Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, Weston Education Centre, UK and South London and Maudsley NHS Foundation Trust, UK.
Department of Biostatistics and Health Informatics and King's Clinical Trials Unit, Institute of Psychiatry Psychology and Neuroscience, King's College London, UK.
Br J Psychiatry. 2023 Feb;222(2):58-66. doi: 10.1192/bjp.2022.103.
Healthcare workers (HCWs) have faced considerable pressures during the COVID-19 pandemic. For some, this has resulted in mental health distress and disorder. Although interventions have sought to support HCWs, few have been evaluated.
We aimed to determine the effectiveness of the 'Foundations' application (app) on general (non-psychotic) psychiatric morbidity.
We conducted a multicentre randomised controlled trial of HCWs at 16 NHS trusts (trial registration number: EudraCT: 2021-001279-18). Participants were randomly assigned to the app or wait-list control group. Measures were assessed at baseline, after 4 and 8 weeks. The primary outcome was general psychiatric morbidity (using the General Health Questionnaire). Secondary outcomes included: well-being; presenteeism; anxiety; depression and insomnia. The primary analysis used mixed-effects multivariable regression, presented as adjusted mean differences (aMD).
Between 22 March and 3 June 2021, 1002 participants were randomised (500:502), and 894 (89.2%) followed-up. The sample was predominately women (754/894, 84.3%), with a mean age of 44⋅3 years (interquartile range (IQR) 34-53). Participants randomised to the app had a reduction in psychiatric morbidity symptoms (aMD = -1.39, 95% CI -2.05 to -0.74), improvement in well-being (aMD = 0⋅54, 95% CI 0⋅20 to 0⋅89) and reduction in insomnia (adjusted odds ratio (aOR) = 0⋅36, 95% CI 0⋅21 to 0⋅60). No other significant findings were found, or adverse events reported.
The app had an effect in reducing psychiatric morbidity symptoms in a sample of HCWs. Given it is scalable with no adverse effects, the app may be used as part of an organisation's tiered staff support package. Further evidence is needed on long-term effectiveness and cost-effectiveness.
医护人员（HCWs）在 COVID-19 大流行期间面临着相当大的压力。对一些人来说，这导致了心理健康困扰和障碍。尽管已经有干预措施来支持 HCWs，但很少有措施得到评估。
我们旨在确定“基础”应用程序（app）对一般（非精神病）精神疾病发病率的有效性。
我们在 16 个 NHS 信托基金中进行了一项针对 HCWs 的多中心随机对照试验（试验注册号：EudraCT：2021-001279-18）。参与者被随机分配到应用程序组或候补对照组。在基线、4 周和 8 周后评估测量结果。主要结局是一般精神疾病发病率（使用一般健康问卷）。次要结局包括：幸福感；出勤；焦虑；抑郁和失眠。主要分析使用混合效应多变量回归，以调整后的平均差异（aMD）表示。
在 2021 年 3 月 22 日至 6 月 3 日期间，随机分配了 1002 名参与者（500：502），894 名（89.2%）进行了随访。该样本主要是女性（894 名中的 754 名，84.3%），平均年龄为 44.3 岁（四分位距（IQR）34-53）。随机分配到应用程序组的参与者精神疾病症状减轻（aMD=-1.39，95%CI-2.05 至-0.74），幸福感提高（aMD=0.54，95%CI0.20 至 0.89），失眠减少（调整后的优势比（aOR）=0.36，95%CI0.21 至 0.60）。没有发现其他显著结果，也没有报告不良反应。
该应用程序在减轻 HCWs 样本中的精神疾病症状方面有效果。鉴于它具有可扩展性且没有不良反应，该应用程序可作为组织分层员工支持计划的一部分。需要进一步的证据来证明长期有效性和成本效益。
