JMIR Publications

ABSTRACT

Background:

Healthcare students experience multiple stressors over the course of their undergraduate education. The resulting psychological and emotional distress can have significant negative effects on their mental well-being, not only as students but may follow them into the work force as healthcare professionals. Positive Intelligence (PQ®) is a digital program aimed at building self-mastery over one’s mind to fulfil one’s potential through strengthening of various ‘mental muscles’.

Objective:

The current work sought to investigate the effectiveness of a 6-week app-delivered mental fitness program—PQ® program in reducing perceived stress, increasing self-compassion, and decreasing rumination tendencies among healthcare undergraduates. We hypothesised that students would demonstrate decreases in perceived stress, increases in self-compassion, and decreases in rumination tendencies at completion of the PQ® program, relative to their scores before the program. We took an exploratory approach for the follow-up at five months as there has been far less consensus on the sustained effects of app-based programs at follow-up after varying periods of time.

Methods:

Participants were first-year students from the occupational therapy degree program in a Singapore-based university. Participants underwent the PQ® program and took surveys that measured their self-compassion, perceived stress, and rumination levels before and after the PQ® program, and again at a follow-up five months later, to understand the efficacy of the PQ® program. Data from 64 students were analysed using repeated measures ANOVA for each intervention outcome to assess for differences across pre-test, immediate post-test, and the follow-up post-test.

Results:

The findings of the study partially support our hypothesis, showing a significant increase in self-compassion and reduction in rumination tendencies immediately post-intervention, but no significant effect on stress levels. These effects were not moderated by the daily practice of PQ® exercises as tracked in the app, and there were no sustained effects on self-compassion, rumination tendencies, or perceived stress at follow-up five months later.

Conclusions:

Our findings suggest that the PQ® program may have brought about a novel metacognitive awareness of self-sabotaging inner critics and helped develop a greater sense of self-acceptance and practising withholding judgment towards oneself and others. Additionally, the study highlights the importance of social support in the form of the weekly ‘Pod’ group meetings as part of the program and suggests that this helped healthcare undergraduates in being more introspective, reflective, and aware of their inner critics, leading to better compassion and acceptance towards others, themselves, and external situations. However, the study is limited in its comparisons and deductions due to the absence of an active control group. Future research using an active control group can uncover the actual impact of the PQ® program and determine which specific components of the program are responsible for producing the most significant effects.