Dataset Information

Brief digital self-care intervention for health anxiety in a Swedish Medical University Clinic: a prospective single-group feasibility study.

ABSTRACT:

Objectives

In routine psychiatric care in Stockholm, Sweden, a comprehensive therapist-guided intervention for clinically significant health anxiety is implemented. However, there is a need for more easily accessible self-care interventions to improve treatment dissemination. This study aimed to transform an existing therapist-guided digital intervention into a self-care intervention, reducing patient burden and used clinical resources while maintaining quality and safety.

Design

An uncontrolled feasibility study.

Setting

Conducted at Karolinska Institutet, a medical university in Sweden, with nationwide recruitment trough online advertisements.

Participants

Twenty-five adults used the self-care intervention and underwent telephone assessments, along with completing self-rated questionnaires.

Intervention

The newly developed 8-week self-care intervention was designed to be user-friendly without therapist guidance, and to facilitate high levels of behavioural engagement.

Primary and secondary outcome measures

Indicators of quality and safety, including changes in health anxiety severity (primary), clinician time, participant adherence, perceived credibility/satisfaction with the intervention and adverse events, were benchmarked against a previous study of the more comprehensive intervention it was based on.

Results

Compared with the original guided intervention, the self-care intervention was condensed in terms of text (up to 70% less reading), duration (8 weeks instead of 12) and number of exercises. Quality indicators were similar to the original version. Most participants worked actively with core components in the self-care intervention. Within-group effects on health anxiety from pretreatment to the 3-month follow-up were large (g=1.37; 95% CI 0.74 to 2.00). No serious adverse events were reported.

Conclusions

This brief digital self-care intervention shows potential for increasing access to treatment for individuals with health anxiety while reducing the burden on patients and clinical resources. Future studies should investigate the optimal type of intervention and support for different individuals, and if non-inferiority can be established.

Trial registration number

NCT05446766.

SUBMITTER: Osterman S

PROVIDER: S-EPMC10748877 | biostudies-literature | 2023 Dec

REPOSITORIES: biostudies-literature

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Publications

Brief digital self-care intervention for health anxiety in a Swedish Medical University Clinic: a prospective single-group feasibility study.

Österman Susanna S Hentati Amira A Forsell Erik E Axelsson Erland E Hedman-Lagerlöf Erik E Lindefors Nils N Ivanov Volen Z VZ Kraepelien Martin M

BMJ open 20231221 12

<h4>Objectives</h4>In routine psychiatric care in Stockholm, Sweden, a comprehensive therapist-guided intervention for clinically significant health anxiety is implemented. However, there is a need for more easily accessible self-care interventions to improve treatment dissemination. This study aimed to transform an existing therapist-guided digital intervention into a self-care intervention, reducing patient burden and used clinical resources while maintaining quality and safety.<h4>Design</h4> ...[more]

PMID: 38135329

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Project description:IntroductionThe concept of procrastination can be described as a conscious, yet irrational, postponement of important tasks or decisions-despite awareness that the delay may lead to negative consequences. Procrastination behaviours are common among university students and is often described as a failure of self-regulation, and the behaviour is associated with stress, symptoms of depression and anxiety, poorer academic performance and negative effects on overall health and well-being.Methods and analysisA two-arm, parallel groups (1:1), single-blind randomised controlled trial will be conducted to assess the effectiveness of a brief digital procrastination intervention (Focus) among university students in Sweden. The intervention consists of a screening and feedback component based on Pure Procrastination Scale (PPS) score, allowing intervention participants to assess their current procrastination behaviours and receive behaviour change advice. Participants in the control group will be shown their total PPS score without any further feedback. Monte Carlo simulations (assuming a standardised effect of 0.35 Cohen's d of the intervention on the primary outcome, to at least 80% of the time estimate a posterior probability of effect of at least 95%) indicated that data from 1000 participants are required for analysis, meaning that 2000 participants are required to be randomised when assuming a 50% attrition rate. The primary outcome will be procrastination behaviour measured at 2 months postrandomisation. Secondary outcomes will be anxiety and stress symptoms and lifestyle behaviours. Outcomes will be analysed using multilevel regression models estimated using Bayesian inference.Ethics and disseminationThe study was approved by the Swedish Ethical Review Authority on 2022-08-24 (dnr 2022-00353). Students will be asked to give informed consent before participation and after having been given information about the study. The results will be submitted for publication in open access, peer-reviewed journals.Trial registration numberISRCTN13533793.

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Project description:IntroductionThe aim of the present paper is to establish feasibility and required power of a one-session psychological intervention devoted to increasing patient's self-efficacy and awareness in dealing with anxiety symptoms before major pancreatic cancer surgery.MethodsParallel assignment RCT. All consenting patients listed for pancreatic major surgery during day-hospital visits (T0) between June 2017-June 2018 were assigned randomly in blocks of ten to a psychological intervention vs usual care group to be held the day before surgery (T1). The psychological intervention provided the patient the opportunity to increase self-efficacy in dealing with anxiety by talking with a psychologist about personal concerns and learning mindfulness based techniques to cope with anxiety.Results400 patients were randomized into the experimental vs. usual care group. 49 and 65, respectively, completed baseline and post-intervention measures. The dropout rate between day-hospital (T0) and pre-surgery intervention (T1) was high (74.5%) due to several management and organization pitfalls. The main outcome, perceived self-efficacy in managing anxiety, showed a significant increase in the intervention group compared to the control group (p < 0.001), and was related to a reduction in state anxiety (p < 0.001). The intervention group perceived also lower emotional pain (p = 0.03). A power analysis was performed to define the appropriate sample size in a definitive RCT.ConclusionBeneath the complexity in retaining patients along their trajectory in pancreatic surgery department, when they had the opportunity to follow a brief psychological intervention, most of them adhered, showing a significant reduction in preoperative emotional distress and less emotional pain perception after surgery. Even if results need caution because of the high attrition rate, we can infer that our psychological intervention has the potential to be proposed in surgical setting, being short, easy to learn and applicable to a wide range of patients.Clinical trial registrationThe trial was registered on ClinicalTrials.gov (identifier: NCT03408002). The full protocol is available from the last author.

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Dataset Information

Brief digital self-care intervention for health anxiety in a Swedish Medical University Clinic: a prospective single-group feasibility study.

Objectives

Design

Setting

Participants

Intervention

Primary and secondary outcome measures

Results

Conclusions

Trial registration number

Publications

Brief digital self-care intervention for health anxiety in a Swedish Medical University Clinic: a prospective single-group feasibility study.

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