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Miao M, Zhou Z, Qi W, Zheng L. The mediating role of hope in the relationship between benefit finding and anxiety: insights from the COVID-19 pandemic. ANXIETY, STRESS, AND COPING 2024:1-17. [PMID: 39098919 DOI: 10.1080/10615806.2024.2378864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/31/2024] [Accepted: 07/06/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND AND OBJECTIVES During large-scale stressful events such as pandemics, situational uncertainty and daily routine disruptions increase anxiety prevalence, underscoring the need for research on approaches to promote effective coping. This study focused on the psychological function of benefit finding in the context of the COVID-19 pandemic. DESIGN AND METHODS Both Study 1a (a cross-sectional survey of 567 Chinese adults) and Study 1b (a two-wave longitudinal survey of 406 Chinese adults) examined the relationship between benefit finding and anxiety, with hope as the mediator. Study 2 used an interventional design to examine the efficacy of daily benefit-finding writing among 129 Chinese college students. RESULTS In Studies 1a and 1b, benefit finding was positively associated with anxiety, which was mediated by hope. Study 2 showed that daily writing tasks significantly promoted benefit finding. Hope mediated the relationship between benefit finding and anxiety at both the within- and between-person levels. CONCLUSIONS Benefit finding can foster hope and relieve anxiety. Daily benefit-finding activities, which can be conducted online, can help improve mental health during pandemics.
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Affiliation(s)
- Miao Miao
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, People's Republic of China
| | - Zhiwei Zhou
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, People's Republic of China
| | - Wei Qi
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, People's Republic of China
| | - Lei Zheng
- School of Business, Macau University of Science and Technology, Taipa, Macau
- School of Economics and Management, Fuzhou University, Fuzhou, People's Republic of China
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Racey M, Whitmore C, Alliston P, Cafazzo JA, Crawford A, Castle D, Dragonetti R, Fitzpatrick-Lewis D, Jovkovic M, Melamed OC, Naeem F, Senior P, Strudwick G, Ramdass S, Vien V, Selby P, Sherifali D. Technology-Supported Integrated Care Innovations to Support Diabetes and Mental Health Care: Scoping Review. JMIR Diabetes 2023; 8:e44652. [PMID: 37159256 DOI: 10.2196/44652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/23/2023] [Accepted: 04/01/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND For individuals living with diabetes and its psychosocial comorbidities (eg, depression, anxiety, and distress), there remains limited access to interprofessional, integrated care that includes mental health support, education, and follow-up. Health technology, broadly defined as the application of organized knowledge or skill as software, devices, and systems to solve health problems and improve quality of life, is emerging as a means of addressing these gaps. There is thus a need to understand how such technologies are being used to support, educate, and help individuals living with co-occurring diabetes and mental health distress or disorder. OBJECTIVE The purpose of this scoping review was to (1) describe the literature on technology-enabled integrated interventions for diabetes and mental health; (2) apply frameworks from the Mental Health Commission of Canada and World Health Organization to elucidate the components, type, processes, and users of technology-enabled integrated interventions for diabetes and mental health; and (3) map the level of integration of interventions for diabetes and mental health. METHODS We searched 6 databases from inception to February 2022 for English-language, peer-reviewed studies of any design or type that used technology to actively support both diabetes and any mental health distress or disorder in succession or concurrently among people with diabetes (type 1 diabetes, type 2 diabetes, and gestational diabetes). Reviewers screened citations and extracted data including study characteristics and details about the technology and integration used. RESULTS We included 24 studies described in 38 publications. These studies were conducted in a range of settings and sites of care including both web-based and in-person settings. Studies were mostly website-based (n=13) and used technology for wellness and prevention (n=16) and intervention and treatment (n=15). The primary users of these technologies were clients and health care providers. All the included intervention studies (n=20) used technology for clinical integration, but only 7 studies also used the technology for professional integration. CONCLUSIONS The findings of this scoping review suggest that there is a growing body of literature on integrated care for diabetes and mental health enabled by technology. However, gaps still exist with how to best equip health care professionals with the knowledge and skills to offer integrated care. Future research is needed to continue to explore the purpose, level, and breadth of technology-enabled integration to facilitate an approach to overcome or address care fragmentation for diabetes and mental health and to understand how health technology can further drive the scale-up of innovative integrated interventions.
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Affiliation(s)
- Megan Racey
- McMaster Evidence Review and Synthesis Team, McMaster University, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Carly Whitmore
- School of Nursing, McMaster University, Hamilton, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Paige Alliston
- McMaster Evidence Review and Synthesis Team, McMaster University, Hamilton, ON, Canada
| | - Joseph A Cafazzo
- Healthcare Human Factors, University Health Network, Toronto, ON, Canada
- eHealth Innovation, University Health Network, Toronto, ON, Canada
| | - Allison Crawford
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - David Castle
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | | | - Milos Jovkovic
- McMaster Evidence Review and Synthesis Team, McMaster University, Hamilton, ON, Canada
| | - Osnat C Melamed
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Farooq Naeem
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Peter Senior
- Clinical Islet Transplant Program, University of Alberta, Edmonton, AB, Canada
- Department of Medicine, Division of Endocrinology, University of Alberta, Edmonton, AB, Canada
| | - Gillian Strudwick
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Seeta Ramdass
- Diabetes Action Canada, Toronto, ON, Canada
- McGill University, Montreal, QC, Canada
| | - Victor Vien
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Peter Selby
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Diana Sherifali
- McMaster Evidence Review and Synthesis Team, McMaster University, Hamilton, ON, Canada
- School of Nursing, McMaster University, Hamilton, ON, Canada
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Bendig E, Schmitt A, Wittenberg A, Kulzer B, Hermanns N, Moshagen M, Baumeister H. ACTonDiabetes: study protocol of a pragmatic randomised controlled trial for the evaluation of an acceptance and commitment-based internet-based and mobile-based intervention for adults living with type 1 or type 2 diabetes. BMJ Open 2022; 12:e059336. [PMID: 36109030 PMCID: PMC9478835 DOI: 10.1136/bmjopen-2021-059336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 07/27/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Living with diabetes can be burdensome and lead to serious emotional distress and impaired mental health. Acceptance and commitment therapy (ACT) can support people facing the challenges of living with diabetes. This trial aims to evaluate the effectiveness and cost-effectiveness of the internet-based and mobile-based intervention (IMI) 'ACTonDiabetes' in reducing diabetes distress against enhanced treatment as usual (TAU+) following specialised diabetes care. METHODS AND ANALYSIS A two-armed pragmatic randomised controlled trial will be conducted to evaluate the guided IMI ACTonDiabetes against TAU+. A total of 210 adults with type 1 or type 2 diabetes and elevated diabetes distress (Problem Areas in Diabetes ≥40) will be recruited at a specialised diabetes centre. The intervention begins 2-4 weeks after hospital discharge and takes about 7-10 weeks to complete. Assessments are performed at baseline and 5 and 10 weeks as well as 6 and 12 months after randomisation. The primary outcome is diabetes distress at a 10-week follow-up (T2). Secondary outcomes are depression (Patient Health Questionnaire-8), psychological well-being (WHO-5), quality of life (Assessment of Quality of Life-8 Dimension), Diabetes-related Self-Management Questionnaire, diabetes acceptance (Acceptance and Action Diabetes Questionnaire) and negative treatment effects (Inventory for the Assessment of Negative Effects of Psychotherapy). All statistical analyses will be performed based on the intention-to-treat principle with additional per-protocol analyses. Changes in outcomes will be evaluated using the general linear model. A health-economic evaluation will be conducted from a societal perspective. Reasons for drop-out will be systematically investigated. ETHICS AND DISSEMINATION This clinical trial has been approved by the State Medical Chamber of Baden-Württemberg (file no. B-F-2019-010). Trial results will be submitted for publication in a peer-reviewed journal and presented at conferences. TRIAL REGISTRATION NUMBER DRKS00016738.
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Affiliation(s)
- Eileen Bendig
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Andreas Schmitt
- Research Institute of the Diabetes Academy Mergentheim, Diabetes Center Mergentheim, Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
| | - Amelie Wittenberg
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Bernhard Kulzer
- Research Institute of the Diabetes Academy Mergentheim, Diabetes Center Mergentheim, Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
| | - Norbert Hermanns
- Research Institute of the Diabetes Academy Mergentheim, Diabetes Center Mergentheim, Bad Mergentheim, Germany
- German Center for Diabetes Research (DZD), Muenchen-Neuherberg, Germany
| | - Morten Moshagen
- Department of Research Methods, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
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Hansen SR, Wetherell MA, Smith MA. Written benefit finding for improving psychological health during the Covid-19 pandemic first wave lockdown. Psychol Health 2021; 37:1223-1240. [PMID: 34130556 DOI: 10.1080/08870446.2021.1936521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives. Written benefit finding is known to improve psychological and physical health in a range of patient groups. Here, we tested the efficacy of written benefit finding, delivered online during the Covid-19 pandemic lockdown, on mood and physical symptoms. We also investigated perseverative thinking as a moderator of these effects. Design. A quantitative longitudinal design was employed. Main Outcome Measures. Participants (n = 91) completed self-report measures of anxiety, depression, stress and physical symptoms at baseline, and two weeks after being randomised to complete three consecutive days of writing about the positive thoughts and feelings they experienced during the pandemic (written benefit finding) or to unemotively describe the events of the previous day (control). State anxiety was measured immediately before and after writing. Perseverative thinking was measured at baseline. Results. Anxiety and depression symptoms decreased between baseline and the two week follow-up, but did not differ significantly between the two conditions. Perseverative thinking was negatively associated with changes in symptoms of anxiety, depression and stress, but did not moderate any writing effects. There was a significant reduction in state anxiety in the written benefit finding condition. Conclusions. Written benefit finding may be a useful intervention for short-term improvements in wellbeing.
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Affiliation(s)
- Sarah R Hansen
- Department of Psychology, Psychobiology, Stress and Wellbeing Research Group, Northumbria University, Newcastle upon Tyne, UK
| | - Mark A Wetherell
- Department of Psychology, Psychobiology, Stress and Wellbeing Research Group, Northumbria University, Newcastle upon Tyne, UK
| | - Michael A Smith
- Department of Psychology, Psychobiology, Stress and Wellbeing Research Group, Northumbria University, Newcastle upon Tyne, UK.,Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Australia
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A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nat Hum Behav 2021; 5:631-652. [PMID: 33875837 DOI: 10.1038/s41562-021-01093-w] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022]
Abstract
Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.
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Bendig E, Meißner D, Erb B, Weger L, Küchler AM, Bauereiss N, Ebert D, Baumeister H. Study protocol of a randomised controlled trial on SISU, a software agent providing a brief self-help intervention for adults with low psychological well-being. BMJ Open 2021; 11:e041573. [PMID: 33558351 PMCID: PMC7871683 DOI: 10.1136/bmjopen-2020-041573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 12/23/2020] [Accepted: 01/21/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Only a minority of people living with mental health problems are getting professional help. As digitalisation moves on, the possibility of providing internet/mobile-based interventions (IMIs) arises. One type of IMIs are fully automated conversational software agents (chatbots). Software agents are computer programs that can hold conversations with a human by mimicking a human conversational style. Software agents could deliver low-threshold and cost-effective interventions aiming at promoting psychological well-being in a large number of individuals. The aim of this trial is to evaluate the clinical effectiveness and acceptance of the brief software agent-based IMI SISU in comparison with a waitlist control group. METHODS AND ANALYSIS Within a two-group randomised controlled trial, a total of 120 adult participants living with low well-being (Well-being Scale/WHO-5) will be recruited in Germany, Austria and Switzerland. SISU is based on therapeutic writing and acceptance and commitment therapy-based principles. The brief intervention consists of three modules. Participants work through the intervention on 3 consecutive days. Assessment takes place before (t1), during (t2) and after (t3) the interaction with SISU, as well as 4 weeks after randomisation (t4). Primary outcome is psychological well-being (WHO-5). Secondary outcomes are emotional well-being (Flourishing Scale), psychological flexibility (Acceptance and Action Questionnaire-II), quality of life (Assessment of Quality of Life -8D), satisfaction with the intervention (Client Satisfaction Questionnaire-8) and side effects (Inventory for the assessment of negative effectsof psychotherapy). Examined mediators and moderators are sociodemographic variables, personality (Big Five Inventory-10), emotion regulation (Emotion Regulation Questionnaire), alexithymia (Toronto Alexithymia Scale-20), centrality of events (Centrality of Events Scale), treatment expectancies (Credibility Expectancy Questionnaire) and technology alliance (Inventory of Technology Alliance-Online Therapy). Data analysis will be based on intention-to-treat principles. SISU guides participants through a 3-day intervention. ETHICS AND DISSEMINATION This trial has been approved by the ethics committee of the Ulm University (No. 448/18, 18.02.2019). Results will be submitted for publication in a peer-reviewed journal and presented at conferences. TRIAL REGISTRATION The trial is registered at the WHO International Clinical Trials Registry Platform via the German Clinical Trials Register (DRKS): DRKS00016799 (date of registration: 25 April 2019). In case of important protocol modifications, trial registration will be updated. This is protocol version number 1.
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Affiliation(s)
- Eileen Bendig
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Dominik Meißner
- Department of Computer Science, Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Benjamin Erb
- Department of Computer Science, Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Lena Weger
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Natalie Bauereiss
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - David Ebert
- Faculty of Behavioural and Movement Sciences, Clinical Psychology, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
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