AnxietyNCT04890665
Online Multi-component Psychological Intervention for Healthcare Workers During COVID-19 Pandemic
A study testing Online psychological intervention for healthcare workers in people with Anxiety and Depression, run by Universidad Internacional de Valencia at 3 sites in Mexico.
Trial summary
The objective of this study is to carry out a randomized clinical trial with healthcare workers in Mexico through a web platform. The intervention aims to reduce anxiety, depressive symptoms, burnout, stress, compassion fatigue, and increase the quality of life and sleep and self-care, as well as improve skills in… Read more about this study
- Who is it for?
- Ages 18 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Anxiety, Depression, Sleep Disturbance
- What is being tested?
- Online psychological intervention for healthcare workers
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 42 participants
- Where
- 3 sitesMexico
- Study dates
- 16 Jul 2021to 20 Jun 2022
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- To have access to a communication device with access to the internet (computer, tablet, and mobile)
- To have a valid email address.
- To have basic digital skills in the use of an operational system and internet browsing.
- To understand Spanish since all the contents are in this language.
- Symptoms of anxiety, depression, burnout, and fatigue compassion
Who cannot join
- To have a diagnosis of psychotic disorder
- To be receiving psychological and/or pharmacological treatment during the study
- Moderate to a high score on the suicide scale
- Recent attempt of suicide (3 months)
- To refuse to accept to participate
Trial locations and contacts
3 sites in 1 country.
Mexico3 sites, 3 recruiting
- Not yet recruiting
Universidad de Guadalajara
Guadalajara, Jalisco, 44160
Reyna Jazmin Martínez Arriaga, PhD, reyna.martinez@academicos.udg.mx
- Recruiting
Universidad Autónoma de Ciudad Juárez
Juárez, Chihuahua, 32315
Rosa Olimpia Castellanos Vargas, MD, +52 1 33 1358 3137, rosa.castellanos@uacj.mx
Flor Rocío Ramírez Martínez, PhD, rocio.ramirez@uacj.mx
- Not yet recruiting
Universidad Nacional Autónoma de México
México, 54090
Anabel De la Rosa Gómez, PhD, anabel.delarosa@iztacala.unam.mx
About this study
Official title: Effectiveness of a Self-applied Multi-component Psychological Online Intervention Based on User Experience, for Anxiety, Depression, Burnout, Fatigue Compassion on Healthcare Workers During the COVID-19 Outbreak: A Randomized Clinical Trial
The objective of this study is to carry out a randomized clinical trial with healthcare workers in Mexico through a web platform. The intervention aims to reduce anxiety, depressive symptoms, burnout, stress, compassion fatigue, and increase the quality of life and sleep and self-care, as well as improve skills in providing bad news to patients and their families. A self-applied intervention will be compared with an intervention delivered by therapists providing the same intervention implemented through Zoom, Skype, or Microsoft Teams, to ensure sanitary protection measures.
Read the detailed description
Recent studies indicate that a lack of personal protective equipment, an unreasonable amount of work, inadequate medications, fear of contracting the disease, spreading the disease to co-workers and family, and lack of qualified training, have put front-line healthcare workers with unimaginable stress. There are various psycho social stressors to which the person who is working in this line of action is exposed. Nurses have been found to be one of the most affected groups because they have manifested various psychological consequences, including anxiety, depression, and stress. Likewise, multiple studies have reported psychological discomfort in health workers, especially those who are in areas of care for patients infected by COVID-19, among the most frequent psychological consequences that have been found, high prevalence of anxiety, depression, stress, insomnia, and high levels of distress are observed. Some of the challenges faced by health personnel who are in contact with patients infected by the virus are having a higher risk of contagion, not having the necessary personal equipment to prevent contagion, excessive workload, and even neglecting activities basic. In addition to these unfavorable working conditions faced by COVID-19 front line care staff, there is a need to make complex decisions that can generate moral or ethical damage. Consequently, this situation can trigger a series of negative emotional alterations, such as anxiety, depression, post-traumatic stress disorder, and even suicidal ideas.
Due to the current restrictions derived from the pandemic, psychological digital interventions have been an effective option to overcome barriers in mental health care for this population. Likewise, this type of intervention can provide various benefits, such as carried out by different means and the efficacy that they have shown to treat a wide range of mental health problems.
The objective of this study is to carry out a randomized clinical trial through a web platform which will have two groups: 1) Self-applied intervention directed at health personnel from all over Mexico for the reduction of symptoms of anxiety, depression, burnout, stress, compassion fatigue and increased self-care, quality of sleep and perceived quality of life, as well as how to offer tools to acquire knowledge about how to notify bad news to patients and families. The contents of the online intervention will be implemented through a responsive web application. In order to create the most fitted intervention for the real needs of the participants will be created following the principles of User Experience, this ensuring that the design characteristics of the tool will meet the desired requirements to be perceived as easy to use, attractive and useful. The User Experience approach refers to the experience that a user has with a product, with special emphasis on human-product interaction.
- The same intervention but implemented by a therapist via Zoom, Skype, or Teams to continue ensuring protection measures for both the therapist and the patient.
The subjective measures will include the following Psychometric instruments:
- Post-traumatic diagnostic scale
- Plutchik Suicide Risk Scale
- Generalized Anxiety Scale.
- The Center for Epidemiological Studies Depression Scale-Revised
- Professional Quality of Life Measure
- Pittsburgh Sleep Quality Index
- Scale for measuring resilience with Mexicans
- Appraisal of Self-care Agency
- The Fear of COVID-19 Scale
- Opinion on the treatment.
- System usability scale
- Conditions
- Anxiety, Depression, Sleep Disturbance, Quality of Life, Burnout, Professional, Stress
- Being tested
- Online psychological intervention for healthcare workers
- Medical subject headings
- Anxiety Disorders, Depression, Parasomnias, Burnout, Professional, Compassion Fatigue
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Online psychological intervention for healthcare workersBehavioural
The intervention is based on Cognitive Behavioral Therapy, Mindfulness, Behavioral Activation Therapy, Acceptance and Commitment Therapy and Positive Psychology, aimed at the Psychoeducation regarding the manifestations of anxiety, depression, burnout, fatigue compassion, posttraumatic stress disorder, and affectations in sleep quality and perception of life quality in healthcare workers.
And 3 complementary modules that according to the scientific literature could affect the mental health of healthcare workers related to how to deliver bad health news, Psychological first aid and how beliefs could influence physical and emotional self-care in the face of the COVID-19 pandemic.
| Study group | Role | What they receive |
|---|---|---|
| Experimental: Self-applied psychological intervention for healthcare workers | Experimental | Participants in this group will receive 9 sessions of a multi-component psychological intervention focused on the reduction of symptoms of anxiety, depression, stress, burnout, fatigue compassion, and post-traumatic stress, and the increase of the quality of sleep and perception of the quality of life. The participants will have the option to do 3 extra modules that are complimentary for the intervention. Receives: Behavioral: Online psychological intervention for healthcare workers |
| Control: Self-applied psychological intervention for healthcare workers | Active comparator | The participants in this group will receive exactly the same intervention but delivered through a therapist in a weekly session through an online video call. The participants will be informed also about the 3 extra modules and briefly what it is the contents of these modules so they can accept or not receive these extra contents. Receives: Behavioral: Online psychological intervention for healthcare workers |
What is being measured
The primary outcome is the main question the study is designed to answer.
The Center for Epidemiologic Studies Depression Scale-Revised (CESD-R)
The CESD-R is an updated version of the CES-D. The CESD-R consists of 20. This scale assesses the number of depression symptoms within 2 weeks. The scale consists 20 items and contains 4-point score responses (0 to 3) as the following; rarely or none of the time (less than 1 day); some of a little of the time (1-2 days); occasionally or moderate amount of time (3-4 days) and most or all of the time (5-7 days). The total possible range of scores is from 0 to 60 where ^16 is the cut-off point for this scale, and higher scores indicate more symptoms of depression. It is expected a statistically significant decrease (P < 0.05) in depression symptoms.
Measured: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Decrease in the symptoms of General Anxiety Disorder (GAD-7)
On the Generalized Anxiety Disorder 7-item (GAD-7) scale subjects are asked how often, during the last 2 weeks, they have been bothered by each of the 7 core symptoms of generalized anxiety disorder. Response options are "not at all," "several days," "more than half the days," and "nearly every day," scored as 0, 1, 2, and 3, respectively. Therefore, GAD-7 scores range from 0 to 21, with scores of ≥5, ≥10, and ≥15 represent mild, moderate, and severe anxiety symptom levels, respectively. Is expected a statistically significant decrease (P < 0.05) in the General Anxiety symptoms.
Measured: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Decrease in the score of The Pittsburgh Sleep Quality Index (PSQI).
This instrument assesses the quality patterns of sleep. It differentiates the "poor" and "good" sleep by measuring seven areas, where the range score of answers are from 0 to 3, the global sum of this scale can be a value between 0 to 60, and the cutoff point is "5" that indicates a "poor" sleep quality. It is expected a statistically significant decrease (P < 0.05) in the Sleep Quality measure.
Measured: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Decrease in the scores of the Post-Traumatic Stress Disorder Symptom Scale (PSS)
The Post-Traumatic Stress Disorder Symptom Scale is a 17-item structured interview. The severity over the last 2 weeks of each item on the PSS is rated by the interviewer using a 4-point scale: 0 = not at all, 1 = a little bit, 2 = somewhat, and 3 = very much. The maximum possible score is 51 (severely affected) and the minimum possible score is 0 (total absence of the symptoms). The total severity score is calculated as the sum of the severity ratings for the 17 items. The diagnosis of the Post-Traumatic Stress Disorder Symptom Scale is made when at least 1 re-experiencing, 3 avoidance, and 2 arousal symptoms are endorsed on the scale by individuals who were traumatized at least one month prior to the assessment. It is expected a statistically significant decrease (P < 0.05) in the symptoms of Post-Traumatic Stress Disorder in the patients suffering from this disorder.
Measured: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Increase in the score of the Professional Quality of Life Measure (ProQOL)
The professional quality of life will be evaluated with the ProQOL scale (Professional Quality of Life Measure). This scale measures the sections of Satisfaction by empathy, compassion fatigue, and Burnout. The scale is composed of 30 Likert-type questions with five possible answers, being: Never = 1, Rarely = 2, Sometimes = 3, Often = 4 and Often = 5. A score of 17 could indicate affect action in the measured dimensions. It is expected a statistically significant decrease (P < 0.05) in the perception of Professional Quality of Life of the patients.
Measured: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Increase in the score of the Appraisal of Self-care Agency (ASA)
This scale is made up of 24 Likert-type reagents with four types of response, which have a score of one to four points, which when performing the final sum may result in the range of 24-96. The higher the resulting score, the greater the person's self-care capabilities. Maximum ability of self-care is reflected with a score of 96 and a minimum with 24, where high scores of self-care are with scores equal or higher to 76, for a medium ability with equal or higher to 70 but equal or lower than 75 and a low ability any score of 69 or lower. It is expected a statistically significant increase (P < 0.05) in the in the score of the Appraisal of Self-care Agency.
Measured: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Secondary outcomes (2)
Decrease in the Plutchik Suicide Risk Scale (BSI)
The Plutchik Suicide Risk Scale is a structured self-report questionnaire for evaluating Suicide Risk. It consists of 15 items that assess the history of suicide attempts, ideation, and suicide plans. It differentiates patients with a suicide risk from the non-suicide risk. This scale has dichotomous responses of Yes/No, and has a cut-off point of 6, where a point above the cut-off means a higher suicide risk. In this study, the suicidal patients are not considering the depression treatment although is necessary to assess depressive patients to refer to specialized treatment.
Measured: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Increase in the Scale for measuring resilience with Mexicans (RESI-M)
The RESI-M scale is composed of 43 items, the responses are Likert type (totally disagree, disagree, agree, and totally agree). It is expected a statistically significant increase (P < 0.05) in the in the score of resilience
Measured: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 May 2021
- Study start16 Jul 2021
- Primary completion20 Jun 2022 (estimated)
- Study completion20 Jun 2022 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (22)Papers the sponsor has linked to this study.
- Other trials for AnxietyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- The study has two arms, one is the experimental group that receives the treatment solely through the online platform, and the other is the comparison group that will receive treatment delivered through a therapist through video calls. The patients in both groups will be evaluated pre and post/treatment. The participants are assigned randomly to the intervention or comparison group.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 42 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Universidad Internacional de Valencia
- Sponsor type
- University, hospital or other
- Collaborators
- Universidad Autonoma de Ciudad Juarez, University of Guadalajara, Universidad Nacional Autonoma de Mexico, Universidad Internacional del Ecuador, University of Buenos Aires, University of Valencia
- Responsible party
- Sponsor
- Investigators
- Anabel de la Rosa Gómez, PhD, Study chair, Universidad Nacional Autonoma de MexicoPaulina Erika Herdoiza Arroyo, PhD, Study chair, Universidad Internacional del EcuadorRosa Olimpia Castellanos Vargas, MD, Study chair, Universidad Autonoma de Ciudad JuarezJoaquín Mateu Molla, PhD, Study chair, Valencian International UniversityLuis Farfallini, PhD, Study chair, University of Buenos AiresEduardo Bautista Valerio, BD, Study chair, Universidad Nacional Autonoma de Mexico
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04890665
- Sponsor's protocol ID
- VIU-Health_care_workers_COVID
- Status last verified
- Sep 2021
- First submitted
- 17 May 2021
- Last updated
- 5 Oct 2021
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The information will be available in a private server or in a server of the journal(s) that we will publish the articles that will be the result of this study. The protocol of the study is currently in progress to be published, in this article will be included such study protocol, the informed consent is already shared in the register of clinical trials.
Publications
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H, Kang L, Yao L, Huang M, Wang H, Wang G, Liu Z, Hu S. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020 Mar 2;3(3):e203976. doi: 10.1001/jamanetworkopen.2020.3976.
PubMed 32202646Shechter A, Diaz F, Moise N, Anstey DE, Ye S, Agarwal S, Birk JL, Brodie D, Cannone DE, Chang B, Claassen J, Cornelius T, Derby L, Dong M, Givens RC, Hochman B, Homma S, Kronish IM, Lee SAJ, Manzano W, Mayer LES, McMurry CL, Moitra V, Pham P, Rabbani L, Rivera RR, Schwartz A, Schwartz JE, Shapiro PA, Shaw K, Sullivan AM, Vose C, Wasson L, Edmondson D, Abdalla M. Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry. 2020 Sep-Oct;66:1-8. doi: 10.1016/j.genhosppsych.2020.06.007. Epub 2020 Jun 16.
PubMed 32590254Paul V, Patel S, Royse M, Odish M, Malhotra A, Koenig S. Proning in Non-Intubated (PINI) in Times of COVID-19: Case Series and a Review. J Intensive Care Med. 2020 Aug;35(8):818-824. doi: 10.1177/0885066620934801.
PubMed 32633215Allan SM, Bealey R, Birch J, Cushing T, Parke S, Sergi G, Bloomfield M, Meiser-Stedman R. The prevalence of common and stress-related mental health disorders in healthcare workers based in pandemic-affected hospitals: a rapid systematic review and meta-analysis. Eur J Psychotraumatol. 2020 Oct 16;11(1):1810903. doi: 10.1080/20008198.2020.1810903.
PubMed 33244359Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020 Aug;88:901-907. doi: 10.1016/j.bbi.2020.05.026. Epub 2020 May 8.
PubMed 32437915Luo M, Guo L, Yu M, Jiang W, Wang H. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public - A systematic review and meta-analysis. Psychiatry Res. 2020 Sep;291:113190. doi: 10.1016/j.psychres.2020.113190. Epub 2020 Jun 7.
PubMed 32563745Smith GD, Ng F, Ho Cheung Li W. COVID-19: Emerging compassion, courage and resilience in the face of misinformation and adversity. J Clin Nurs. 2020 May;29(9-10):1425-1428. doi: 10.1111/jocn.15231. Epub 2020 Mar 10. No abstract available.
PubMed 32155302Hossain F, Clatty A. Self-care strategies in response to nurses' moral injury during COVID-19 pandemic. Nurs Ethics. 2021 Feb;28(1):23-32. doi: 10.1177/0969733020961825. Epub 2020 Oct 30.
PubMed 33124492Williamson V, Stevelink SAM, Greenberg N. Occupational moral injury and mental health: systematic review and meta-analysis. Br J Psychiatry. 2018 Jun;212(6):339-346. doi: 10.1192/bjp.2018.55.
PubMed 29786495Drissi N, Ouhbi S, Marques G, de la Torre Diez I, Ghogho M, Janati Idrissi MA. A Systematic Literature Review on e-Mental Health Solutions to Assist Health Care Workers During COVID-19. Telemed J E Health. 2021 Jun;27(6):594-602. doi: 10.1089/tmj.2020.0287. Epub 2020 Sep 22.
PubMed 32970532Yang L, Yin J, Wang D, Rahman A, Li X. Urgent need to develop evidence-based self-help interventions for mental health of healthcare workers in COVID-19 pandemic. Psychol Med. 2021 Jul;51(10):1775-1776. doi: 10.1017/S0033291720001385. Epub 2020 Apr 28. No abstract available.
PubMed 32340642Koslowsky M, Bleich A, Greenspoon A, Wagner B, Apter A, Solomon Z. Assessing the validity of the Plutchik Suicide Risk Scale. J Psychiatr Res. 1991;25(4):155-8. doi: 10.1016/0022-3956(91)90019-7.
PubMed 1779413Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4.
PubMed 2748771Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. doi: 10.1001/archinte.166.10.1092.
PubMed 16717171Novy DM, Stanley MA, Averill P, Daza P. Psychometric comparability of English- and Spanish-language measures of anxiety and related affective symptoms. Psychol Assess. 2001 Sep;13(3):347-55. doi: 10.1037//1040-3590.13.3.347.
PubMed 11556271
Study at a glance
From the registry record, last updated by the sponsor on 5 Oct 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effectiveness of a Self-applied Multi-component Psychological Online Intervention Based on User Experience, for Anxiety, Depression, Burnout, Fatigue Compassion on Healthcare Workers During the COVID-19 Outbreak: A Randomized Clinical Trial
- ClinicalTrials.gov ID
- NCT04890665
- Acronym / sponsor ID
- VIU-Health_care_workers_COVID
- Conditions
- Anxiety, Depression, Sleep Disturbance, Quality of Life, Burnout, Professional, Stress
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 42 participants (estimated)
- Lead sponsor
- Universidad Internacional de ValenciaUniversity, hospital or other
- Collaborators
- Universidad Autonoma de Ciudad Juarez, University of Guadalajara, Universidad Nacional Autonoma de Mexico, Universidad Internacional del Ecuador, University of Buenos Aires, University of Valencia
- Study start
- 16 Jul 2021 (actual)
- Primary completion
- 20 Jun 2022 (estimated)
- Study completion
- 20 Jun 2022 (estimated)
- First posted
- 18 May 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The objective of this study is to carry out a randomized clinical trial with healthcare workers in Mexico through a web platform. The intervention aims to reduce anxiety, depressive symptoms, burnout, stress, compassion fatigue, and increase the quality of life and sleep and self-care, as well as improve skills in providing bad news to patients and their families. A self-applied intervention will be compared with an intervention delivered by therapists providing the same intervention implemented through Zoom, Skype, or Microsoft Teams, to ensure sanitary protection measures.
Detailed description
Recent studies indicate that a lack of personal protective equipment, an unreasonable amount of work, inadequate medications, fear of contracting the disease, spreading the disease to co-workers and family, and lack of qualified training, have put front-line healthcare workers with unimaginable stress. There are various psycho social stressors to which the person who is working in this line of action is exposed. Nurses have been found to be one of the most affected groups because they have manifested various psychological consequences, including anxiety, depression, and stress. Likewise, multiple studies have reported psychological discomfort in health workers, especially those who are in areas of care for patients infected by COVID-19, among the most frequent psychological consequences that have been found, high prevalence of anxiety, depression, stress, insomnia, and high levels of distress are observed. Some of the challenges faced by health personnel who are in contact with patients infected by the virus are having a higher risk of contagion, not having the necessary personal equipment to prevent contagion, excessive workload, and even neglecting activities basic. In addition to these unfavorable working conditions faced by COVID-19 front line care staff, there is a need to make complex decisions that can generate moral or ethical damage. Consequently, this situation can trigger a series of negative emotional alterations, such as anxiety, depression, post-traumatic stress disorder, and even suicidal ideas.
Due to the current restrictions derived from the pandemic, psychological digital interventions have been an effective option to overcome barriers in mental health care for this population. Likewise, this type of intervention can provide various benefits, such as carried out by different means and the efficacy that they have shown to treat a wide range of mental health problems.
The objective of this study is to carry out a randomized clinical trial through a web platform which will have two groups: 1) Self-applied intervention directed at health personnel from all over Mexico for the reduction of symptoms of anxiety, depression, burnout, stress, compassion fatigue and increased self-care, quality of sleep and perceived quality of life, as well as how to offer tools to acquire knowledge about how to notify bad news to patients and families. The contents of the online intervention will be implemented through a responsive web application. In order to create the most fitted intervention for the real needs of the participants will be created following the principles of User Experience, this ensuring that the design characteristics of the tool will meet the desired requirements to be perceived as easy to use, attractive and useful. The User Experience approach refers to the experience that a user has with a product, with special emphasis on human-product interaction.
- The same intervention but implemented by a therapist via Zoom, Skype, or Teams to continue ensuring protection measures for both the therapist and the patient.
The subjective measures will include the following Psychometric instruments:
- Post-traumatic diagnostic scale
- Plutchik Suicide Risk Scale
- Generalized Anxiety Scale.
- The Center for Epidemiological Studies Depression Scale-Revised
- Professional Quality of Life Measure
- Pittsburgh Sleep Quality Index
- Scale for measuring resilience with Mexicans
- Appraisal of Self-care Agency
- The Fear of COVID-19 Scale
- Opinion on the treatment.
- System usability scale
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- The study has two arms, one is the experimental group that receives the treatment solely through the online platform, and the other is the comparison group that will receive treatment delivered through a therapist through video calls. The patients in both groups will be evaluated pre and post/treatment. The participants are assigned randomly to the intervention or comparison group.
| Arm | Type | Receives |
|---|---|---|
| Experimental: Self-applied psychological intervention for healthcare workers | Experimental | Behavioral: Online psychological intervention for healthcare workersParticipants in this group will receive 9 sessions of a multi-component psychological intervention focused on the reduction of symptoms of anxiety, depression, stress, burnout, fatigue compassion, and post-traumatic stress, and the increase of the quality of sleep and perception of the quality of life. The participants will have the option to do 3 extra modules that are complimentary for the intervention. |
| Control: Self-applied psychological intervention for healthcare workers | Active comparator | Behavioral: Online psychological intervention for healthcare workersThe participants in this group will receive exactly the same intervention but delivered through a therapist in a weekly session through an online video call. The participants will be informed also about the 3 extra modules and briefly what it is the contents of these modules so they can accept or not receive these extra contents. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- To have access to a communication device with access to the internet (computer, tablet, and mobile)
- To have a valid email address.
- To have basic digital skills in the use of an operational system and internet browsing.
- To understand Spanish since all the contents are in this language.
- Symptoms of anxiety, depression, burnout, and fatigue compassion
Key exclusion criteria (5 listed)
- To have a diagnosis of psychotic disorder
- To be receiving psychological and/or pharmacological treatment during the study
- Moderate to a high score on the suicide scale
- Recent attempt of suicide (3 months)
- To refuse to accept to participate
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Online psychological intervention for healthcare workersThe intervention is based on Cognitive Behavioral Therapy, Mindfulness, Behavioral Activation Therapy, Acceptance and Commitment Therapy and Positive Psychology, aimed at the Psychoeducation regarding the manifestations of anxiety, depression, burnout, fatigue compassion, posttraumatic stress disorder, and affectations in sleep quality and perception of life quality in healthcare workers. And 3 complementary modules that according to the scientific literature could affect the mental health of healthcare workers related to how to deliver bad health news, Psychological first aid and how beliefs could influence physical and emotional self-care in the face of the COVID-19 pandemic. | Behavioural | Control: Self-applied psychological intervention for healthcare workers, Experimental: Self-applied psychological intervention for healthcare workers |
Primary outcome
The Center for Epidemiologic Studies Depression Scale-Revised (CESD-R)
Time frame: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
The CESD-R is an updated version of the CES-D. The CESD-R consists of 20. This scale assesses the number of depression symptoms within 2 weeks. The scale consists 20 items and contains 4-point score responses (0 to 3) as the following; rarely or none of the time (less than 1 day); some of a little of the time (1-2 days); occasionally or moderate amount of time (3-4 days) and most or all of the time (5-7 days). The total possible range of scores is from 0 to 60 where ^16 is the cut-off point for this scale, and higher scores indicate more symptoms of depression. It is expected a statistically significant decrease (P < 0.05) in depression symptoms.
Decrease in the symptoms of General Anxiety Disorder (GAD-7)
Time frame: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
On the Generalized Anxiety Disorder 7-item (GAD-7) scale subjects are asked how often, during the last 2 weeks, they have been bothered by each of the 7 core symptoms of generalized anxiety disorder. Response options are "not at all," "several days," "more than half the days," and "nearly every day," scored as 0, 1, 2, and 3, respectively. Therefore, GAD-7 scores range from 0 to 21, with scores of ≥5, ≥10, and ≥15 represent mild, moderate, and severe anxiety symptom levels, respectively. Is expected a statistically significant decrease (P < 0.05) in the General Anxiety symptoms.
Decrease in the score of The Pittsburgh Sleep Quality Index (PSQI).
Time frame: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
This instrument assesses the quality patterns of sleep. It differentiates the "poor" and "good" sleep by measuring seven areas, where the range score of answers are from 0 to 3, the global sum of this scale can be a value between 0 to 60, and the cutoff point is "5" that indicates a "poor" sleep quality. It is expected a statistically significant decrease (P < 0.05) in the Sleep Quality measure.
Decrease in the scores of the Post-Traumatic Stress Disorder Symptom Scale (PSS)
Time frame: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
The Post-Traumatic Stress Disorder Symptom Scale is a 17-item structured interview. The severity over the last 2 weeks of each item on the PSS is rated by the interviewer using a 4-point scale: 0 = not at all, 1 = a little bit, 2 = somewhat, and 3 = very much. The maximum possible score is 51 (severely affected) and the minimum possible score is 0 (total absence of the symptoms). The total severity score is calculated as the sum of the severity ratings for the 17 items. The diagnosis of the Post-Traumatic Stress Disorder Symptom Scale is made when at least 1 re-experiencing, 3 avoidance, and 2 arousal symptoms are endorsed on the scale by individuals who were traumatized at least one month prior to the assessment. It is expected a statistically significant decrease (P < 0.05) in the symptoms of Post-Traumatic Stress Disorder in the patients suffering from this disorder.
Increase in the score of the Professional Quality of Life Measure (ProQOL)
Time frame: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
The professional quality of life will be evaluated with the ProQOL scale (Professional Quality of Life Measure). This scale measures the sections of Satisfaction by empathy, compassion fatigue, and Burnout. The scale is composed of 30 Likert-type questions with five possible answers, being: Never = 1, Rarely = 2, Sometimes = 3, Often = 4 and Often = 5. A score of 17 could indicate affect action in the measured dimensions. It is expected a statistically significant decrease (P < 0.05) in the perception of Professional Quality of Life of the patients.
Increase in the score of the Appraisal of Self-care Agency (ASA)
Time frame: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
This scale is made up of 24 Likert-type reagents with four types of response, which have a score of one to four points, which when performing the final sum may result in the range of 24-96. The higher the resulting score, the greater the person's self-care capabilities. Maximum ability of self-care is reflected with a score of 96 and a minimum with 24, where high scores of self-care are with scores equal or higher to 76, for a medium ability with equal or higher to 70 but equal or lower than 75 and a low ability any score of 69 or lower. It is expected a statistically significant increase (P < 0.05) in the in the score of the Appraisal of Self-care Agency.
2 secondary outcomes
Decrease in the Plutchik Suicide Risk Scale (BSI)
Time frame: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Increase in the Scale for measuring resilience with Mexicans (RESI-M)
Time frame: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Oct 2021.
- Background: PubMed 32202646Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H, Kang L, Yao L, Huang M, Wang H, Wang G, Liu Z, Hu S. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020 Mar 2;3(3):e203976. doi: 10.1001/jamanetworkopen.2020.3976.
- Background: PubMed 32590254Shechter A, Diaz F, Moise N, Anstey DE, Ye S, Agarwal S, Birk JL, Brodie D, Cannone DE, Chang B, Claassen J, Cornelius T, Derby L, Dong M, Givens RC, Hochman B, Homma S, Kronish IM, Lee SAJ, Manzano W, Mayer LES, McMurry CL, Moitra V, Pham P, Rabbani L, Rivera RR, Schwartz A, Schwartz JE, Shapiro PA, Shaw K, Sullivan AM, Vose C, Wasson L, Edmondson D, Abdalla M. Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry. 2020 Sep-Oct;66:1-8. doi: 10.1016/j.genhosppsych.2020.06.007. Epub 2020 Jun 16.
- Background: PubMed 32633215Paul V, Patel S, Royse M, Odish M, Malhotra A, Koenig S. Proning in Non-Intubated (PINI) in Times of COVID-19: Case Series and a Review. J Intensive Care Med. 2020 Aug;35(8):818-824. doi: 10.1177/0885066620934801.
- Background: PubMed 33244359Allan SM, Bealey R, Birch J, Cushing T, Parke S, Sergi G, Bloomfield M, Meiser-Stedman R. The prevalence of common and stress-related mental health disorders in healthcare workers based in pandemic-affected hospitals: a rapid systematic review and meta-analysis. Eur J Psychotraumatol. 2020 Oct 16;11(1):1810903. doi: 10.1080/20008198.2020.1810903.
- Background: PubMed 32437915Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020 Aug;88:901-907. doi: 10.1016/j.bbi.2020.05.026. Epub 2020 May 8.
- Background: PubMed 32563745Luo M, Guo L, Yu M, Jiang W, Wang H. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public - A systematic review and meta-analysis. Psychiatry Res. 2020 Sep;291:113190. doi: 10.1016/j.psychres.2020.113190. Epub 2020 Jun 7.
- Background: PubMed 32155302Smith GD, Ng F, Ho Cheung Li W. COVID-19: Emerging compassion, courage and resilience in the face of misinformation and adversity. J Clin Nurs. 2020 May;29(9-10):1425-1428. doi: 10.1111/jocn.15231. Epub 2020 Mar 10. No abstract available.
- Background: PubMed 33124492Hossain F, Clatty A. Self-care strategies in response to nurses' moral injury during COVID-19 pandemic. Nurs Ethics. 2021 Feb;28(1):23-32. doi: 10.1177/0969733020961825. Epub 2020 Oct 30.
- Background: PubMed 29786495Williamson V, Stevelink SAM, Greenberg N. Occupational moral injury and mental health: systematic review and meta-analysis. Br J Psychiatry. 2018 Jun;212(6):339-346. doi: 10.1192/bjp.2018.55.
- Background: PubMed 32970532Drissi N, Ouhbi S, Marques G, de la Torre Diez I, Ghogho M, Janati Idrissi MA. A Systematic Literature Review on e-Mental Health Solutions to Assist Health Care Workers During COVID-19. Telemed J E Health. 2021 Jun;27(6):594-602. doi: 10.1089/tmj.2020.0287. Epub 2020 Sep 22.
- Background: PubMed 32340642Yang L, Yin J, Wang D, Rahman A, Li X. Urgent need to develop evidence-based self-help interventions for mental health of healthcare workers in COVID-19 pandemic. Psychol Med. 2021 Jul;51(10):1775-1776. doi: 10.1017/S0033291720001385. Epub 2020 Apr 28. No abstract available.
- Background: PubMed 1779413Koslowsky M, Bleich A, Greenspoon A, Wagner B, Apter A, Solomon Z. Assessing the validity of the Plutchik Suicide Risk Scale. J Psychiatr Res. 1991;25(4):155-8. doi: 10.1016/0022-3956(91)90019-7.
- Individual participant dataSharing planned: Yes. The information will be available in a private server or in a server of the journal(s) that we will publish the articles that will be the result of this study. The protocol of the study is currently in progress to be published, in this article will be included such study protocol, the informed consent is already shared in the register of clinical trials.
Related trials for Anxiety
RecruitingPhase 2
Study of Neuro-Cognitive Correlates of Pediatric Anxiety Disorders
Anxiety Disorders, Major Depressive Disorder
RecruitingObservational study
Development of Magnetic Resonance Imaging Techniques for Studying Mood and Anxiety Disorders
Mood Disorders, Anxiety Disorders
Active, not recruiting
Preventing Anxiety and Depression in Older Hispanics
Depression, Anxiety
RecruitingPhase 1
Effects of Intranasal Oxytocin in Patients With Arginine-vasopressin Deficiency
Vasopressin Deficiency
Recruiting
Music Interventions During Wide-Awake Hand Surgery
Anxiety, Surgery
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Anabel de la Rosa Gómez, PhD study chair
Universidad Nacional Autonoma de Mexico
Paulina Erika Herdoiza Arroyo, PhD study chair
Universidad Internacional del Ecuador
Rosa Olimpia Castellanos Vargas, MD study chair
Universidad Autonoma de Ciudad Juarez
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Online psychological intervention for healthcare workers in people with Anxiety and Depression, run by Universidad Internacional de Valencia at 3 sites in Mexico.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 5 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in Mexico. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Alejandro Dominguez Rodriguez, PhD (+521 664 471 3277, alejandro.dominguez.r@campusviu.es), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) (time frame: Time Frame: 1 to 1.5 months, depending on the development of the patient and the completion of the 9 nuclear modules.). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04890665, which also lists 22 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Oct 2021; AzTrials last refreshed its copy on 26 Oct 2026.