Digitalizing a Brief Intervention to Reduce Intrusive Memories of Psychological Trauma for Healthcare Staff Working During COVID-19 : An Exploratory Pilot Study with Nurses.

BACKGROUND: The COVID-19 pandemic has accelerated the worldwide need for simple, remotely delivered (digital), scalable interventions that can also be used preventatively to protect the mental health of healthcare staff exposed to psychologically traumatic events during their COVID-19 related work. We have developed a brief behavioral intervention which aims to reduce the number of intrusive memories of traumatic events, but has only been delivered face-to-face so far. After digitalising intervention materials, here, the intervention is delivered digitally to target-users (healthcare staff) for the first time. Adaption for staff's working context in a hospital setting used a co-design approach. OBJECTIVE: Aims of this mixed method exploratory pilot study with healthcare staff who experienced working in the pandemic were to: 1) Pilot the intervention that we have (a) digitalised (for remote delivery and with remote support) and (b) adapted for this target population (healthcare staff working clinically during a pandemic) to explore its ability to reduce the number of intrusive memories of traumatic events, as well as improve related symptoms (e.g. posttraumatic stress) and participant's perception of their functioning; 2) Explore feasibility and acceptability of both digitalised intervention and digitalised data collection. METHODS: We worked closely with target-users with lived experience of working clinically during the COVID-19 pandemic in a hospital context, here registered nurses who experienced intrusive memories from traumatic events at work (N=3). We used a mixed-method design and exploratory quantitative and qualitative analysis. RESULTS: After completing the digitalised intervention once with remote researcher support (approximately 25 minutes) and a brief follow-up check-in, participants learnt to use the intervention independently. All three participants reported zero intrusive memories during week 5 (primary outcome, 100% digital data capture). Prior to study inclusion, pre-intervention two or more intrusions in the week were reported (assessed retrospectively). There was a general pattern of symptom reduction and improvement in perceived functioning (e.g. concentration) at follow-up. Digitalised intervention and data collection were perceived as feasible and rated as acceptable (e.g. all three participants would recommend it to a colleague). Participants were positive towards the digital intervention as a useful tool that could readily be incorporated into work life and repeated in the face of ongoing/repeated trauma exposure. CONCLUSIONS: The digitalised intervention when adapted for this population was well received by participants. Since it could be tailored around work/daily life and used preventatively, the digital intervention may hold promise for healthcare staff pending future evaluations of efficacy. Limitations include the small sample, lack of daily intrusion frequency data in the week before the intervention, and lack of control condition. Following this co-design process in adapting/improving intervention delivery and evaluation, a next step is to investigate the efficacy of the digitalised intervention in a randomised controlled trials