-being and reduces feelings of loneliness.
In addition to direct support from the workplace and colleagues, having personal support in one's private life was also identified as being important for buffering against the negative effects of working from home.For example, the negative impact of working from home on personal life was mitigated by having a partner when compared with single individuals who were younger. 69Therefore, remote workers should ideally have support on a spectrum ranging from colleague and co-worker social support and regular contact, social support from middle management, and peer as well as family social support when working remotely to promote well-being.

Gender differences in remote workplace well-being
Women reported higher levels of stress and lower levels of wellbeing than men in several studies. 32,33,34,59,61,65,71One study noted that women's well-being scores were contingent on the amount of housework, with women experiencing lowest levels of well-being when they undertook the majority of housework while they were teleworking. 65Similar findings on unequal role play were noted in another study, whereby women took on greater roles in family activities. 75hildcare or having children was also associated with poorer overall mental health or well-being. 32,52,59,61,71,72,74For example, women were 1.6 times as likely to be vulnerable to the stressors from COVID, and those with children were 2 times as likely, relative to their male counterparts and those without children. 71nterestingly, a study estimated that remote work may lead to inequality as it benefits men and those in the higher income brackets, and could lead to higher income for these groups. 82nother study recommended equitable childcare accessibility for women when working from home, 83 supporting research indicating that women experience burnout especially when they work remotely and cannot access childcare. 52Productivity was also reported to be significantly lower in women in Australia if they had children when compared with those without children (reduction of 63% vs 32%). 30Thus, there is a need to better understand the unique differences between men and women and to offer tailored supportive interventions in order to reduce inequalities.

Work-life balance
In addition to social support, isolation, and the role of organizational support, other challenges associated with remote work life that have been identified include work-life balance and workfamily conf lict issues.5][86] A large study in Germany and Switzerland found that those who worked from home were 2.77 times more likely to report improved worklife balance compared with non-remote workers.The exception was when the lives of employees were directly affected by COVID-19. 69Likewise, a large study in Europe found that improved worklife balance was a benefit of working from home. 6There was variability between countries, however, when considering remote work-life balance perceptions during the pandemic.For example, a study in the Faroe Islands found that 37% struggled with working from home. 32Likewise, a study in Latin America found that remote work during the pandemic reduced work-life balance. 58t appears that work-life balance also varied between different professions.A large study in Europe found that part-time teleworkers had a good work-life balance, but that this balance was compromised in individuals who worked full time and were mobile (needed to move for work). 84A study found that work-life balance was not affected if employees had regular employment, instead of under precarious employment conditions. 85Work-life balance also varied across different professions.A study in teachers found that 86% felt that telework caused difficulties with maintaining work-life balance, primarily due to increased work hours. 5Increased work hours in tandem with work-life imbalance were predictors of poor quality of life on the mental health part of the survey. 5Higher workloads and monitoring of work from home led to greater conf licts in the home-work sphere. 86Higher levels of stress and isolation were also negatively associated with worklife balance. 36,39Thus, ways to reduce excessive work hours and stress are needed and stress coping skills may also be useful to improve work-life balance in remote work.

Productivity and work time
Productivity varied across studies and was measured mostly through self-report, 6,18,20,23,24,27,36,37,42,54,64,67,68,72 which may limit conclusions to be drawn from these results as such selfreports are open to bias. 87Whereas some studies found increases in productivity during remote work, 6 others found reductions in productivity. 54,64,67,72A large study in Europe found that productivity increased when working remotely from home as well as greater control over work. 6A study in Italy found that 39% of employees reported reduced productivity during remote work, 54 and a study in Brazil similarly found that 69% of workers felt that their productivity had declined. 67Research in Austria found that remote workers were 1.48 times more likely to be unproductive when compared with their non-remote-working counterparts. 72esearch in Japan found that productivity or presenteeism (being present during virtual work by completing online log books) declined when workers worked remotely on a full-time basis. 64A study involving 704 academics found that productivity decreased in 50% of the sample, but approximately 25% of the academics found that they were more productive when working from home during the pandemic. 19However, they found that 70% were willing to work from home and could build on their work efficiency from this experience, which made them better prepared to undertake remote work in the future. 19Academics reported that they could work better in the traditional workplace when communicating with colleagues and undertaking necessary data collection, but they could focus more on data analysis and on the literature when working from home. 19Thus, it seems that productivity changes were not uniform when working from home, but also depended on the tasks, and that this transition suited some individuals and professions more than others.It also seems that adjusting and building habits associated with remote work is important for supporting productivity.
Factors that affected productivity throughout the studies included caring for children 27 or work-family conf licts, 36 lack of regular office space (including a reserved desk and chair), 6,23,42 distractions, 23 lack of habit formation for working from home 27 or self-leadership, 36 isolation 36 or emotional stress, 18,68 communication with co-workers and trust, 37 satisfaction with remote work 20 and with the relationship with the supervisor, 24 and IT support. 42Productivity was also affected by higher levels of communication with co-workers and less isolation in tandem with overall good health. 23Thus, it seems that in order to stabilize or even increase productivity, employers should aim to improve communication with employees and their co-workers, reduce isolation, assist with an adequate home work-station setup, and promote a work-life balance.Productivity may also vary by income or type of employment.Older individuals and those in a higher income bracket were more likely to report being productive during remote work, 23 indicating that there may be an inequality gap.A study in Norway further found that 38% of jobs can be performed remotely. 43This highlights that inequalities in remote work accessibility and capability to perform productively exist. 43

Working time
In addition to productivity, 3 studies explored changes in work time during remote work.A large study in the United States found that working time increased by 1.5 extra hours of work each day when working from home, 23 whereas another study in the United States found that 28% of workers increased their work hours by 1-3 hours during remote work. 40By contrast, in a Swedish study, individuals who worked from home slept for 34 minutes longer, which took away time from work. 41Thus, it is unclear whether work time increased or decreased for workers around the globe, given the conf licting findings.However, it should be noted that longer work hours do not necessarily linearly equate with increased productivity, and shorter work-weeks have been suggested in previous research for increasing productivity. 88

Gender differences in productivity
Gender differences in productivity were reported across some studies, but the results were variable.Men were more likely to report poor levels of productivity, 20 and stress affected productivity more in men than in women in 1 study in Latin America. 58ikewise, in another study, women in the United States were found to report higher levels of productivity when working from home during remote online work or "telework." 23An analysis of Twitter/X posts in the United States found that women were more likely to post positive things about remote working life. 75By contrast, a study in Latvia found that women had more chores than men and that they were more likely to suffer from worklife imbalances. 49Similarly, a study in Turkey found that women had increased workloads, work hours, and chores, and were more likely to report stress than men. 61Women in the age group 18-44 were particularly negatively affected by remote work relative to men in 1 study. 61Women were also found to have higher technostress scores than men in Italy 66 and in Egypt. 35A large study in Europe found that men adapted to working from home better than women and had fewer office adaptability issues. 6 study in Brazil in academics found that women were less productive than men when submitting manuscripts during the pandemic, especially if they had children. 67Similarly, a study in academics in the United States found that they submitted significantly fewer manuscripts when working remotely from home. 48Thus, it appears that productivity was lower in females in the academic profession, but more research is needed to better understand whether this was a consistent trend.Likewise, it appears that there may be gender inequalities in home-office adaptability as well as balancing chores at home.Understanding reasons for differences in productivity and well-being, especially levels of support, role sharing in housework, and accessibility to childcare, is important for reducing inequalities in the homework sphere.

Job satisfaction
Job satisfaction was measured by self-report questionnaires 6,20,24,28,29,32,38,42,47,54,58,68,85 and differed between the studies.A study across 29 European countries found that 55% of workers had an overall good experience when working from home. 6A study in Latin America, however, found that job satisfaction declined during remote work. 58By contrast, job satisfaction in Italian employees working from home remained the same for 50% of participants 54 when compared with their former satisfaction in the traditional workplace.The exception was that workers who had neck or back pain were less likely to be satisfied with remote work. 54A study in Malaysian university employees found that 87% were satisfied with working from home, although their reported productivity was only 54%, due to gaps in the availability of telework technical support and equipment. 42A study in the United States found that 61% of workers enjoyed working at home and that 70% felt that they had more freedom. 38ifferent factors across the studies that may affect remote job satisfaction include the type of contract (level of security), overall well-being and sleep, isolation, and work relations. 20,28,29,32,47,58,68,85A study found that employees had higher levels of job satisfaction when working from home only when they had a strict regular employment contract and not working under uncertain, precarious, or irregular employment conditions. 85nother study found that 74% of teleworkers reported poor sleep quality, which was inversely related to job satisfaction. 20aintaining positive relations at work might also be integral for job satisfaction during the pandemic and that trust was a mediator between positive relations and job satisfaction. 28utonomy, 29 social identity in the workplace, and connectivity with co-workers were also found to be key determinants of remote work job satisfaction, 47 whereas social isolation was associated with lower job satisfaction 29 and overall productivity 68 as well as stress. 68Satisfaction with the quality of supervision was also related to satisfaction 24 as well as overall employee relations, including with co-workers and trust as a fundamental element 28 and identity leadership. 47There was also a positive relationship between well-being and overall remote job satisfaction 32 and a negative relationship with stress and satisfaction. 58Thus, finding ways to improve relationships at work, improve sleep, and reduce stress may be beneficial for job satisfaction during telework.

Home office adjustment
The home office as a physical space was identified as being an integral element of remote work in various domains including well-being and productivity.This includes a consideration of the desk, the table, the room, lighting, or technical aspects such as Wi-Fi. 6,23,30,35,40,42,56,59,74Research in Japan found that home office lighting was integral for workers and that those who had inadequate lighting were 2 times as likely to suffer impairments in their work. 56Wi-Fi connectivity was not ideal for 22% of university staff in Egypt and was associated with technostress. 35Research in Australian academics found that most did not have access to a home office and worked primarily from their kitchens (42%), whereas others shared an office space (22%). 30Interestingly, in the United States, 12% reported sharing office space when working remotely across diverse professions. 40Workers who had an adequate room to work in reported higher productivity compared with those who did not have acceptable home office adaptabaility. 23,42Owning desk space was associated with working longer during remote work. 23Adequate workspace, workstation, lack of distractions, and regular work hours were associated with higher well-being in remote workers in one study. 74A large study from 29 European countries found that the main setbacks and barriers associated with working from home during the pandemic were inadequate home office space/adaptability as well as insufficient tools available to employees. 6Thus, the home office space and its various dimensions are integral for supporting successful remote work and well-being.
There is also some evidence that employees reported greater physical pain from ergonomic stressors when working from home.One study recommended an ergonomic work station for home office work and well-being during the pandemic, 89 supporting previous research that found that 50% of employees reported greater neck pain when working from home. 54Overall workrelated health indicators declined in remote workers in one study. 24Another study found a negative relationship between home desk and chair ergonomic and overall suitability and musculoskeletal strain. 62Thus, employers should make efforts to reduce ergonomic stressors by providing their employees with suitable adjustable chairs and workstations.In addition to this, a study that investigated home office adaptability in health care workers found that not all could adapt equally to the home office, especially those who required seeing patients, technical support, or when hand on work at the actual work setting was necessary to complete the tasks. 46Thus, the home office should ideally be created to maximize working opportunities, but even with adjustments, some professions are not suited for homebased work.

Leadership style
In addition to managerial support, which was described previously, the actual leadership style played a role in shaping remote worker well-being. 37,47,50,61,66,70,90Participative leadership was an important determinant of employee health, whereby employees were empowered to be active decision makers in the workplace. 70nother study found that identity leadership, through greater group cohesion and sense of collective belonging in the workplace, was positively related to work satisfaction and negatively related to loneliness during remote work. 47Additionally, leadership style was found to moderate the effect on well-being of working from home.For example, intrusive leadership was found to be negatively associated with mental health and well-being in workers (increased depression, anxiety, and reduced happiness). 50In other words, pushing workers to be workaholics through excessive pressure was found to be detrimental to well-being. 50ommunication and trust in leaders were found to be integral during remote work, especially doing virtual teams. 37Low levels of perceived control in the work setting and higher workloads were associated with lower levels of mental health and well-being. 61 study in Italian university workers and administrators found that highly authoritarian leadership was detrimental to work-life balance, as it promoted workaholism and led to increased levels of technostress (stress associated with using technology). 66Likewise, intrusive or toxic leadership was found to be associated with higher levels of stress in a study in Italy in trade and service sector workers. 50Thus, this form of leadership demonstrates negative effects in diverse employees.Another study suggested that trust in leaders, effective communication, empowerment, and social cohesion are all integral for successful virtual teams. 37A study suggested that responsible management and strategic leadership are essential for workplace well-being and overall performance when working from home. 90Work uncertainties were identified as key setbacks associated with remote work in a large study across Europe, 6 highlighting the need for clear direction, role identity, and organizational leadership.Interestingly, not only leadership by top management, but also self-leadership in the form of selfdirection and personal initiative were important for productivity during remote work. 36Thus, employees also seem to have a role in managing and organizing themselves in their new home-work office sphere.

Discussion
The aims of this study were to review the relationship between remote work and well-being, including its determinants, as well as its relationship with work-life balance, productivity, job satisfaction, and home office adaptability.This review also aimed to better understand the role of management and leadership in promoting well-being and ideal remote working conditions.
The dimensions associated with remote work life in employees who worked at home during the COVID-19 pandemic have been reviewed.This is important given that it explored various dimensions of remote workplace health and well-being in depth on a global scale.It is novel as it focused on several key areas that are interconnected, including remote workplace well-being and its determinants, work-life balance, productivity, the roles of management and leadership, job satisfaction, and home office adaptability.The review also compared differences in gender across each dimension, highlighting inequities in remote worker wellbeing and aspects of work at home.The review was not limited to early stages of lockdown in March 2020 but included research on remote work throughout 2021 (second and third lockdown waves), demonstrating some longer-term effects of remote work rather than focusing on only the immediate adjustment over the short term.Although this review found variability across studies, including between countries and different employment sectors, several emergent themes were identified.Their implications for the workplace and well-being will be discussed.
First, many employees enjoyed working at home overall.Nevertheless, social isolation and loneliness were identified as barriers in many studies.This review found that remote workplace lone-liness has an impact on well-being and stress.Finding ways to engage workers with their co-workers and with their managers is one solution that may ease isolation, given that several studies found that co-worker and employee support are integral.It is no surprise to find that social support is a prerequisite for employee well-being when working remotely from home.Previous Whitehall II studies on workplace health found that social support was integral for workplace well-being, supporting the findings in this review. 91A previous review similarly recommended that employers should provide social networking opportunities for employees when working from home. 81Some commercially available apps have been recently developed that aim to provide a platform for employees to connect and feel less isolated, such as SquadPal, 92 which is a social remote work messaging app for co-workers.More research is needed to develop evidence-based resources for employees.There is a need for future public health interventions to be tailored to the current needs of remote workers, by targeting the determinants of remote work isolation and loneliness.
Second, work-life balance may be positively or negatively impacted by remote work, which was also found to inf luence wellbeing and stress.This is contingent upon regulation of work hours, and supervisory support.A review suggested that companies will need to find ways to manage the boundaries between work and private life for future remote workers. 81Productivity is both positively and negatively affected by remote work, depending on the contextual living situation.Factors that need to be considered include work office adaptability and accessibility to IT support, which were identified as determinants of successful remote work from home.Employers should provide employees with desks, ergonomic chairs, and other necessary work tools that will promote workplace well-being and productivity in the homework sphere.Similar to our review, previous reviews found that employers should provide employees with sufficient technical support when working from home. 78,81Another review had suggested that companies should have working from home indicators, 81 and another suggested that employee skills training is needed. 93Finally, productivity may be affected by childcaring, hence the need for universal daycare accessibility, not only but especially when people need to work from home.
Third, this review found that leadership plays an important role in remote work.This not only includes leadership style, by being less authoritative or "toxic," but also includes effective communication and trust building.Toxic leadership was associated with higher stress and was not conducive to well-being but rather to workaholism. 50,66This review found that employees had better overall experiences when they had good relationships with their supervisors as well as co-workers.A review suggested that companies should readjust their structure to be more equitable and less hierarchal, whilst ensuring a fine balance between productivity and taking care of the well-being of employees. 94Another review concluded that levels of organizational support are integral for remote workplace well-being. 95Indeed, effort-reward balance and level of control and decisional support had been previously identified as being integral to workplace well-being and health in the classic Whitehall studies in workers. 91Similar strategies should be applied to remote work, whereby managers should aim to promote effort-reward balance and provide employees with greater control.
Self-leadership and identity also appear to be important, as employees who had a clear direction of what they were doing and had created a routine in their remote work life, had a better experience when working from home.Thus, it appears that "it takes two to tango" when working remotely, as one must have self-discipline in tandem with effective leadership from supervisors.A review also suggested that leaders should clarify roles for employees, to set a clear direction when working from home. 81ourth, attention needs to be paid to special groups, especially women and those with children who may find it challenging to cope with both work and childcare.Nevertheless, this review did find that some women enjoyed working from home more than men.Reasons for differences between studies could be due to factors such as accessibility to childcare.Supporting women through universally accessible childcare may reduce any inequalities 96 from remote work.Both gender and access to childcare have been identified as some of the social determinants of health by Raphael, 96 highlighting that these determinants need to be targeted by policymakers in order to ensure that working from home will be equitable.A review also found that women did not have improvements in their health when working from home. 81dditionally, more studies on remote work and domestic abuse are needed, to better understand the needs of vulnerable populations who are working from home and to develop policy and public health interventions.
In addition to gender, more research is needed in diverse groups to better understand diverse needs.One study examined the effects of disability on remote work and found that individuals with a disability were more likely to work from home and could benefit from this new adjustment in the workplace setting. 97Thus, future research could further explore the dynamics between remote work and disabled workers, to support equity when working from home.Additionally, there is a gap in the remote work literature, whereby differences according to age group, ethnicity, and socio-economic status were not evaluated.Future studies should explore these dimensions to better understand and address health and work inequities.Finally, as many studies used self-report questionnaires assessing constructs of interest, there is a need for greater validation of these measures and more universal scales to measure this emerging work-related and well-being dynamic in the home-work sphere.

Conclusion
In summary, this review found that remote workplace well-being varies on a continuum, and factors such as employment characteristics, gender, isolation and loneliness, co-worker support, leadership style and support, as well as home office conditions all play a role.Whereas some workers had a positive experience with remote work, others experienced challenges.Remote work may promote well-being if conditions are supportive and when barriers such as isolation, loneliness, and work-life imbalances are reduced.Productivity and job satisfaction may be enhanced through greater support from managers and by offering employees support with their office setup, and by providing women and those with children with adequate accessibility to childcare.

TwoFigure 1 .
Figure 1.Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) f low diagram of the search.

Table 1 .
Definitions of essential remote work dimensions.
This review broadly included all studies in white-collar workers over 18 years of age.Studies must have been undertaken during the COVID-19 epidemic, while employees worked remotely from home.Studies must have been published in the English language or in one of the languages that the co-authors were f luent in such as French, German, Polish, or Italian.Intervention studies were excluded.Studies were excluded if they did not assess well-being, stress, or workplace satisfaction.Studies on pain were included if they measured 1 or more work-related indicators or mental 29