Internet-Delivered Cognitive Behavior Therapy for Young Taiwanese Female Nursing Students with Irritable Bowel Syndrome—A Cluster Randomized Controlled Trial

Abstract

Irritable Bowel Syndrome (IBS) is prevalent within the general population. Studies have shown that stress and anxiety co-exist with IBS. Young Taiwanese women commonly exhibit physical and psychological health problems caused by academic stress. The purpose of our current study was to evaluate the efficacy of short-term Internet-delivered cognitive-behavioral therapy (ICBT) on female nursing students in practicum. We performed a cluster randomized controlled trial comprised of 160 participants who met the inclusion criteria, which were divided into three groups: (1) ICBT, (2) expressive writing (EW), and (3) wait-list control. Treatment interventions lasted for 6 weeks. Levels of anxiety, depression, and IBS symptoms were assessed at four time points, baseline assessment at T0, 2 weeks after T0 (T1), at the end of practicum (T2), and at 3-month follow-up (T3). The results showed that ICBT and EW groups exhibited a significant, yet small, reduction in anxiety and depression at T2 and T3 compared to the wait-list control group. The EW group exhibited significantly greater reduction in anxiety and depression compared to the ICBT group at T2. However, the ICBT group demonstrated greater improvements in alleviating anxiety and depression at T3 compared to the EW group. These data indicate that ICBT and EW groups exhibited small effects on anxiety and depression reduction at T2 and T3 compared to the wait-list control group, with no effects on IBS symptoms in young Taiwanese female nursing students.

Avaliação da ansiedade em estudantes de Enfermagem: revisão integrativa da literatura

“…Elementos que compõem a avaliação da ansiedade em estudantes de enfermagem Instrumentos Akca et al, 2015;Alshammari, 2019;Augner, 2011;Baksi et al, 2017;Gebhart et al, 2020;Hollenbach, 2016;Hsiung D-Y et al, 2019;Kavurmaci et al, 2015;Lee et al, 2019;Lima et al, 2017;Mojarrab et al, 2020;Plaiti et al, 2016;Prado et al, 2012;Prato & Yucha, 2013;Rajagopal, Pugazhanthi, & George, 2012;Sancar et al, 2018 O elevado número de estudos envolvendo a ansiedade no contexto acadêmico pode se dar pela relação direta da ansiedade com o desempenho educacional dos estudantes. Quando se deparam com sentimento de competividade, atrelados às exigências e cobranças quanto ao futuro profissional, os estudantes podem experenciar certas desordens (Chaves et al, 2015;Costa et al, 2017;Son et al, 2019).…”

“…Este compreende 20 itens em cada uma de suas subescalas: ansiedade estado (IDATE-E) e ansiedade traço (IDATE-T), e cada item pode ser classificado a partir de uma escala tipo likert de quatro pontos. Assim, a pontuação total do instrumento pode variar de 20 a 80 (Akca et al, 2015;Alshammari, 2019;Baksi et al, 2017;Gebhart et al, 2020;Hollenbach, 2016;Hsiung et al, 2019;Kavurmaci et al, 2015;Lee et al, 2019;Mojarrab et al, 2020;Plaiti et al, 2016;Prato & Yucha, 2013;Sancar et al, 2018;Sharma & Sharma, 2015;Son et al, 2019). Torna-se importante salientar que, apesar de avaliar a ansiedade traço e estado, observa-se, em alguns estudos, a aplicação de somente uma subescala, a exemplo da IDATE-E (Mojarrab et al, 2020;Son et al, 2019).…”

“…Nos estudos de Kavurmaci et al (2019) e Gebhart et al (2020), o IDATE foi aplicado para avaliação da ansiedade antes e após uma avaliação escrita, a fim de se investigar os efeitos de intervenções propostas sobre a variável de interesse. Já no ensaio de Lee et al (2019), o IDATE foi utilizado durante o estágio prático dos estudantes; e no estudo de Hollenbach (2016), durante uma experiência clínica simulada, em ambas as abordagens com o objetivo de mensurar os efeitos de uma estratégia de intervenção.…”

Understanding Psychosocial Wellbeing in the Context of Complex and Multidimensional Problems

“…Lee et al [ 19 ] evaluated the efficacy of short-term internet-delivered cognitive–behavioral therapy (ICBT) on female nursing practicum students with irritable bowel syndrome. They performed a cluster randomized controlled trial comprising 160 participants, which were divided into three groups: (1) ICBT, (2) expressive writing (EW), and (3) wait-list control.…”

Treating irritable bowel syndrome through an interdisciplinary approach

“…In view of the limited healthcare resources and its high costs and increasing demand, online or internet-delivered CBT approaches have been proposed. Generally the use of online/internet based therapies is controversial, but according to their supporters, such interventions can overcome many existing barriers and provide at least short-term effectiveness in managing depression and anxiety [73,74]. However, a systematic review has revealed no sufficient evidence for the effectiveness of online CBT in GI disorders, including IBS [75].…”