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Using a Novel Gameplay Intervention to Target Intrusive Memories After Work-Related Trauma: Iterative Qualitative Analysis of Intensive Care Unit Staff Experiences

Patel, Priya; Brown, Susan; Guo, Boliang; Holmes, Emily A.; Iyadurai, Lalitha; Kingslake, Jonathan; Highfield, Julie; Morriss, Richard

Using a Novel Gameplay Intervention to Target Intrusive Memories After Work-Related Trauma: Iterative Qualitative Analysis of Intensive Care Unit Staff Experiences Thumbnail


Authors

Susan Brown

Emily A. Holmes

Lalitha Iyadurai

Jonathan Kingslake

Julie Highfield



Abstract

Background: Many intensive care unit (ICU) staff experience intrusive memories following work-related traumatic events, which can lead to long-term mental health outcomes and impact work functioning. There is a need for interventions that target intrusive memories in this population; however, factors such as mental health stigma and difficulty in fitting interventions into busy schedules can pose barriers. The Brief Gameplay Intervention For National Health Service Intensive Care Unit Staff Affected By COVID-19 Trauma (GAINS) study tested a brief, digital imagery-competing task intervention (including computer gameplay) with the aim of reducing the recurrence of intrusive memories, which holds promise for overcoming some of these barriers.

Objective: This substudy aims to explore barriers and facilitators to the uptake and practical use of the intervention by ICU staff, along with its acceptability, and iteratively explore the impact of intervention optimizations to further refine the intervention.

Methods: The GAINS study is a randomized controlled trial comparing access to a brief digital imagery-competing task intervention for 4 weeks with usual care followed by delayed access to the intervention. The participants were ICU staff who worked during the COVID-19 pandemic and experienced intrusive memories. All participants were sent a questionnaire at 4 weeks to gather data about intervention acceptability. Nested within the randomized controlled trial, a subset of 16 participants was interviewed, and data were analyzed using thematic analysis drawing from a framework approach.

Results: Both quantitative and qualitative data indicated high acceptability of the intervention. Intervention use data show that, on average, staff were able to target approximately 73% (3.64/4.88) of their intrusive memories and engaged with the Tetris component for the full 20 minutes per session. Overall, on the acceptability questionnaire, staff found the intervention easy to use, helpful, and highly acceptable. The interviews generated four themes: approach to the intervention, positives of the intervention, negatives of the intervention, and improvements and optimizations. Findings highlighted barriers that ICU staff experienced: stigma, feeling weak for seeking help, not wanting colleagues to know they were struggling, and skepticism. However, they provided suggestions on how barriers could be overcome and discussed the advantages of the intervention when compared with other treatments. Although participants described many positive aspects of the intervention, such as being easy to use, enjoyable, and leading to a reduction in the frequency or intensity of intrusive memories, they also raised practical issues for implementation.

Conclusions: The intervention has the potential to overcome stigma and reduce the frequency of intrusive memories after traumatic events among ICU staff. Further refinement is needed to improve the adoption and reach of this intervention. A limitation is that we could not interview the National Health Service staff who were unable or unwilling to take part in the trial.

Citation

Patel, P., Brown, S., Guo, B., Holmes, E. A., Iyadurai, L., Kingslake, J., Highfield, J., & Morriss, R. (2024). Using a Novel Gameplay Intervention to Target Intrusive Memories After Work-Related Trauma: Iterative Qualitative Analysis of Intensive Care Unit Staff Experiences. JMIR Formative Research, 8(1), Article e47458. https://doi.org/10.2196/47458

Journal Article Type Article
Acceptance Date Nov 20, 2023
Online Publication Date Feb 29, 2024
Publication Date Feb 29, 2024
Deposit Date Apr 15, 2024
Publicly Available Date Apr 15, 2024
Journal JMIR Formative Research
Electronic ISSN 2561-326X
Publisher JMIR Publications
Peer Reviewed Peer Reviewed
Volume 8
Issue 1
Article Number e47458
DOI https://doi.org/10.2196/47458
Keywords intensive care; posttraumatic stress disorder; PTSD; qualitative research; intervention study; health care professionals; digital intervention; staff well-being; pandemic; intrusive memories; work-related trauma; mobile phone
Public URL https://nottingham-repository.worktribe.com/output/27599367
Publisher URL https://formative.jmir.org/2024/1/e47458

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