Efficacy of an Internet-based intervention for job stress and burnout among medical professionals: study protocol for a randomized controlled trial

Ewelina Smoktunowicz, Magdalena Lesnierowska, Roman Cieslak, Per Carlbring, Gerhard Andersson, Ewelina Smoktunowicz, Magdalena Lesnierowska, Roman Cieslak, Per Carlbring, Gerhard Andersson

Abstract

Background: Medical professionals are at high risk of job stress and burnout. Research shows that work-related stress can be reduced through enhancing psychological resources, in particular, self-efficacy and perceived social support. These psychological resources can operate either individually or sequentially: in line with the cultivation hypothesis, self-efficacy precedes and cultivates perceived social support, whereas according to the enabling hypothesis it is perceived social support that comes first and enables self-efficacy. Based on this theoretical framework we developed an internet-based intervention, Med-Stress, dedicated to healthcare providers and aimed at reducing job stress and burnout. Med-Stress contains two modules that enhance self-efficacy and perceived social support, which are tested in four variants reflected in four study conditions. We expect that sequential enhancement of resources: self-efficacy and social support or social support and self-efficacy will yield larger posttest results than individual enhancement.

Methods: In this four-arm randomized controlled trial we will test four variants of the Med-Stress intervention. The trial is open for professionally active medical providers aged at least 18 years (N = 1200) with access to an Internet-connected device. We will compare the effects of two experimental conditions reflecting cultivation and enabling effects of self-efficacy and perceived social support (sequential enhancement of resources), and two active controls strengthening self-efficacy or perceived social support. Job stress and job burnout will be the primary outcomes, whereas depression, job-related traumatic stress, and work engagement will be secondary ones. Additionally, we will measure perceived social support, self-efficacy to manage job stress and burnout, and the ability to obtain social support, exposure to traumatic events, and users' expectancy and credibility of the intervention. All assessments will be applied before the intervention, at posttest (at 3 or 6 weeks depending on the study condition), and at 6-month and 12-month follow up. In the case of experimental groups, additional measurements will be taken after enhancing each resource.

Discussion: Resource-based interventions are relatively context-free and could potentially benefit medical professionals across the field. If Med-Stress is successful, its most effective variant could be implemented in the healthcare system as a standalone, supportive tool for employees.

Trial registration: ClinicalTrials.gov, NCT03475290 Registered on 23 March 2018.

Keywords: Health professionals; Internet-based intervention; Job burnout; Job stress; Occupational health; Perceived social support; Randomized controlled trial; Resources; Self-efficacy; e-mental health.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Cultivation hypothesis
Fig. 2
Fig. 2
Enabling hypothesis
Fig. 3
Fig. 3
Study flow. SE, Self-efficacy enhancement module; SS, Social support enhancement module
Fig. 4
Fig. 4
Schedule of enrolment, interventions, and assessments

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