JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic has accelerated the worldwide need for simple, remotely delivered (digital), scalable interventions to protect the mental health of frontline healthcare staff exposed to traumatic events at work. We have developed a brief behavioral intervention, which aims to reduce the frequency of intrusive memories of traumatic events, but has only been delivered face-to-face so far. After developing digitalised intervention materials (Gamble et al., in press, JMIR Mental Health), here, the intervention is delivered digitally to target-users (frontline healthcare staff) for the first time and adapted for their working context in Swedish hospital settings.

Objective:

The aims of this pilot study with healthcare staff with lived experience of working in the pandemic were to: 1) Pilot the intervention when digitalised (with potential remote support) and adapted for this working context to explore its ability to reduce intrusive memories of trauma and related symptoms and improve functioning (e.g. concentration); 2) Explore feasibility and acceptability of the digitalised intervention and data collection.

Methods:

We worked closely with target-users with lived experience of working on the frontline during the COVID-19 pandemic, i.e. registered nurses who experienced intrusive memories from traumatic events at work (N=3). Primary and secondary outcome data was analysed descriptively. Qualitative analysis was used to evaluate feedback on the digitalised intervention and implement changes (person-based approach).

Results:

After completing the digitalised intervention once with remote researcher support (approximately 25 minutes) and a brief follow-up check-in, all three participants learned to use the intervention independently. All reported zero intrusive memories during week 5 (primary outcome, 100% digital data capture) despite having had two or more intrusions in the week before study inclusion (assessed retrospectively). There was a general pattern of symptom reduction and improvement in functioning (e.g. concentration) at follow-up. Importantly, the digitalised intervention and data collection were rated as feasible and acceptable (e.g. all three participants would recommend it to a colleague). Participants were positive towards the use of the digital intervention as a self-help tool that could readily be fitted into work life and repeated in the face of ongoing trauma exposure.

Conclusions:

The digitalised intervention when adapted for this working context was well received by participants. All reported zero intrusions during week 5 post-intervention. They used the intervention independently with little remote-support from researchers. Since it fitted into their work/daily life, the digital intervention holds promise for healthcare staff with repeated trauma exposure, which is particularly relevant during the ongoing pandemic. Limitations of this pilot study include the small sample size, lack of daily intrusion frequency data in the week before the intervention, and lack of a control condition. The next step will be to investigate the efficacy of the digitalised intervention in a randomised controlled trial.