Efectividad de una Intervención Online para Prevención de Ansiedad: Un Ensayo Clínico
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El propósito de este estudio fue probar la eficacia y el efecto sostenido (seguimiento) de una intervención de atención plena de cuatro semanas para reducir la ansiedad y el estrés en un grupo de estudiantes universitarios brasileños, la intervención se adaptó para estar disponible a través del app. Neurosaúde, creada como parte de este trabajo para servir como plataforma de intervención. La investigación en su conjunto se llevó a cabo en un entorno virtual, siendo reclutados cuarenta y ocho participantes que fueron asignados aleatoriamente al grupo de intervención o al control en lista de espera. Se utilizaron medidas para evaluar los niveles de atención plena, ansiedad y estrés antes, después de la intervención y en el seguimiento a las 4 semanas. Al aplicar el análisis por intención de tratar, encontramos diferencias significativas entre los grupos para la medida de ansiedad en el seguimiento con un tamaño de efecto grande (F (2.92) = 10.275, p = 0.000, η2 = 0.183). Nuestros resultados sugieren que la intervención de mindfulness de 4 semanas a través de una aplicación móvil fue capaz de actuar como factor protector contra la ansiedad desarrollada por estudiantes universitarios durante la ocurrencia de la pandemia de Covid-19, ya que mientras el grupo de tratamiento mantuvo niveles, el grupo control demostró un aumento continuo de la ansiedad en el postest y seguimiento que coincidió con la primera ola de Covid-19 en la región donde residían los participantes.
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Andersson, G., Rozental, A., Shafran, R., & Carlbring, P. (2018). Long-term effects of internet-supported cognitive behaviour therapy. Expert Review of Neurotherapeutics, 18(1), 21–28. https://doi.org/10.1080/14737175.2018.1400381
Ariño, D. O., & Bardagi, M. P. (2018). Relação entre fatores acadêmicos e a saúde mental de estudantes universitários. Psicologia em Pesquisa, 12(3), 44–52. https://dx.doi.org/10.24879/2018001200300544
Bamber, M. D., & Morpeth, E. (2019). Effects of mindfulness meditation on college student anxiety: A meta-analysis. Mindfulness, 10(2), 203–214. https://doi.org/10.1007/s12671-018-0965-5
Barros, V. V. de, Kozasa, E. H., Souza, I. C. W. de, & Ronzani, T. M. (2014). Validity evidence of the Brazilian version of the Five Facet Mindfulness Questionnaire (FFMQ). Psicologia: Teoria e Pesquisa, 30(3), 317– 327. https://doi.org/10.1590/s0102-37722014000300009
Birks, Y., McKendree, J., & Watt, I. (2009). Emotional intelligence and perceived stress in healthcare students: A multi-institutional, multi-professional survey. BMC Medical Education, 9(61), 1–8. https://doi.org/10.1186/1472-6920-9-61
Carvalho, A. P. V. de, Silva, V., & Grande, A. J. (2013). Avaliação do risco de viés de ensaios clínicos randomizados pela ferramenta da colaboração Cochrane. Diagnóstico & Tratamento, 18(1), 38–44.
Cavalcante, J. R., Cardoso-dos-Santos, A. C., Bremm, J. M., Lobo, A. de P., Macário, E. M., Oliveira, W. K. de, & França, G. V. A. de. (2020). Covid-19 no Brasil: Evolução da epidemia até a semana epidemiológica 20 de 2020. Epidemiologia e serviços de saúde: Revista do Sistema Único de Saúde do Brasil, 29(4), e2020376. https://doi.org/10.5123/s1679-49742020000400010
Cavanagh, K., Strauss, C., Cicconi, F., Griffiths, N., Wyper, A., & Jones, F. (2013). A randomised controlled trial of a brief online mindfulness-based intervention. Behaviour Research and Therapy, 51(9), 573–578. https://doi.org/10.1016/j.brat.2013.06.003
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed). Routledge. https://doi.org/10.4324/9780203771587
Conversano, C., Di Giuseppe, M., Miccoli, M., Ciacchini, R., Gemignani, A., & Orrù, G. (2020). Mindfulness, age and gender as protective factors against psychological distress during Covid-19 pandemic. Frontiers in Psychology, 11, 1–9. https://doi.org/10.3389/fpsyg.2020.01900
Demarzo, M., Montero-Marin, J., Puebla-Guedea, M., Navarro-Gil, M., Herrera-Mercadal, P., Moreno- -González, S., Calvo-Carrión, S., Bafaluy-Franch, L., & Garcia-Campayo, J. (2017). Efficacy of 8- and 4-session mindfulness-based interventions in a non-clinical population: A controlled study. Frontiers in Psychology, 8, 1343. https://doi.org/10.3389/fpsyg.2017.01343
Eberth, J., & Sedlmeier, P. (2012). The effects of mindfulness meditation: A meta-analysis. Mindfulness, 3, 174–189. https://doi.org/10.1007/s12671-012-0101-x
Economides, M., Martman, J., Bell, M. J., & Sanderson, B. (2018). Improvements in stress, affect, and irritability following brief use of a mindfulness-based smartphone app: A randomized controlled trial. Mindfulness, 9, 1584–1593. https://doi.org/10.1007/s12671-018-0905-4
Faro, A., Bahiano, M. de A., Nakano, T. de C., Reis, C., Silva, B. F. P. da, & Vitti, L. S. (2020). Covid-19 e saúde mental: A emergência do cuidado. Estudos de Psicologia (Campinas), 37, e200074. https://doi.org/10.1590/1982-0275202037e200074
Faul, F., Erdfelder, E., Buchner, A., & Lang, A-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160. https://doi.org/10.3758/BRM.41.4.1149
Flett, J. A. M., Hayne, H., Riordan, B. C., Thompson, L. M., & Conner, T. S. (2019). Internet-based mindfulness treatment for anxiety disorders: A randomized controlpular apps on mental health. Mindfulness, 10, 863–876. https://doi.org/10.1007/s12671-018-1050-9
Hofmann, S. G., & Gómez BA, A. F. (2017). Mindfulness-based interventions for anxiety and depression. Psychiatric Clinics of North America, 40(4), 739–749. https://doi.org/10.1016/j.psc.2017.08.008
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 169–183. https://doi.org/10.1037/a0018555
Hollis, S., & Campbell, F. (1999). What is meant by intention to treat analysis? Survey of published randomised controlled trials. BMJ, 319, 670–674. https://doi.org/10.1136/bmj.319.7211.670
Huberty, J., Green, J., Glissmann, C., Larkey, L., Puzia, M., & Lee, C. (2019). Efficacy of the mindfulness meditation mobile app “calm” to reduce stress among college students: Randomized controlled trial. JMIR Mhealth and Uhealth, 7(6), e14273. https://doi.org/10.2196/14273
Jones, P. J., Park, S. Y., & Lefevor, G. T. (2018). Contemporary college student anxiety: The role of academic distress, financial stress, and support. Journal of College Counseling, 21(3), 252–264. https://doi.org/10.1002/jocc.12107
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. https://doi.org/10.1093/clipsy/bpg016
Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., Crane, C., Bondolfi, G., Hayes, R., Huijbers, M., Ma, H., Schweizer, S., Segal, Z., Speckens, A., Teasdale, J. D., Van Heeringen, K., Williams, M., Byford, S., Byng, R., & Dalgleish, T. (2016). Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse an individual patient data meta-analysis from randomized trials. JAMA Psychiatry, 73(6), 565– 574. https://doi.org/10.1001/jamapsychiatry.2016.0076
Lenhard, W., & Lenhard, A. (2016). Computation of effect sizes. Psychometrica. https://doi.org/10.13140/RG.2.2.17823.92329
Leyland, A., Rowse, G., & Emerson, L.-M. (2019). Experimental effects of mindfulness inductions on selfregulation: Systematic review and meta-analysis. Emotion, 19(1), 108–122. https://doi.org/10.1037/emo0000425
Lima, C. K. T., Carvalho, P. M. de M., Lima, I. de A. A. S., Nunes, J. V. A. de O., Saraiva, J. S., Souza, R. I. de, Silva, C. G. L. da, & Rolim Neto, M. L. R. (2020). The emotional impact of Coronavirus 2019-nCoV (new Coronavirus disease). Psychiatry Research, 287, 112915. https://doi.org/10.1016/j.psychres.2020.112915
Liu-Seifert, H., Zhang, S., D’Souza, D., & Skljarevski, V. (2010). A closer look at the baseline-observationcarriedforward (BOCF). Patient Preference and Adherence, 4, 11–16. https://doi.org/10.2147/ppa.s8135
Maia, B. R., & Dias, P. C. (2020). Anxiety, depression and stress in university students: The impact of Covid-19. Estudos de Psicologia (Campinas), 37, 1–8. https://doi.org/10.1590/1982-0275202037e200067
McCoy, E. (2017). Understanding the intention-to-treat principle in randomized controlled trials. Western Journal of Emergency Medicine, 18(6), 1075–1078. https://doi.org/10.5811/westjem.2017.8.35985
Ministério da Saúde do Brasil. (2020). Plano de Contingência Nacional para Infecção Humana pelo novo Coronavírus Covid-19: Centro de Operações de Emergências em Saúde Pública (Vol. 1). Ministério da Saúde. Mussi, F. C., Pires, C. G. da S., Carneiro, L. S., Costa, A. L. S., Ribeiro, F. M. S. e S., & Santos, A. F. dos. (2019). Comparison of stress in freshman and senior nursing students. Revista da Escola de Enfermagem da USP, 53, 1–7. https://doi.org/10.1590/s1980-220x2017023503431
O’Driscoll, M., Sahm, L. J., Byrne, H., Lambert, S., & Byrne, S. (2019). Impact of a mindfulness-based intervention on undergraduate pharmacy students’ stress and distress: Quantitative results of a mixed-methods study. Currents in Pharmacy Teaching and Learning, 11(9), 876–887. https://doi.org/10.1016/j.cptl.2019.05.014
Portaria n. 340, de 30 de março de 2020. Diário Oficial da União do Brasil, Seção 1. (2020). https://www.in.gov.br/en/web/dou/-/portaria-n-340-de-30-de-marco-de-2020-250405535
Silva, S. M. da, & Rosa, A. R. (2021). The impact of Covid-19 on the students’ mental health and the role of teaching institutions to protect and promote their emotional well-being. Praksis, 2, 189–206. https://doi.org/10.25112/RPR.V2I0.2446
Turner, J. A., Deyo, R. A., Loeser, J. D., Von Korff, M., & Fordyce, W. E. (1994). The importance of placebo effects in pain treatment and research. JAMA: The Journal of the American Medical Association, 271(20), 1609–1614. https://doi.org/10.1001/jama.1994.03510440069036
ul Haq, M. A., Dar, I. S., Aslam, M., & Mahmood, Q. K. (2018). Psychometric study of depression, anxiety and stress among university students. Journal of Public Health (Germany), 26(2), 211–217. https://doi.org/10.1007/s10389-017-0856-6
Victorson, D. E., Sauer, C. M., Wolters, L., Maletich, C., Lukoff, K., & Sufrin, N. (2020). Meta-analysis of technology-enabled mindfulness-based programs for negative affect and mindful awareness. Mindfulness, 11(8), 1884–1899. https://doi.org/10.1007/s12671-020-01373-y
Vignola, R. C. B., & Tucci, A. M. (2014). Adaptation and validation of the depression, anxiety and stress scale (DASS) to Brazilian Portuguese. Journal of Affective Disorders, 155(1), 104–109. https://doi.org/10.1016/j.jad.2013.10.031
World Health Organization. (2020a). Coronavirus disease 2019 (Covid-19): Situation Report – 199, August 6 2020 (pp. 1–18). WHO. https://reliefweb.int/report/world/coronavirus-disease-covid-19-situation-report-199-6-august-2020
World Health Organization. (2020b). Coronavirus disease 2019 (Covid-19): Situation Report – 168, July 6 2020. WHO. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200706-covid19-sitrep-168.pdf?sfvrsn=7fed5c0b_2
World Health Organization. (2020c). Coronavirus disease (Covid-19): Situation Report, September 6 2020 (pp. 1–22). WHO. https://www.who.int/publications/m/item/weekly-epidemiological-update---7-september-2020