Exploring Digitalized Interventions for Stress and Problem Solving

The New Age of Cyber Care: Exploring Digitalized Interventions for Stress and Problem Solving - A Randomized Controlled Trial

Excessive and prolonged stress can have detrimental effects on both psychological and physiological health, compromising overall well-being and functioning. This study examines the impact of telepsychiatric group consultation using Instagram as an unexplored online social media platform on stress levels and problem-solving skills among young adults.

Study Overview

• Status: Completed
• Conditions: Stress; Problem-solving
• Intervention / Treatment: Behavioral: Cognitive Behavioural Theory-based group consultation

Detailed Description

A randomized, single-blind factorial trial with a control group was conducted. Over eight weeks, participants received cognitive behavioral-based intervention through online sessions. Pre-/post-test and follow-up assessments employed the Problem-Solving Inventory and Perceived Stress Scale, analyzed using factorial analysis of variance. Effect sizes were determined using ηp2 and Cohen's r.

Significant differences were found between groups for Problem-Solving Inventory (F(2-104):5.005)(p<0.05). The key findings of our RCT study is the strong impact of digitalized intervention on the time-group interaction (p<0.05). This highlights the effectiveness of the Instagram-based telehealth tool in facilitating long-lasting improvements among young adults. These findings shed light on the potential of social media platforms, like Instagram, as not only popular but successful tools for mental health interventions. Nurses can incorporate these digital interventions to enhance mental health support, reach a wider audience, and overcome barriers associated with traditional methods.

1. H1: There is a significant difference between the mean scores of the Problem Solving Inventory in favour of the Instagram-based intervention group in the time series.
2. H1: There is a significant difference between the mean scores of the Perceived Stress Scale in favour of the Instagram-based intervention group in the time series.
3. H1: Instagram-based telehealth is effective for reducing Problem Solving Inventory scores.
4. H1: Instagram-based telehealth is effective for reducing Perceived Stress Scale scores.

• Study Type: Interventional
• Enrollment (Actual): 54
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • İzmir, Turkey, 35100
    • Ege University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Be over 18 years of age,
• Being an university student,
• Volunteer for the study,
• Possess the necessary technological resources

Exclusion Criteria:

• Have a physical or sensory impairment that would affect the ability to use online technology (e.g., history of temporal brain damage, limb loss, hearing loss, etc.),
• Have a psychiatric diagnosis that would affect decision-making and orientation assessment abilities
• Be receiving any professional support that could potentially influence their coping skills during data collection

This calculation was performed to ensure that the study would have an appropriate sample size to detect meaningful effects and draw reliable conclusions. In this study, an alpha level of 0.05 and a beta level of 0.20 have been set. Based on the results of previous similar studies, it has been determined that a minimum sample size of 24 (total 48) is required for each group.

Following the completion of the announcement and registration phase, a random assignment process was conducted to allocate 54 students into either the control or intervention groups, adhering to the guidelines of the Consort Model.

Gender, problem-solving skills, and perceived stress levels were taken into account during the group allocation process.

The RCT's statistical power, calculated post hoc within a 95% confidence interval and a sampling error of d=.05, was determined to be 83.0%.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Any intervention applied. Following the completion of the research, the need for psychosocial support among the control group participants was assessed, and it was found that none of the students in the control group required such support.
Experimental: Cognitive Behavioural Theory-based group consultation; Cognitive Behavioural Theory-based group consultation was given to the intervention group through an Instagram as online social media platform. This approach has been developed with the philosophy of Cognitive Behavioral Theory (Eskin, 2009). For three days a week over eight weeks of intervention conducted with synchronized psychoeducation sessions, online posts, surveys, personal sharing messages, and group interaction tools.; Introduction and warm-up,; Problem orientation-identifying the problem,; Identifying prior problems-Which one I want to start?; Recognizing the losses caused by problems and complaints,; Setting reachable and realistic goals,; Generating alternatives-What can I do?; Regulating emotions,; Experimenting and exploring. Sessions were completed in approximately one hour as semi-structured interactive group training according to group dynamics.	Behavioral: Cognitive Behavioural Theory-based group consultation; Cognitive Behavioural Theory-based group consultation was given to the intervention group through an Instagram as online social media platform. This approach has been developed with the philosophy of Cognitive Behavioral Theory (Eskin, 2009). For three days a week over eight weeks, informative posts were shared, asynchronous testing and self-discovery activities were carried out, and a synchronous tele-psychoeducation session was held once a week. The participants were connected to the live broadcast of the research team, and they interacted via text messages. In this interaction, further suggestions related to the goals of the week were given, previous assignments were checked, homework for the next session was given, personal experiences and the needs of the participants were determined, and necessary feedback was provided. Instagram had the feature of maintaining the records of all participants' attendance at these events.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived Stress Scale (first evaluation with posttest)	The Perceived Stress Scale is designed to measure how stressful situations in one's life are perceived. The five-point Likert-type scale items (0-never, 4-very often) are interpreted over the total score and two sub-dimensions (insufficient self-efficacy and stress disturbance perception). A high total score indicates that the person perceives the stress he/she has been loaded with as high; it is interpreted as the methods used in coping with stress are not functional, and therefore they cannot cope with stress effectively. In our study, the Cronbach's alpha coefficient of the scale was determined as .75.	Through intervention completion, an average of 2 month
Problem Solving Inventory (first evaluation with posttest)	The Problem Solving Inventory is a Likert-type scale, scored between 1 and 6, consisting of 35 items that measure adults' self-perception of problem-solving skills. There are items that are reverse coded and excluded from scoring. The scale's Turkish adaptation study's Cronbach alpha consistency coefficient was found to be .88. In our study, the Cronbach alpha coefficient was .78.The higher total scores obtained from the scale indicate that the individual perceives himself/herself as inadequate in terms of problem-solving skills.	Through intervention completion, an average of 2 months
Perceived Stress Scale (second evaluation with follow up)	The Perceived Stress Scale is designed to measure how stressful situations in one's life are perceived. The five-point Likert-type scale items (0-never, 4-very often) are interpreted over the total score and two sub-dimensions (insufficient self-efficacy and stress disturbance perception). A high total score indicates that the person perceives the stress he/she has been loaded with as high; it is interpreted as the methods used in coping with stress are not functional, and therefore they cannot cope with stress effectively. In our study, the Cronbach's alpha coefficient of the scale was determined as .75.	Through intervention completion, an average of 5 month
Problem Solving Inventory (second evaluation with follow up)	The Problem Solving Inventory is a Likert-type scale, scored between 1 and 6, consisting of 35 items that measure adults' self-perception of problem-solving skills. There are items that are reverse coded and excluded from scoring. The scale's Turkish adaptation study's Cronbach alpha consistency coefficient was found to be .88. In our study, the Cronbach alpha coefficient was .78.The higher total scores obtained from the scale indicate that the individual perceives himself/herself as inadequate in terms of problem-solving skills.	Through intervention completion, an average of 5 months

Collaborators and Investigators

• Sponsor: Ege University

Study record dates

Study Major Dates

• Study Start (Actual): April 16, 2021
• Primary Completion (Actual): July 30, 2021
• Study Completion (Actual): November 28, 2021

Study Registration Dates

• First Submitted: February 26, 2024
• First Submitted That Met QC Criteria: February 26, 2024
• First Posted (Actual): March 4, 2024

Study Record Updates

• Last Update Posted (Actual): March 7, 2024
• Last Update Submitted That Met QC Criteria: March 5, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: stress; telemedicine; internet-based intervention; problem-solving
• Other Study ID Numbers: EgeTrial4

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

Public data sharing is available for this study.

beycan ekitli, gizem (2022), "Digitalization in Psychoeducation' The Effect of Tele-Psychoeducation", Mendeley Data, V1, doi: 10.17632/5g9bcjv43b.1

http://dx.doi.org/10.17632/5g9bcjv43b.1

• IPD Sharing Time Frame: By publication with no end date.
• IPD Sharing Access Criteria: It is planned to publish the research results in a high-impact journal in the field.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No