COVID-19 트라우마의 영향을 받는 NHS 직원을 위한 간략한 인지 작업 개입(GAINS-2 연구) (GAINS-2)

실험적: 간략한 디지털 이미지 경쟁 작업

24주 동안 간단한 디지털 이미지 경쟁 작업에 액세스할 수 있습니다(처음 4주에는 선택적 연구원 지원 포함).

행동: 간략한 디지털 이미지 경쟁 작업

연구원이 안내하는 첫 번째 세션: 정신 회전 지침이 포함된 컴퓨터 게임을 한 후 메모리 큐.

첫 번째 세션 후 자체 관리/안내 세션에 참여할 수 있는 옵션.

실험적: 간단한 디지털 음악 듣기 작업

24주 동안 간단한 디지털 음악 듣기 작업에 액세스할 수 있습니다(처음 4주에는 선택적 연구원 지원 포함).

행동: 간단한 디지털 음악 듣기 작업

연구원 안내 첫 번째 세션: 작곡가의 음악에 대한 정보와 클래식 음악 감상.

첫 번째 세션 후 자체 관리/안내 세션에 참여할 수 있는 옵션.

실험적: 평소와 같은 치료

참가자가 24주 동안 충격적인 사건에 대한 침투적 기억이 있는 경우 그렇지 않으면 받을 수 있는 일상적인 치료에 대한 액세스.

다른: 평소와 같은 치료

참가자가 충격적인 사건에 대한 침투적 기억이 있는 경우 그렇지 않으면 받을 수 있는 일상적인 치료에 대한 액세스.

Number of Intrusive Memories of Traumatic Event(s)

Number of intrusive memories of traumatic event(s) recorded by participants in a brief daily online diary for 7 days.

수면 상태 표시기(SCI)

이 2개 항목 척도는 불면증 장애에 대한 DSM-5 기준에 대해 수면 문제를 측정합니다. 항목 응답은 각각 0~4점으로 평가되며, 0~2점은 불면증 장애의 역치 기준을 나타냅니다. 총점 범위는 0~8점이며, 점수가 높을수록 수면 상태가 양호한 것을 의미합니다.

Number of Intrusive Memories of Traumatic Event(s)

Number of intrusive memories of traumatic event(s) recorded by participants in a brief daily online diary for 7 days.

PTSD Checklist for DSM-5 (PCL-5)

This 20-item measure assesses symptoms of PTSD over the last week. Items are rated on a 5-point scale ranging from 0 ("not at all") to 4 ("extremely"). Scores are summed to give a total severity score (ranging 0 to 80), with greater scores indicating greater symptom severity.

Generalised Anxiety Disorder 2-item Scale (GAD-2)

This 2-item short-form self-report measure assesses symptoms of anxiety. Items are rated for how often they have bothered the respondent over the last two weeks, from 0 ("not at all") to 3 ("nearly every day"). Total score is the sum of both items and ranges from 0 to 6, with greater scores indicating greater symptom severity.

Patient Health Questionnaire 2-item Version (PHQ-2)

This 2-item short-form self-report measure assesses symptoms of depression. Items are rated for how often they have bothered the respondent over the last two weeks, from 0 ("not at all") to 3 ("nearly every day"). Total score is the sum of both items and ranges from 0 to 6, with greater scores indicating greater symptom severity.

Scale of Work Engagement and Burnout (SWEBO) - Work Engagement Total Score

This 19-item self-report measure assesses work engagement and burnout. The work engagement subscale consists of 10 items assessing three dimensions (vigour, attentiveness, dedication). The burnout subscale consists of 9 items assessing three dimensions (exhaustion, disengagement and inattentiveness). Respondents rate how often they have felt each descriptive in the past two weeks, from 1 (not at all) to 4 (all the time). The work engagement subscale total score is calculated as a mean of items (range 1-4), with greater scores indicating greater work engagement.

Scale of Work Engagement and Burnout (SWEBO) - Work Burnout Total Score

This 19-item self-report measure assesses work engagement and burnout. The work engagement subscale consists of 10 items assessing three dimensions (vigour, attentiveness, dedication). The burnout subscale consists of 9 items assessing three dimensions (exhaustion, disengagement and inattentiveness). Respondents rate how often they have felt each descriptive in the past two weeks, from 1 (not at all) to 4 (all the time). The work burnout subscale total score is calculated as a mean of items (range 1-4), with greater scores indicating greater work burnout.

Sickness Absence

Single item assessing self-reported number of sick days taken from work in the last 4 weeks.

Intention to Leave Job

3 items assess participants' intention to leave their job e.g. "I think a lot about leaving the job", each rated from 1 (strongly agree) to 5 (strongly disagree). The total score ranges 3 to 15, with a lower score indicating stronger intention to leave the job.

5-level European Quality of Life 5 Dimension (EQ-5D-5L), Mobility

The 5-level version of the EuroQol-5D (EQ-5D-5L) is a brief, five-item measure for assessing general quality of life and health status. Items assess mobility, self-care, usual activities, pain/discomfort and anxiety/depression each on a 5-point scale. The mobility item is scored on a 5-point ordinal scale from "I have no problems in walking about" to "I am unable to walk about".

5-level European Quality of Life 5 Dimension (EQ-5D-5L), Self Care

The 5-level version of the EuroQol-5D (EQ-5D-5L) is a brief, five-item measure for assessing general quality of life and health status. Items assess mobility, self-care, usual activities, pain/discomfort and anxiety/depression each on a 5-point scale. The self care item is scored on a 5-point ordinal scale from "I have no problems washing or dressing myself" to "I am unable to wash or dress myself".

5-level European Quality of Life 5 Dimension (EQ-5D-5L), Usual Activities

The 5-level version of the EuroQol-5D (EQ-5D-5L) is a brief, five-item measure for assessing general quality of life and health status. Items assess mobility, self-care, usual activities, pain/discomfort and anxiety/depression each on a 5-point scale. The usual activities item is scored on a 5-point ordinal scale from "I have no problems doing my usual activities" to "I am unable to do my usual activities".

5-level European Quality of Life 5 Dimension (EQ-5D-5L), Pain / Discomfort

The 5-level version of the EuroQol-5D (EQ-5D-5L) is a brief, five-item measure for assessing general quality of life and health status. Items assess mobility, self-care, usual activities, pain/discomfort and anxiety/depression each on a 5-point scale. The pain / discomfort item is scored on a 5-point ordinal scale from "I have no pain or discomfort" to "I have extreme pain or discomfort".

5-level European Quality of Life 5 Dimension (EQ-5D-5L), Anxiety / Depression

The 5-level version of the EuroQol-5D (EQ-5D-5L) is a brief, five-item measure for assessing general quality of life and health status. Items assess mobility, self-care, usual activities, pain/discomfort and anxiety/depression each on a 5-point scale. The anxiety / depression item is scored on a 5-point ordinal scale from "I am not anxious or depressed" to "I am extremely anxious or depressed".

5-level European Quality of Life 5 Dimension (EQ-5D-5L), Overall Health

The 5-level version of the EuroQol-5D (EQ-5D-5L) is a brief measure for assessing general quality of life and health status. Respondents rate their overall health today on a visual analogue scale from 0 (the worst health you can imagine) to 100 (the best health you can imagine).

World Health Organization Disability Assessment Schedule 12-item Version (WHODAS 2.0)

The 12-item, self-report version of the WHODAS 2.0 will be used to assess difficulties in relation to the impact of intrusive memories. Respondents rate how much difficulty they have had in each area in the past 30 days, from 0 (none) to 4 (extreme or cannot do). The overall score is calculated as a percentage of the maximum possible score (i.e., 48 points), with greater scores indicating greater impairment.

Intrusive Memory Ratings: Item 1. Approximately How Often Did Intrusive Memories of the Traumatic Event Pop Into Your Mind?

This questionnaire assesses a number of intrusive memories characteristics, including frequency (Item 1: 7-point categorical response from 'never' to 'many times a day'); distress (Item 2: 0=not at all to 10=extremely); disruption to concentration (Item 3: 0=not at all to 10=extremely); interference (Item 4: how much (0=not at all to 10=extremely), and Item 4a: for how long (6-point response from '<1min' to '>60mins')); impact on work functioning (Item 5: how much (0=not at all to 10=extremely) and Item 6: in what ways (open text response)); impact on functioning in other areas of life (Item 7: how much (0=not at all to 10=extremely) and in what ways (Item 8: open text response)).

Here we present Item 1 assessing the frequency of intrusive memories on a 7-point scale from 'never' to 'many times a day'. Other items from this questionnaire are presented below.

Intrusive Memory Ratings: Item 4a. Duration of Interference

This questionnaire assesses a number of intrusive memories characteristics, including frequency (Item 1: 7-point categorical response from 'never' to 'many times a day'); distress (Item 2: 0=not at all to 10=extremely); disruption to concentration (Item 3: 0=not at all to 10=extremely); interference (Item 4: how much (0=not at all to 10=extremely), and Item 4a: for how long (6-point response from '<1min' to '>60mins')); impact on work functioning (Item 5: how much (0=not at all to 10=extremely) and Item 6: in what ways (open text response)); impact on functioning in other areas of life (Item 7: how much (0=not at all to 10=extremely) and in what ways (Item 8: open text response)).

Here we present Item 4a assessing the for how long intrusive memories interfered with what participants were doing on a 7-point scale from '<1 min' to '>60 mins'. Other items from this questionnaire are presented below.

Intrusive Memory Ratings: Distress (Item 2), Disruption to Concentration (Item 3), Interference (Item 4), Impact on Work Functioning (Item 5), and Impact on Functioning in Other Areas of Life (Item 7)

This questionnaire assesses a number of intrusive memories characteristics, including frequency (Item 1: 7-point categorical response from 'never' to 'many times a day'); distress (Item 2: 0=not at all to 10=extremely); disruption to concentration (Item 3: 0=not at all to 10=extremely); interference (Item 4: how much (0=not at all to 10=extremely), and Item 4a: for how long (6-point response from '<1min' to '>60mins')); impact on work functioning (Item 5: how much (0=not at all to 10=extremely) and Item 6: in what ways (open text response)); impact on functioning in other areas of life (Item 7: how much (0=not at all to 10=extremely) and in what ways (Item 8: open text response)).

Here we present data for the five items scored on an 11-point scale (0=not at all to 10=extremely) assessing distress (Item 2), disruption to concentration (Item 3), interference (Item 4), impact on work functioning (Item 5), and impact on functioning in other areas of life (Item 7).

Changes to Health and Work - Dichotomous Outcomes

The 9-item questionnaire will be used to assess the occurrence and number of any new traumatic events, any additional stressful life events (e.g. relationship problems, financial problems), new treatments received, untoward medical occurrences, changes to the job, or changes to the number of hours worked per week since the last assessment. Dichotomous outcomes are presented below, and discrete outcomes with count data are presented under "Changes to health and work - discrete outcomes".

Changes to Health and Work - Discrete Outcomes

The 9-item questionnaire will be used to assess the occurrence and number of any new traumatic events, any additional stressful life events (e.g. relationship problems, financial problems), new treatments received, untoward medical occurrences, changes to the job, or changes to the number of hours worked per week since the last assessment. Discrete outcomes are presented below, and dichotomous outcomes are presented under "Changes to health and work - dichotomous outcomes".

Feedback Questionnaire

A 12-item questionnaire assessing participants' experience of using the brief cognitive task. The first ten items assess how easy, helpful, distressing, burdensome and acceptable participants found the brief cognitive task, how willing they would be to use it in the future, how confident they would be in recommending it to a friend and how much they feel it could be used to support staff within the NHS, each rated from 0 (not at all) to 10 (very). The last two items ask how the brief cognitive task could be improved, and for any other comments or suggestions about the brief cogntive task, both with an open response.

Feedback Questionnaire (Total Score)

A 12-item questionnaire assessing participants' experience of using the brief cognitive task. The first ten items assess how easy, helpful, distressing, burdensome and acceptable participants found the brief cognitive task, how willing they would be to use it in the future, how confident they would be in recommending it to a friend and how much they feel it could be used to support staff within the NHS, each rated from 0 (not at all) to 10 (very); items for distress and burden are reverse scored from 0 (very) to 10 (not at all). The last two items ask how the brief cognitive task could be improved, and for any other comments or suggestions about the brief cognitive task, both with an open response. A total score of the eight categorical items is presented (range 0 - 80), with greater scores indicating more favourable feedback towards the allocated digital task.

Optional Qualitative Interview

This semi-structured interview will consist of a number of questions designed to gain an in-depth understanding of participants' experience of using the brief cognitive task, including acceptability, improvement suggestions, and potential barriers/facilitators to implementation.

Weekly Work Pattern, Number of Days Worked

One item asses the number of days worked in the last week (both with responses from 0 to 7 days).

Weekly Work Pattern, Number of Night Shifts Worked

One item asses the number of night shifts worked in the last week (both with responses from 0 to 7).

Expectancy of Intervention Effect (Credibility and Expectancy Questionnaire, CEQ) - Categorical Items

The Credibility and Expectancy Questionnaire (CEQ) consists of 6 items. Items 1, 2, 3, and 5 were assessed on a 9-point integer scale ranging from 1 ("not at all") to 9 ("very"). Items 4 and 6 were assessed on an 11-point scale (response range of 0-100%) and, for comparability, were converted to the same 9-point scale as other items. CEQ total score was calculated by summing all six items producing a possible total score range of 6-54; with greater scores indicating greater credibility and expectancy of intervention effect. Participants completed the Credibility and Expectancy Questionnaire (CEQ) after being informed of treatment allocation (Day 0).

Expectancy of Intervention Effect (Credibility and Expectancy Questionnaire, CEQ) - Total Score

The Credibility and Expectancy Questionnaire (CEQ) consists of 6 items. Items 1, 2, 3, and 5 were assessed on a 9-point integer scale ranging from 1 ("not at all") to 9 ("very"). Items 4 and 6 were assessed on an 11-point scale (response range of 0-100%) and, for comparability, were converted to the same 9-point scale as other items. CEQ total score was calculated by summing all six items producing a possible total score range of 6-54; with greater scores indicating greater credibility and expectancy of intervention effect. Participants completed the Credibility and Expectancy Questionnaire (CEQ) after being informed of treatment allocation (Day 0).