1. Moderators of a resiliency group intervention for frontline clinicians during the COVID-19 pandemic
- Author
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Christina M. Luberto, Dustin J. Rabideau, Maurizio Fava, Louisa G. Sylvia, Darshan H. Mehta, Joanna M. Streck, Sara E. Looby, Sydney Crute, Evan A. Albury, Helen Mizrach, Gregory L. Fricchione, Sabine Wilhelm, Mary Susan Convery, Daniel L. Hall, Giselle K. Perez, Nevita George, and Elyse R. Park
- Subjects
Stress management ,Mindfulness ,Short Communication ,media_common.quotation_subject ,COVID-19 pandemic ,03 medical and health sciences ,0302 clinical medicine ,Intervention (counseling) ,Adaptation, Psychological ,medicine ,Humans ,Pandemics ,media_common ,Relaxation (psychology) ,SARS-CoV-2 ,business.industry ,Frontline clinicians ,COVID-19 ,Loneliness ,Resilience, Psychological ,Resiliency program ,Confidence interval ,030227 psychiatry ,Psychiatry and Mental health ,Clinical Psychology ,Stress coping ,Anxiety ,Psychological resilience ,medicine.symptom ,business ,Stress, Psychological ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Background To mitigate the psychological burdens of COVID-19 for frontline clinicians (FCs), we adapted an existing evidence-based resiliency program, Stress Management and Resilience Training Relaxation Response Program (SMART-3RP), for FCs. This analysis explores moderators of stress coping to determine which subgroups of FCs benefited most from SMART-3RP. Methods 102 FCs from Mass General Brigham hospitals engaged in the adapted SMART-3RP. Assessments were completed at group entry (Week 0) and completion (Week 4). The primary outcome was stress coping, and we examined 15 possible baseline moderators. We fit linear mixed effects regression models and assessed potential baseline moderators using a likelihood ratio test. We report model-based estimates and confidence intervals for each moderator-by-time interaction (i.e., differential effect), where positive/negative values indicate more/less improvement in average perceived stress coping. Results Stress coping improved from Week 0 to Week 4 (mean improvement [95% CI] = 0.9 [0.6 to 1.2]). FCs with higher anxiety (differential effect [95% CI] = 0.3 [0.1 to 0.4]), depression (0.4 [0.2 to 0.6]), and loneliness (0.4 [0.1 to 0.6]), but lower levels of mindfulness (CAMS-Rfocus: 1.0 [0.4 to 1.6]; CAMS-Raccept: 1.3 [0.7 to 2.0]) and self-compassion (0.4, [0.1 to 0.8]) at baseline experienced greater benefits in perceived stress coping from the SMART-3RP. Baseline health uncertainty along with sociodemographic and work characteristics did not moderate stress coping. Discussion Results highlight particular sub-populations of FCs that may benefit more from a stress management intervention, especially during emergency responses (e.g., COVID-19 pandemic).
- Published
- 2021
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