Efficacy of video-based psychotherapy in reducing psychological distress of COVID-19 patients treated in isolation ward
BACKGROUND Hospitalized patients with COVID-19 experience isolation during treatment, which may cause psychological distress. Thus, alternative ways to deliver psychological support are needed when face-to-face therapy is not possible. This study aimed to investigate the efficacy of video-based psychotherapy in reducing distress in COVID-19 patients treated in an isolation ward.
METHODS This quasi-experimental trial without a control group included 42 COVID-19 patients aged 20–59 years. Participants were recruited conveniently in the COVID-19 isolation ward in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. They watched three brief psychotherapy videos including relaxation, managing thoughts and emotions, and mindfulness for approximately 30 min. The videos were created by the Department of Psychiatry, Faculty of Medicine, Universitas Indonesia. Subjective units of distress scale (SUDS) was measured before and after watching all videos. Data were analyzed using the Wilcoxon-signed rank test.
RESULTS All 42 subjects finished watching the videos. 31 subjects experienced a significant median decrease in SUDS score after the intervention. The effect size of the psychotherapy videos for the SUDS score was 0.485 (95% CI 0.302 to 0.634).
CONCLUSIONS Watching psychotherapy videos is effective in reducing the SUDS score for COVID-19 patients in an isolation ward. Our brief video-based psychotherapy intervention has reduced psychological distress in hospitalized COVID-19 patients with limited access to face-to-face consultations due to the risk of disease transmission.
Kaligis F, Indraswari MT, Ismail RI. Stress during COVID-19 pandemic: mental health condition in Indonesia. Med J Indones. 2020;29(4):436-41. https://doi.org/10.13181/mji.bc.204640
Aziza L, Aqmarina A, Ihsan M. Guideline of coronavirus disease (COVID-19) control and prevention. 1st ed. Jakarta: Ministry of Health Republic of Indonesia Director-General of Disase Control and Prevention; 2020.
Abad C, Fearday A, Safdar N. Adverse effects of isolation in hospitalised patients: a systematic review. J Hosp Infect. 2010;76(2):97-102. https://doi.org/10.1016/j.jhin.2010.04.027
Huremović D. Psychiatry of pandemics: a mental health response to infection outbreak. 1st ed. Manhasset: Springer; 2019. https://doi.org/10.1007/978-3-030-15346-5_1
Wolpe J. The practice of behavior therapy. 1st ed. London: Pergamon Press; 1973.
Zandifar A, Badrfam R, Yazdani S, Arzaghi SM, Rahimi F, Ghasemi S, et al. Prevalence and severity of depression, anxiety, stress and perceived stress in hospitalized patients with COVID-19. J Diabetes Metab Disord. 2020;19(2):1-8. https://doi.org/10.1007/s40200-020-00667-1
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912-20. https://doi.org/10.1016/S0140-6736(20)30460-8
Zarghami A, Farjam M, Fakhraei B, Hashemzadeh K, Yazdanpanah MH. A report of the telepsychiatric evaluation of SARS-CoV-2 patients. Telemed J E Health. 2020;26(12):1461-5. https://doi.org/10.1089/tmj.2020.0125
Cheng W, Zhang F, Hua Y, Yang Z, Liu J. Development of a psychological first-aid model in inpatients with COVID-19 in Wuhan, China. Gen Psychiatry. 2020;33(3): 100292. https://doi.org/10.1136/gpsych-2020-100292
Sherifali D, Ali MU, Ploeg J, Markle-Reid M, Valaitis R, Bartholomew A, et al. Impact of internet-based interventions on caregiver mental health: systematic review and meta-analysis. J Med Internet Res. 2018;20(7):e10668. https://doi.org/10.2196/10668
Wei N, Huang BC, Lu SJ, Hu JB, Zhou XY, Hu CC, et al. Efficacy of internet-based integrated intervention on depression and anxiety symptoms in patients with COVID-19. J Zhejiang Univ Sci B. 2020;21(5):400-4. https://doi.org/10.1631/jzus.B2010013
Liu K, Chen Y, Wu D, Lin R, Wang Z, Pan L. Effects of progressive muscle relaxation on anxiety and sleep quality in patients with COVID-19. Complement Ther Clin Pract. 2020;39:101132. https://doi.org/10.1016/j.ctcp.2020.101132
Smith CA, Levett KM, Collins CT, Armour M, Dahlen HG, Suganuma M. Relaxation techniques for pain management in labour. Cochrane Database Syst Rev. 2018;2018(3):CD009514. https://doi.org/10.1002/14651858.CD009514.pub2
Valliani K, Mughal FB. Human emotions during COVID-19: a lens through Kubler-Ross grief theory. Psychol Trauma. Forthcoming 2021. https://doi.org/10.1037/tra0001064
Dekker RL, Moser DK, Peden AR, Lennie TA. Cognitive therapy improves three-month outcomes in hospitalized patients with heart failure. J Card Fail. 2012;18(1): 10-20. https://doi.org/10.1016/j.cardfail.2011.09.008
Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Gemignani A, Orrù G. Mindfulness, age and gender as protective factors against psychological distress during COVID-19 pandemic. Front Psychol. 2020; 11:1900. https://doi.org/10.3389/fpsyg.2020.01900
Behan C. The benefits of meditation and mindfulness practices during times of crisis such as COVID-19. Ir J Psychol Med. 2020;37(4):256-8. https://doi.org/10.1017/ipm.2020.38
Grazzi L, Rizzoli P, Andrasik F. Effectiveness of mindfulness by smartphone, for patients with chronic migraine and medication overuse during the Covid-19 emergency. Neurol Sci. 2020;41(Suppl 2):461-2. https://doi.org/10.1007/s10072-020-04659-0
Reyes AT. A mindfulness mobile app for traumatized COVID-19 healthcare workers and recovered patients: a response to "the use of digital applications and COVID-19." Community Ment Health J. 2020;56(7):1204-5. https://doi.org/10.1007/s10597-020-00690-9
Nelson N, Bergeman C. Daily stress processes in a pandemic: the effects of worry, age, and affect. Gerontologist. 2021; 61(2):196-204. https://doi.org/10.1093/geront/gnaa187
Nwachukwu I, Nkire N, Shalaby R, Hrabok M, Vuong W, Gusnowski A, et al. COVID-19 pandemic: age-related differences in measures of stress, anxiety and depression in Canada. Int J Environ Res Public Health. 2020;17(17):6366. https://doi.org/10.3390/ijerph17176366
Copyright (c) 2021 Petrin Redayani Lukman, Alvin Saputra, Sylvia Detri Elvira, Heriani, Alfi Fajar Almasyhur, Leonita Ariesti Putri, César Alberto Alfonso, Reina Rahma Noviasari
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.