Resource-Based Internet Intervention (Med-Stress) to Improve Well-Being Among Medical Professionals: Randomized Controlled Trial.
Resource-Based Internet Intervention (Med-Stress) to Improve Well-Being Among Medical Professionals: Randomized Controlled Trial.
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DOI：
10.2196/21445
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发表时间：
2021-01-11
影响因子：
7.4
通讯作者：
Cieslak R
中科院分区：
文献类型：
--
作者：
Smoktunowicz E;Lesnierowska M;Carlbring P;Andersson G;Cieslak R
医疗专业人员在他们的工作环境中暴露于多种要求，而且往往是过度的要求。低强度的互联网干预使他们即使在没有机构帮助的情况下也能从心理支持中受益。注重提高心理资源--自我效能感和感受到的社会支持--使干预措施与医疗专业内的各种职业相关。以前，这些资源被发现在社会支持(培养过程)之前或之后(使能过程)以自我效能感单独或顺序地运行。这项随机对照试验的目的是比较Med-Stress的4种变种的疗效，Med-Stress是一种自我引导的互联网干预措施，旨在改善医疗专业人员的多方面福祉。这项研究是在新冠肺炎大流行之前进行的。参与者(N=1240)主要通过媒体活动和社交媒体定向广告招募。他们被分成以下四组中的一组：反映培养过程的实验条件、反映使能过程的实验条件、仅提高自我效能的积极比较者和仅提高感知社会支持的积极比较者。结果包括幸福感的5个方面：工作压力、工作倦怠、工作投入、抑郁和与工作相关的创伤应激。在基线(时间1)、干预后立即(时间2)和6个月随访(时间3)在网络上进行测量。为了分析数据，在意向处理样本上使用了线性混合效应模型。由于关于试验持续时间的信息是公开的，试验和对照条件不同，所以试验部分是盲目的。在第二时间，反映培养过程的工作压力低于只加强社会支持的参与者(d=−0.21)；在第三时间，该实验条件下的参与者的工作压力最低，与其余3组相比(DS介于−0.24和−0.41之间)。对于与工作相关的创伤应激，我们发现只有在时间3时，研究组之间才有显著差异：首先提高自我效能感的实验条件下的压力低于只加强社会支持的积极对照组(d=−0.24)。同样的结果也适用于工作敬业度(d=−0.20)，这意味着在对缓解压力有利的相同条件下，敬业度更低。研究条件对职业倦怠和抑郁的影响在时间2和时间3都没有差异。研究中有很高的辍学率(1023/1240，后测82.50%)，反映了本实验的语用性质。当活动按特定顺序完成时，中等压力互联网干预会改善幸福感的某些组成部分--最明显的是工作压力。工作参与度的下降可能支持这种现象的阴暗面，但还需要进一步的研究。临床试验.gov NCT03475290；https://clinicaltrials.gov/ct2/show/NCT03475290 rr2-10.1186/s13063-019-3401-9
Medical professionals are exposed to multiple and often excessive demands in their work environment. Low-intensity internet interventions allow them to benefit from psychological support even when institutional help is not available. Focusing on enhancing psychological resources—self-efficacy and perceived social support—makes an intervention relevant for various occupations within the medical profession. Previously, these resources were found to operate both individually or sequentially with self-efficacy either preceding social support (cultivation process) or following it (enabling process). The objective of this randomized controlled trial is to compare the efficacy of 4 variants of Med-Stress, a self-guided internet intervention that aims to improve the multifaceted well-being of medical professionals. This study was conducted before the COVID-19 pandemic. Participants (N=1240) were recruited mainly via media campaigns and social media targeted ads. They were assigned to 1 of the following 4 groups: experimental condition reflecting the cultivation process, experimental condition reflecting the enabling process, active comparator enhancing only self-efficacy, and active comparator enhancing only perceived social support. Outcomes included 5 facets of well-being: job stress, job burnout, work engagement, depression, and job-related traumatic stress. Measurements were taken on the web at baseline (time 1), immediately after intervention (time 2), and at a 6-month follow-up (time 3). To analyze the data, linear mixed effects models were used on the intention-to-treat sample. The trial was partially blinded as the information about the duration of the trial, which was different for experimental and control conditions, was public. At time 2, job stress was lower in the condition reflecting the cultivation process than in the one enhancing social support only (d=−0.21), and at time 3, participants in that experimental condition reported the lowest job stress when compared with all 3 remaining study groups (ds between −0.24 and −0.41). For job-related traumatic stress, we found a significant difference between study groups only at time 3: stress was lower in the experimental condition in which self-efficacy was enhanced first than in the active comparator enhancing solely social support (d=−0.24). The same result was found for work engagement (d=−0.20), which means that it was lower in exactly the same condition that was found beneficial for stress relief. There were no differences between study conditions for burnout and depression neither at time 2 nor at time 3. There was a high dropout in the study (1023/1240, 82.50% at posttest), reflecting the pragmatic nature of this trial. The Med-Stress internet intervention improves some components of well-being—most notably job stress—when activities are completed in a specific sequence. The decrease in work engagement could support the notion of dark side of this phenomenon, but further research is needed. ClinicalTrials.gov NCT03475290; https://clinicaltrials.gov/ct2/show/NCT03475290 RR2-10.1186/s13063-019-3401-9
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影响因子：
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作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
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