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1.
Artículo en Inglés | MEDLINE | ID: mdl-38541374

RESUMEN

Research into digital interventions for mental well-being promotion has grown in recent years, fuelled by the need to improve mental health prevention strategies and respond to challenges arising from the coronavirus (COVID-19) pandemic. This bibliometric analysis provides a structured overview of publication trends and themes in primary research studies reporting an array of digital interventions indexed at WoS from 2004 to 2023. Bibliometric data were collected on a sample of 1117 documents and analysed using the Biblioshiny package. Supplemental network visualisation analysis was conducted using VosViewer. The study, based on Web of Science and Scopus databases, indicates a marked increase in publications post-2020. There were seven groups of research themes clustered around "Mindfulness", "Anxiety", "COVID-19", "Acceptance and Commitment Therapy", "Depression", "Web-based", and "Positive Psychology". Further, results demonstrated the growth of specific themes (e.g., mindfulness, mhealth), the defining impact of COVID-19 studies, and the importance of both randomised controlled trials and formative research. Overall, research in the field is still early in its development and is expected to continue to grow. Findings highlight the field's dynamic response to societal and technological changes, suggesting a future trajectory that leans increasingly on digital platforms for mental health promotion and intervention. Finally, study limitations and implications for future studies are discussed.


Asunto(s)
Terapia de Aceptación y Compromiso , COVID-19 , Humanos , Salud Mental , Ansiedad , Bibliometría , COVID-19/epidemiología
2.
Front Psychol ; 15: 1293171, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38445057

RESUMEN

Background: The unprecedented rapid re-deployment of healthcare workers from different care pathways into newly created and fluid COVID-19 teams provides a unique opportunity to examine the interaction of many of the established non-technical factors for successful delivery of clinical care and teamwork in healthcare settings. This research paper therefore aims to address these gaps by qualitatively exploring the impact of COVID work throughout the pandemic on permanent and deployed personnel's experiences, their ability to effectively work together, and the effect of social dynamics (e.g., cohesion, social support) on teamwork and mental health. Methods: Seventy-five interviews were conducted across the UK between March and December 2021 during wave 2 and 3 of COVID-19 with 75 healthcare workers who were either permanent staff on Intensive Care/High Dependency Units used as COVID wards, had been rapidly deployed to such a ward, or had managed such wards. Work Life Balance was measured using the WLB Scale. Interview transcripts were qualitatively coded and thematic codes were compared using network graph modeling. Results: Using thematic network analysis, four overarching thematic clusters were found, (1) teamwork, (2) organizational support and management, (3) cohesion and social support, and (4) psychological strain. The study has three main findings. First, the importance of social factors for teamwork and mental health, whereby team identity may influence perceptions of preparedness, collaboration and communication, and impact on the collective appraisal of stressful events and work stressors. Secondly, it demonstrates the positive and negative impact of professional roles and skills on the development of teamwork and team identity. Lastly the study identifies the more pronounced negative impact of COVID work on deployed personnel's workload, mental health, and career intentions, exacerbated by reduced levels of social support during, and after, their deployment. Conclusion: The thematic network analysis was able to highlight that many of the traditional factors associated with the successful delivery of patient care were impeded by pandemic constraints, markedly influencing personnel's ability to work together and cope with pandemic work stressors. In this environment teamwork, delivery of care and staff well-being appear to depend on relational and organizational context, social group membership, and psycho-social skills related to managing team identity. While results hold lessons for personnel selection, training, co-location, and organizational support during and after a pandemic, further research is needed into the differential impact of pandemic deployment on HCWs mental health and teamwork.

3.
Eur J Investig Health Psychol Educ ; 12(10): 1471-1497, 2022 Oct 03.
Artículo en Inglés | MEDLINE | ID: mdl-36286087

RESUMEN

BACKGROUND: Digital psychological interventions can target deficit-oriented and asset-oriented psychological outcomes in the workplace. This review examined: (a) the effectiveness of digital interventions for psychological well-being at work, (b) associations with workplace outcomes, and (c) associations between interventions' effectiveness and their theory-base. METHODS: six electronic databases were searched for randomised controlled trials (RCT) and quasi-experimental studies. The methodological quality of studies that used randomisation was conducted with the "Cochrane Collaboration's Risk of Bias" tool, while the "JBI Critical Appraisal Checklist" was used for non-randomised studies. Studies' theory-base was evaluated using an adaptation of the "theory coding scheme" (TSC). Due to heterogeneity, narrative synthesis was performed. RESULTS: 51 studies were included in a synthesis describing four clusters of digital interventions: (a) cognitive behavioural therapy, (b) stress-management interventions and workplace well-being promotion, (c) meditation training and mindfulness-based interventions, and (d) self-help interventions. Studies demonstrated a high risk of contamination effects and high attrition bias. Theory-informed interventions demonstrated greater effectiveness. Cognitive behavioural therapy demonstrated the most robust evidence for reducing depression symptoms among healthy employees. With the exception of the Headspace application, there was weak evidence for meditation training apps, while relaxation training was a key component of effective stress-management interventions.

4.
PLoS One ; 17(8): e0272942, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35980893

RESUMEN

The rapid increase of acute and intensive care capacities in hospitals needed during the response to COVID-19 created an urgent demand for skilled healthcare staff across the globe. To upscale capacity, many hospitals chose to increase their teams in these departments with rapidly re-deployed inter-professional healthcare personnel, many of whom had no prior experience of working in a high-risk environment and were neither prepared nor trained for work on such wards. This systematic review of reviews examines the current evidence base for successful teamwork in rapidly deployed interprofessional teams in intensive and acute care settings, by assessing systematic reviews of empirical studies to inform future deployments and support of rapidly formed clinical teams. This study identified 18 systematic reviews for further analysis. Utilising an integrative narrative synthesis process supported by thematic coding and graphical network analysis, 13 themes were found to dominate the literature on teams and teamwork in inter-professional and inter-disciplinary teams. This approach was chosen to make the selection process more transparent and enable the thematic clusters in the reviewed papers to be presented visually and codifying four factors that structure the literature on inter-professional teams (i.e., team-internal procedures and dynamics, communicative processes, organisational and team extrinsic influences on teams, and lastly patient and staff outcomes). Practically, the findings suggest that managers and team leaders in fluid and ad-hoc inter-professional healthcare teams in an intensive care environment need to pay attention to reducing pre-existing occupational identities and power-dynamics by emphasizing skill mix, establishing combined workspaces and break areas, clarifying roles and responsibilities, facilitating formal information exchange and developing informal opportunities for communication. The results may guide the further analysis of factors that affect the performance of inter-professional teams in emergency and crisis deployment.


Asunto(s)
COVID-19 , COVID-19/epidemiología , Cuidados Críticos , Atención a la Salud , Personal de Salud , Humanos , Relaciones Interprofesionales , Grupo de Atención al Paciente
5.
Bone Jt Open ; 2(8): 573-583, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34346738

RESUMEN

AIMS: COVID-19 has compounded a growing waiting list problem, with over 4.5 million patients now waiting for planned elective care in the UK. Views of patients on waiting lists are rarely considered in prioritization. Our primary aim was to understand how to support patients on waiting lists by hearing their experiences, concerns, and expectations. The secondary aim was to capture objective change in disability and coping mechanisms. METHODS: A minimum representative sample of 824 patients was required for quantitative analysis to provide a 3% margin of error. Sampling was stratified by body region (upper/lower limb, spine) and duration on the waiting list. Questionnaires were sent to a random sample of elective orthopaedic waiting list patients with their planned intervention paused due to COVID-19. Analyzed parameters included baseline health, change in physical/mental health status, challenges and coping strategies, preferences/concerns regarding treatment, and objective quality of life (EuroQol five-dimension questionnaire (EQ-5D), Generalized Anxiety Disorder 2-item scale (GAD-2)). Qualitative analysis was performed via the Normalization Process Theory. RESULTS: A total of 888 patients responded. Better health, pain, and mood scores were reported by upper limb patients. The longest waiters reported better health but poorer mood and anxiety scores. Overall, 82% had tried self-help measures to ease symptoms; 94% wished to proceed with their intervention; and 21% were prepared to tolerate deferral. Qualitative analysis highlighted the overall patient mood to be represented by the terms 'understandable', 'frustrated', 'pain', 'disappointed', and 'not happy/depressed'. COVID-19-mandated health and safety measures and technology solutions were felt to be implemented well. However, patients struggled with access to doctors and pain management, quality of life (physical and psychosocial) deterioration, and delay updates. CONCLUSION: This is the largest study to hear the views of this 'hidden' cohort. Our findings are widely relevant to ensure provision of better ongoing support and communication, mostly within the constraints of current resources. In response, we developed a reproducible local action plan to address highlighted issues. Cite this article: Bone Jt Open 2021;2(8):573-583.

6.
Trials ; 22(1): 671, 2021 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-34593024

RESUMEN

BACKGROUND: Dupuytren's contracture is a fibro-proliferative disease of the hands affecting over 2 million UK adults, particularly the white, male population. Surgery is the traditional treatment; however, recent studies have indicated that an alternative to surgery-collagenase clostridium histolyticum (collagenase)-is better than a placebo in the treatment of Dupuytren's contracture. There is however no robust randomised controlled trial that provides a definitive answer on the clinical effectiveness of collagenase compared with limited fasciectomy surgery. Dupuytren's intervention surgery vs collagenase trial (DISC) trial was therefore designed to fill this evidence gap. METHODS/DESIGN: The DISC trial is a multi-centre pragmatic two-arm parallel-group, randomised controlled trial. Participants will be assigned 1:1 to receive either collagenase injection or surgery (limited fasciectomy). We aim to recruit 710 adult participants with Dupuytren's contracture. Potential participants will be identified in primary and secondary care, screened by a delegated clinician and if eligible and consenting, baseline data will be collected and randomisation completed. The primary outcome will be the self-reported patient evaluation measure assessed 1 year after treatment. Secondary outcome measures include the Unité Rhumatologique des Affections de la Main Scale, the Michigan Hand Questionnaire, EQ-5D-5L, resource use, further procedures, complications, recurrence, total active movement and extension deficit, and time to return to function. Given the limited evidence comparing recurrence rates following collagenase injection and limited fasciectomy, and the importance of a return to function as soon as possible for patients, the associated measures for each will be prioritised to allow treatment effectiveness in the context of these key elements to be assessed. An economic evaluation will assess the cost-effectiveness of treatments, and a qualitative sub-study will assess participants' experiences and preferences of the treatments. DISCUSSION: The DISC trial is the first randomised controlled trial, to our knowledge, to investigate the clinical and cost-effectiveness of collagenase compared to limited fasciectomy surgery for patients with Dupuytren's contracture. TRIAL REGISTRATION: Clinical.Trials.gov ISRCTN18254597 . Registered on April 11, 2017.


Asunto(s)
Contractura de Dupuytren , Recurrencia Local de Neoplasia , Adulto , Colagenasas/efectos adversos , Contractura de Dupuytren/diagnóstico , Contractura de Dupuytren/tratamiento farmacológico , Contractura de Dupuytren/cirugía , Fasciotomía , Humanos , Masculino , Colagenasa Microbiana/efectos adversos , Estudios Multicéntricos como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto
7.
Artículo en Inglés | MEDLINE | ID: mdl-31905882

RESUMEN

OBJECTIVE: Psychological well-being has been associated with desirable individual and organisational outcomes. This systematic review aims to assess the effectiveness of digital interventions for the improvement of psychological well-being and/or the prevention/management of poor mental well-being in the workplace. METHODS: This review protocol is registered in PROSPERO (CRD42019142428). Scientific databases including MEDLINE, Web of Science, CINAHL, PsycINFO, Cochrane Register of Controlled Trials (CENTRAL) and EMBASE will be searched for relevant studies published between January 1990 and July 2019. Studies will be included if they report specific primary and secondary outcomes of digital interventions delivered to adults in the workplace for the improvement of their psychological wellbeing and/or the prevention/management of poor mental well-being and were published in English. Following screening of titles and abstracts, full texts of potentially eligible papers will be screened in duplicate to identify studies that assess the effectiveness of those digital interventions. Discrepancies will be resolved through consensus or by consulting a third reviewer. An integrated narrative synthesis will assess included studies' findings, and a meta-analysis will be performed if included studies appear to be homogeneous. The "Cochrane Collaboration's Risk of Bias" tool and the JBI (Joanna Briggs Institute) Critical Appraisal Checklist for Quasi-Experimental Studies will be used to appraise included studies. CONCLUSION: The results of this work will provide recommendations on the use of digital interventions for the promotion of psychological well-being at work. It will also guide the development of future workplace digital interventions and subsequent primary research in this field.


Asunto(s)
Atención a la Salud/estadística & datos numéricos , Promoción de la Salud/métodos , Salud Mental/estadística & datos numéricos , Lugar de Trabajo/psicología , Humanos , Revisiones Sistemáticas como Asunto
8.
BMJ Open ; 9(1): e022746, 2019 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-30670507

RESUMEN

OBJECTIVES: Employment following illness is associated with better physical and psychological functioning. This study aimed to assess the feasibility and acceptability of a theoretically led workbook intervention designed to support patients with cancer returning to work. DESIGN: Parallel-group randomised controlled trial with embedded qualitative interviews. SETTING: Oncology clinics within four English National Health Service Trusts. PARTICIPANTS: Patients who had received a diagnosis of breast, gynaecological, prostate or colorectal cancer and who had been receiving treatment for a minimum of two weeks. INTERVENTION: A self-guided WorkPlan workbook designed to support patients with cancer to return to work with fortnightly telephone support calls to discuss progress. The control group received treatment as usual and was offered the workbook at the end of their 12-month follow-up. OUTCOME MEASURES: We assessed aspects of feasibility including eligibility, recruitment, data collection, attrition, feasibility of the methodology, acceptability of the intervention and potential to calculate cost-effectiveness. RESULTS: The recruitment rate of eligible patients was 44%; 68 participants consented and 58 (85%) completed baseline measures. Randomisation procedures were acceptable, data collection methods (including cost-effectiveness data) were feasible and the intervention was acceptable to participants. Retention rates at 6-month and 12-month follow-up were 72% and 69%, respectively. At 6-month follow-up, 30% of the usual care group had returned to full-time or part-time work (including phased return to work) compared with 43% of the intervention group. At 12 months, the percentages were 47% (usual care) and 68% (intervention). CONCLUSIONS: The findings confirm the feasibility of a definitive trial, although further consideration needs to be given to increasing the participation rates among men and black and ethnic minority patients diagnosed with cancer. TRIAL REGISTRATION NUMBER: ISRCTN56342476; Pre-results.


Asunto(s)
Supervivientes de Cáncer/psicología , Objetivos , Reinserción al Trabajo/estadística & datos numéricos , Adulto , Anciano , Análisis Costo-Beneficio , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/economía , Neoplasias/terapia , Medicina Estatal , Factores de Tiempo , Reino Unido
9.
BMC Psychol ; 5(1): 34, 2017 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-28978353

RESUMEN

BACKGROUND: Returning to work after cancer is associated with improved physical and psychological functioning, but managing this return can be a challenging process. A workbook based intervention (WorkPlan) was developed to support return-to-work among cancer survivors. The aim of this study was to explore how participants using the workbook engaged with the intervention and utilised the content of the intervention in their plan to return-to-work. METHODS: As part of a feasibility randomised controlled trial, 23 participants from the intervention group were interviewed 4-weeks post intervention. Interviews focussed on intervention delivery and data was analysed using Framework analysis. RESULTS: Participants revealed a sense of empowerment and changes in their outlook as they transitioned from patient to employee, citing the act of writing as a medium for creating their own return-to-work narrative. Participants found the generation of a return-to-work plan useful for identifying potential problems and solutions, which also served as a tool for aiding discussion with the employer on return-to-work. Additionally, participants reported feeling less uncertain and anxious about returning to work. Timing of the intervention in coordination with ongoing cancer treatments was crucial to perceived effectiveness; participants identified the sole or final treatment as the ideal time to receive the intervention. CONCLUSIONS: The self-guided workbook supports people diagnosed with cancer to build their communication and planning skills to successfully manage their return-to-work. Further research could examine how writing plays a role in this process. TRIAL REGISTRATION: Current Controlled Trials ISRCTN56342476 . Retrospectively registered 14 October 2015.


Asunto(s)
Supervivientes de Cáncer/psicología , Objetivos , Reinserción al Trabajo/psicología , Adulto , Emociones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/psicología , Poder Psicológico
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