A Web-Based App for Emotional Management During the COVID-19 Pandemic: Platform Development and Retrospective Analysis of its Use Throughout Two Waves of the Outbreak in Spain

Abstract

Background Quarantines and nationwide lockdowns implemented for containing the spread of the COVID-19 pandemic may lead to distress and increase the frequency of anxiety and depression symptoms among the general population. During the nationwide lockdown of the first wave of the COVID-19 outbreak in Spain, we developed and launched a web-based app to promote emotional self-care in the general population and facilitate contact with health care professionals. Objective This study aimed to describe a web-based app and analyze its utilization pattern throughout 2 successive waves of the COVID-19 outbreak in Spain. Methods Our web-based app targeted all individuals aged 18 years or more and was designed by adapting the contents of a mobile app for adjuvant treatment of posttraumatic stress disorder (ie, the PTSD Coach app) to the general population and the pandemic or lockdown scenario. We retrospectively assessed the utilization pattern of the web-based app using data systematically retrieved from Google Analytics. Data were grouped into 3 time periods, defined using Joinpoint regression analysis of COVID-19 incidence in our area: first wave, between-wave period, and second wave. Results The resulting web-based app, named gesioemocional.cat, maintains the navigation structure of the PTSD Coach app, with three main modules: tools for emotional self-care, a self-assessment test, and professional resources for on-demand contact. The self-assessment test combines the Patient Health Questionnaire-2 and the 7-item Generalized Anxiety Disorder scale and offers professional contact in the advent of a high level of depression and anxiety; contact is prioritized in accordance with a screening questionnaire administered at the time of obtaining individual consent to be contacted. The tools for emotional self-care can be accessed either on-demand or symptom-driven. The utilization analysis showed a high number of weekly accesses during the first wave. In this period, press releases regarding critical events of the pandemic progression and government decisions on containment measures were followed by a utilization peak, irrespective of the sense (ie, positive or negative) of the information. Positive information pieces (eg, relaxation of containment measures due to a reduction of COVID-19 cases) resulted in a sharp increase in utilization immediately after information release, followed by a successive decline in utilization. The second wave was characterized by a lower and less responsive utilization of the web-based app. Conclusions mHealth tools may help the general population cope with stressful conditions associated with the pandemic scenario. Future studies shall investigate the effectiveness of these tools among the general population—including individuals without diagnosed mental illnesses—and strategies to reach as many people as possible.

Impact of COVID-19 pandemic on the incidence of suicidal behaviors: a retrospective analysis of integrated electronic health records in a 7.5-million population

“…Finally, Yoshioka et al, observed that the decreasing trend in suicides experienced in Japan during the 2016-2019 period was reverted in the overall 2020-2021 period, although a delay of several months in the rough observed cases was reported [15]. Interestingly, the strict lockdown period, an important stressor associated with an increased number of anxiety episodes and psychiatric consultations in our area [7,21], was followed by a drop in suicidal behavior events in our analysis. This phenomenon, observed also in a city-based study in our area [22], is in line with the decreasing demand for the suicide prevention helpline observed in a nation-wide analysis in the Netherlands right after the general lockdown [12]; of note, a partial lockdown dictated in that country eight months after was followed by a demand peak in the service.…”

“…Aside from the stressors directly derived from social distancing, other factors such as uncertainty associated with the pandemic scenario, impossibility of accompanying loved ones during their hospital stay or end-of-life stage, or financial crises (including unemployment) experienced in many countries have contributed to psychological overwhelming in many cases [6]. Likewise, the persistence of the health crisis, with alternating periods of normal live and social restrictions due to successive waves of the COVID-19 has caused learned helplessness behaviors, increasing the risk of depressive disorders [7]. Irrespective of the cause of mental health decline, various authors have reported increasing use of mental health services during the pandemic [3,4].…”

Cancer Patients with Chronic Pain and Their Caregivers during COVID-19: A Descriptive Study

“…Importantly, most of the participants in both groups identified the rural area as their area of residence. The acceptability and effectiveness of eHealth tools to complement communication and supportive processes throughout the cancer care journey are increasingly recognized [ 33 ], particularly to bridge geographical disparities [ 41 ]. Yet, evidence suggests the need for embedding such innovative tools as part of a clinical workflow, ideally grounded on person-centered care principles so that they are put in use to favor the therapeutical relationship and shared decision-making at distance [ 42 , 43 ].…”

Impact of the COVID-19 Pandemic on the Incidence of Suicidal Behaviors: A Retrospective Analysis of Integrated Electronic Health Records in a Population of 7.5 Million

“…This delay was in line with our analysis, which revealed a lag time of almost 4 months after the declaration of the state of emergency and population lockdown. Interestingly, our analysis showed that the strict lockdown period, an important stressor associated with an increased number of anxiety episodes and psychiatric consultations in our area [ 7 , 21 ], was followed by a drop in suicidal behavior events. This phenomenon was also observed in a city-based study in our area [ 22 ].…”

“…Aside from the stressors directly derived from social distancing, other factors, such as the uncertainty associated with the pandemic scenario, the impossibility of accompanying loved ones during hospital stays or end-of-life stages, or the financial crises (including unemployment) experienced in many countries, have contributed to psychological overwhelming in many cases [ 6 ]. Likewise, successive waves of COVID-19 translated into periods of the intensification and relaxing of social restrictions, according to infectious transmission rates; such intermittent distortions of social interaction have caused learned helplessness behaviors, increasing the risk of depressive disorders [ 7 ]. Irrespective of the cause of declining mental health, various authors have reported the increasing use of mental health services during the pandemic [ 3 , 4 ].…”