Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: a randomized trial of the optimal dose of training

“…a pandemic situation, we also proposed, based on the theory of social learning [21], that enhancing self-efficacy (expectations about personal ability to respond adaptively to pandemic-related stresses) should be a goal of training because it is expected to be a proximal predictor of behavior [22].”

“The resilience literature is large and varied [16], ranging from studies of individual differences between children that promote healthy outcomes after early life adversity [15] to the factors that protect individuals exposed to extreme traumatic stressors [17,18] or protect adults from mental…”

“…training is to change the behavior of healthcare workers in a pandemic situation, we also proposed, based on the theory of social learning [21], that enhancing self-efficacy (expectations about personal ability to respond adaptively to pandemic-related stresses) should be a goal of…”

“Coping via problem-solving, seeking support from others and escape-avoidance were measured with sub-scales of the Ways of Coping Inventory [42,43] a widely used instrument which yields eight subscales of coping strategies, which are supported in clinical and non-clinical samples [44].”

“The IIP has adequate test-retest reliability, convergence to an established measure of interpersonal styles, and responsiveness to changes in psychotherapy [40,41].”

“Nurses ’ resilience to workplace stresses may be bol-stered by processes that enhance the quality of professional relationships and that foster the development of emotional insight, life balance, spirituality, and reflective thinking [20].”

“…literature is large and varied [16], ranging from studies of individual differences between children that promote healthy outcomes after early life adversity [15] to the factors that protect individuals exposed to extreme traumatic stressors [17,18] or protect adults from mental illness [19].”

“Confidence in training and support was measured with a questionnaire derived to measure responses of health-care workers to SARS [39] that was found to predict long-term effects of SARS [13], modified to apply to influenza.”

“…of severe acute respiratory syndrome (SARS) suggested that an emerging infectious disease causes stress in healthcare settings because of fear of contagion [5-7], concern for family health [6,8,9], job stress [6,7], inter-personal isolation [6,7], quarantine [10] and perceived stigma [7,10,11].”

“…of severe acute respiratory syndrome (SARS) suggested that an emerging infectious disease causes stress in healthcare settings because of fear of contagion [5-7], concern for family health [6,8,9], job stress [6,7], inter-personal isolation [6,7], quarantine [10] and perceived stigma [7,10,11].”

“…of severe acute respiratory syndrome (SARS) suggested that an emerging infectious disease causes stress in healthcare settings because of fear of contagion [5-7], concern for family health [6,8,9], job stress [6,7], inter-personal isolation [6,7], quarantine [10] and perceived stigma [7,10,11].”

“Improvements in interpersonal problems were similar to those achieved with brief dynamic psychotherapy, in which improvements in socially avoidant, nonassertive and overly accommodating problems are more readily achieved than improvements in the cold, self-centered and controlling dimensions [46].”

“Compared to other learning modalities the effects on these outcomes have been small, non-significant and inconsistent [28,30-32].”

“…of severe acute respiratory syndrome (SARS) suggested that an emerging infectious disease causes stress in healthcare settings because of fear of contagion [5-7], concern for family health [6,8,9], job stress [6,7], inter-personal isolation [6,7], quarantine [10] and perceived stigma [7,10,11].”

“These pandemic related stressors could be expected to amplify the stress and strain which is commonly experienced by health care workers in the contemporary health care environment [24].”

“…of severe acute respiratory syndrome (SARS) suggested that an emerging infectious disease causes stress in healthcare settings because of fear of contagion [5-7], concern for family health [6,8,9], job stress [6,7], inter-personal isolation [6,7], quarantine [10] and perceived stigma [7,10,11].”

“Moving beyond plans to support affected healthcare workers after exposure to a pandemic, evidence suggests that psychosocial support and training should be provided to healthcare workers prior to a pandemic to build resilience [12], thereby reducing the impact of stress after exposure.”

“…of severe acute respiratory syndrome (SARS) suggested that an emerging infectious disease causes stress in healthcare settings because of fear of contagion [5-7], concern for family health [6,8,9], job stress [6,7], inter-personal isolation [6,7], quarantine [10] and perceived stigma [7,10,11].”

“…of severe acute respiratory syndrome (SARS) suggested that an emerging infectious disease causes stress in healthcare settings because of fear of contagion [5-7], concern for family health [6,8,9], job stress [6,7], inter-personal isolation [6,7], quarantine [10] and perceived stigma [7,10,11].”

“Based on research in continuing professional education, we expected that the format of the course should address both objective and perceived learning needs, and include both cognitive interactivity and practicing of skills [25,33].”

“Compared to other learning modalities the effects on these outcomes have been small, non-significant and inconsistent [28,30-32].”

“Coping via problem-solving, seeking support from others and escape-avoidance were measured with sub-scales of the Ways of Coping Inventory [42,43] a widely used instrument which yields eight subscales of coping strategies, which are supported in clinical and non-clinical samples [44].”

“The importance of discretionary absenteeism was highlighted by a report that up to 53% of healthcare workers would refuse to attend work if multiple patients infected with pandemic influenza were admitted to their hospital [14].”

“…are directly or indirectly of an interpersonal nature (e.g. concern for family health, interpersonal job stresses, interpersonal isolation and perceived stigma) and because interpersonal problems are associated with job stress in healthcare workers [23], reducing interpersonal problems was a goal.”

“Compared to other learning modalities the effects on these outcomes have been small, non-significant and inconsistent [28, [30] [31] [32] .”

“On the other hand, computer-assisted and Internet-based learning technologies have been promoted as effective strategies to facilitate learning, which may overcome barriers related to timing and cost [26].”

“(87) found that computer-assisted resilience training in healthcare workers appeared to be of significant benefit under pandemic conditions.”

“Maunder and colleagues conducted an uncontrolled before-after study to explore the impact of a computer-assisted resilience training to prepare HCWs for a potential pandemic influenza (Maunder et al., 2010).”

“Previous research with healthcare workers preparing for an influenza epidemic has suggested that predisaster training and education programmes are helpful in terms of increasing confidence.(36,37) Occupational role often had an effect on psychological outcomes, with those directly involved in patient care and in parti…”