Accepted for/Published in: JMIR Formative Research
Date Submitted: Nov 16, 2023
Open Peer Review Period: Nov 15, 2023 - Jan 10, 2024
Date Accepted: Dec 22, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A non-randomized pilot feasibility study into Strength Back: a digital health intervention for spinal surgery patients – benefits, recruitment, drop-out and acceptability
ABSTRACT
Background:
Spinal surgery patients report high levels of insecurity, pain, stress and anxiety, before and after surgery. A digital health intervention, based on Acceptance and Commitment Therapy and positive psychology has been developed to enhance psychological flexibility and well-being and to reduce postsurgical pain.
Objective:
The objective of this study was to assess 1) the feasibility of a future RCT of the digital intervention called “Strength Back” in terms of benefits, recruitment and drop-out and 2) the acceptability of the intervention.
Methods:
We used a non-randomized experimental design with an intervention group (n=17) and a control group (n=20). Outcome measures were pain intensity (NRS), pain interference (MPI), anxiety and depression (HADS), valued living (ELS), psychological flexibility (PIPS), and mental well-being (MHC-SF). Semi-structured interviews in combination with log data and scores on the TWente Engagement with Ehealth Technologies Scale (TWEETS) were used to assess acceptability.
Results:
A significant improvement over time on emotional and overall well-being (MHC-SF) was only found for the intervention group (resp. V = 99, p = .026; V = 55, p = .004). In addition, the intervention group showed a significantly larger decline in pain intensity (NRS) than the control group (U = 75, p = .003). On average 75% of the available weekly modules were completed and 68% of the participants used the intervention until the final interview. The majority of the participants (n=15) in the intervention group would recommend the intervention to future patients.
Conclusions:
The current study shows that combining ACT and PP in a digital intervention such as Strength Back is promising for spinal surgery patients. A larger RCT is now warranted.
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