scholarly journals Web-based Self-help Program for Adjustment Problems After an Accident (SelFIT): Protocol for a Randomized Controlled Trial

10.2196/21200 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e21200
Author(s):  
Julia Katharina Hegy ◽  
Noemi Anja Brog ◽  
Thomas Berger ◽  
Hansjoerg Znoj
Keyword(s):  
Health Care ◽  
Psychological Distress ◽  
Cost Effectiveness ◽  
Well Being ◽  
Control Group ◽  
User Friendliness ◽  
Adjustment Problems ◽  
Web Based ◽  
Self Help ◽  
Wide Range

Background Accidents and the resulting injuries are among the world’s biggest health care issues, often causing long-term effects on psychological and physical health. With regard to psychological consequences, accidents can cause a wide range of burdens including adjustment problems. Although adjustment problems are among the most frequent mental health problems, there are few specific interventions available. The newly developed program SelFIT (German acronym: Selber wieder fit nach einem Unfall; “fit again after an accident”) aims to remedy this situation by offering a low-threshold, web-based self-help intervention for psychological distress after an accident. Objective The overall aim is to evaluate the efficacy and cost-effectiveness of the SelFIT program plus care as usual (CAU) compared to only CAU. Furthermore, the program’s user-friendliness, acceptance, and adherence are assessed. We expect that the use of SelFIT will be associated with a greater reduction in psychological distress, greater improvement in mental and physical well-being, and greater cost-effectiveness compared to CAU. Methods Adults (n=240) experiencing adjustment problems due to an accident they had between 2 weeks and 2 years before entering the study will be randomized into either the intervention or control group. Participants in the intervention group receive direct access to SelFIT. The control group receives access to the program after 12 weeks. There are 6 measurement points for both groups (baseline as well as after 4, 8, 12, 24, and 36 weeks). The main outcome is a reduction in anxiety, depression, and stress symptoms that indicate adjustment problems. Secondary outcomes include well-being, optimism, embitterment, self-esteem, self-efficacy, emotion regulation, pain, costs of health care consumption, and productivity loss, as well as the program’s adherence, acceptance, and user-friendliness. Results Recruitment began in December 2019 and will continue at least until January 2021, with the option to extend this for another 6 months until July 2021. As of July 2020, 324 people have shown interest in participating, and 48 people have given their informed consent. Conclusions To the best of our knowledge, this is the first study examining a web-based self-help program designed to treat adjustment problems resulting from an accident. If effective, the program could complement the still limited offerings for secondary and tertiary prevention of psychological distress after an accident. Trial Registration ClinicalTrials.gov NCT03785912; https://clinicaltrials.gov/ct2/show/NCT03785912 International Registered Report Identifier (IRRID) DERR1-10.2196/21200

Investigating the Efficacy and Cost-Effectiveness of a Web-based Self-help Program for People With Adjustment Problems After an Accident (SelFIT): Protocol for a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Julia Hegy ◽  
Noemi Anja Brog ◽  
Thomas Berger ◽  
Hansjoerg Znoj
Keyword(s):  
Health Care ◽  
Psychological Distress ◽  
Cost Effectiveness ◽  
Well Being ◽  
User Friendliness ◽  
Adjustment Problems ◽  
Health Care Consumption ◽  
Web Based ◽  
Self Help ◽  
Wide Range

BACKGROUND Accidents and the resulting injuries are one of the world’s biggest health care issues often causing long-term effects on psychological and physical health. With regard to psychological consequences, accidents can cause a wide range of burdens including adjustment problems. Although adjustment problems are among the most frequent mental health problems, there are few specific interventions available. The newly developed program SelFIT aims to remedy this situation by offering a low-threshold web-based self-help intervention for psychological distress after an accident. OBJECTIVE The overall aim is to evaluate the efficacy and cost-effectiveness of the SelFIT program plus care as usual (CAU) compared to only care as usual. Furthermore, the program’s user friendliness, acceptance and adherence are assessed. We expect that the use of SelFIT is associated with a greater reduction in psychological distress, greater improvement in mental and physical well-being, and greater cost-effectiveness compared to CAU. METHODS Adults (n=240) showing adjustment problems due to an accident they experienced between 2 weeks and 2 years before entering the study will be randomized. Participants in the intervention group receive direct access to SelFIT. The control group receives access to the program after 12 weeks. There are 6 measurement points for both groups (baseline as well as after 4, 8, 12, 24 and 36 weeks). The main outcome is a reduction in anxiety, depression and stress symptoms that indicate adjustment problems. Secondary outcomes include well-being, optimism, embitterment, self-esteem, self-efficacy, emotion regulation, pain, costs of health care consumption and productivity loss as well as the program’s adherence, acceptance and user-friendliness. RESULTS Recruitment started in December 2019 and is ongoing. CONCLUSIONS To the best of our knowledge, this is the first study examining a web-based self-help program designed to treat adjustment problems resulting from an accident. If effective, the program could complement the still limited offer of secondary and tertiary psychological prevention after an accident. CLINICALTRIAL ClinicalTrials.gov NCT03785912; https://clinicaltrials.gov/ct2/show/NCT03785912?cond=NCT03785912&draw=2&rank=1

scholarly journals Complaint-Directed Mini-Interventions for Depressive Symptoms: A Health-Economic Evaluation of Unguided Web-Based Self-Help Interventions (Preprint)

2018 ◽  
Author(s):  
Ben F.M. Wijnen ◽  
Suzanne Lokman ◽  
Stephanie Leone ◽  
Silvia M.A.A. Evers ◽  
Filip Smit
Keyword(s):  
Health Economic ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Depressive Symptomatology ◽  
Health Economic Evaluation ◽  
Control Group ◽  
Web Based ◽  
Self Help ◽  
Low Threshold

BACKGROUND The past decades depression prevention and early intervention has become a top priority within the Netherlands, however, there is still considerable room for improvement. To this extent, web-based complaint-directed mini-interventions (CDMIs) were developed. These brief and low-threshold interventions focus on psychological stress, sleep problems, and worry, because these complaints are highly prevalent, are demonstrably associated with depression and have a substantial economic impact. OBJECTIVE Aim of the current economic evaluation is to examine the added value of web-based unguided self-help CDMIs as compared to a wait-listed control group with unrestricted access to usual care both from a societal and healthcare perspective. METHODS This health economic evaluation was embedded in a randomized controlled trial. The study entailed two-arms in which three web-based CMDIs were compared to a no-intervention waiting-list control group (control group received intervention at three months follow-up). Measurements were conducted at baseline, and at three- and six-months follow-up. Primary outcome of the study was response rate on depressive symptomatology as measured by the Inventory of Depressive Symptomatology Self-Report (IDS-SR). Change in quality of life was estimated by calculating effect sizes (Cohens’ d) for individual pre- and post-treatment IDS-SR scores. Incremental cost-effectiveness ratios (ICERs) were calculated using bootstraps (5000 times) of seemingly unrelated regression equations and cost-effectiveness acceptability curves were constructed for the costs per QALY gained. RESULTS In total, 329 participants were included in the study of which 165 randomized to the CDMI group. At three months follow-up the responder rate was 13.9% in the CDMI group and 7.3% in the control group. Participants in the CDMI group gained 0.15 QALY at three months follow-up compared to baseline, whereas participants in the control group gained 0.03 QALY at three months follow-up. Average total costs per patient during 3 months follow-up were €2,094 for the CDMI group and €2,230 for the control group (excluding baseline costs). Bootstrapped SURE models resulted in a dominant ICER (i.e. less costs and a higher responder rate) for the CDMI group compared to the control group at three months follow-up. The same result was found for the costs per QALY gained. Various sensitivity analyses attested to the robustness of the findings of the main analysis. CONCLUSIONS This study demonstrated that brief and low-threshold web-based unguided self-help CDMIs have the potential to be a cost-effective addition to usual care for adults with mild-to-moderate depressive symptoms. The CDMIs were shown to improve health status while at the same time reduced healthcare costs of participants and hence dominates the care as usual control condition. As intervention costs are relatively low, and Internet is nowadays readily available in the Western world, we believe the CDMIs can be easily implemented on a large scale. CLINICALTRIAL Netherlands Trial Register (NTR): NTR4612; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4612 (Archived by WebCite at http://www.webcitation.org/6n4PVYddM)

scholarly journals Comorbidity and COVID-19: Investigating the Relationship between Medical and Psychological Well-being

2021 ◽  
pp. 1-22
Author(s):  
Owen Stafford ◽  
Anna Berry ◽  
Laura K. Taylor ◽  
Sinead Wearen ◽  
Cian Prendergast ◽  
...  
Keyword(s):  
Public Health ◽  
Psychological Distress ◽  
Vulnerable Populations ◽  
Illness Perceptions ◽  
Medical Condition ◽  
Well Being ◽  
Control Group ◽  
Medical Conditions ◽  
Significant Difference ◽  
The Relationship

Abstract Objective: The unprecedented occurrence of a global pandemic is accompanied by both physical and psychological burdens that may impair quality of life. Research relating to COVID-19 aims to determine the effects of the pandemic on vulnerable populations who are at high risk of developing negative health or psychosocial outcomes. Having an ongoing medical condition during a pandemic may lead to greater psychological distress. Increased psychological distress may be due to preventative public health measures (e.g. lockdown), having an ongoing medical condition, or a combination of these factors. Methods: This study analyses data from an online cross-sectional national survey of adults in Ireland and investigates the relationship between comorbidity and psychological distress. Those with a medical condition (n128) were compared to a control group without a medical condition (n128) and matched according to age, gender, annual income, education, and work status during COVID-19. Participants and data were obtained during the first public lockdown in Ireland (27.03.202008.06.2020). Results: Individuals with existing medical conditions reported significantly higher levels of anxiety (p<.01) and felt less gratitude (p.001). Exploratory analysis indicates that anxiety levels were significantly associated with illness perceptions specific to COVID-19. Post-hoc analysis reveal no significant difference between the number of comorbidities and condition type (e.g. respiratory disorders). Conclusion: This research supports individualised supports for people with ongoing medical conditions through the COVID-19 pandemic, and has implications for the consideration of follow-up care specifically for mental health. Findings may also inform future public health policies and post-vaccine support strategies for vulnerable populations.

The Efficacy and Mechanism of Positive Psychological Intervention on Well-Being for Colostomy Patients: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Yanfei Jin ◽  
Yuqing Wang ◽  
Hongwen Ma ◽  
Xu Tian ◽  
Wang Honghong
Keyword(s):  
Life Satisfaction ◽  
Psychological Distress ◽  
Standard Care ◽  
Psychological Capital ◽  
Psychological Intervention ◽  
Well Being ◽  
Control Group ◽  
Significant Difference ◽  
Experimental Group ◽  
Positive Psychological Intervention

Abstract Aims To evaluate the efficacy and mechanism of positive psychological intervention (PPI) on the psychological capital, psychological distress, and life satisfaction among colostomy patients. Methods Patients (n=120) with permanent stomas were recruited and randomly assigned into two groups. Patients in the experimental group (n=60) received standard care and PPI, whereas patients in the control group (n=60) only received standard care. The psychological capital, psychological distress, and life satisfaction were measured and compared between two groups before the intervention, the immediate post-intervention, and follow-up. Results All 120 patients completed the study. The hope, optimism, resilience, psychological distress, and life satisfaction score of the experimental group were significantly higher than those of the control group at T1 and T2 (P<0.05). Self-efficacy score of the experimental group had no significant difference at the two-time points after the intervention than the control group (P>0.05). Changes in hope and resilience which belong to psychological capital mediated the intervention’s efficacy on changes in PPI on life satisfaction (β = 0.265, P=0.005; β = 0.686, P=0.002). Conclusions PPI could effectively improve psychological capital, psychological distress, and life satisfaction among patients with stomas. Besides, our findings add novel support that increased hope and resilience are the active ingredients that promote intervention change.

scholarly journals A Web-Delivered Acceptance and Commitment Therapy Intervention With Email Reminders to Enhance Subjective Well-Being and Encourage Engagement With Lifestyle Behavior Change in Health Care Staff: Randomized Cluster Feasibility Stud

10.2196/18586 ◽  
2020 ◽  
Vol 4 (8) ◽  
pp. e18586
Author(s):  
Menna Brown ◽  
Nic Hooper ◽  
Phillip James ◽  
Darren Scott ◽  
Owen Bodger ◽  
...  
Keyword(s):  
Health Care ◽  
Behavior Change ◽  
Controlled Trial ◽  
Well Being ◽  
Care Staff ◽  
Health Care Staff ◽  
Subjective Well Being ◽  
Web Based ◽  
Lifestyle Behavior ◽  
Acceptance And Commitment

Background Poor mental health and emotional well-being can negatively impact ability to engage in healthy lifestyle behavior change. Health care staff have higher rates of sickness and absence than other public sector staff, which has implications at both individual and societal levels. Individual efforts to self-manage health and well-being which add to the UK mental health prevention agenda need to be supported. Objective The objective of this study was to establish the feasibility and acceptability of the inclusion of a self-guided, automated, web-based acceptance and commitment therapy intervention in an existing health promotion program, to improve subjective well-being and encourage engagement with lifestyle behavior change. Methods For this 12-week, 4-armed, randomized controlled cluster feasibility study, we recruited participants offline and randomly allocated them to 1 of 3 intervention arms or control (no well-being intervention) using an automated web-based allocation procedure. Eligibility criteria were current health care staff in 1 Welsh health board, age≥18 years, ability to read English, and ability to provide consent. The primary researcher was blinded to cluster allocation. Feasibility outcomes were randomization procedure, acceptance of intervention, and adherence to and engagement with the wider program. We evaluated health and well-being data via self-assessment at 2 time points, registration and postintervention, using the 14-item Warwick-Edinburgh Mental Well-Being Scale, the 4-item Patient Health Questionnaire, and the 7-item Acceptance and Action Questionnaire—Revised. Results Of 124 participants who provided consent and were randomly allocated, 103 completed full registration and engaged with the program. Most participants (76/103) enrolled in at least one health behavior change module, and 43% (41/96) of those randomly allocated to an intervention arm enrolled in the well-being module. Adherence and engagement was low (7/103, 6.8%), but qualitative feedback was positive. Conclusions The procedure and randomization process proved feasible, and the addition of the well-being module proved acceptable to health care staff. However, participant engagement was limited, and no one completed the full 12-week program. User feedback should be used to develop the intervention to address poor engagement. Effectiveness should then be evaluated in a full-scale randomized controlled trial, which would be feasible with additional recruitment. Trial Registration International Standard Randomised Controlled Trial Number (ISRCTN) 50074817; http://www.isrctn.com/ISRCTN50074817

scholarly journals Impact of family social support on psychological wellbeing of infertile women attending Yusuf Dantsoho Memorial Hospital, Kaduna, Nigeria

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Abubakar R ◽  
Zubairu HD ◽  
Yohanna S
Keyword(s):  
Social Support ◽  
Psychological Distress ◽  
Well Being ◽  
Social Consequences ◽  
Psychological Wellbeing ◽  
Memorial Hospital ◽  
Infertile Women ◽  
Family Social Support ◽  
Wide Range ◽  
The Impact

Infertility could be a life crisis with a wide range of socio-cultural and emotional problems. These social consequences are usually not voluntarily disclosed by the affected women and consequently do not receive adequate attention so the women continue to suffer in silence. The study aimed to determine the impact of family social support on psychological well-being of infertile women attending Yusuf Dantsoho Memorial Hospital (YDMH), Kaduna. The study was a cross sectional study conducted at the YDMH, T/Wada, Kaduna. Two hundred and fifty-four women who presented to the gynecology clinic during the study period and consented to participate in the study were recruited consecutively. Data on socio-demographics and family social support were determined using a self-structured questionnaire. Psychological wellbeing was assessed using a General Health Questioner. Data was analyzed using EPI-INFO statistical package. Majority of the participants were Northerners (70.1%), Muslims (91.7%), and Unemployed (52.8%) with an average monthly income of less than N 20,000 (73.6%). Most were within the age group of 25–30 years (40.2%) and from monogamous families (70.1%) with most families having 0–5 children (89.4%). 67.7% of the participants had adequate social support from their husbands as against 32.3% who had inadequate support (such as availability of financial, support encouragement, concern and sense of social belonging). Only 33.5% had adequate social support from their in-laws while majority of them (66.5%) had inadequate social support. A total of 203 (79.9%) of the participants had psychological distress (self-administered questioner) while 51 (20.1%) had no psychological distress. Husbands and in-laws support were significantly related to psychological wellbeing of the infertile women. Adequate social support provided by family members reduces stress, improves psychological wellbeing and quality of life of infertile women.

scholarly journals Psychological Distress Among the U.S. General Population During the COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Christi J. Guerrini ◽  
Sophie C. Schneider ◽  
Andrew G. Guzick ◽  
Gifty N. Amos Nwankwo ◽  
Isabel Canfield ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Psychological Distress ◽  
Online Survey ◽  
Well Being ◽  
The United States ◽  
Healthy Behaviors ◽  
Factors Associated ◽  
Clinically Significant ◽  
Amazon's Mechanical Turk

The COVID-19 pandemic is taking a significant global toll on emotional well-being, but evidence of mental health impacts in the United States remains limited. In April 2020, we conducted an exploratory survey of U.S. residents to understand prevalence of and factors associated with psychological distress during the pandemic. Data collection was conducted using Qualtrics, an online survey platform, and U.S. adult respondents were recruited via Amazon's Mechanical Turk platform. Among 1,366 respondents, 42% (n = 571) reported clinically significant anxiety and 38% (n = 519) reported clinically significant depression. Factors associated with anxiety and depressive symptoms included Hispanic/Latino ethnicity; younger age; lower income; employment as or living with a health care worker-first responder; caregiver status; SARS-CoV-2 infection status; decreased frequency of engagement in healthy behaviors; and changed frequency of engagement in unhealthy behaviors. That some of these factors are associated with elevated distress during the pandemic is not yet widely appreciated and might be useful in informing management of mental health care resources.

scholarly journals Web-based intervention for depressive symptoms in adults with types 1 and 2 diabetes mellitus: a health economic evaluation

2018 ◽  
Vol 212 (4) ◽  
pp. 199-206 ◽  
Author(s):  
Stephanie Nobis ◽  
David Daniel Ebert ◽  
Dirk Lehr ◽  
Filip Smit ◽  
Claudia Buntrock ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Treatment Response ◽  
Active Control ◽  
Cost Effective ◽  
Control Group ◽  
Active Control Group ◽  
Comorbid Depression ◽  
Web Based ◽  
Life Years ◽  
The Cost

BackgroundWeb-based interventions are effective in reducing depression. However, the evidence for the cost-effectiveness of these interventions is scarce.AimsThe aim is to assess the cost-effectiveness of a web-based intervention (GET.ON M.E.D.) for individuals with diabetes and comorbid depression compared with an active control group receiving web-based psychoeducation.MethodWe conducted a cost-effectiveness analysis with treatment response as the outcome and a cost-utility analysis with quality-adjusted life-years (QALYs) alongside a randomised controlled trial with 260 participants.ResultsAt a willingness-to-pay ceiling of €5000 for a treatment response, the intervention has a 97% probability of being regarded as cost-effective compared with the active control group. If society is willing to pay €14 000 for an additional QALY, the intervention has a 51% probability of being cost-effective.ConclusionsThis web-based intervention for individuals with diabetes and comorbid depression demonstrated a high probability of being cost-effective compared with an active control group.Declaration of interestS.N., D.D.E., D.L., M.B. and B.F. are stakeholders of the Institute for Online Health Trainings, which aims to transfer scientific knowledge related to this research into routine healthcare.

scholarly journals Impact of COVID-19 on the mental health of healthcare workers in different regions of the world

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S258-S258
Author(s):  
Mahfuja Islam ◽  
Philip George ◽  
Sindhu Sankaran ◽  
Janet Leu Su Hui ◽  
Tzun Kit
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Psychological Distress ◽  
Healthcare Workers ◽  
Well Being ◽  
Subjective Assessment ◽  
Survey Tool ◽  
Frontline Workers ◽  
The World ◽  
The Impact

AimsThe global health system is facing a serious challenge after the recent outbreak of COVID-19 coronavirus infection which was first identified in Wuhan, China in November 2019 and declared as a pandemic in March 2020 by WHO. There is a wide consensus that this pandemic has negative psychosocial consequences as well as unforeseeable provision of mental health care services and just not on physical health alone. The aim of this research study is to determine the prevalence of psychological distress and to identify the sociodemographic variables with the main attributable factors associated with the psychological distress among healthcare workers and suggestions on how to reduce the impact on the mental health of healthcare workers during the COVID-19 pandemic in different regions of the world.MethodWe performed a cross-sectional study from September-November 2020. We used a self-administered survey tool which was distributed electronically to healthcare workers across the globe. The data were stored on an online database with password protected devices where survey responses were restricted to investigators exclusively.Data collected were: 1) Socio-demographic data (age, gender, marital status, ethnicity, religion, role in the healthcare, region of practice); 2) Psychological General Well-Being Index (PGWBI) questionnaire which contains 22 standardized items. This is a subjective assessment to score the degree of psychological well-being by focusing on 6 domains: depression; anxiety; positive-well-being; self-control; vitality and general health; 3) Subjective assessment from respondents of the main attributable factors causing psychological distress and suggested methods to help reduce the impact on mental health on health care workers.ResultMajority out of the 217 respondents were from a younger age group; females and married/domestic partnership, mainly from Western Pacific Region, South East Asian and the African Region. More than half the respondents were moderate-severely psychologically distressed and the three main attributable factors causing psychological distress were: fear of family/friends contracting COVID-19 followed by lack of PPE and discomfort caused by wearing PPE for long hours. Respondents suggested that the distress would be reduced if: more resources were provided in hospital; protocols and guidelines were implemented and counselling facilities with recreational activities were available to frontline workers.ConclusionThis study showed that the COVID-19 pandemic has affected the mental health of healthcare workers and more support or strategies need to come in place to protect frontline workers at the time of crises.

scholarly journals A Web-based Survey for the Association Between Food Allergy and Depression/psychological Distress in 11,876 Japanese (P18-019-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Shinsuke Hidese ◽  
Shun Nogawa ◽  
Kenji Saito ◽  
Hiroshi Kunugi
Keyword(s):  
Food Allergy ◽  
Psychological Distress ◽  
Control Group ◽  
Food Allergens ◽  
Kiwi Fruit ◽  
Web Based ◽  
Funding Sources ◽  
Depression Group ◽  
Japanese Sample ◽  
History Of

Abstract Objectives The aim of this study is to examine whether food allergy (FA) is associated with depression/psychological distress in a large Japanese sample. Methods This web-based survey was conducted on a platform of “Yahoo! JAPAN -HealthData Lab” and the Genequest Inc. (Tokyo, Japan). Participants were 1000 individuals with self-reported history of depression (mean age: 41.4 years, 501 men and 499 women) and the remaining 10,876 controls (mean age: 45.1 years, 5691 men and 5185 women). Six-item Kessler scale (K6) test cut-off score ≥13 was used to estimate severe psychological distress. We gained self-reported information on FA and 27 specific food allergens. Results The proportion of individuals with FA, 2 or more, 3 or more, and 4 or more allergens was higher in the depression group compared to the control group (odds ratio [OR] = 1.64, 1.75, 2.02, and 2.27, respectively; P < 0.001). Allergen analyses revealed that allergies for shrimp, egg, mackerel, crab, kiwi fruit, milk, banana, and squid were more common in the depression group compared to the control group (P < 0.05). Individuals who had severe psychological distress was more common in the FA group than in the non-FA group, in the total participants (OR = 1.32, 1.62, 2.04 and 2.51; 1, 2, 3, and 4 or more allergens, respectively; P < 0.001). Conclusions We suggest that FA is likely to be a risk factor for depression and severe psychological distress, which is dependent on the number of food allergens. Funding Sources This work was supported by an Intramural Research Grant for Neurological and Psychiatric Disorders of National Center of Neurology and Psychiatry.

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