Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.
Health Sciences Area, Valencian International University, Valencia, Spain.
J Med Internet Res. 2023 Apr 6;25:e43839. doi: 10.2196/43839.
The death of a loved one was a challenge many people faced during the COVID-19 pandemic within the context of extraordinary circumstances and great uncertainty. Grief is an unavoidable part of life, and for most people, feelings of grief decrease naturally over time. However, for some people, grieving can become a particularly painful process with clinical symptoms that may require professional help to resolve. To provide psychological support to people who had lost a loved one during the COVID-19 pandemic, an unguided web-based psychological intervention was developed.
The main objective of this study was to evaluate the efficacy of the web-based treatment, Grief COVID (Duelo COVID in Spanish; ITLAB), in reducing clinical symptoms of complicated grief, depression, posttraumatic stress, hopelessness, anxiety, and suicidal risk in adults. The secondary aim was to validate the usability of the self-applied intervention system.
We used a randomized controlled trial with an intervention group (IG) and a waitlist control group (CG). The groups were assessed 3 times (before beginning the intervention, upon completing the intervention, and 3 months after the intervention). The intervention was delivered on the web in an asynchronous format through the Duelo COVID web page. Participants created an account that could be used on their computers, smartphones, or tablets. The evaluation process was automated as part of the intervention.
A total of 114 participants were randomly assigned to the IG or CG and met criteria for inclusion in the study (n=45, 39.5% completed the intervention and n=69, 60.5% completed the waitlist period). Most participants (103/114, 90.4%) were women. The results indicated that the treatment significantly reduced baseline clinical symptoms in the IG for all variables (P<.001 to P=.006), with larger effect sizes for depression, hopelessness, grief, anxiety, and risk of suicide (all effect sizes ≥0.5). The follow-up evaluation showed that symptom reduction was maintained at 3 months after the intervention. The results from the CG showed that participants experienced significantly decreased levels of hopelessness after completing the time on the waitlist (P<.001), but their suicidal risk scores increased. Regarding the usability of the self-applied intervention system, the results indicated a high level of satisfaction with the Grief COVID.
The self-applied web-based intervention Grief COVID was effective in reducing symptoms of anxiety, depression, hopelessness, risk of suicide risk, posttraumatic stress disorder, and complicated grief disorder. Grief COVID was evaluated by the participants, who reported that the system was easy to use. These results affirm the importance of developing additional web-based psychological tools to help reduce clinical symptoms in people experiencing grief because of the loss of a loved one during a pandemic.
ClinicalTrials.gov NCT04638842; https://clinicaltrials.gov/ct2/show/NCT04638842.
在 COVID-19 大流行期间，许多人在特殊情况下和极大的不确定性下，面临着失去亲人的挑战。悲伤是生命中不可避免的一部分，对于大多数人来说，悲伤的情绪会随着时间的推移自然减轻。然而，对于一些人来说，悲伤可能会成为一个特别痛苦的过程，出现临床症状，可能需要专业帮助来解决。为了为在 COVID-19 大流行期间失去亲人的人提供心理支持，开发了一种无指导的基于网络的心理干预措施。
本研究的主要目的是评估基于网络的治疗方案 Grief COVID（西班牙语为 Duelo COVID；ITLAB）在减轻成年人复杂悲伤、抑郁、创伤后应激、绝望、焦虑和自杀风险的临床症状方面的疗效。次要目的是验证自我应用干预系统的可用性。
我们使用了一项随机对照试验，包括干预组（IG）和候补对照组（CG）。两组在 3 次评估中（开始干预前、完成干预后和干预后 3 个月）进行评估。干预以异步格式通过 Duelo COVID 网页在网络上进行。参与者创建一个可以在他们的计算机、智能手机或平板电脑上使用的账户。评估过程是作为干预的一部分自动化进行的。
共有 114 名参与者被随机分配到 IG 或 CG，并符合纳入研究的标准（n=45，39.5%完成干预，n=69，60.5%完成候补期）。大多数参与者（114 名中的 103 名，90.4%）为女性。结果表明，与候补组相比，治疗方案显著降低了 IG 中所有变量的基线临床症状（P<.001 至 P=.006），抑郁、绝望、悲伤、焦虑和自杀风险的效应量较大（所有效应量≥0.5）。随访评估显示，干预后 3 个月症状仍有减轻。候补组的结果表明，参与者在完成候补期后，绝望感明显降低（P<.001），但自杀风险评分升高。关于自我应用干预系统的可用性，结果表明参与者对 Grief COVID 非常满意。
自我应用的基于网络的干预方案 Grief COVID 在减轻焦虑、抑郁、绝望、自杀风险、创伤后应激障碍和复杂悲伤障碍的症状方面是有效的。参与者对该系统进行了评估，他们报告说该系统易于使用。这些结果肯定了开发额外的基于网络的心理工具的重要性，以帮助减轻因大流行而失去亲人的人因悲伤而出现的临床症状。
ClinicalTrials.gov NCT04638842；https://clinicaltrials.gov/ct2/show/NCT04638842。
