Heyen Janna Marie, Weigl Noé, Müller Mario, Müller Stefan, Eberle Urs, Manoliu Andrei, Vetter Stefan, Brown Adam D, Berger Thomas, Kleim Birgit
Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zürich, Switzerland.
Department of Psychology, University of Zurich, Zürich, Switzerland.
JMIR Form Res. 2021 Jun 7;5(6):e28055. doi: 10.2196/28055.
Since the emergence of COVID-19, health care workers and first responders have been at a high risk for mental health symptoms owing to their exposure to the virus and increased work stress during the pandemic. Although interventions exist to address mental health issues following exposure to disasters, emergencies, and humanitarian crises, considerably less is known about web-based unguided interventions to help mitigate the negative impacts of such events. Additionally, in contexts in which emergencies reduce access to in-person care, remote forms of support are critical, yet there are limited studies on the use of such interventions. Evidence-based, easy-to-use, scalable interventions are direly needed for this population.
This study aimed to develop and test the feasibility of an unguided electronic mental health program, COVID-19 Anxiety and Stress Resilience Training (COAST), tailored to first responders and health care personnel, based on scientific evidence and empirically based techniques.
We developed COVID-19-specific training modules focusing on several domains that are previously reported as key to resilience and stress recovery: self-efficacy, mindfulness, sleep quality, and positive thinking. The program was made available to 702 first responders between May and August 2020, during the COVID-19 pandemic. Sociodemographic, work-, and COVID-19-related information was collected, and psychometric questionnaires were completed. We examined user acceptance and user activity, including module choice and participant feedback.
In total, 52 of 702 (7%) first responders to whom we reached out used the program at least once. COAST use was independent of age, sex, or baseline levels of self-efficacy, mindful awareness, sleep quality, and positive thinking (for all, P>.39). First responders who had tested positive and those who had been quarantined were more likely to engage in the program. A click count analysis per module showed that participants used the self-efficacy and mindfulness modules most often, with 382 and 122 clicks, respectively, over 15 weeks. Overall, first responders expressed satisfaction with the program.
Engagement of first responders in the multimodule web-based COAST program was feasible and the first responder cohort expressed overall satisfaction with the program. Those in more difficult circumstances, including those in quarantine and those who tested positive, may be more likely to engage in such programs. Further controlled studies could pave the way for efficacy studies and the development of additional modules, including just-in-time interventions or blended interventions combining individual use of an unguided self-help intervention, such as COAST, with subsequent individual psychotherapy for those who continue to experience stress and psychological symptoms.
自新冠疫情出现以来，医护人员和急救人员由于接触病毒以及疫情期间工作压力增加，面临着出现心理健康症状的高风险。尽管存在应对接触灾害、紧急情况和人道主义危机后心理健康问题的干预措施，但对于基于网络的无指导干预措施以帮助减轻此类事件的负面影响，人们了解得要少得多。此外，在紧急情况导致难以获得面对面护理的情况下，远程支持形式至关重要，但关于此类干预措施使用的研究有限。对于这一人群，迫切需要基于证据、易于使用且可扩展的干预措施。
本研究旨在开发并测试一个无指导的电子心理健康项目——新冠焦虑与压力恢复力训练（COAST），该项目基于科学证据和实证技术，专为急救人员和医护人员量身定制。
我们开发了针对新冠疫情的特定培训模块，重点关注先前报告的对恢复力和压力恢复至关重要的几个领域：自我效能感、正念、睡眠质量和积极思维。该项目在2020年5月至8月新冠疫情期间向702名急救人员提供。收集了社会人口学、工作以及与新冠疫情相关的信息，并完成了心理测量问卷。我们检查了用户接受度和用户活动，包括模块选择和参与者反馈。
在我们联系的702名急救人员中，共有52人（7%）至少使用过一次该项目。COAST的使用与年龄、性别或自我效能感、正念意识、睡眠质量和积极思维的基线水平无关（所有P>.39）。检测呈阳性的急救人员和被隔离的急救人员更有可能参与该项目。每个模块的点击次数分析表明，参与者最常使用自我效能感和正念模块，在15周内分别有382次和122次点击。总体而言，急救人员对该项目表示满意。
急救人员参与基于网络的多模块COAST项目是可行的，急救人员群体对该项目总体满意。处于更困难情况的人员，包括被隔离人员和检测呈阳性的人员，可能更有可能参与此类项目。进一步的对照研究可为疗效研究以及开发更多模块铺平道路，这些模块包括即时干预或混合干预，即结合使用无指导的自助干预措施（如COAST），随后为那些持续经历压力和心理症状的人员提供个体心理治疗。
