The Efficacy of the Internet-Based Stress Recovery Intervention FOREST for Nurses Amid the COVID-19 Pandemic: A Randomized Controlled Trial

Dumarkaite, Austeja; Truskauskaite, Inga; Andersson, Gerhard; Jovarauskaite, Lina; Jovaisiene, Ieva; Nomeikaite, Auguste; Kazlauskas, Evaldas

The Efficacy of the Internet-Based Stress Recovery Intervention FOREST for Nurses Amid the COVID-19 Pandemic: A Randomized Controlled Trial

Dumarkaite, Austeja; Truskauskaite, Inga; Andersson, Gerhard; Jovarauskaite, Lina; Jovaisiene, Ieva; Nomeikaite, Auguste; Kazlauskas, Evaldas

Abstract

BACKGROUND: The COVID-19 pandemic demanded exceptional physical and mental effort from healthcare workers worldwide. Since healthcare workers often refrain from seeking professional psychological support, internet-delivered interventions could serve as a viable alternative option. OBJECTIVE: We aimed to investigate the effects of a therapist-guided six-week CBT-based internet-delivered stress recovery intervention among medical nurses using a randomized controlled trial design. We also aimed to assess program usability. METHODS: 168 nurses working in a healthcare setting (Mage = 42.12, SDage = 11.38; 97 % female) were included in the study. The intervention group included 77 participants, and the waiting list control group had 91 participants. Self-report data were collected online at three timepoints: pre-test, post-test, and three-month follow-up. The primary outcome was stress recovery. Secondary outcomes included measures of perceived stress, anxiety and depression symptoms, psychological well-being, posttraumatic stress and complex posttraumatic stress symptoms, and moral injury. RESULTS: We found that the stress recovery intervention FOREST improved stress recovery, including psychological detachment (d = 0.83 [0.52; 1.15]), relaxation (d = 0.93 [0.61, 1.25]), mastery (d = 0.64 [0.33; 0.95]), and control (d = 0.46 [0.15; 0.76]). The effects on psychological detachment, relaxation, and mastery remained stable at the three month follow-up. The intervention was also effective in reducing its users' stress (d = − 0.49 [− 0.80; − 0.18]), anxiety symptoms (d = − 0.31 [− 0.62; − 0.01]), depression symptoms (d = − 0.49 [− 0.80; − 0.18]) and increasing psychological well-being (d = 0.53 [0.23; 0.84]) with the effects on perceived stress, depression symptoms, and well-being remaining stable at the three-month follow-up. High user satisfaction and good usability of the intervention were also reported. CONCLUSIONS: The present study demonstrated that an internet-based intervention for healthcare staff could increase stress recovery skills, promote psychological well-being, and reduce stress, anxiety, and depression symptoms, with most of the effects being stable over three months.

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International Journal of Nursing Studies
2023
Profession(s)
Nurses
Topic(s)
Stress/Trauma
Moral Distress or Moral Injury
Resource Types
Peer-Reviewed Research
Study Type(s)
Randomized Controlled Trial (RCT)
Action Strategy Area(s)
Physical & Mental Health
Measurement
Setting(s)
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Academic Role(s)
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