Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 1, 2025
Date Accepted: Jan 16, 2026
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How do well-being and cognitive factors influence healthcare workers’ adherence to internet-based stress management: A mixed methods study
ABSTRACT
Background:
High levels of stress are common among healthcare employees (HCWs), which are harmful to their health and the stability of healthcare human resources. Mobile stress management has been identified as a promising intervention for reducing work-related stress; however, poor adherence may limit its maximum effectiveness. Exploring factors influencing HCW adherence to mobile stress management may thus aid in the development of optimal interventions to help reduce work-related stress in the healthcare setting.
Objective:
The current research sought to investigate: (1) how HCWs' well-being and cognitive factors influenced their treatment adherence in MSM; and (2) what HCWs' specific needs for MSM were.
Methods:
The research employs a convergent mixed-methods design. HCWs are recruited through a mobile stress management project in a large Chinese general hospital. Quantitative data included sociodemographic characteristics, fatigue symptom assessment, perceived stress, user experience, attitudes towards mobile stress management, and practicing frequency, all of which were analyzed using hierarchical regression analyses and a structural equation model. Qualitative data are collected online using an open-ended question, and they are analyzed using a pragmatic method to reflexive-thematic analysis.
Results:
A total of 157 participants were included in the present study. Results from the hierarchical regression analyses showed that fatigue, user experience, and perceived usefulness were independent predictors of treatment adherence. Results from the structural equation model demonstrated that user experience indirectly influenced treatment adherence via perceived usefulness (indirect effect = 0.045, P = 0.001). The qualitative data identified four themes about the experience of individualized intervention, effective feedback, reward and constraint mechanisms, and duration of intervention.
Conclusions:
This study indicates that alleviating fatigue symptoms and improving attitudes towards mobile stress management by promoting a user experience is vital to ensuring treatment adherence. To improve the user experience, future studies may need to consider focusing on individualized needs, providing effective feedback, developing reward and constraint mechanisms, and developing flexible intervention duration.
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