PDF(Pubmed)
Abstract：
BACKGROUND: Health care workers (HCWs) frequently face multiple stressors at work, particularly those working night shifts. HCWs who have experienced distress may find it difficult to adopt stress management approaches, even if they are aware of the effects of stress and coping processes. Therefore, an individualized intervention may be required to assist distressed HCWs in bridging the \"knowledge-practice\" gap in stress management and effectively alleviating stress symptoms.
OBJECTIVE: The main objective of this research was to compare the effects of a complex interactive multimodal intervention (CIMI) to self-guided stress management interventions on stress symptoms of distressed HCWs, as measured by physiological (heart rate variability), psychological (perceived stress, mental distress, and subjective happiness), and sleep disorder (fatigue and sleepiness) indicators.
METHODS: We conducted a nonrandomized, controlled study in 2 Chinese general hospitals. The participants in this study were 245 HCWs who fulfilled at least 1 of the 3 dimensions on the Depression, Anxiety, and Stress Scale. All eligible individuals were required to complete a questionnaire and wear a 24-hour Holter device to determine the physiological signs of stress as indexed by heart rate variability at both baseline and after the intervention. The CIMI group received a 12-week online intervention with 4 components-mobile stress management instruction, a web-based WeChat social network, personalized feedback, and a nurse coach, whereas the control group simply received a self-guided intervention.
RESULTS: After a 12-week intervention, the Perceived Stress Scale (PSS) scores reduced significantly in the CIMI group (mean difference [MD] -5.31, 95% CI -6.26 to -4.37; P<.001) compared to the baseline levels. The changes in PSS scores before and after the intervention exhibited a significant difference between the CIMI and control groups (d=-0.64; MD -4.03, 95% CI -5.91 to -2.14; P<.001), and the effect was medium. In terms of physiological measures, both the control group (MD -9.56, 95% CI -16.9 to -2.2; P=.01) and the CIMI group (MD -8.45, 95% CI -12.68 to -4.22; P<.001) demonstrated a significant decrease in the standard deviation of normal-to-normal intervals (SDNN) within the normal clinical range; however, there were no significant differences between the 2 groups (d=0.03; MD 1.11, 95% CI -7.38 to 9.59; P=.80).
CONCLUSIONS: The CIMI was an effective intervention for improving sleep disorders, as well as parts of the psychological stress measures in distressed HCWs. The findings provide objective evidence for developing a mobile stress management intervention that is adaptable and accessible to distressed HCWs, but its long-term effects should be investigated in future research.
BACKGROUND: ClinicalTrials.gov NCT05239065; https://clinicaltrials.gov/ct2/show/NCT05239065.
OBJECTIVE: The main objective of this research was to compare the effects of a complex interactive multimodal intervention (CIMI) to self-guided stress management interventions on stress symptoms of distressed HCWs, as measured by physiological (heart rate variability), psychological (perceived stress, mental distress, and subjective happiness), and sleep disorder (fatigue and sleepiness) indicators.
METHODS: We conducted a nonrandomized, controlled study in 2 Chinese general hospitals. The participants in this study were 245 HCWs who fulfilled at least 1 of the 3 dimensions on the Depression, Anxiety, and Stress Scale. All eligible individuals were required to complete a questionnaire and wear a 24-hour Holter device to determine the physiological signs of stress as indexed by heart rate variability at both baseline and after the intervention. The CIMI group received a 12-week online intervention with 4 components-mobile stress management instruction, a web-based WeChat social network, personalized feedback, and a nurse coach, whereas the control group simply received a self-guided intervention.
RESULTS: After a 12-week intervention, the Perceived Stress Scale (PSS) scores reduced significantly in the CIMI group (mean difference [MD] -5.31, 95% CI -6.26 to -4.37; P<.001) compared to the baseline levels. The changes in PSS scores before and after the intervention exhibited a significant difference between the CIMI and control groups (d=-0.64; MD -4.03, 95% CI -5.91 to -2.14; P<.001), and the effect was medium. In terms of physiological measures, both the control group (MD -9.56, 95% CI -16.9 to -2.2; P=.01) and the CIMI group (MD -8.45, 95% CI -12.68 to -4.22; P<.001) demonstrated a significant decrease in the standard deviation of normal-to-normal intervals (SDNN) within the normal clinical range; however, there were no significant differences between the 2 groups (d=0.03; MD 1.11, 95% CI -7.38 to 9.59; P=.80).
CONCLUSIONS: The CIMI was an effective intervention for improving sleep disorders, as well as parts of the psychological stress measures in distressed HCWs. The findings provide objective evidence for developing a mobile stress management intervention that is adaptable and accessible to distressed HCWs, but its long-term effects should be investigated in future research.
BACKGROUND: ClinicalTrials.gov NCT05239065; https://clinicaltrials.gov/ct2/show/NCT05239065.
摘要：
背景：医护人员（HCWs）在工作中经常面临多种压力源，尤其是那些上夜班的人。经历过痛苦的医护人员可能会发现很难采用压力管理方法，即使他们意识到压力和应对过程的影响。因此,可能需要进行个性化干预,以帮助陷入困境的医护人员弥合压力管理中的"知识-实践"差距,并有效缓解压力症状.
目的：这项研究的主要目的是比较复杂的交互式多模式干预（CIMI）与自我指导的压力管理干预对陷入困境的HCW的压力症状的影响，以生理(心率变异性)衡量，心理(感知压力，精神痛苦,和主观幸福)，和睡眠障碍（疲劳和嗜睡）指标。
方法：我们进行了非随机，中国2家综合医院的对照研究。这项研究的参与者是245名HCWs，他们至少满足了抑郁症三个维度中的一个，焦虑,和应力量表。所有符合条件的个体都需要完成问卷并佩戴24小时Holter设备，以确定基线和干预后心率变异性指标的压力生理迹象。TheCIMI组接受了为期12周的在线干预，包括4个组成部分-移动压力管理指导，基于网络的微信社交网络，个性化反馈，还有一个护士教练,而对照组仅接受自我指导干预.
结果：经过12周的干预，与基线水平相比,CIMI组的感知压力量表(PSS)评分显著降低(均差[MD]-5.31,95%CI-6.26至-4.37;P<.001).干预前后PSS评分的变化在CIMI组和对照组之间显示出显着差异（d=-0.64；MD-4.03，95％CI-5.91至-2.14；P<.001），效果是中等的。在生理测量方面，对照组(MD-9.56,95%CI-16.9至-2.2;P=.01)和CIMI组(MD-8.45,95%CI-12.68至-4.22;P<.001)均显示在正常临床范围内正常-正常间期(SDNN)的标准差显著降低;两组间无显著差异(d=0.03;MD1.11,95%CI-7.38~9.59;P=.80)。
结论：TheCIMI是改善睡眠障碍的有效干预措施，以及部分痛苦的医护人员的心理压力措施。研究结果提供了客观的证据，为开发一种可适应和可访问的移动压力管理干预措施，但其长期影响应在未来的研究中进行研究。
背景：ClinicalTrials.govNCT05239065;https://clinicaltrials.gov/ct2/show/NCT05239065。
目的：这项研究的主要目的是比较复杂的交互式多模式干预（CIMI）与自我指导的压力管理干预对陷入困境的HCW的压力症状的影响，以生理(心率变异性)衡量，心理(感知压力，精神痛苦,和主观幸福)，和睡眠障碍（疲劳和嗜睡）指标。
方法：我们进行了非随机，中国2家综合医院的对照研究。这项研究的参与者是245名HCWs，他们至少满足了抑郁症三个维度中的一个，焦虑,和应力量表。所有符合条件的个体都需要完成问卷并佩戴24小时Holter设备，以确定基线和干预后心率变异性指标的压力生理迹象。TheCIMI组接受了为期12周的在线干预，包括4个组成部分-移动压力管理指导，基于网络的微信社交网络，个性化反馈，还有一个护士教练,而对照组仅接受自我指导干预.
结果：经过12周的干预，与基线水平相比,CIMI组的感知压力量表(PSS)评分显著降低(均差[MD]-5.31,95%CI-6.26至-4.37;P<.001).干预前后PSS评分的变化在CIMI组和对照组之间显示出显着差异（d=-0.64；MD-4.03，95％CI-5.91至-2.14；P<.001），效果是中等的。在生理测量方面，对照组(MD-9.56,95%CI-16.9至-2.2;P=.01)和CIMI组(MD-8.45,95%CI-12.68至-4.22;P<.001)均显示在正常临床范围内正常-正常间期(SDNN)的标准差显著降低;两组间无显著差异(d=0.03;MD1.11,95%CI-7.38~9.59;P=.80)。
结论：TheCIMI是改善睡眠障碍的有效干预措施，以及部分痛苦的医护人员的心理压力措施。研究结果提供了客观的证据，为开发一种可适应和可访问的移动压力管理干预措施，但其长期影响应在未来的研究中进行研究。
背景：ClinicalTrials.govNCT05239065;https://clinicaltrials.gov/ct2/show/NCT05239065。
