Applicability of acceptance and commitment therapy-based mobile app in depression nursing

Exploring the relationships between resilience, mindfulness, and experiential avoidance after the use of a mindfulness- and acceptance-based mobile app for posttraumatic stress disorder

PURPOSE

This study used a mindfulness- and acceptance-based mobile app to examine the relationships between resilience, mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptoms.

DESIGN AND METHODS

A quasi-experimental pre-posttest, single-group study design was used. A total of 23 college student veterans used the app for 4 weeks. Outcomes of resilience, mindfulness, experiential avoidance, and PTSD were measured at three time-points (baseline, end of Week 2, and end of Week 4).

FINDINGS

All outcomes significantly improved at postintervention. Improvements in resilience and PTSD significantly correlated with improvement in mindfulness.

PRACTICE IMPLICATIONS

Mindfulness- and acceptance-based mobile apps can be safely used by individuals with PTSD as a complementary approach to enhance resilient coping with PTSD.

Design and Preliminary Realization of a Screening and Early Warning Health Management System for Populations at High Risk for Depression

Depression has a high incidence in the world. Based on the concept of preventive treatment of disease of traditional Chinese medicine, timely screening and early warning of depression in populations at high risk for this condition can avoid, to a certain extent, the dysfunctions caused by depression. This work studied a method to collect information on depression, generate a database of depression features, design algorithms for screening populations at high risk for depression and creating an early warning model, develop an early warning short-message service (SMS) platform, and implement a scheme of depression screening and an early warning health management system. The implementation scheme included mobile application (app), cloud form, screening and early warning model, cloud platform, and computer software. Multiple modules jointly realized the screening, early warning, and management of the health functions of individuals at high risk for depression. At the same time, function modules such as mobile app and cloud form for collecting depression health information, early warning SMS platform, and health management software were designed, and the functions of the modules were preliminarily developed. Finally, the black-box test and white-box test were used to assess the system’s functions and ensure the reliability of the system. Through the integration of mobile app and computer software, this study preliminarily realized the screening and early warning health management of a population at high risk for depression.

The impact of a multilevel interactive nursing quality control and audit application on nursing quality management

Background

This study aims to investigate the effects of a nursing quality control and audit application (app) on the autonomous learning of nursing staff and nursing quality management by nursing supervisors. A multilevel interactive app is developed to assist nursing staff in conducting online autonomous learning and nursing supervisors in identifying problems and creating nursing quality improvement plans. The app could also present the different evaluation results of wards in visual charts for supervisors to review.

Methods

A single-group pre- and post-test design was applied. Data were collected from 131 nurses between October 2019 and October 2020 to analyze the differences between nursing staffs’ willingness to engage in autonomous learning and the integrity of nursing quality improvement plan writing before and after the intervention. The structured questionnaires included open-ended questions that cover aspects of nursing quality control, the audit app, and the information acceptance intention of nurses.

Results

The participants’ age and job title are negatively correlated with the app’s usability, while the ability to use 3C (Computer, Communication, and Consumer Electronics products including mobile phones and laptops) equipment is positively correlated with the willingness to use the app. Nurses’ satisfaction with the convenience of the online autonomous learning method is 92%, which indicates that the app could improve their willingness to learn. Following the intervention of the app, nursing supervisors’ satisfaction with the integrity of nursing quality improvement plan writing increased from 41 to 88%.

Conclusions

Using information technology products to assist in nursing quality management in clinical practice has a significant effect on nurses’ load reduction and head nurses’ satisfaction. Multilevel interactive nursing quality control and audit apps can improve nursing staff’s willingness to learn independently, nursing quality, and the integrity of plan writing. Thus, nursing quality control and audit apps can be considered as suitable nursing quality control tools.

Occupational stressors, mental health, and sleep difficulty among nurses during the COVID-19 pandemic: The mediating roles of cognitive fusion and cognitive reappraisal

This study aimed to examine the relationships between occupational stressors, mental health problems, and sleep difficulty, and the mediating roles of cognitive fusion and cognitive reappraisal on the relationships in Chinese nurses. A total of 323 nurses (mean age = 32.11 ± 6.75 years) from 25 hospitals in China participated a cross-sectional online survey. Participants were asked to refer to the period during the severest time of the COVID-19 pandemic in China (January to March 2020) when assessing the psychological variables. The direct links from occupational stressors to cognitive fusion, cognitive reappraisal, mental health and sleep difficulty were significant. Cognitive fusion and cognitive reappraisal mediated the links from occupational stressors to mental health problems, while cognitive fusion and mental health problems mediated the links from occupational stressors to sleep difficulty. The sequential mediation via cognitive fusion and mental health problems as well as via cognitive reappraisal and mental health problems on the links from occupational stressors to sleep difficulty were also significant. Findings from the current study indicate that intervention strategies focusing on the reduction of cognitive fusion and improvement of cognitive reappraisal could help better prepare nurses to alleviate mental health problems and sleep difficulties that are related to COVID-19 and potentially similar pandemics in the future.

Exploring the Feasibility of Relapse Prevention Strategies in Interdisciplinary Multimodal Pain Therapy Programs: Qualitative Study

BACKGROUND

Although interdisciplinary multimodal pain treatment (IMPT) programs are widely regarded as treatment of choice for patients with chronic pain, there are signs that many patients are unable to maintain their treatment gains in the long term. To facilitate the maintenance of positive treatment outcomes over time, we developed two relapse prevention strategies.

OBJECTIVE

The main objective of this study was to explore the feasibility of these strategies within the context of IMPT programs.

METHODS

We performed a feasibility study using 3 workbook prototypes containing either one or both strategies. For a period of 6 months, the workbooks were made available in two IMPT facilities. Qualitative data were collected through a focus group and semistructured interviews. We performed a thematic analysis using a deductive approach with (1) applicability to the treatment program, (2) acceptability of the workbook content, and (3) form, as predefined themes.

RESULTS

The final dataset consisted of transcripts from a focus group with health care providers and 11 telephone interviews and 2 additional in-depth interviews with patients. In general, the intervention was perceived as useful, easy to use, and in line with the treatment program. The data also include suggestions to further improve the use of both strategies, including more specific implementation guidelines, revised goal-setting procedure, and development of a mobile health version. However, several factors, including a high dropout rate and small sample size, impact the external validity of our findings.

CONCLUSIONS

This study should be regarded as a first step in the process of transforming the prototype workbook into an effective intervention for clinical practice. Although these initial results indicate a favorable evaluation of both behavior regulation strategies within the workbook, this study encountered multiple barriers regarding implementation and data collection that limit the generalizability of these results. Future research efforts should specifically address the fidelity of HCPs and patients and should include clear procedures regarding recruitment and use of both relapse prevention strategies during treatment.

Apps for Depression: Are They Ready to Work?

PURPOSE OF REVIEW

To summarize the latest evidence about mobile phone applications for the management of depression.

RECENT FINDINGS

Depression apps are very heterogeneous, given the absence of standards for their development, description, and evaluation. Randomized clinical trials show the effectiveness of some of these applications in reducing depressive symptoms. Attrition is an important issue whose evaluation is limited by the frequent use of incentives in the studies. The number of mobile applications for depression far exceeds the number of studies evaluating their efficacy and feasibility. Despite the limitations of the digital market, there are a small number of apps that have demonstrated sufficient effectiveness and tolerability to think of short-term clinical use. However, there are still barriers at different levels that may delay the implementation of these interventions in daily clinical practice.

Review and Implementation of Self-Help and Automated Tools in Mental Health Care

Self-help and automated technologies can be useful for behavioral and mental health education and interventions. These technologies include interactive media, online courses, artificial intelligence-powered chatbots, voice assistants, and video games. Self-help media can include books, videos, audible media like podcasts, blog and print articles, and self-contained Internet sites. Social media, online courses, and mass-market mobile apps also can include such media. These technologies serve to decrease geospatial, temporal, and financial barriers. This article describes different self-help and automated technologies, how to implement such technologies in existing clinical services, and how to implement according to patient needs.

Feasibility of mobile mental wellness training for older adults

Mobile technology has been increasingly adopted in promotion of mental health among older people. This study assessed the feasibility of a mobile mental wellness training application for individual use and for group work from the perspectives of older adults and social care professionals. The older individuals recruited for the study were participants in a Circle of Friends group and family caregivers' peer support group offered by the communal senior services. The qualitative and quantitative results of interviews, questionnaires, observation, and application usage were reported. Seven older adults started using the application independently at home in parallel with the group activity. This study revealed new information regarding the barriers to the older adults' full adoption of such mobile technologies. The results indicated that there may be potential in the incorporation of mobile technologies in promotion of mental health of older people at group settings.

Review of Use and Integration of Mobile Apps Into Psychiatric Treatments

PURPOSE OF REVIEW

Mental health practitioners should understand the features of current, publicly available apps; the features of novel, research apps; and issues behind the integration of mobile apps and digital health services into clinical workflows.

RECENT FINDINGS

The review is based on a research literature and the authors' clinical and healthcare administration experiences. Articles searched-on telepsychiatry, telemental health, mobile mental health, informatics, cellular phone, ambulatory monitoring, telemetry, and algorithms-were restricted to 2016 and 2017. Technologies are used in a variety of clinical settings, including patients with varying mental illness severity, social supports, and technological literacy. Good practices for evaluating apps, understanding user needs, and training and educating users can increase success rates. Ethics and risk management should be considered. Mobile apps are versatile. Integrating apps into psychiatric treatment requires addressing both patient and clinical workflows, design and usability principles, accessibility, social concerns, and digital health literacy.