Efficacy of online psychoeducation and relaxation training program (OnPR) on mental health problems in COVID-19 patients: A randomized controlled trial.

Publication date: Mar 01, 2024

Prior studies found that the prevalence of anxiety, depression, stress and insomnia were relatively high in COVID-19 patients. This study aimed to explore the efficacy of OnPR on mental health outcomes in patients with asymptomatic or mildly symptomatic COVID-19. We employed a randomized controlled trial following the CONSORT guidelines. The Thai Clinical Trials Registry identification number of this study is TCTR20220729003. We used a block of 4 randomizations generated by a computer program. The intervention group (n = 38) received the OnPR program, and the control group (n = 36) received care as usual. OnPR was an online psychological intervention comprising psychoeducation, sleep hygiene education and relaxation techniques. OnPR was provided by qualified therapists trained with a standard protocol. The primary outcomes were depression, anxiety, and stress, which were determined by the Depression Anxiety and Stress Scale-21 (DASS-21). Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Outcomes were compared between groups at pre-intervention and post-intervention at 1, 4, and 12 weeks using paired t-test or Wilcoxon signed-rank test. In addition, a linear mixed model was employed to demonstrate the effect changes of OnPR over time. All analyses were two-tailed, with a significance level of 0. 05. Of 74 Thai participants, 89. 2 % were female, and 11. 8 % were male. The average age was 31 years. Participants’ baseline characteristics were not statistically significant between the intervention and control groups except for depression and stress scores from DASS-21. OnPR resulted in significantly better improvement in depression, anxiety, stress, and sleep quality. The mean differences between groups of DASS-21 scores in depression, anxiety and stress at 7-day follow-up were -4. 69, -3. 29, and -5. 50 respectively. The differences continue to be significant at 4-week and 12-week follow-ups. The mean difference between groups of PSQI at 7-day follow-up is -0. 91. OnPR improved mental health outcomes, and the effect on depression, anxiety and stress lasted for at least a 12-week follow-up period. In addition, it could enhance sleep quality after the intervention.

Concepts Keywords
Pittsburgh COVID-19
Sleep Mental health problems
Tctr20220729003 Online
Thai Psychoeducation
Therapists Randomized controlled trial
Relaxation training


Type Source Name
disease MESH COVID-19
disease MESH insomnia
disease IDO intervention
disease VO protocol
disease MESH Sleep quality
disease VO time
drug DRUGBANK Tropicamide

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