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 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

Consequences of Elder Abuse and Neglect: A Systematic Review of Observational Studies

2017 ◽  
Vol 20 (2) ◽  
pp. 197-213 ◽  
Author(s):  
Raudah Mohd Yunus ◽  
Noran Naqiah Hairi ◽  
Wan Yuen Choo
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Low Income ◽  
Observational Studies ◽  
Elder Abuse ◽  
Care Utilization ◽  
Health Care Consumption ◽  
Elder Abuse And Neglect ◽  
Wide Range ◽  
Abuse And Neglect

This article presents the results of a systematic review of the consequences of elder abuse and neglect (EAN). A systematic search was conducted in seven electronic databases and three sources of gray literature up to January 8, 2016, supplemented by scanning of citation lists in relevant articles and contact with field experts. All observational studies investigating elder abuse as a risk factor for adverse health outcomes, mortality, and health-care utilization were included. Of 517 articles initially captured, 19 articles met our inclusion criteria and were analyzed. Two reviewers independently performed abstract screening, full-texts appraisal, and quality assessment using the Newcastle–Ottawa Scale. Across 19 studies, methodological heterogeneity was a prominent feature; seven definitions of EAN and nine measurement tools for abuse were employed. Summary of results reveals a wide range of EAN outcomes, from premature mortality to increased health-care consumption and various forms of physical and psychological symptoms. Higher risks of mortality emerged as the most credible outcome, while the majority of morbidity outcomes originated from cross-sectional studies. Our findings suggest that there is an underrepresentation of older adults from non-Western populations and developing countries, and there is a need for more population-based prospective studies in middle- and low-income regions. Evidence gathered from this review is crucial in upgrading current practices, formulating policies, and shaping the future direction of research.

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 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.

What do patients do before it starts? Coping with mental health problems on a CBT waiting list

2008 ◽  
Vol 1 (1) ◽  
pp. 45-54 ◽  
Author(s):  
Sylvia Helbig ◽  
Jürgen Hoyer
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Coping Strategies ◽  
Waiting Time ◽  
Waiting List ◽  
Care Utilization ◽  
Passive Coping ◽  
Self Help ◽  
Mean Waiting Time ◽  
Wide Range

AbstractData from a patient survey on self-help and coping strategies during waiting time for CBT are reported. Individuals on an outpatient treatment centre waiting list received a short questionnaire assessing problem-related activities carried out in the interval before therapy (mean waiting time 69 days). A total of 306 patients with a wide range of reliably diagnosed mental disorders were assessed. Results showed that the vast majority of patients (~95%) instigated at least one form of coping or self-help activity related to their mental problem. Resource-orientated strategies were most often reported (88%), but ‘seeking information about the problem’ was also highly prevalent. About one third of persons reported additional health-care utilization. Higher rates of symptom distress and depression were associated with additional health-care utilization and with more passive coping strategies such as distraction. Active self-help strategies contributed to poorer depression outcome and were, thus, no indicator of good prognosis. Other coping strategies were not linked to outcome variables. It can be concluded that problem-related processes do start before treatment. A more systematic integration of self-help activities into the case-formulation and more systematic research on the related (motivational) processes are recommended.

scholarly journals Web-Based Intervention for Developing Long-Term Health Literacy of Individuals: Possibilities and Limitations

2016 ◽  
Vol 18 (1) ◽  
pp. 69-83
Author(s):  
Aira Aija Krūmiņa ◽  
Jelena Ļubenko
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Structural Model ◽  
Scientific Literature ◽  
Online Programs ◽  
Web Based ◽  
Health Maintenance ◽  
Medical Practitioners ◽  
Wide Range

Abstract Web-based interventions (WBI) are purposefully developed online programs designed for wide range of users (clients, patients, health care specialists, as well as medical practitioners) which allow obtaining and using information on various issues related to health maintenance and improvement. On the basis of the analysis of scientific literature, the article provides an overview of WBI types and components, as well as a structural model of WBI and its user in the context of environment factors. The possibilities of using WBI for developing long-term health literacy of individuals are specified. By summarising the main advantages and limitations of using WBI, the possible suggestions for the WBI use and development are offered.

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-S259
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 Recovery Program (ICUTogether) for Intensive Care Survivors: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Beverley Ewens ◽  
Helen Myers ◽  
Lisa Whitehead ◽  
Karla Seaman ◽  
Deborah Sundin ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Family Support ◽  
Well Being ◽  
Web Based ◽  
Time Points ◽  
Recovery Program ◽  
The Impact ◽  
Mental Well Being

BACKGROUND Those who experience a critical illness or condition requiring admission to an intensive care unit (ICU) frequently experience physical and psychological complications as a direct result of their critical illness or condition and ICU experience. Complications, if left untreated, can affect the quality of life of survivors and impact health care resources. Explorations of potential interventions to reduce the negative impact of an ICU experience have failed to establish an evidence-based intervention. OBJECTIVE The aim of this study is to evaluate the impact of a Web-based intensive care recovery program on the mental well-being of intensive care survivors and to determine if it is a cost-effective approach. METHODS In total, 162 patients that survived an ICU experience will be recruited and randomized into 1 of 2 groups. The intervention group will receive access to the Web-based intensive care recovery program, ICUTogether, 2 weeks after discharge (n=81), and the control group will receive usual care (n=81). Mental well-being will be measured using the Hospital Anxiety and Depression Scale, The Impact of Events Scale-Revised and the 5-level 5-dimension EuroQoL at 3 time points (2 weeks, 6 months, and 12 months post discharge). Family support will be measured using the Multidimensional Scale of Perceived Social Support at 3 time points. Analysis will be conducted on an intention-to-treat basis using regression modeling. Covariates will include baseline outcome measures, study allocation (intervention or control), age, gender, length of ICU stay, APACHE III score, level of family support, and hospital readmissions. Participants’ evaluation of the mobile website will be sought at 12 months postdischarge. A cost utility analysis conducted at 12 months from a societal perspective will consider costs incurred by individuals as well as health care providers. RESULTS Participant recruitment is currently underway. Recruitment is anticipated to be completed by December 2020. CONCLUSIONS This study will evaluate a novel intervention in a group of ICU survivors. The findings from this study will inform a larger study and wider debate about an appropriate intervention in this population.

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