Effect of smartphone-based stress management programs on depression and anxiety of hospital nurses in Vietnam: a three-arm randomized controlled trial

Abstract

There are growing concerns on stress among nurses in low- and middle-income countries (LMICs) in South-East Asia. It is important to improve mental health among nurses in these countries. The objective of this study was to examine the efficacy of two types of newly developed smartphone-based stress management programs in improving depressive and anxiety symptoms among hospital nurses in Vietnam. This study was a three-arm (including two intervention groups and one control group) randomized trial. Participants were recruited from nurses in a large general hospital in Hanoi, Vietnam. Two types (free-choice and fixed sequential order) of smartphone-based stress management programs were developed. Participants were randomly allocated to Program A (a free-choice, multimodule stress management), Program B (a fixed-order, internet cognitive behavioral therapy, iCBT), or a control group (treatment as usual). The depressive and anxiety symptoms were measured by using the Depression Anxiety and Stress Scales at baseline, 3-, and 7-month follow-up surveys. 951 participants were randomly allocated to each of the three groups. Program B showed a statistically significant effect on improving depressive symptoms at 3-month (p = 0.048), but not at 7-month (p = 0.92); Cohen’s d was − 0.18 (95% CI − 0.34 to − 0.02) and 0.03 (95% CI − 1.00 to 1.05), respectively. Program A failed to show a significant intervention effect on any of the outcomes at 3- or 7-month follow-up (p > 0.05). Despite the small effect size, the present fixed-order iCBT program seems effective in improving depression of hospital nurses in Vietnam. A public health impact of the intervention can be scalable, when considering its accessibility and minimal cost.Trial registration number: The study protocol is registered at the UMIN Clinical Trials Registry (UMINCTR; ID = UMIN000033139). Registered date of the protocol is 1st Jul. 2018. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037796

The preventive effect of internet‐based cognitive behavioral therapy for prevention of depression during pregnancy and in the postpartum period (iPDP): a large scale randomized controlled trial

“…It might have been better to interview patients with perinatal depression to determine the topics. Furthermore, compared with our previous smartphone based RCT, 32 the completion rate in this study was relatively low. This might be explained by the fact that many pregnant women participated in the study in a casual manner and did not have a very high commitment to completion.…”

Effect of a Smartphone-Based Stress Management Program on Depression and Other Health- and Work-Related Outcomes among Hospital Nurses in the COVID-19 Pandemic in Vietnam and Thailand: A Protocol of a Randomized Controlled Trial of the COCONATS Project

“…A previous randomized controlled trial (RCT) reported that an Internet cognitive behavioral therapy (iCBT) program reduced perceived work-related stress among nurses in the US [14]. We also found that a selfguided iCBT program reduced depression of nurses in Vietnam at 3-month follow-up [15]. However, these studies were conducted before the COVID-19 pandemic.…”

“…To date, the region had a largest total number of mortality due to COVID-19 following Europe and Americas [18]. We intend to test the effectiveness of a smart-phone iCBT stress management program on improving mental health of nurses in this region in the COVID-19 pandemic, by using a modified version of our previous iCBT program for nurses in Vietnam [15,19] adapted to the COVID-19 situations. To increase the generalizability of the study finding, we select two rapidly industrialized middle-income countries of the region, i.e.…”

Síndrome de Burnout em profissionais da área da saúde: uma revisão integrativa da literatura

“…Além disso, mostram efeitos positivos de curto e médio prazo na satisfação por compaixão, estresse traumático secundário e saúde mental. Até mesmo, o desenvolvimento de programas para smartphones, com cunho educacional demonstrou eficácia na melhora de sintomas depressivos (Fu et al, 2021;Imamura et al, 2021).…”