Preventing and Addressing the Stress Reactions of Health Care Workers Caring for Patients With COVID-19: Development of a Digital Platform (Be + Against COVID)

Abstract

Background COVID-19 became a major public health concern in March 2020. Due to the high rate of hospitalizations for COVID-19 in a short time, health care workers and other involved staff are subjected to a large workload and high emotional distress. Objective The objective of this study is to develop a digital tool to provide support resources that might prevent and consider acute stress reactions in health care workers and other support staff due to the COVID-19 pandemic. Methods The contents of the digital platform were created through an evidence-based review and consensus conference. The website was built using the Google Blogger tool. The Android version of the app was developed in the Java and XML languages using Android Studio version 3.6, and the iOS version was developed in the Swift language using Xcode version 11.5. The app was evaluated externally by the Andalusian Agency for Healthcare Quality. Results We detected the needs and pressing situations of frontline health care workers, and then, we proposed a serial of recommendations and support resources to address them. These resources were redesigned using the feedback received. A website in three different languages (Spanish, English, and Portuguese) and a mobile app were developed with these contents, and the AppSaludable Quality Seal was granted to the app. A specific self-report scale to measure acute stress and additional tools were included to support the health care workforce. This instrument has been used in several Latin American countries and has been adapted considering cultural differences. The resources section of the website was the most visited with 18,516 out of 68,913 (26.9%) visits, and the “Self-Report Acute Stress Scale” was the most visited resource with 6468 out of 18,516 (34.9%) visits. Conclusions The Be + against COVID platform (website and app) was developed and launched to offer a pool of recommendations and support resources, which were specifically designed to protect the psychological well-being and the work morale of health care workers. This is an original initiative different from the usual psychological assistance hotlines.

Interventions to address mental health issues in healthcare workers during infectious disease outbreaks: A systematic review

“…Most of the included articles reported interventions implemented in China (20.8%) ( Cai et al, 2020 ; Cheng et al, 2020 ; Cheung et al, 2020 ; Hong et al, 2020 ; Zhou et al, 2020 ) and Canada (16.7%) ( Aiello et al, 2011 ; Maunder et al, 2003 , 2010 ; Sockalingam et al, 2020 ), followed by USA ( Albott et al, 2020 ; Robert E. Feinstein et al, 2020 ; Gonzalez et al, 2020 ) and UK ( Blake et al, 2020 ; Cole et al, 2020 ; Donnelly et al, 2020 ) (12.6%, respectively). The rest of the articles referred to Italy ( Buselli et al, 2020 ; Giordano et al, 2020 ) and Africa ( Schreiber et al, 2019 ; Waterman et al, 2018 ) (8.4%, respectively), and Taiwan ( Chen et al, 2006 ), Singapore ( Khee et al, 2004 ), Malaysia ( Ping et al, 2020 ), France ( Geoffroy et al, 2020 ), Spain ( Mira et al, 2020 ) (4.1%, respectively).…”

“…One third of the articles had a cross-sectional design (33.35%) ( Aiello et al, 2011 ; Blake et al, 2020 ; Buselli et al, 2020 ; Cheung et al, 2020 ; Geoffroy et al, 2020 ; Hong et al, 2020 ; Maunder et al, 2003 ; Sockalingam et al, 2020 ), followed by a before-after design (20.8%) ( Chen et al, 2006 ; Cheng et al, 2020 ; Giordano et al, 2020 ; Maunder et al, 2010 ; Zhou et al, 2020 ), cohort (8.4%) ( Cai et al, 2020 ; Waterman et al, 2018 ) and qualitative (4.1%) ( Khee et al, 2004 ) design. Meanwhile, 33.35% of articles did not have a specific study design ( Albott et al, 2020 ; Cole et al, 2020 ; Donnelly et al, 2020 ; Robert E. Feinstein et al, 2020 ; Gonzalez et al, 2020 ; Mira et al, 2020 ; Ping et al, 2020 ; Schreiber et al, 2019 ), since they just described the interventions implemented, and were classified as narrative descriptions. As for the infectious disease outbreaks, the vast majority of articles referred to COVID-19 pandemics (70.7%) ( Albott et al, 2020 ; Blake et al, 2020 ; Buselli et al, 2020 ; Cai et al, 2020 ; Cheng et al, 2020 ; Cheung et al, 2020 ; Cole et al, 2020 ; Donnelly et al, 2020 ; Robert E. Feinstein et al, 2020 ; Geoffroy et al, 2020 ; Giordano et al, 2020 ; Gonzalez et al, 2020 ; Hong et al, 2020 ; Mira et al, 2020 ; Ping et al, 2020 ; Sockalingam et al, 2020 ; Zhou et al, 2020 ), 12.5% to SARS ( Chen et al, 2006 ; Khee et al, 2004 ; Maunder et al, 2003 ), and 8.4% to Ebola ( Schreiber et al, 2019 ; Waterman et al, 2018 ) and Influenza A H1N1 ( Aiello et al, 2011 ; Maunder et al, 2010 ), respect...…”

“…Meanwhile, 33.35% of articles did not have a specific study design ( Albott et al, 2020 ; Cole et al, 2020 ; Donnelly et al, 2020 ; Robert E. Feinstein et al, 2020 ; Gonzalez et al, 2020 ; Mira et al, 2020 ; Ping et al, 2020 ; Schreiber et al, 2019 ), since they just described the interventions implemented, and were classified as narrative descriptions. As for the infectious disease outbreaks, the vast majority of articles referred to COVID-19 pandemics (70.7%) ( Albott et al, 2020 ; Blake et al, 2020 ; Buselli et al, 2020 ; Cai et al, 2020 ; Cheng et al, 2020 ; Cheung et al, 2020 ; Cole et al, 2020 ; Donnelly et al, 2020 ; Robert E. Feinstein et al, 2020 ; Geoffroy et al, 2020 ; Giordano et al, 2020 ; Gonzalez et al, 2020 ; Hong et al, 2020 ; Mira et al, 2020 ; Ping et al, 2020 ; Sockalingam et al, 2020 ; Zhou et al, 2020 ), 12.5% to SARS ( Chen et al, 2006 ; Khee et al, 2004 ; Maunder et al, 2003 ), and 8.4% to Ebola ( Schreiber et al, 2019 ; Waterman et al, 2018 ) and Influenza A H1N1 ( Aiello et al, 2011 ; Maunder et al, 2010 ), respectively. When reported, the sample size ranged from 25 nurses in a pilot study in Malaysia ( Ping et al, 2020 ), to 10240 staff members in a cross-sectional study in China ( Hong et al, 2020 ) during COVID-19.…”

Availability of personal protective equipment and diagnostic and treatment facilities for healthcare workers involved in COVID-19 care: A cross-sectional study in Brazil, Colombia, and Ecuador

“…During an epidemic, the development of infection in healthcare professionals negatively impacts the capacity to treat patients, staff morale [ 7 , 25 ], and public confidence. Therefore, healthcare professionals must be adequately protected.…”

Attitudes Toward Using COVID-19 mHealth Tools Among Adults With Chronic Health Conditions: Secondary Data Analysis of the COVID-19 Impact Survey

“…Reviews of contact tracing apps have highlighted their effectiveness in improving the spatiotemporal reporting of new cases, management and follow-up of COVID-19 cases, and education on preventive behaviors [ 52 , 53 , 57 , 58 , 67 - 70 ]. To address the mental and social impacts of the COVID-19 pandemic, several apps have focused on reducing social isolation, providing positive coping strategies, and monitoring mental health symptoms [ 55 , 56 , 63 , 71 - 74 ]. Although researchers have noted the utility of COVID-19 apps in providing education and public health surveillance amid a rapidly evolving landscape, reviews of COVID-19 apps have highlighted several barriers to the availability, safety, and long-term sustainability of these technologies, including cost, the use of evidence-based guidelines, and user-centered design considerations for functionality and content [ 45 , 61 , 75 - 77 ].…”