A Mobile Phone-Based Intervention to Reduce Mental Health Problems in Health Care Workers During the COVID-19 Pandemic (PsyCovidApp): Randomized Controlled Trial.
A Mobile Phone-Based Intervention to Reduce Mental Health Problems in Health Care Workers During the COVID-19 Pandemic (PsyCovidApp): Randomized Controlled Trial.
复制标题
DOI：
10.2196/27039
复制
发表时间：
2021-05-18
影响因子：
5
通讯作者：
Ricci-Cabello I
中科院分区：
文献类型：
--
作者：
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
COVID-19大流行引发的全球卫生紧急情况给医护人员带来了前所未有的挑战，他们在心理困难的情况下面临繁重的工作量。尽管缺乏证据表明心理移动健康（mHealth）干预措施在这一特定人群和环境中的有效性，但由于其有吸引力的实施功能，目前正在广泛部署。本试验的目的是评估心理教育、基于正念的移动健康干预措施的有效性，以减少 COVID-19 大流行期间医护人员的心理健康问题。我们在西班牙进行了一项盲法、平行组、对照试验。为 COVID-19 患者提供面对面医疗保健的医护人员被随机分配 (1:1) 接受为期 2 周的 PsyCovidApp 干预（一款针对情绪技能、健康生活方式、倦怠和社会支持的应用程序）或对照应用程序（有关心理保健的一般建议）。参与者对他们的分组分配不知情。由训练有素的健康心理学家在基线时和两周后通过电话收集数据。主要结局是抑郁、焦虑和压力的综合结果（抑郁焦虑压力量表-21 [DASS-21] 的总体评分）。次要结果是失眠（失眠严重程度指数）、倦怠（Maslach 倦怠清单人类服务调查）、创伤后应激（戴维森创伤量表）、自我效能（一般自我效能量表）和 DASS-21 个人量表评分。根据意向治疗方案，使用一般线性模型分析组间差异。此外，我们还测量了 PsyCovidApp（系统可用性量表）的可用性。结果数据收集者和试验统计学家不知道治疗分配。 2020 年 5 月 14 日至 7 月 25 日期间，招募了 482 名医护人员，并随机分配到 PsyCovidApp (n=248) 或对照应用程序 (n=234)。 2 周时，436/482 名参与者 (90.5%) 获得了完整的结果数据。 2 周时，各组之间的主要结局（标准化平均差 –0.04；95% CI –0.11 至 0.04；P=.15）或其他结局没有观察到显着差异。在我们预先指定的亚组分析中，我们观察到服用精神药物的医护人员 (n=79) 在主要结局 (–0.29; 95% CI –0.48 至 –0.09; P=.004) 以及创伤后应激、失眠、焦虑和压力方面都有显着改善。同样，在接受心理治疗的医护人员 (n=43) 中，我们观察到主要结局（–0.25；95% CI –0.49 至 –0.02；P=.02）以及失眠、焦虑和压力方面有所改善。 PsyCovidApp 的平均可用性得分很高（87.21/100，SD 12.65）。试验结束后，干预组中有 208/221 名参与者（94.1%）要求重新访问 PsyCovidApp，表明接受度较高。在西班牙协助 COVID-19 患者的医护人员中，与对照应用程序相比，PsyCovidApp 仅在接受心理治疗或精神药物的医护人员中在两周内减少了心理健康问题。 ClinicalTrials.gov NCT04393818； https://clinicaltrials.gov/ct2/show/NCT04393818。
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. 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. 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. 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. 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. ClinicalTrials.gov NCT04393818; https://clinicaltrials.gov/ct2/show/NCT04393818.
登录
查看更多内容
DOI：
10.3390/ijerph17155514
发表时间：
2020-08-01
影响因子：
--
作者：
Luceno-Moreno, Lourdes;Talavera-Velasco, Beatriz;Martin-Garcia, Jesus
通讯作者：
Martin-Garcia, Jesus
DOI：
10.4067/s0718-48082012000300005
发表时间：
2012-12-01
期刊：
Terapia psicológica
影响因子：
--
作者：
Antúnez, Zayra;Vinet, Eugenia V
通讯作者：
Vinet, Eugenia V
影响因子：
4.8
作者：
Bastien, Celyne H.;Vallieres, Annie;Morin, Charles M.
通讯作者：
Morin, Charles M.
影响因子：
73.3
作者：
Firth, Joseph;Torous, John;Sarris, Jerome
通讯作者：
Sarris, Jerome
影响因子：
7.3
作者：
Herrero, R.;Espinoza, M.;Banos, R. M.
通讯作者：
Banos, R. M.