The Use of a Mobile Application to Reduce Work-related Stress Symptoms Among Healthcare Workers (DIARY)

Karolinska Institute

Status: Completed

Conditions: Burnout, Professional; Stress, Psychological

Treatments: Behavioral: The DIARY mobile application

Study type: Interventional

Funder types: Other

Identifiers

NCT04719351

2020-05800 (Other Identifier)

4-2092/2020

Details and patient eligibility

About

The current pandemic highlighted an urgent need for early interventions to mitigate the psychological effects of extreme work demands that healthcare workers currently experience. This project aims at developing a data driven monitoring system to efficiently track work-related stress reactions over time. The system will also include a self-awareness intervention grounded on evidence-based strategies to improve workers' recovery. The solution will be delivered through a mobile application for a rapid implementation among healthcare workers and related professions. The mobile application will be developed through an initial analysis of pilot data, a factorial experiment and a user-experience analysis. Qualitative user experience data will also be used to validate the functionality of the monitoring system. The solution developed in this project will be easily scalable to related occupations, for example workers at elderly homes and social workers. After the pandemic, it can also be used as a preventive intervention for workers who are at risk of burnout and as a support for patients returning to work after treatment for common mental disorders.

Full description

Symptoms indicating possibly pathological stress reactions among healthcare workers are more prevalent during the current pandemic than they were before. Possible reasons for that include higher levels of known risk factors such as cognitive, emotional, and physical demands at work; new stressors such as risk for moral injury and worry about personal safety; and diminished protective mechanisms, which include recovery opportunities and psychological detachment. Thus, frontline healthcare workers should be given priority in access to psychological support.

Despite the urgent need for it, a rapid implementation of psychological support for healthcare workers has proved to be challenging during previous crises and the current pandemic. Guidelines published thus far underline the necessity of close real-time monitoring in order to early identify at risk populations and individuals, who should be referred to seek professional support. However, appropriate tools for efficient real-time monitoring of stress responses and early screening for possibly pathological reactions among healthcare workers are currently lacking. Available tools focus either on tracking of stress indicators e.g. sleep disturbances, or on teaching strategies to better cope with stress e.g. mindfulness.

In this study, the investigators will test whether a separate use or a combination of these different functions may be the most efficient in managing work-related stress symptoms among healthcare workers. The study has a factorial design in order to closely investigate the functionalities focused on real-time monitoring of emotional responses and the functionalities based on evidence-based strategies to improve workers' recovery, as well as the possible interactions among them.

Enrollment: 330 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• adult participants
• working (active employment)

Exclusion criteria

• no active employment e.g. sick leave, maternity leave during the entire period of an intervention (four weeks)

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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330 participants in 32 patient groups

Condition 1: Positive: no; Workload: no; Controllability: no; Open: no; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: not included; 4. Questions with open answers: not included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 2: Positive: yes; Workload: no; Controllability: no; Open: no; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: not included; 4. Questions with open answers: not included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 3: Positive: no; Workload: yes; Controllability: no; Open: no; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: included; 3. Questions about controllability: not included; 4. Questions with open answers: not included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 4: Positive: yes; Workload: yes; Controllability: no; Open: no; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: included; 3. Questions about controllability: not included; 4. Questions with open answers: not included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 5: Positive: no; Workload: no; Controllability: yes; Open: no; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: included; 4. Questions with open answers: not included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 6: Positive: yes; Workload: no; Controllability: yes; Open: no; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: included; 4. Questions with open answers: not included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 7: Positive: no; Workload: yes; Controllability: yes; Open: no; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: included; 3. Questions about controllability: included; 4. Questions with open answers: not included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 8: Positive: yes; Workload: yes; Controllability: yes; Open: no; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: included; 3. Questions about controllability: included; 4. Questions with open answers: not included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 9: Positive: no; Workload: no; Controllability: no; Open: yes; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: not included; 4. Questions with open answers: included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 10: Positive: yes; Workload: no; Controllability: no; Open: yes; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: not included; 4. Questions with open answers: included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 11: Positive: no; Workload: yes; Controllability: no; Open: yes; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: included; 3. Questions about controllability: not included; 4. Questions with open answers: included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 12: Positive: yes; Workload: yes; Controllability: no; Open: yes; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: included; 3. Questions about controllability: not included; 4. Questions with open answers: included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 13: Positive: no; Workload: no; Controllability: yes; Open: yes; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: included; 4. Questions with open answers: included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 14: Positive: yes; Workload: no; Controllability: yes; Open: yes; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: included; 4. Questions with open answers: included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 15: Positive: no; Workload: yes; Controllability: yes; Open: yes; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: included; 3. Questions about controllability: included; 4. Questions with open answers: included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 16: Positive: yes; Workload: yes; Controllability: yes; Open: yes; Prompt: no;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: included; 3. Questions about controllability: included; 4. Questions with open answers: included; 5. Behavioral prompts: not included;

Treatment:

Behavioral: The DIARY mobile application

Condition 17: Positive: no; Workload: no; Controllability: no; Open: no; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: not included; 4. Questions with open answers: not included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 18: Positive: yes; Workload: no; Controllability: no; Open: no; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: not included; 4. Questions with open answers: not included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 19: Positive: no; Workload: yes; Controllability: no; Open: no; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: included; 3. Questions about controllability: not included; 4. Questions with open answers: not included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 20: Positive: yes; Workload: yes; Controllability: no; Open: no; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: included; 3. Questions about controllability: not included; 4. Questions with open answers: not included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 21: Positive: no; Workload: no; Controllability: yes; Open: no; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: included; 4. Questions with open answers: not included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 22: Positive: yes; Workload: no; Controllability: yes; Open: no; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: included; 4. Questions with open answers: not included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 23: Positive: no; Workload: yes; Controllability: yes; Open: no; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: included; 3. Questions about controllability: included; 4. Questions with open answers: not included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 24: Positive: yes; Workload: yes; Controllability: yes; Open: no; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: included; 3. Questions about controllability: included; 4. Questions with open answers: not included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 25: Positive: no; Workload: no; Controllability: no; Open: yes; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: not included; 4. Questions with open answers: included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 26: Positive: yes; Workload: no; Controllability: no; Open: yes; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: not included; 4. Questions with open answers: included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 27: Positive: no; Workload: yes; Controllability: no; Open: yes; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: included; 3. Questions about controllability: not included; 4. Questions with open answers: included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 28: Positive: yes; Workload: yes; Controllability: no; Open: yes; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: included; 3. Questions about controllability: not included; 4. Questions with open answers: included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 29: Positive: no; Workload: no; Controllability: yes; Open: yes; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: included; 4. Questions with open answers: included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 30: Positive: yes; Workload: no; Controllability: yes; Open: yes; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: not included; 3. Questions about controllability: included; 4. Questions with open answers: included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 31: Positive: no; Workload: yes; Controllability: yes; Open: yes; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: not included; 2. Questions about workload/work environment: included; 3. Questions about controllability: included; 4. Questions with open answers: included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application

Condition 32: Positive: yes; Workload: yes; Controllability: yes; Open: yes; Prompt: yes;

Experimental group

Description:

Component list: 1. Questions about positive emotions: included; 2. Questions about workload/work environment: included; 3. Questions about controllability: included; 4. Questions with open answers: included; 5. Behavioral prompts: included;

Treatment:

Behavioral: The DIARY mobile application