Feasibility and preliminary evaluation of internet-based compassion and cognitive-behavioral stress-management courses for health care professionals: A randomized controlled pilot trial

Maude Johansson; David Marcusson-Clavertz; Cecilia Gunnarsson; Ida Olsson; Viktor Kaldo; Anna Bratt

doi:10.1016/j.invent.2022.100574

Feasibility and preliminary evaluation of internet-based compassion and cognitive-behavioral stress-management courses for health care professionals: A randomized controlled pilot trial

Internet Interv. 2022 Sep 21:30:100574. doi: 10.1016/j.invent.2022.100574. eCollection 2022 Dec.

Authors

Maude Johansson¹, David Marcusson-Clavertz¹, Cecilia Gunnarsson², Ida Olsson¹, Viktor Kaldo^{1

3}, Anna Bratt¹

Affiliations

¹ Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
² Previa, Växjö, Sweden.
³ Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden.

Abstract

Health care professionals (HCPs) are exposed to excessive demands in their work environment. In Sweden, work-related stress is one of the most common reasons for sick leaves. Finding cost-effective and easily accessible interventions for HCPs is crucial to counteract stress-related problems and reduce the number of sick leaves. The study aimed to evaluate the feasibility of two internet-based stress management courses and their preliminary effectiveness to reduce HCPs' stress of conscience and work-related stress, and act as a pilot for a larger randomized controlled trial (RCT). Thirty-two HCPs registered for the courses and were randomized to either an internet-based compassion course, ICOP (n = 18), or an internet-based cognitive-behavioral course, ICB (n = 14). Participants completed measures pre- (i.e., baseline, n = 32), post-intervention (at five weeks, n = 21), and at follow-up at 10 weeks (n = 17), 15 weeks (n = 13), and six months (n = 12). The study used the following scales: Stress of Conscience Questionnaires, Copenhagen Psychosocial Questionnaire, Self-Compassion Scale, and Professional Quality of Life Scale. Adherence of HCPs (n = 21) was measured using the number of logins, messages between course leaders and HCPs, and completed modules. Twelve interviews were conducted to explore participants' perceptions of the accessibility of the courses. Participants reported overall satisfaction with both the ICOP and ICB courses, stating that the courses contributed to new knowledge, individual insight, and behavior change. Both courses showed similar patterns of adherence. Quantitative analyses on pre-and post-intervention data (n = 21) showed that stress of conscience and secondary traumatic stress decreased, and self-compassion increased following ICOP. Following ICB, HCPs reported decreased burnout symptoms (according to one of two questionnaires) and increased compassion satisfaction. Both courses seemed feasible, showed promising results, and could be further evaluated in a larger study with a similar design.

Keywords: Cognitive behavioral therapy; Compassionate mind training course; Health care professionals; Internet-based interventions; Stress management course; Stress of conscience.