Dataset Information

The efficacy of the internet-based stress recovery intervention FOREST for nurses amid the COVID-19 pandemic: A randomized controlled trial.

ABSTRACT:

Background

The COVID-19 pandemic demanded exceptional physical and mental effort from healthcare workers worldwide. Since healthcare workers often refrain from seeking professional psychological support, internet-delivered interventions could serve as a viable alternative option.

Objective

We aimed to investigate the effects of a therapist-guided six-week CBT-based internet-delivered stress recovery intervention among medical nurses using a randomized controlled trial design. We also aimed to assess program usability.

Methods

168 nurses working in a healthcare setting (M_age = 42.12, SD_age = 11.38; 97 % female) were included in the study. The intervention group included 77 participants, and the waiting list control group had 91 participants. Self-report data were collected online at three timepoints: pre-test, post-test, and three-month follow-up. The primary outcome was stress recovery. Secondary outcomes included measures of perceived stress, anxiety and depression symptoms, psychological well-being, posttraumatic stress and complex posttraumatic stress symptoms, and moral injury.

Results

We found that the stress recovery intervention FOREST improved stress recovery, including psychological detachment (d = 0.83 [0.52; 1.15]), relaxation (d = 0.93 [0.61, 1.25]), mastery (d = 0.64 [0.33; 0.95]), and control (d = 0.46 [0.15; 0.76]). The effects on psychological detachment, relaxation, and mastery remained stable at the three month follow-up. The intervention was also effective in reducing its users' stress (d = -0.49 [-0.80; -0.18]), anxiety symptoms (d = -0.31 [-0.62; -0.01]), depression symptoms (d = -0.49 [-0.80; -0.18]) and increasing psychological well-being (d = 0.53 [0.23; 0.84]) with the effects on perceived stress, depression symptoms, and well-being remaining stable at the three-month follow-up. High user satisfaction and good usability of the intervention were also reported.

Conclusions

The present study demonstrated that an internet-based intervention for healthcare staff could increase stress recovery skills, promote psychological well-being, and reduce stress, anxiety, and depression symptoms, with most of the effects being stable over three months.

Trial registration

NCT04817995 (https://clinicaltrials.gov/ct2/show/NCT04817995). Registration date: March 30, 2021. Date of first recruitment: April 1, 2021.

SUBMITTER: Dumarkaite A

PROVIDER: S-EPMC9684088 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

The efficacy of the internet-based stress recovery intervention FOREST for nurses amid the COVID-19 pandemic: A randomized controlled trial.

Dumarkaite Austeja A Truskauskaite Inga I Andersson Gerhard G Jovarauskaite Lina L Jovaisiene Ieva I Nomeikaite Auguste A Kazlauskas Evaldas E

International journal of nursing studies 20221124

<h4>Background</h4>The COVID-19 pandemic demanded exceptional physical and mental effort from healthcare workers worldwide. Since healthcare workers often refrain from seeking professional psychological support, internet-delivered interventions could serve as a viable alternative option.<h4>Objective</h4>We aimed to investigate the effects of a therapist-guided six-week CBT-based internet-delivered stress recovery intervention among medical nurses using a randomized controlled trial design. We a ...[more]

PMID: 36527859

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Project description:BackgroundPrompts offer a promising strategy to promote client engagement in internet-delivered cognitive behavioral therapy (ICBT). However, if the prompts do not meet the needs of clients, they can potentially be more obtrusive rather than helpful.ObjectiveThe aim of this study was to test if prompts tailored based on timing and frequency, aligned with preintervention goal setting, can increase usage and the efficacy of a therapist-supported ICBT stress recovery intervention for health care workers.MethodsThe 2-arm randomized controlled trial included 87 health care workers (99% female, aged 19-68 years: mean 39.61, SD 11.49): 43 in the standard intervention group and 44 in the tailored prompts group. The primary outcome measure was the Recovery Experiences Questionnaire, and the secondary outcomes were the Perceived Stress Scale-4, the Patient Health Questionnaire-4, and the World Health Organization-5 Well-Being Index. The self-report data were collected before the intervention (September 2022), postintervention (October 2022), and 6-month follow-up (May 2023).ResultsThe results showed that tailored prompts, although appreciated by the majority (39/40, 98%), did not improve intervention usage indicators, such as the number of logins (t85=-0.91; P=.36), modules opened (t83.57=-1.47; P=.15), modules completed (t85=-0.71; P=.48), exercises completed (t85=-1.05; P=.30), or the time spent using the program (χ22=1.1; P=.57). Similarly, tailored prompts did not increase the effects of the intervention in terms of stress recovery skills (Cohen d ranging from 0.31 to 0.85), perceived stress (d=-0.08; -0.70), depression (d=-0.11; -0.38), anxiety (d=-0.32; -0.64), or psychological well-being (d=0.26; 0.46). In addition, the standard intervention group showed greater long-term stress recovery effects than the group using the internet-delivered intervention supplemented by tailored prompts (β=-0.24, P=.03).ConclusionsAlthough the study confirmed the efficacy of the program, the merits of tailored prompts in ICBT for stress recovery were not supported. Future research is needed to test the effects of the stress recovery intervention supplemented by goal setting and tailored prompts.Trial registrationClinicalTrials.gov NCT05553210; https://clinicaltrials.gov/study/NCT05553210.

Project description:BackgroundMedical professionals are at high risk of job stress and burnout. Research shows that work-related stress can be reduced through enhancing psychological resources, in particular, self-efficacy and perceived social support. These psychological resources can operate either individually or sequentially: in line with the cultivation hypothesis, self-efficacy precedes and cultivates perceived social support, whereas according to the enabling hypothesis it is perceived social support that comes first and enables self-efficacy. Based on this theoretical framework we developed an internet-based intervention, Med-Stress, dedicated to healthcare providers and aimed at reducing job stress and burnout. Med-Stress contains two modules that enhance self-efficacy and perceived social support, which are tested in four variants reflected in four study conditions. We expect that sequential enhancement of resources: self-efficacy and social support or social support and self-efficacy will yield larger posttest results than individual enhancement.MethodsIn this four-arm randomized controlled trial we will test four variants of the Med-Stress intervention. The trial is open for professionally active medical providers aged at least 18 years (N = 1200) with access to an Internet-connected device. We will compare the effects of two experimental conditions reflecting cultivation and enabling effects of self-efficacy and perceived social support (sequential enhancement of resources), and two active controls strengthening self-efficacy or perceived social support. Job stress and job burnout will be the primary outcomes, whereas depression, job-related traumatic stress, and work engagement will be secondary ones. Additionally, we will measure perceived social support, self-efficacy to manage job stress and burnout, and the ability to obtain social support, exposure to traumatic events, and users' expectancy and credibility of the intervention. All assessments will be applied before the intervention, at posttest (at 3 or 6 weeks depending on the study condition), and at 6-month and 12-month follow up. In the case of experimental groups, additional measurements will be taken after enhancing each resource.DiscussionResource-based interventions are relatively context-free and could potentially benefit medical professionals across the field. If Med-Stress is successful, its most effective variant could be implemented in the healthcare system as a standalone, supportive tool for employees.Trial registrationClinicalTrials.gov, NCT03475290 Registered on 23 March 2018.

Project description:BackgroundWork-related stress is widespread among employees and associated with high costs for German society. Internet-based stress management interventions (iSMIs) are effective in reducing such stress. However, evidence for their cost-effectiveness is scant.ObjectiveThe aim of this study was to assess the cost-effectiveness of a guided iSMI for employees.MethodsA sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale≥22) was assigned to either the iSMI or a waitlist control condition (WLC) with unrestricted access to treatment as usual. Participants were recruited in Germany in 2013 and followed through 2014, and data were analyzed in 2017. The iSMI consisted of 7 sessions plus 1 booster session. It was based on problem-solving therapy and emotion regulation techniques. Costs were measured from the societal perspective, including all direct and indirect medical costs. We performed a cost-effectiveness analysis and a cost-utility analysis relating costs to a symptom-free person and quality-adjusted life years (QALYs) gained, respectively. Sampling uncertainty was handled using nonparametric bootstrapping (N=5000).ResultsWhen the society is not willing to pay anything to get an additional symptom-free person (eg, willingness-to-pay [WTP]=€0), there was a 70% probability that the intervention is more cost-effective than WLC. This probability rose to 85% and 93% when the society is willing to pay €1000 and €2000, respectively, for achieving an additional symptom-free person. The cost-utility analysis yielded a 76% probability that the intervention is more cost-effective than WLC at a conservative WTP threshold of €20,000 (US $25,800) per QALY gained.ConclusionsOffering an iSMI to stressed employees has an acceptable likelihood of being cost-effective compared with WLC.Trial registrationGerman Clinical Trials Register DRKS00004749; https://www.drks.de/DRKS00004749.International registered report identifier (irrid)RR2-10.1186/1471-2458-13-655.

Project description:ObjectiveMigration is a profound life transition that may threaten migrants' well-being and mental health. Results of several studies suggest that social self-efficacy beliefs may be beneficial for the psychological adjustment of migrants, buffering the effect of specific stressors related to migration, helping them reduce anxiety levels, and providing support in forming of new social bonds and better integration with a new community or culture. The primary purpose of this randomized controlled trial was to examine the effectiveness of the New in Town internet-based self-efficacy intervention for internal migrants in Poland.MethodsParticipants were 158 internal adult migrants who had changed residence in the last 6 months. They were randomized into two groups: an experimental group (receiving an internet-based self-efficacy intervention), and a waiting list control group. We examined if the intervention was effective in enhancing participants' social self-efficacy (primary outcome), general self-efficacy, social support, satisfaction with life, and reduced reported loneliness (secondary outcomes). Outcome measures were assessed at baseline (Time 1) and 3-weeks later (Time 2). The dropout rate was 50.6%. Initially, we planned to gather follow-up data also 8-weeks after baseline (Time 3). However, due to health and safety reasons related to the COVID-19 pandemic, we decided to stop the trial. Finally, we included in our analysis only data gathered before the COVID-19 pandemic at Time 1 and Time 2.ResultsA total of 159 individuals who met the study's inclusion criteria and completed the baseline assessment were randomly assigned to either the experimental group (n = 80) or the waiting list control group (n = 79). Nevertheless, one participant assigned to the control group was excluded from the analyses because they withdrew their consent to participate after being randomized. The study results suggest that compared to the waitlist control group (n = 78), participants in the experimental group (n = 80) reported a higher level of general self-efficacy beliefs at Time 2 (Cohen's d = 0.47; 95% CI: 0.15-0.79). However, there were no statistically significant effects on social self-efficacy, social support, satisfaction with life, and loneliness.ConclusionThe study offers preliminary support for the effectiveness of an internet-based self-efficacy intervention designed for internal migrants on general self-efficacy beliefs.Trial registrationThe trial was registered with ClinicalTrials.gov (identifier: NCT04088487) on 11th September 2019.

Dataset Information

The efficacy of the internet-based stress recovery intervention FOREST for nurses amid the COVID-19 pandemic: A randomized controlled trial.

Background

Objective

Methods

Results

Conclusions

Trial registration

Publications

The efficacy of the internet-based stress recovery intervention FOREST for nurses amid the COVID-19 pandemic: A randomized controlled trial.

Similar Datasets

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