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Fiol-deRoque MA, Serrano-Ripoll MJ, Mira-Martínez S, Pastor-Moreno G, Sitges C, García-Buades ME, Gervilla E, Garcia-Toro M, Zamanillo-Campos R, Ricci-Cabello I. Process evaluation of PsyCovidApp, a digital tool for mobile devices aimed at protecting the mental health of healthcare professionals during the COVID-19 pandemic: a mixed method study. Front Psychol 2024; 15:1378372. [PMID: 38577118 PMCID: PMC10994142 DOI: 10.3389/fpsyg.2024.1378372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction PsyCovidApp, a digital intervention aimed at safeguarding the mental health of healthcare workers during the COVID-19 pandemic, demonstrated in a randomized clinical trial to yield significant improvements solely among healthcare workers undergoing psychotherapy or receiving psychotropic medication. Objectives (1) To identify contextual factors and mechanisms of action that influenced the impact of PsyCovidApp during the aforementioned trial; (2) To pinpoint enhancements for optimizing its efficacy. Materials and methods For the first objective, a process evaluation was conducted, amalgamating quantitative techniques (surveying 216 healthcare professionals who had utilized PsyCovidApp during the trial) and qualitative methods (in-depth interviews with 16 healthcare workers). The second objective involved a panel of seven experts, utilizing the RAND-UCLA methodology. Results The quantitative study (response rate = 40%) revealed that 22% of respondents had not fully accessed the content of PsyCovidApp. The average usage time was 22.7 min/day, being higher (p < 0.05) among consumers of psychotropic medications. Contents related to relaxation and mindfulness were most highly rated. Acceptability and usefulness scores ranged between 7.3-7.5/10 points, with higher ratings (p < 0.05) among women and older healthcare workers. The qualitative study uncovered that the primary barriers to using PsyCovidApp were workload, lack of time, and exhaustion. Its primary mechanisms of action included emotion identification, mental health regulation (e.g., insomnia, intense emotions), and learning of techniques and skills. The expert panel reached a consensus on 29 proposals to optimize PsyCovidApp. Conclusion The knowledge derived from this study could inform the design and implementation of future similar digital tools.
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Affiliation(s)
- Maria A. Fiol-deRoque
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Majorca, Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | - Maria J. Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Majorca, Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
| | | | - Guadalupe Pastor-Moreno
- Andalusian School of Public Health, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Granada Biosanitary Research Institute, Granada, Spain
| | - Carolina Sitges
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- University of the Balearic Islands, Palma, Spain
| | | | - Elena Gervilla
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- University of the Balearic Islands, Palma, Spain
| | - Mauro Garcia-Toro
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- University of the Balearic Islands, Palma, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Majorca, Palma, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Majorca, Palma, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Blake H, Mancini H, Coyne E, Cooper J, Stanulewicz-Buckley N. Workforce wellbeing centres and their positive role for wellbeing and presenteeism in healthcare workers during the COVID-19 pandemic: secondary analysis of COVID-Well data. BMC Health Serv Res 2024; 24:302. [PMID: 38448919 PMCID: PMC10918935 DOI: 10.1186/s12913-024-10730-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/15/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Supported wellbeing centres established during the COVID-19 pandemic provided high quality rest spaces and access to peer-to-peer psychological first aid for healthcare workers (HCWs). The centres were well accessed and valued by HCWs, but their relationship with wellbeing and job-related factors is not well established. The aim of this study was to explore the relationship between wellbeing centre use, HCWs wellbeing and job-related factors (job stressfulness, job satisfaction, presenteeism, turnover intentions). METHODS Secondary analysis of data from 819 HCWs from an acute hospital trust who completed an online survey in April-July 2020, as part of the COVID-Well study. Measures included the Warwick Edinburgh Mental Wellbeing Scale, and four single-item global measures of job stressfulness, job satisfaction, presenteeism and turnover intentions. ANCOVA models and regression analyses were conducted on these data. RESULTS HCWs who had not accessed the wellbeing centres had lower wellbeing (β = 0.12, p < .001), higher job stressfulness (β = - 0.22, p < .001), lower job satisfaction (β = 0.39, p < .001), higher presenteeism (β = - 0.22, p < .001) and were of younger age (β = 0.09, p = .002). Centre use was associated with wellbeing irrespective of job stressfulness. Those reporting presenteeism and who accessed the centre (M = 3.30, SE = 0.04) had higher wellbeing than those who accessed the centre but did not report presenteeism (M = 3.06, SE = 0.04) (F(1, 791) = 18.65, p < .001, ηp2 = 0.02). Centre use was not significantly associated with turnover intentions (B = - 0.30, p = .13; Wald = 2.26; odds = 0.74), while job stress and job satisfaction showed significant effects. CONCLUSIONS Accessing wellbeing centres was associated with higher wellbeing of HCWs, particularly for those reporting presenteeism. Therefore, the centres may have provided greatest respite and restoration for those present at work but not in optimal health. Younger workers were disproportionately affected in terms of wellbeing, and targeted support for this population is needed. Strategies to decrease presenteeism and maximise job satisfaction are urgently required. Healthcare organisations should provide rest spaces and psychological support to HCWs for the long-term, as part of a systems-wide approach to improving workforce health and wellbeing.
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Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK.
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.
| | - Helen Mancini
- Human Resources, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Emma Coyne
- Clinical Psychology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Joanne Cooper
- Nursing and Midwifery, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Neil-Sztramko SE, Belita E, Hopkins S, Sherifali D, Anderson L, Apatu E, Kapiriri L, Tarride JE, Bellefleur O, Kaasalainen S, Marr S, Dobbins M. What are effective strategies to respond to the psychological impacts of working on the frontlines of a public health emergency? Front Public Health 2023; 11:1282296. [PMID: 38131026 PMCID: PMC10733471 DOI: 10.3389/fpubh.2023.1282296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
Background The COVID-19 pandemic has disrupted the healthcare and public health sectors. The impact of working on the frontlines as a healthcare or public health professional has been well documented. Healthcare organizations must support the psychological and mental health of those responding to future public health emergencies. Objective This systematic review aims to identify effective interventions to support healthcare workers' mental health and wellbeing during and following a public health emergency. Methods Eight scientific databases were searched from inception to 1 November 2022. Studies that described strategies to address the psychological impacts experienced by those responding to a public health emergency (i.e., a pandemic, epidemic, natural disaster, or mass casualty event) were eligible for inclusion. No limitations were placed based on study design, language, publication status, or publication date. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute critical appraisal tools. Discrepancies were resolved through discussion and a third reviewer when needed. Results were synthesized narratively due to the heterogeneity of populations and interventions. Outcomes were displayed graphically using harvest plots. Results A total of 20,018 records were screened, with 36 unique studies included in the review, 15 randomized controlled trials, and 21 quasi-experimental studies. Results indicate that psychotherapy, psychoeducation, and mind-body interventions may reduce symptoms of anxiety, burnout, depression, and Post Traumatic Stress Disorder, with the lowest risk of bias found among psychotherapy interventions. Psychoeducation appears most promising to increase resilience, with mind-body interventions having the most substantial evidence for increases in quality of life. Few organizational interventions were identified, with highly heterogeneous components. Conclusion Promoting healthcare workers' mental health is essential at an individual and health system level. This review identifies several promising practices that could be used to support healthcare workers at risk of adverse mental health outcomes as they respond to future public health emergencies.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=203810, identifier #CRD42020203810 (PROSPERO).
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Affiliation(s)
- Sarah E. Neil-Sztramko
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
| | - Emily Belita
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Stephanie Hopkins
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
| | - Diana Sherifali
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Laura Anderson
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Emma Apatu
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Lydia Kapiriri
- Health, Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Jean Eric Tarride
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
- Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- Programs for Assessment of Technology in Health, Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Olivier Bellefleur
- National Collaborating Centre for Healthy Public Policy, Montreal, QC, Canada
| | | | | | - Maureen Dobbins
- National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
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de Moraes SHM, Cunha IPD, Lemos EF, Abastoflor LLL, Oshiro MDL, Bohrer RTDODA, Sarubbi V, Souza FBD, Nascimento DDGD, do Valle Leone de Oliveira SM. Prevalence and associated factors of mental health disorders among Brazilian healthcare workers in times of the COVID-19 pandemic: A web-based cross-sectional study. PLoS One 2023; 18:e0274927. [PMID: 37279233 DOI: 10.1371/journal.pone.0274927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 05/23/2023] [Indexed: 06/08/2023] Open
Abstract
The COVID-19 pandemic in Brazil affected mental health among healthcare workers. To objective of this study was to evaluate the mental health of healthcare workers in in the central-west region of the Brazil, estimating the prevalence of mental health disorders, and investigating associated factors, perceptions of safety, and self-perceptions about mental health in times of the COVID-19 pandemic. The questionnaire was divided into two parts that included general information and perceptions about the work process and identified symptoms using the Depression Anxiety Stress Scale-21 (DASS-21), and multiple linear regression analysis was conducted. A total of 1,522 healthcare workers participated in the survey. Overall prevalence of symptoms was calculated for depression (58.7%), anxiety (59.7%), and stress (61.7%). Physicians had 3.75 times greater risk of depression (1.59-8.85, 95% CI). Independent variables associated with depression symptoms were not feeling safe with the way services were organized (1.12:1.03-1.21, 95% CI) and self-perception of poor mental health (8.06: 4.03-16.10% CI). Working in management was protective, and married professionals had 12% lower risk of exhibiting symptoms of depression (0.79-0.99, 95% CI). Participants with self-perception of poor mental health had 4.63 greater risk for symptoms of anxiety (2.58-8.31, 95% CI). Protective factors were not having sought support for mental health (0.90: 0.82-0.99, 95% CI), having a graduate degree (0.71: 0.54-0.94, 95% CI), and not having been diagnosed with COVID-19 (0.90: 0.83-0.98, 95% CI). Perception of poor mental health was associated with 6.95-fold greater chance of developing stress symptoms. Protective factors from stress were having a degree in dentistry (0.81: 0.68-0.97, 95% CI), residing in Mato Grosso do Sul (0.91: 0.85-0.98, 95% CI), and not having sought mental health support services (0.88: 0.82-0.95, 95% CI). The prevalence of mental health disorders is high among healthcare workers, and is associated with professional category, organization of services provided, and self-perception of poor mental health, reinforcing the need for preventative measures.
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Affiliation(s)
| | - Inara Pereira da Cunha
- Escola de Saúde Pública Dr. Jorge David Nasser, Campo Grande, Mato Grosso do Sul, Brasil
| | | | - Lesly Lidiane Ledezma Abastoflor
- Fiocruz Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brasil
- Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brasil
| | | | | | - Vicente Sarubbi
- Universidade Estadual de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brasil
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Tamminga SJ, Emal LM, Boschman JS, Levasseur A, Thota A, Ruotsalainen JH, Schelvis RM, Nieuwenhuijsen K, van der Molen HF. Individual-level interventions for reducing occupational stress in healthcare workers. Cochrane Database Syst Rev 2023; 5:CD002892. [PMID: 37169364 PMCID: PMC10175042 DOI: 10.1002/14651858.cd002892.pub6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Healthcare workers can suffer from work-related stress as a result of an imbalance of demands, skills and social support at work. This may lead to stress, burnout and psychosomatic problems, and deterioration of service provision. This is an update of a Cochrane Review that was last updated in 2015, which has been split into this review and a review on organisational-level interventions. OBJECTIVES: To evaluate the effectiveness of stress-reduction interventions targeting individual healthcare workers compared to no intervention, wait list, placebo, no stress-reduction intervention or another type of stress-reduction intervention in reducing stress symptoms. SEARCH METHODS: We used the previous version of the review as one source of studies (search date: November 2013). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL, Web of Science and a trials register from 2013 up to February 2022. SELECTION CRITERIA We included randomised controlled trials (RCT) evaluating the effectiveness of stress interventions directed at healthcare workers. We included only interventions targeted at individual healthcare workers aimed at reducing stress symptoms. DATA COLLECTION AND ANALYSIS: Review authors independently selected trials for inclusion, assessed risk of bias and extracted data. We used standard methodological procedures expected by Cochrane. We categorised interventions into ones that: 1. focus one's attention on the (modification of the) experience of stress (thoughts, feelings, behaviour); 2. focus one's attention away from the experience of stress by various means of psychological disengagement (e.g. relaxing, exercise); 3. alter work-related risk factors on an individual level; and ones that 4. combine two or more of the above. The crucial outcome measure was stress symptoms measured with various self-reported questionnaires such as the Maslach Burnout Inventory (MBI), measured at short term (up to and including three months after the intervention ended), medium term (> 3 to 12 months after the intervention ended), and long term follow-up (> 12 months after the intervention ended). MAIN RESULTS: This is the second update of the original Cochrane Review published in 2006, Issue 4. This review update includes 89 new studies, bringing the total number of studies in the current review to 117 with a total of 11,119 participants randomised. The number of participants per study arm was ≥ 50 in 32 studies. The most important risk of bias was the lack of blinding of participants. Focus on the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Fifty-two studies studied an intervention in which one's focus is on the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.52 to -0.23; 41 RCTs; 3645 participants; low-certainty evidence) and medium term (SMD -0.43, 95% CI -0.71 to -0.14; 19 RCTs; 1851 participants; low-certainty evidence). The SMD of the short-term result translates back to 4.6 points fewer on the MBI-emotional exhaustion scale (MBI-EE, a scale from 0 to 54). The evidence is very uncertain (one RCT; 68 participants, very low-certainty evidence) about the long-term effect on stress symptoms of focusing one's attention on the experience of stress. Focus away from the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Forty-two studies studied an intervention in which one's focus is away from the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (SMD -0.55, 95 CI -0.70 to -0.40; 35 RCTs; 2366 participants; low-certainty evidence) and medium term (SMD -0.41 95% CI -0.79 to -0.03; 6 RCTs; 427 participants; low-certainty evidence). The SMD on the short term translates back to 6.8 fewer points on the MBI-EE. No studies reported the long-term effect. Focus on work-related, individual-level factors versus no intervention/no stress-reduction intervention Seven studies studied an intervention in which the focus is on altering work-related factors. The evidence is very uncertain about the short-term effects (no pooled effect estimate; three RCTs; 87 participants; very low-certainty evidence) and medium-term effects and long-term effects (no pooled effect estimate; two RCTs; 152 participants, and one RCT; 161 participants, very low-certainty evidence) of this type of stress management intervention. A combination of individual-level interventions versus no intervention/wait list/no stress-reduction intervention Seventeen studies studied a combination of interventions. In the short-term, this type of intervention may result in a reduction in stress symptoms (SMD -0.67 95%, CI -0.95 to -0.39; 15 RCTs; 1003 participants; low-certainty evidence). The SMD translates back to 8.2 fewer points on the MBI-EE. On the medium term, a combination of individual-level interventions may result in a reduction in stress symptoms, but the evidence does not exclude no effect (SMD -0.48, 95% CI -0.95 to 0.00; 6 RCTs; 574 participants; low-certainty evidence). The evidence is very uncertain about the long term effects of a combination of interventions on stress symptoms (one RCT, 88 participants; very low-certainty evidence). Focus on stress versus other intervention type Three studies compared focusing on stress versus focusing away from stress and one study a combination of interventions versus focusing on stress. The evidence is very uncertain about which type of intervention is better or if their effect is similar. AUTHORS' CONCLUSIONS Our review shows that there may be an effect on stress reduction in healthcare workers from individual-level stress interventions, whether they focus one's attention on or away from the experience of stress. This effect may last up to a year after the end of the intervention. A combination of interventions may be beneficial as well, at least in the short term. Long-term effects of individual-level stress management interventions remain unknown. The same applies for interventions on (individual-level) work-related risk factors. The bias assessment of the studies in this review showed the need for methodologically better-designed and executed studies, as nearly all studies suffered from poor reporting of the randomisation procedures, lack of blinding of participants and lack of trial registration. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence. Last, there is a need for more studies on interventions which focus on work-related risk factors.
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Affiliation(s)
- Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Lima M Emal
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Julitta S Boschman
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Alice Levasseur
- Faculté des sciences de l'éducation, Université Laval, Québec, Canada
| | | | - Jani H Ruotsalainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Roosmarijn Mc Schelvis
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, Netherlands
| | - Karen Nieuwenhuijsen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Henk F van der Molen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Liu X, Xu Y, Xu H, Jiang L, Wang T, Chen C, Lee A, Zhu P. Anxiety and sleep quality among front-line nurses treating first wave COVID-19 in China: The mediating role of mindfulness. Arch Psychiatr Nurs 2022; 41:341-347. [PMID: 36428069 PMCID: PMC9479381 DOI: 10.1016/j.apnu.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/07/2021] [Accepted: 09/10/2022] [Indexed: 12/14/2022]
Abstract
AIM To explore anxiety, sleep quality, and mindfulness of frontline nurses at the initial epicenter of the pandemic, to examine the mediating effects of mindfulness. BACKGROUND COVID-19 was first identified in Wuhan, China in January 2020. Nurses were at the forefront of care and treatment across hospitals in response to the pandemic. METHODS Single site cross-sectional survey conducted in Wuhan province (China) between March and April in 2020. Quantitative analysis of survey data from N118 nurses working in the frontline COVID response. Questionnaires included: The general information questionnaire, the Self-Anxiety Scale, the Short Inventory of Mindfulness, and the Pittsburgh Sleep Quality Index. RESULTS Front-line nurses' anxiety was positively associated with sleep quality and mindfulness was negatively associated with anxiety and sleep quality. Mindfulness had a mediating role on anxiety and sleep quality, with intermediary adjustment effects (ES = 0.136, 95 % CI 0.02 to 0.26), accounting for 21.9 % of the total effect ratio. CONCLUSIONS Anxiety causes a reduction in sleep quality and mindfulness can help with anxiety. Mindfulness strategies may help during periods of higher anxiety in the workplace; however, other factors must be considered. Further research is required on strategies for assisting nurses during periods of extreme anxiety.
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Affiliation(s)
- Xinyi Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yingying Xu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Huiwen Xu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Lin Jiang
- School of Nursing, Yangzhou University, Yangzhou, China; The First People's Hospital of Jiangxia District, Wuhan City, Hubei, China
| | - Ting Wang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Chen Chen
- School of Nursing, Yangzhou University, Yangzhou, China
| | | | - Pingting Zhu
- School of Nursing, Yangzhou University, Yangzhou, China; Jiangsu Key Laboratory of Zoonosis, Yangzhou, China.
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Akinsulore A, Aloba O, Oginni O, Oloniniyi I, Ibigbami O, Seun-Fadipe CT, Opakunle T, Owojuyigbe AM, Olibamoyo O, Mapayi B, Okorie VO, Adewuya AO. Developing an mHealth Intervention to Reduce COVID-19-Associated Psychological Distress Among Health Care Workers in Nigeria: Protocol for a Design and Feasibility Study. JMIR Res Protoc 2022; 11:e36174. [PMID: 36318638 PMCID: PMC9674083 DOI: 10.2196/36174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 09/09/2022] [Accepted: 10/25/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Globally, COVID-19-related psychological distress is seriously eroding health care workers' mental health and well-being, especially in low-income countries like Nigeria. The use of mobile health (mHealth) interventions is now increasingly recognized as an innovative approach that may improve mental health and well-being. This project aims to develop an mHealth psychological intervention (mPsyI) to reduce COVID-19-related psychological distress among health care workers in Nigeria. OBJECTIVE Our objective is to present a study protocol to determine the level of COVID-19-related psychological distress among health care workers in Nigeria; explore health care workers' experience of COVID-19-related psychological distress; develop and pilot test mPsyI to reduce this distress; and assess the feasibility of this intervention (such as usability, engagement, and satisfaction). METHODS A mixed (quantitative and qualitative) methods approach is used in which health care workers will be recruited from 2 tertiary health care facilities in southwest Nigeria. The study is divided into 4 phases based on the study objectives. Phase 1 involves a quantitative survey to assess the type and levels of psychosocial distress. Phase 2 collects qualitative data on psychosocial distress among health care workers. Phase 3 involves development of the mHealth-based psychological intervention, and phase 4 is a mixed methods study to assess the feasibility and acceptability of the intervention. RESULTS This study was funded in November 2020 by the Global Effort on COVID-19 Health Research, and collection of preliminary baseline data started in July 2021. CONCLUSIONS This is the first study to report the development of an mHealth-based intervention to reduce COVID-19-related psychological distress among health care workers in Nigeria. Using a mixed methods design in this study can potentially facilitate the adaptation of an evidence-based treatment method that is culturally sensitive and cost-effective for the management of COVID-19-related psychological distress among health care workers in Nigeria. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/36174.
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Affiliation(s)
- Adesanmi Akinsulore
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Olutayo Aloba
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Olakunle Oginni
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Ibidunni Oloniniyi
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Olanrewaju Ibigbami
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | | | - Tolulope Opakunle
- Department of Mental Health, State Specialist Hospital, Osogbo, Nigeria
| | - Afolabi Muyiwa Owojuyigbe
- Department of Anaesthesia and Intensive Care, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Anaesthesia and Intensive Care, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Olushola Olibamoyo
- Department of Behavioural Medicine, Lagos State University College of Medicine, Lagos, Nigeria
| | - Boladale Mapayi
- Department of Mental Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Victor Ogbonnaya Okorie
- Department of Agricultural Extension and Rural Development, Obafemi Awolowo University, Ile-Ife, Nigeria
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Effects of a smartphone-based nursing counseling and feedback system for women with gestational diabetes on compliance, glycemic control, and satisfaction: a randomized controlled study. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01142-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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9
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Dominguez-Rodriguez A, Martínez-Arriaga RJ, Herdoiza-Arroyo PE, Bautista-Valerio E, de la Rosa-Gómez A, Castellanos Vargas RO, Lacomba-Trejo L, Mateu-Mollá J, Lupercio Ramírez MDJ, Figueroa González JA, Ramírez Martínez FR. E-Health Psychological Intervention for COVID-19 Healthcare Workers: Protocol for its Implementation and Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912749. [PMID: 36232049 PMCID: PMC9566813 DOI: 10.3390/ijerph191912749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/24/2022] [Accepted: 09/30/2022] [Indexed: 05/13/2023]
Abstract
(1) Background: Healthcare workers have been affected by the COVID-19 pandemic. Digital interventions have been carried out that have been effective with this population; however, few have been reported in Latin America. Our aim is to describe the components and methods to evaluate the feasibility and utility of an online multi-component psychological intervention for healthcare workers in Mexico during COVID-19. (2) Methods: This study is a randomized clinical trial with two arms: (1) self-applied intervention and (2) intervention delivered online by therapists. The participants are randomly assigned to one arm, receiving the same treatment contents in both groups. The "Personal COVID" intervention consists of an internet platform containing 9 nuclear and 3 complementary modules. The objectives of the intervention are: (1) to reduce anxiety, depressive symptoms, burnout, and compassion fatigue, and (2) to increase the quality of life, sleep quality, self-care, and their skills to give bad news. The protocol has been registered on ClinicalTrials.gov (identifier: NCT04890665). (3) Discussion: This protocol is designed according to the highest scientific standards following the SPIRIT guidelines. The "Personal COVID" intervention is expected to be of high efficacy in treating the emotional distress of healthcare workers and promoting their health during the COVID-19 pandemic.
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Affiliation(s)
| | - Reyna Jazmín Martínez-Arriaga
- Departamento de Clínicas de Salud Mental, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
- Correspondence: ; Tel.: +52-3310585200
| | | | - Eduardo Bautista-Valerio
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Mexico City 54090, Mexico
| | - Anabel de la Rosa-Gómez
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Mexico City 54090, Mexico
| | | | - Laura Lacomba-Trejo
- Department of Personality, Evaluation and Psychological Treatment, Universitat de València, 46010 Valencia, Spain
| | - Joaquín Mateu-Mollá
- Health Sciences Area, Valencian International University, 46002 Valencia, Spain
| | - Miriam de Jesús Lupercio Ramírez
- Maestría en Psicología de la Salud, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco 44340, Mexico
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Culbreth R, Spratling R. Mindfulness: Implications for Research Methods. J Pediatr Health Care 2022; 36:286-290. [PMID: 35168819 DOI: 10.1016/j.pedhc.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 10/19/2022]
Abstract
Mindfulness, defined as focusing on the present moment without judgment, has shown clinical efficacy in pediatric research. Mindfulness-based interventions reduce anxiety, depression, and burnout in pediatric nurses and health care providers, and improve asthmatic symptoms, eating disorders, and stress in pediatric patients. We provide an overview of mindfulness-based interventions in pediatric research, a summary of the techniques and exercises that comprise mindfulness, and a list of mindfulness measures that can be used for evaluating mindful practices in research. We aimed to provide an educational overview of how mindfulness can be incorporated into research methods, including interventions in pediatric health care.
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11
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Dong L, Meredith LS, Farmer CM, Ahluwalia SC, Chen PG, Bouskill K, Han B, Qureshi N, Dalton S, Watson P, Schnurr PP, Davis K, Tobin JN, Cassells A, Gidengil CA. Protecting the mental and physical well-being of frontline health care workers during COVID-19: Study protocol of a cluster randomized controlled trial. Contemp Clin Trials 2022; 117:106768. [PMID: 35470104 PMCID: PMC9023359 DOI: 10.1016/j.cct.2022.106768] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 11/18/2022]
Abstract
Introduction The COVID-19 pandemic has placed health care workers at unprecedented risk of stress, burnout, and moral injury. This paper describes the design of an ongoing cluster randomized controlled trial to compare the effectiveness of Stress First Aid (SFA) to Usual Care (UC) in protecting the well-being of frontline health care workers. Methods We plan to recruit a diverse set of hospitals and health centers (eight matched pairs of hospitals and six pairs of centers), with a goal of approximately 50 HCW per health center and 170 per hospital. Participating sites in each pair are randomly assigned to SFA or UC (i.e., whatever psychosocial support is currently being received by HCW). Each site identified a leader to provide organizational support of the study; SFA sites also identified at least one champion to be trained in the intervention. Using a “train the trainer” model, champions in turn trained their peers in selected HCW teams or units to implement SFA over an eight-week period. We surveyed HCW before and after the implementation period. The primary outcomes are posttraumatic stress disorder and general psychological distress; secondary outcomes include depression and anxiety symptoms, sleep problems, social functioning problems, burnout, moral distress, and resilience. In addition, through in-depth qualitative interviews with leaders, champions, and HCW, we assessed the implementation of SFA, including acceptability, feasibility, and uptake. Discussion Results from this study will provide initial evidence for the application of SFA to support HCW well-being during a pandemic. Trial registration: (Clinicaltrials.govNCT04723576).
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Affiliation(s)
- Lu Dong
- RAND Corporation, Santa Monica, CA, USA.
| | | | | | - Sangeeta C Ahluwalia
- RAND Corporation, Santa Monica, CA, USA; UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | | | | | - Bing Han
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | | | | | | | - Paula P Schnurr
- National Center for PTSD, VT, USA; Geisel School of Medicine at Dartmouth, NH, USA
| | | | - Jonathan N Tobin
- Clinical Directors Network (CDN), NY, USA; The Rockefeller University Center for Clinical and Translational Science, NY, USA
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12
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David E, DePierro JM, Marin DB, Sharma V, Charney DS, Katz CL. COVID-19 Pandemic Support Programs for Healthcare Workers and Implications for Occupational Mental Health: A Narrative Review. Psychiatr Q 2022; 93:227-247. [PMID: 34606067 PMCID: PMC8488324 DOI: 10.1007/s11126-021-09952-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2021] [Indexed: 02/08/2023]
Abstract
This narrative review aims to summarize initiatives developed during the COVID-19 pandemic to support healthcare workers' emotional well-being within the context of a pre-existing framework of occupational mental health guidelines. This occupational mental health framework integrates principles from multiple disciplines to optimize prevention and management of mental health issues among employees. We conducted an online search on Medline/PubMed, Cochrane Library, and Embase for studies that reported on design or execution of medical institution-based interventions, aiming to support healthcare worker mental health during the COVID-19 pandemic. Inclusion criteria was intentionally broad in order to incorporate as many types of interventions at varying stages of development or evaluation. We included 31 studies in our review that reported on newly designed psychological support interventions for healthcare workers (HCW) during the COVID-19 pandemic. We found that most programs commonly supported HCW mental health through offering one or more of the following initiatives: expanded basic need resources/services, additional workplace training programs that bolstered professional preparedness while also indirectly boosting HCW emotional health, and/or expanded psychological support programs, such as peer support programs, psychoeducational or counseling services. Most programs, however, did not consider methods to ensure program longevity or sustainability. The COVID-19 pandemic has underscored the acuity of HCW mental health issues and is likely to leave long lasting mental health strains among HCW. This pandemic is a critical point in time to catalyze much needed progress in reducing stigma and expanding HCW mental health care access.
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Affiliation(s)
- Eden David
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Jonathan M DePierro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah B Marin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vanshdeep Sharma
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dennis S Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Craig L Katz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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13
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Serrano-Ripoll MJ, Zamanillo-Campos R, Fiol-DeRoque MA, Castro A, Ricci-Cabello I. Impact of Smartphone App-Based Psychological Interventions for Reducing Depressive Symptoms in People With Depression: Systematic Literature Review and Meta-analysis of Randomized Controlled Trials. JMIR Mhealth Uhealth 2022; 10:e29621. [PMID: 35084346 PMCID: PMC8832272 DOI: 10.2196/29621] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/16/2021] [Accepted: 11/11/2021] [Indexed: 02/06/2023] Open
Abstract
Background Depression is a serious, disabling mental disorder that severely affects quality of life. Patients with depression often do not receive adequate treatment. App-based psychotherapy is considered to have great potential to treat depression owing to its reach and easy accessibility. Objective We aim to analyze the impact of app-based psychological interventions for reducing depressive symptoms in people with depression. Methods We conducted a systematic literature review and meta-analysis. We searched Medline, Embase, PsycINFO, Web of Science, and Cochrane Central Register of Controlled Trials from inception to December 23, 2020. We selected randomized controlled trials to examine the impact of app-based psychological interventions for reducing depressive symptoms in people with depression. Study selection, data extraction, and critical appraisal (using the Cochrane Risk of Bias tool for randomized studies and the ROBINS-I tool for nonrandomized studies) were conducted independently by 2 reviewers. Where possible, we pooled data using random effects meta-analyses to obtain estimates of the effect size of the intervention. We conducted post hoc meta-regression analyses to explore the factors associated with intervention success. Results After screening 3468 unique references retrieved from bibliographic searches and assessing the eligibility of 79 full texts, we identified 12 trials (2859 participants) evaluating 14 different interventions. Of 14 trials, 7 (58%) were conducted in the United States; 3 (25%) trials, in Asia (Japan, South Korea, and China); 1 (8%) trial, in Australia; and 1 (8%) trial, in Germany. Of the 12 trials, 5 (42%) trials presented a low risk of bias. The mean duration of the interventions was 6.6 (SD 2.8) weeks. Two-thirds of the interventions were based on cognitive behavioral therapy alone or included it in combination with cognitive control therapy, positive psychology, brief behavioral activation, or mindfulness- and acceptance-based therapy. With no evidence of publication bias, a pooled analysis of 83% (10/12) of the trials and 86% (12/14) of the interventions showed that app-based interventions, compared with a control group receiving usual care or minimal intervention, produced a moderate reduction in depressive symptoms (standardized mean difference [SMD] −0.51, 95% CI −0.69 to −0.33; 2018/2859, 70.58% of the participants; I2=70%). Our meta-regression analyses indicated that there was a greater reduction in symptoms of depression (P=.04) in trials that included participants with moderate to severe depression (SMD −0.67, 95% CI −0.79 to −0.55), compared with trials with participants exhibiting mild to moderate depression (SMD −0.15, 95% CI −0.43 to −0.12). Conclusions App-based interventions targeted at people with depression produce moderate reductions in the symptoms of depression. More methodologically robust trials are needed to confirm our findings, determine which intervention features are associated with greater improvements, and identify those populations most likely to benefit from this type of intervention. Trial Registration PROSPERO CRD42019145689; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=145689
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Affiliation(s)
- Maria J Serrano-Ripoll
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.,Balearic Islands Health Services, Primary Care Research Unit of Mallorca, Palma de Mallorca, Spain.,Primary Care Prevention and Health Promotion Network, RedIAPP, Barcelona, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.,Balearic Islands Health Services, Primary Care Research Unit of Mallorca, Palma de Mallorca, Spain
| | - Maria A Fiol-DeRoque
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.,Balearic Islands Health Services, Primary Care Research Unit of Mallorca, Palma de Mallorca, Spain
| | - Adoración Castro
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.,Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.,Balearic Islands Health Services, Primary Care Research Unit of Mallorca, Palma de Mallorca, Spain.,Centro de Investigación Biomedica en Red (CIBERESP), Madrid, Spain
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Fernández-Ávalos MI, Pérez-Marfil MN, Fernández-Alcántara M, Ferrer-Cascales R, Cruz-Quintana F, Turnbull OH. Post-Traumatic Growth in Professionals Caring for People with Intellectual Disabilities during COVID-19: A Psychological Intervention. Healthcare (Basel) 2021; 10:healthcare10010048. [PMID: 35052212 PMCID: PMC8775061 DOI: 10.3390/healthcare10010048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Health professionals present a greater vulnerability to the effects of COVID-19 on their mental health, especially those who work with vulnerable groups such as those who suffer from intellectual disability (ID). The objective of the present research was to develop and verify the effectiveness of a psychological intervention for professionals in the field of ID to improve their mental health during this health crisis. METHODS A total of 32 professionals participated. The variables measured were: post-traumatic growth, mental health, burnout, coping strategies, resilience, life satisfaction, optimism, and cognitive and affective empathy. RESULTS The results revealed statistically significant differences in the post-traumatic growth variable. In the rest of the variables (mental health, burnout, coping strategies, resilience, vital satisfaction, optimism, and empathy), no significant differences between groups were found. CONCLUSIONS An increase in the levels of post-traumatic growth was observed in the intervention group after a brief online psychological intervention. However, given the small sample size, these results should be taken with caution. Institutions should foster and promote interventions aimed at reducing the high emotional impact produced by COVID-19 in professionals that care for people diagnosed with ID.
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Affiliation(s)
- María Inmaculada Fernández-Ávalos
- Faculty of Health Sciences, Department of Health Psychology, University of Alicante, 03690 Alicante, Spain; (M.I.F.-Á.); (M.F.-A.); (R.F.-C.)
| | - María Nieves Pérez-Marfil
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain;
- End-of-Life Research Network (EOL), 18071 Granada, Spain
- Correspondence:
| | - Manuel Fernández-Alcántara
- Faculty of Health Sciences, Department of Health Psychology, University of Alicante, 03690 Alicante, Spain; (M.I.F.-Á.); (M.F.-A.); (R.F.-C.)
- End-of-Life Research Network (EOL), 18071 Granada, Spain
| | - Rosario Ferrer-Cascales
- Faculty of Health Sciences, Department of Health Psychology, University of Alicante, 03690 Alicante, Spain; (M.I.F.-Á.); (M.F.-A.); (R.F.-C.)
| | - Francisco Cruz-Quintana
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain;
- End-of-Life Research Network (EOL), 18071 Granada, Spain
| | - Oliver Hugh Turnbull
- School of Psychology Brigantia Building, Bangor University, Bangor LL57 2AS, UK;
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15
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Bureau R, Bemmouna D, Faria CGF, Goethals AAC, Douhet F, Mengin AC, Fritsch A, Zinetti Bertschy A, Frey I, Weiner L. My Health Too: Investigating the Feasibility and the Acceptability of an Internet-Based Cognitive-Behavioral Therapy Program Developed for Healthcare Workers. Front Psychol 2021; 12:760678. [PMID: 34925163 PMCID: PMC8677821 DOI: 10.3389/fpsyg.2021.760678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background: The COVID-19 crisis has had a considerable mental health impact on healthcare workers. High levels of psychological distress are expected to have a significant impact on healthcare systems, warranting the need for evidence-based psychological interventions targeting stress and fostering resilience in this population. Online cognitive behavioral therapy (CBT) has proved to be effective in targeting stress and promoting resilience. However, online CBT programs targeting stress in healthcare workers are lacking. Objective: The aim of our study is to evaluate the feasibility and acceptability of an internet-based CBT intervention, the My Health Too program we developed during the first COVID-19 epidemic peak in France. Methods: We recruited 10 participants among Alsace region hospital staff during the first peak of the pandemic in France. They were given 1 week to test the website and were then asked to answer an internet survey and a semi-structured phone interview. Results: We conducted a thematic analysis of the content from the phone interviews. Major themes were identified, discussed and coded: the technical aspects, the content of the website and its impact on participants' emotions and everyday life. Overall, the participants reported finding the website easy to use and interactive. They described the resources as easy to understand, readily usable, and useful in inducing calm and in helping them practice self-compassion. Conclusion: Our results suggest that the My Health Too online CBT program is highly feasible and acceptable to healthcare workers during the highly stressful times of the pandemic peak. The feedback provided helped to improve the program whose efficacy is to be tested.
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Affiliation(s)
- Raven Bureau
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Doha Bemmouna
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Department of Psychology, Laboratoire de Psychologie des Cognitions, Université de Strasbourg, Strasbourg, France
| | | | - Anne-Aline Catteau Goethals
- Department of Psychology, Laboratoire de Psychologie des Cognitions, Université de Strasbourg, Strasbourg, France
| | - Floriane Douhet
- Department of Psychology, Laboratoire de Psychologie des Cognitions, Université de Strasbourg, Strasbourg, France
| | | | - Aurélie Fritsch
- Department of Psychology, Laboratoire de Psychologie des Cognitions, Université de Strasbourg, Strasbourg, France
| | | | - Isabelle Frey
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Department of Psychology, Laboratoire de Psychologie des Cognitions, Université de Strasbourg, Strasbourg, France
| | - Luisa Weiner
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Department of Psychology, Laboratoire de Psychologie des Cognitions, Université de Strasbourg, Strasbourg, France
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16
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Gupta S, Kumar M, Rozatkar AR, Basera D, Purwar S, Gautam D, Jahan R. Feasibility and Effectiveness of Telecounseling on the Psychological Problems of Frontline Healthcare Workers Amidst COVID-19: A Randomized Controlled Trial from Central India. Indian J Psychol Med 2021; 43:343-350. [PMID: 34385729 PMCID: PMC8327876 DOI: 10.1177/02537176211024537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Preliminary reports suggest that during the COVID-19 pandemic, telecounseling could be an effective model of psychological intervention for the frontline healthcare workers (fHCW) with psychological problems. Literature is sparse in this area, particularly from low- and middle-income countries, including India. We aimed to investigate the feasibility and the effectiveness of telecounseling (vs. general education) on the psychological problems of the fHCW over three time-points (baseline vs. end-of-session and at two and four weeks after the intervention). METHODS The study followed a single-blind, active arm versus general education, parallel-group randomized control design, with participant allocation in 1:1. Active healthcare workers (HCWs) with mild- to-severe or clinically concerning scores on any of the sub-scales of Depression, Anxiety and Stress Scale (DASS-21) or Impact of Event Scale-Revised (IES-R; represented by higher scores) were included, while those with known psychiatric illness were excluded. Chi-square and Mann-Whitney U test and linear-mixed effect model (group-, time, and group by time-effect) were used for analysis. RESULTS There were no baseline group differences (telecounseling group, active arm, n = 9; general education group, control arm, n = 10). A significant time-effect (P = 0.044 to <.001) was found on DASS-21 on intention-to-treat analysis. Per-protocol analysis, additionally, found a significant group effect on Impact of Event Scale-Revised (IES-R; P = 0.036). A significant random effect of the participants was also found (P <.001). CONCLUSION Telecounseling could be a feasible and scalable model of psychological interventions for the fHCW with psychological problems, albeit with some feasibility challenges.
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Affiliation(s)
- Snehil Gupta
- Dept. of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Mohit Kumar
- Dept. of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Abhijit R Rozatkar
- Dept. of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Devendra Basera
- Dept. of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Shashank Purwar
- Dept. of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Disha Gautam
- Dept. of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Rahat Jahan
- Dept. of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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17
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Fiol-DeRoque MA, Serrano-Ripoll MJ, Jiménez R, Zamanillo-Campos R, Yáñez-Juan AM, Bennasar-Veny M, Leiva A, Gervilla E, García-Buades ME, García-Toro M, Alonso-Coello P, Pastor-Moreno G, Ruiz-Pérez I, Sitges C, García-Campayo J, Llobera-Cánaves J, Ricci-Cabello I. A Mobile Phone-Based Intervention to Reduce Mental Health Problems in Health Care Workers During the COVID-19 Pandemic (PsyCovidApp): Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e27039. [PMID: 33909587 PMCID: PMC8133164 DOI: 10.2196/27039] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/08/2021] [Accepted: 03/31/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The global health emergency generated by the COVID-19 pandemic is posing an unprecedented challenge to health care workers, who are facing heavy workloads under psychologically difficult situations. Mental mobile Health (mHealth) interventions are now being widely deployed due to their attractive implementation features, despite the lack of evidence about their efficacy in this specific population and context. OBJECTIVE The aim of this trial is to evaluate the effectiveness of a psychoeducational, mindfulness-based mHealth intervention to reduce mental health problems in health care workers during the COVID-19 pandemic. METHODS We conducted a blinded, parallel-group, controlled trial in Spain. Health care workers providing face-to-face health care to patients with COVID-19 were randomly assigned (1:1) to receive the PsyCovidApp intervention (an app targeting emotional skills, healthy lifestyle behavior, burnout, and social support) or a control app (general recommendations about mental health care) for 2 weeks. The participants were blinded to their group allocation. Data were collected telephonically at baseline and after 2 weeks by trained health psychologists. The primary outcome was a composite of depression, anxiety, and stress (overall score on the Depression Anxiety Stress Scale-21 [DASS-21]). Secondary outcomes were insomnia (Insomnia Severity Index), burnout (Maslach Burnout Inventory Human Services Survey), posttraumatic stress (Davidson Trauma Scale), self-efficacy (General Self-Efficacy Scale), and DASS-21 individual scale scores. Differences between groups were analyzed using general linear modeling according to an intention-to-treat protocol. Additionally, we measured the usability of the PsyCovidApp (System Usability Scale). The outcome data collectors and trial statisticians were unaware of the treatment allocation. RESULTS Between May 14 and July 25, 2020, 482 health care workers were recruited and randomly assigned to PsyCovidApp (n=248) or the control app (n=234). At 2 weeks, complete outcome data were available for 436/482 participants (90.5%). No significant differences were observed between the groups at 2 weeks in the primary outcome (standardized mean difference -0.04; 95% CI -0.11 to 0.04; P=.15) or in the other outcomes. In our prespecified subgroup analyses, we observed significant improvements among health care workers consuming psychotropic medications (n=79) in the primary outcome (-0.29; 95% CI -0.48 to -0.09; P=.004), and in posttraumatic stress, insomnia, anxiety, and stress. Similarly, among health care workers receiving psychotherapy (n=43), we observed improvements in the primary outcome (-0.25; 95% CI -0.49 to -0.02; P=.02), and in insomnia, anxiety, and stress. The mean usability score of PsyCovidApp was high (87.21/100, SD 12.65). After the trial, 208/221 participants in the intervention group (94.1%) asked to regain access to PsyCovidApp, indicating high acceptability. CONCLUSIONS In health care workers assisting patients with COVID-19 in Spain, PsyCovidApp, compared with a control app, reduced mental health problems at 2 weeks only among health care workers receiving psychotherapy or psychotropic medications. TRIAL REGISTRATION ClinicalTrials.gov NCT04393818; https://clinicaltrials.gov/ct2/show/NCT04393818.
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Affiliation(s)
- Maria Antònia Fiol-DeRoque
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
| | - Maria Jesús Serrano-Ripoll
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Rafael Jiménez
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Rocío Zamanillo-Campos
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Department of Health, Valencian International University (VIU), Valencia, Spain
| | - Aina María Yáñez-Juan
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Research Group on Global Health & Human Development, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Miquel Bennasar-Veny
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Alfonso Leiva
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
| | - Elena Gervilla
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - M Esther García-Buades
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Mauro García-Toro
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
| | - Pablo Alonso-Coello
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau, Iberoamerican Cochrane Centre, Barcelona, Spain
| | - Guadalupe Pastor-Moreno
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - Isabel Ruiz-Pérez
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
| | - Carolina Sitges
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Department of Psychology, University of the Balearic Islands (UIB), Palma de Mallorca, Spain
- Department of Psychology, Research Institute of Health Sciences, Palma de Mallorca, Spain
| | - Javier García-Campayo
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
- Aragon Institute for Health Research, Miguel Servet University Hospital, Zaragoza, Spain
| | - Joan Llobera-Cánaves
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Primary Care Prevention and Health Promotion Research Network, Madrid, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- CIBER de Epidemiología y Salud Pública, Madrid, Spain
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Sun Z, Yu C, Zhou Y, Liu Z. Psychological Interventions for Healthcare Providers With PTSD in Life-Threatening Pandemic: Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:697783. [PMID: 34393858 PMCID: PMC8358144 DOI: 10.3389/fpsyt.2021.697783] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aims to evaluate the effect of psychological interventions on healthcare providers (HCP) with post-traumatic stress disorder (PTSD) due to their necessary exposure in life-threatening pandemic. Methods: We performed a systematic research on Medline, Embase, Cochrane Central, PsycInfo, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, ProQuest PTSD Pubs ProQuest Dissertations & Theses Global, and other gray databases by January 2021. Randomized controlled trials involving therapeutic interventions for HCP with PTSD were included. The primary outcome was PTSD symptom severity. Summary standardized mean differences (SMDs) and 95% confidence intervals were estimated using inverse variance meta-analysis with fixed effects. Risks of bias were assessed using Cochrane methods. Results: Among 773 citations, this review includes six studies, randomizing 810 participants. A meta-analysis of the effect of interventions compared to placebo showed a significant reduction of PTSD symptom severity: Cognitive Behavioral Therapy-Brief (CBT-B) (M = 27.80, 95% CI: 17.12, 38.48), Cognitive Behavioral Therapy-Long (CBT-L) (M = 26.50, 95% CI: 15.75, 37.25), and Mindfulness-Based Stretching and Deep Breathing Exercise (MBX) (M = 17.2, 95% CI: 6.57, 27.83). CBT-L and CBT-B also showed a significant effect on depression severity. Conclusions: The most effective and feasible treatment option for HCP with PTSD is still unclear, but CBT and MBX have displayed the most significant effects based on current limited evidence. Future research in this area-preferably large robust randomized controlled trials-is much needed.
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Affiliation(s)
- Zeyuan Sun
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Chuan Yu
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Yue Zhou
- Harvard Law School, Harvard University, Cambridge, MA, United States
| | - Zhenmi Liu
- West China School of Public Health, Sichuan University, Chengdu, China
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