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Online Multi-component Psychological Intervention for Healthcare Workers During COVID-19 Pandemic

27 de septiembre de 2021 actualizado por: Universidad Internacional de Valencia

Effectiveness of a Self-applied Multi-component Psychological Online Intervention Based on User Experience, for Anxiety, Depression, Burnout, Fatigue Compassion on Healthcare Workers During the COVID-19 Outbreak: A Randomized Clinical Trial

The objective of this study is to carry out a randomized clinical trial with healthcare workers in Mexico through a web platform. The intervention aims to reduce anxiety, depressive symptoms, burnout, stress, compassion fatigue, and increase the quality of life and sleep and self-care, as well as improve skills in providing bad news to patients and their families. A self-applied intervention will be compared with an intervention delivered by therapists providing the same intervention implemented through Zoom, Skype, or Microsoft Teams, to ensure sanitary protection measures.

Descripción general del estudio

Descripción detallada

Recent studies indicate that a lack of personal protective equipment, an unreasonable amount of work, inadequate medications, fear of contracting the disease, spreading the disease to co-workers and family, and lack of qualified training, have put front-line healthcare workers with unimaginable stress. There are various psycho social stressors to which the person who is working in this line of action is exposed. Nurses have been found to be one of the most affected groups because they have manifested various psychological consequences, including anxiety, depression, and stress. Likewise, multiple studies have reported psychological discomfort in health workers, especially those who are in areas of care for patients infected by COVID-19, among the most frequent psychological consequences that have been found, high prevalence of anxiety, depression, stress, insomnia, and high levels of distress are observed. Some of the challenges faced by health personnel who are in contact with patients infected by the virus are having a higher risk of contagion, not having the necessary personal equipment to prevent contagion, excessive workload, and even neglecting activities basic. In addition to these unfavorable working conditions faced by COVID-19 front line care staff, there is a need to make complex decisions that can generate moral or ethical damage. Consequently, this situation can trigger a series of negative emotional alterations, such as anxiety, depression, post-traumatic stress disorder, and even suicidal ideas.

Due to the current restrictions derived from the pandemic, psychological digital interventions have been an effective option to overcome barriers in mental health care for this population. Likewise, this type of intervention can provide various benefits, such as carried out by different means and the efficacy that they have shown to treat a wide range of mental health problems.

The objective of this study is to carry out a randomized clinical trial through a web platform which will have two groups: 1) Self-applied intervention directed at health personnel from all over Mexico for the reduction of symptoms of anxiety, depression, burnout, stress, compassion fatigue and increased self-care, quality of sleep and perceived quality of life, as well as how to offer tools to acquire knowledge about how to notify bad news to patients and families. The contents of the online intervention will be implemented through a responsive web application. In order to create the most fitted intervention for the real needs of the participants will be created following the principles of User Experience, this ensuring that the design characteristics of the tool will meet the desired requirements to be perceived as easy to use, attractive and useful. The User Experience approach refers to the experience that a user has with a product, with special emphasis on human-product interaction.

2) The same intervention but implemented by a therapist via Zoom, Skype, or Teams to continue ensuring protection measures for both the therapist and the patient.

The subjective measures will include the following Psychometric instruments:

  1. Post-traumatic diagnostic scale
  2. Plutchik Suicide Risk Scale
  3. Generalized Anxiety Scale.
  4. The Center for Epidemiological Studies Depression Scale-Revised
  5. Professional Quality of Life Measure
  6. Pittsburgh Sleep Quality Index
  7. Scale for measuring resilience with Mexicans
  8. Appraisal of Self-care Agency
  9. The Fear of COVID-19 Scale
  10. Opinion on the treatment.
  11. System usability scale

Tipo de estudio

Intervencionista

Inscripción (Anticipado)

42

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

Copia de seguridad de contactos de estudio

Ubicaciones de estudio

      • Mexico, México, 54090
    • Chihuahua
      • Juarez, Chihuahua, México, 32315
        • Reclutamiento
        • Universidad Autonoma de Ciudad Juarez
        • Contacto:
        • Contacto:
          • Rosa Olimpia Castellanos Vargas, MD
          • Número de teléfono: +52 1 33 1358 3137
          • Correo electrónico: rosa.castellanos@uacj.mx
    • Jalisco
      • Guadalajara, Jalisco, México, 44160

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 65 años (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

Sí

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • To have access to a communication device with access to the internet (computer, tablet, and mobile)
  • To have a valid email address.
  • To have basic digital skills in the use of an operational system and internet browsing.
  • To understand Spanish since all the contents are in this language.
  • Symptoms of anxiety, depression, burnout, and fatigue compassion

Exclusion Criteria:

  • To have a diagnosis of psychotic disorder
  • To be receiving psychological and/or pharmacological treatment during the study
  • Moderate to a high score on the suicide scale
  • Recent attempt of suicide (3 months)
  • To refuse to accept to participate

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Único

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Experimental: Self-applied psychological intervention for healthcare workers
Participants in this group will receive 9 sessions of a multi-component psychological intervention focused on the reduction of symptoms of anxiety, depression, stress, burnout, fatigue compassion, and post-traumatic stress, and the increase of the quality of sleep and perception of the quality of life. The participants will have the option to do 3 extra modules that are complimentary for the intervention.

The intervention is based on Cognitive Behavioral Therapy, Mindfulness, Behavioral Activation Therapy, Acceptance and Commitment Therapy and Positive Psychology, aimed at the Psychoeducation regarding the manifestations of anxiety, depression, burnout, fatigue compassion, posttraumatic stress disorder, and affectations in sleep quality and perception of life quality in healthcare workers.

And 3 complementary modules that according to the scientific literature could affect the mental health of healthcare workers related to how to deliver bad health news, Psychological first aid and how beliefs could influence physical and emotional self-care in the face of the COVID-19 pandemic.

Comparador activo: Control: Self-applied psychological intervention for healthcare workers
The participants in this group will receive exactly the same intervention but delivered through a therapist in a weekly session through an online video call. The participants will be informed also about the 3 extra modules and briefly what it is the contents of these modules so they can accept or not receive these extra contents.

The intervention is based on Cognitive Behavioral Therapy, Mindfulness, Behavioral Activation Therapy, Acceptance and Commitment Therapy and Positive Psychology, aimed at the Psychoeducation regarding the manifestations of anxiety, depression, burnout, fatigue compassion, posttraumatic stress disorder, and affectations in sleep quality and perception of life quality in healthcare workers.

And 3 complementary modules that according to the scientific literature could affect the mental health of healthcare workers related to how to deliver bad health news, Psychological first aid and how beliefs could influence physical and emotional self-care in the face of the COVID-19 pandemic.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
The Center for Epidemiologic Studies Depression Scale-Revised (CESD-R)
Periodo de tiempo: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
The CESD-R is an updated version of the CES-D. The CESD-R consists of 20. This scale assesses the number of depression symptoms within 2 weeks. The scale consists 20 items and contains 4-point score responses (0 to 3) as the following; rarely or none of the time (less than 1 day); some of a little of the time (1-2 days); occasionally or moderate amount of time (3-4 days) and most or all of the time (5-7 days). The total possible range of scores is from 0 to 60 where ^16 is the cut-off point for this scale, and higher scores indicate more symptoms of depression. It is expected a statistically significant decrease (P < 0.05) in depression symptoms.
Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Decrease in the symptoms of General Anxiety Disorder (GAD-7)
Periodo de tiempo: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
On the Generalized Anxiety Disorder 7-item (GAD-7) scale subjects are asked how often, during the last 2 weeks, they have been bothered by each of the 7 core symptoms of generalized anxiety disorder. Response options are "not at all," "several days," "more than half the days," and "nearly every day," scored as 0, 1, 2, and 3, respectively. Therefore, GAD-7 scores range from 0 to 21, with scores of ≥5, ≥10, and ≥15 represent mild, moderate, and severe anxiety symptom levels, respectively. Is expected a statistically significant decrease (P < 0.05) in the General Anxiety symptoms.
Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Decrease in the score of The Pittsburgh Sleep Quality Index (PSQI).
Periodo de tiempo: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
This instrument assesses the quality patterns of sleep. It differentiates the "poor" and "good" sleep by measuring seven areas, where the range score of answers are from 0 to 3, the global sum of this scale can be a value between 0 to 60, and the cutoff point is "5" that indicates a "poor" sleep quality. It is expected a statistically significant decrease (P < 0.05) in the Sleep Quality measure.
Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Decrease in the scores of the Post-Traumatic Stress Disorder Symptom Scale (PSS)
Periodo de tiempo: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
The Post-Traumatic Stress Disorder Symptom Scale is a 17-item structured interview. The severity over the last 2 weeks of each item on the PSS is rated by the interviewer using a 4-point scale: 0 = not at all, 1 = a little bit, 2 = somewhat, and 3 = very much. The maximum possible score is 51 (severely affected) and the minimum possible score is 0 (total absence of the symptoms). The total severity score is calculated as the sum of the severity ratings for the 17 items. The diagnosis of the Post-Traumatic Stress Disorder Symptom Scale is made when at least 1 re-experiencing, 3 avoidance, and 2 arousal symptoms are endorsed on the scale by individuals who were traumatized at least one month prior to the assessment. It is expected a statistically significant decrease (P < 0.05) in the symptoms of Post-Traumatic Stress Disorder in the patients suffering from this disorder.
Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Increase in the score of the Professional Quality of Life Measure (ProQOL)
Periodo de tiempo: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
The professional quality of life will be evaluated with the ProQOL scale (Professional Quality of Life Measure). This scale measures the sections of Satisfaction by empathy, compassion fatigue, and Burnout. The scale is composed of 30 Likert-type questions with five possible answers, being: Never = 1, Rarely = 2, Sometimes = 3, Often = 4 and Often = 5. A score of 17 could indicate affect action in the measured dimensions. It is expected a statistically significant decrease (P < 0.05) in the perception of Professional Quality of Life of the patients.
Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Increase in the score of the Appraisal of Self-care Agency (ASA)
Periodo de tiempo: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
This scale is made up of 24 Likert-type reagents with four types of response, which have a score of one to four points, which when performing the final sum may result in the range of 24-96. The higher the resulting score, the greater the person's self-care capabilities. Maximum ability of self-care is reflected with a score of 96 and a minimum with 24, where high scores of self-care are with scores equal or higher to 76, for a medium ability with equal or higher to 70 but equal or lower than 75 and a low ability any score of 69 or lower. It is expected a statistically significant increase (P < 0.05) in the in the score of the Appraisal of Self-care Agency.
Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Decrease in the Plutchik Suicide Risk Scale (BSI)
Periodo de tiempo: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
The Plutchik Suicide Risk Scale is a structured self-report questionnaire for evaluating Suicide Risk. It consists of 15 items that assess the history of suicide attempts, ideation, and suicide plans. It differentiates patients with a suicide risk from the non-suicide risk. This scale has dichotomous responses of Yes/No, and has a cut-off point of 6, where a point above the cut-off means a higher suicide risk. In this study, the suicidal patients are not considering the depression treatment although is necessary to assess depressive patients to refer to specialized treatment.
Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Increase in the Scale for measuring resilience with Mexicans (RESI-M)
Periodo de tiempo: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
The RESI-M scale is composed of 43 items, the responses are Likert type (totally disagree, disagree, agree, and totally agree). It is expected a statistically significant increase (P < 0.05) in the in the score of resilience
Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Silla de estudio: Anabel de la Rosa Gómez, PhD, Universidad Nacional Autonoma de Mexico
  • Silla de estudio: Paulina Erika Herdoiza Arroyo, PhD, Universidad Internacional del Ecuador
  • Silla de estudio: Joaquín Mateu Molla, PhD, Valencian International University
  • Silla de estudio: Eduardo Bautista Valerio, BD, Universidad Nacional Autonoma de Mexico

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

16 de julio de 2021

Finalización primaria (Anticipado)

20 de junio de 2022

Finalización del estudio (Anticipado)

20 de junio de 2022

Fechas de registro del estudio

Enviado por primera vez

17 de mayo de 2021

Primero enviado que cumplió con los criterios de control de calidad

17 de mayo de 2021

Publicado por primera vez (Actual)

18 de mayo de 2021

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

5 de octubre de 2021

Última actualización enviada que cumplió con los criterios de control de calidad

27 de septiembre de 2021

Última verificación

1 de septiembre de 2021

Más información

Términos relacionados con este estudio

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

SÍ

Descripción del plan IPD

The information will be available in a private server or in a server of the journal(s) that we will publish the articles that will be the result of this study. The protocol of the study is currently in progress to be published, in this article will be included such study protocol, the informed consent is already shared in the register of clinical trials.

Marco de tiempo para compartir IPD

This data will be available approximately in June 2022 and it will be permanently available. It will be shared in the databases of the journal where the article(s) will be published.

Criterios de acceso compartido de IPD

Through the servers of the journal(s) where we will publish the articles.

Tipo de información de apoyo para compartir IPD

  • PROTOCOLO DE ESTUDIO
  • CIF

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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