Digital-based nursing interventions for decreasing Stress | JMDH

Digital-based nursing interventions for reducing Stress | JMDH


Coronavirus Illness 2019 (COVID-19) has grow to be a pandemic and a extremely contagious illness on the planet. In response to the Ministry of Well being of the Republic of Indonesia, Coronavirus Illness 2019 (COVID-19) is attributable to the Extreme Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which assaults the respiratory system. The prevalence of COVID-19 victims has elevated day-after-day since 2019. Primarily based on information from the World Well being Group (WHO) on March 18, 2022, it was said that the full confirmed instances of COVID-19 globally have been 462,758,117 with 6,056,725 instances of dying (Case Fatality Charge 5.1%) in 229 affected international locations.1 The COVID-19 pandemic can have an effect on individuals of all ages from kids to youngsters.

A number of research in most of the people additionally confirmed a rise within the prevalence of psychological issues, specifically instances of despair (14.6–48.3%), stress (8.1–81.9%), and nervousness (6.33%-50). 9%).2,3 The COVID-19 pandemic has additionally had an influence on youngsters. Analysis in Spain reveals that youngsters can expertise psychological misery throughout Covid-19.4 Analysis in China additionally reveals that adolescents expertise psychological issues, specifically signs of Put up-traumatic Stress-Dysfunction (PTSD).3,5,6 COVID-19 may trigger psychological well being issues reminiscent of stress, nervousness, depressive signs, insomnia, rejection, anger, and concern in adolescents.7,8 The federal government and the general public have taken a number of measures to cut back the influence of COVID-19.

The efforts made by the federal government in decreasing the influence and unfold of COVID-19 are by implementing insurance policies, specifically lockdown, bodily distancing, restrictions on social actions, working from house, and on-line studying.9 Modifications in studying strategies from offline to on-line resulted within the emergence of psychological issues in college students.10 These psychological issues are attributable to restricted communication and interplay, and the shortage of socialization with lecturers, buddies, and the setting.11,12

Adolescence is a stage that’s weak to emotional and behavioral improvement as a result of it’s a interval of transition from kids to adults. The adolescent stage is a stage that undergoes many adjustments, each organic, psychological, and social.13 Youngsters favor actions outdoors the house and work together with their friends. Peer teams have an vital position in adolescent identification.14 That is actually a problem for adolescent development and improvement when it comes to psychosocial, emotional improvement, and likewise psychological well being. Youth psychological well being is identical significance of bodily well being.

Psychological well being is vital for adolescents, particularly associated to lack of high quality sleep, issue focusing, usually forgetting and may make adolescents demotivated in studying in order that studying is missing.15–17 Disturbances in a toddler’s psychological well being have a major influence on different elements of kid and adolescent improvement reminiscent of poor faculty adjustment, decreased focus, issues with achievement and social relationships.18–22

Psychological well being issues must be addressed as a result of it is going to trigger different severe results reminiscent of suicide.23 Nurses have a task in making nursing care to cut back psychological well being issues skilled by adolescents. Up to now, well being employees have solely centered on dealing with bodily issues in adolescents throughout the COVID-19 pandemic.24 In order that interventions are wanted that may be achieved to cut back the influence of psychological well being issues.

Earlier research on digital nursing interventions might be carried out utilizing an utility that gives details about psychological well being issues throughout the Covid-19 pandemic.25–27 As well as, the applying additionally gives modules for rest to enhance college students’ adaptive coping in coping with stress. This utility additionally gives a bunch as a way of help system and is accompanied by a facilitator, specifically a nurse.28 The help system within the utility is an effort to cut back depressive signs in college students. The event of the applying collaborated with the varsity. One other research used chatbots for consultations between college students and nurses.29,30 Chatbots present data to cut back stress signs by offering details about self-therapy. Nonetheless, different research present that digital interventions trigger college students to grow to be individualistic as a result of they’re carried out individually and there aren’t any face-to-face conferences with different college students.29 Lack of concern for different college students can also be attributable to college students who concentrate on themselves in finishing up interventions. Though, different research additionally present that digital peer-support teams can be utilized to cut back depressive signs in college students.25 Nonetheless, different research present that offline peer-support teams are extra important for rising social help when achieved by offline.31 As well as, the web site technique with facilitators and nurse counselors can present data and consulting companies by the web site to cut back signs of despair and stress in college students.32 Web sites and purposes are accessed independently by college students or facilitated by dad and mom or academics as a liaison between nurses and college students.25,27,33 As well as, these information point out that efforts to cut back signs of stress and despair might be carried out utilizing digital nursing interventions.

A earlier systematic critiques of digital-based interventions to cut back nervousness in adolescents when studying on-line confirmed a major discount in nervousness.25,34 Nonetheless, the research didn’t analyze ranges of stress and despair. Different research additionally present that on-line nursing interventions can enhance adaptive coping in adolescents throughout the Covid-19 pandemic.34 The three research suggest conducting research on on-line nursing interventions to cut back signs of stress and despair in adolescents throughout the Covid-19 pandemic. So this research is the primary scoping assessment to debate online-based nursing interventions to cut back signs of stress and despair on adolescents throughout the covid-19 pandemic.

Web psychological interventions can be utilized in coping with psychological well being issues.35 Contemplating that adolescents are affected by psychological well being throughout the COVID-19 pandemic and the obstacles of distance in offering psychological well being interventions.36 The applying of digital/internet-based nursing interventions has a big attain, is definitely accessible, and the net format permits adherence to keep up distance.37 Due to this fact, the researcher intends to conduct a literature assessment with a design scoping assessment to explain interventions that may be carried out in decreasing psychological well being in adolescents as a result of COVID-19 pandemic.

Supplies and Strategies


This research used a scoping assessment design. Scoping assessment is a methodological method that may discover new subjects based on present situations.38 The broad conceptual vary of this analysis framework can clarify numerous research which might be related to the analysis aims.39 There have been 5 core steps on this analysis framework, specifically identification of analysis questions, identification of related research outcomes, research choice, information mapping, compilations of outcomes, and reporting of research outcomes.40 The research search technique used the PRISMA Extension for Scoping Evaluations (PRISMA-ScR) to establish numerous subjects that debate digital-based nursing interventions to cut back signs of stress and despair on adolescents throughout the COVID-19 pandemic.

Search Strategies

The seek for articles on this research used 3 databases, specifically: CINAHL, Pubmed, and Proquest. The key phrases used are: “addolescence OR addolescent OR younger grownup” AND “stress” AND “depressive OR despair” AND “e-health OR web OR digital remedy OR utility OR m-health” AND “nursing care OR nursing intervention”. The analysis questions have been: what the kinds of digital-based nursing interventions to cut back signs of stress and despair on adolescents throughout the COVID-19 pandemic?

Inclusion and Exclusion Standards

The way in which to measure the factors on this research is utilizing PICO specifically:

Affected person: adolescents

Intervention: online-based nursing interventions

Comparability: no comparability

Final result: stress and despair.

This research used the PRISMA Extension for Scoping Evaluation (PRISM -ScR) which serves to establish numerous subjects that debate interventions to cut back the influence of psychological well being issues on adolescents throughout the COVID-19 pandemic (Determine 1). Articles have been chosen primarily based on inclusion and exclusion standards. The inclusion standards for this research have been that the affected person have been a full textual content article, a pattern of youngsters, major analysis, there was an intervention, the article was an authentic research, utilizing English, and the time setting for the final 5 years (2018–2022).

Determine 1 PRISMA circulate diagram.

Notes: Tailored from Web page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 assertion: an up to date guideline for reporting systematic critiques. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71. Artistic Commons.69

Knowledge Extraction

The authors used guide tables for information extraction. The elements within the extraction desk have been authors, 12 months, nation, research design, pattern, intervention, and outcomes of the research. The authors have function of made a guide desk was to make it simpler for the author to match the research outcomes from every article. Then the authors can classify primarily based on related information.

High quality Appraisal

The authors used The Joanna Briggs Institute (JBI) to evaluate the standard of articles. JBI is a technique for figuring out the standard of articles by filling out statements concerning the contents of the articles being reviewed. There are 13 statements for articles with a randomized management trial design and 9 statements for articles with a quasi-experimental design. Every assertion has reply choices, specifically sure, no, not relevant, and unclear. Sure solutions got a rating of 1 and all different solutions got a rating of 0. The articles have been analyzed utilizing the JBI essential evaluation technique with good article requirements for use if above 75% primarily based on standards and subject relevance.

Knowledge Evaluation

Articles have been obtained primarily based on the choice outcomes from the inclusion and exclusion standards, then analyzed to be reported within the research outcomes. The articles obtained have been then learn in full and analyzed by all authors. Knowledge evaluation was carried out used a descriptive method to explain kinds of online-based nursing interventions to cut back signs of stress and despair in adolescents throughout the Covid-19 pandemic. After being analyzed, every intervention obtained from the research was categorized primarily based on related interventions after which described and defined in a story method.


The variety of articles obtained from the search is 448 articles. After duplicating the collected articles, 408 articles have been obtained. Moreover, after elimination primarily based on the inclusion standards, the remaining 28 articles. Then after checking the title and summary, 18 articles have been discovered. After analyzing the total textual content of the article, the remaining 11 articles. Articles have been analyzed utilizing the JBI Important Appraisal Device evaluation technique with good article requirements above 75% primarily based on standards and subject relevance (Desk 1).

Desk 1 JBI Important Appraisal Device

There are 11 articles that specify digital-based nursing interventions to enhance adolescent psychological well being throughout the COVID-19 pandemic. The analysis topics of the articles analyzed have been youngsters and college students at colleges and universities. Of the 11 articles analyzed, the strategy of offering digital intervention might be by web-based intervention or mobile-based intervention. The authors recognized the 2 strategies by offering an evidence of the interventions and their impacts. The outcomes of the evaluation of the article are offered in tabular type as follows (Desk 2):

Desk 2 Extraction Knowledge

This scoping assessment discusses digital nursing interventions to enhance adolescent psychological well being throughout the COVID-19 pandemic. Generally, this discovering discusses the intervention and the influence of the intervention carried out. There are 2 strategies of digital nursing intervention, specifically mobile-based intervention and web-based intervention.

Cellular Software Intervention (m-Well being)

The coaching supplied by the cellular utility consists of centered consideration, physique scanning, and loving-kindness meditation.41 Members might be supplied with video content material to information their actions, which embrace: (a) experiences of psychological stress reminiscent of extreme worrying about faculty and well being, emotions of loneliness, and disappointment; (b) mindfulness observe as a type of clarification of the advantages obtained; and (c) desire for brief educational movies (3 minutes) for intervention for two–4 weeks), and supply through social media WeChat. This intervention by m-health considerably reduces psychological stress throughout lockdown and reduces nervousness.

Interventions that may be achieved through cellular are to construct structured friendships with communication on social media.42 These interventions can construct optimistic and mutually supportive relationships, present emotional help, and supply psychoeducation about COVID-19 reminiscent of preventive measures. The second step is to resolve the issue with supportive remedy and formulate the issue for resolution making. The third step is to make an intervention plan by involving the area people; thereby rising the method of social help inside the circle of friendship. This intervention can cut back signs of tension and enhance psychological well being due to getting social help by cellphones.

This cellular utility gives details about the applying together with settings. The intervention was carried out for five weeks.43 Members might be taught and monitored through e-mail notifications relating to mindfulness remedy. Every week, members have been requested to observe remedy based on the directions given. This intervention is confirmed to cut back psychological issues and enhance elements of the standard of psychological well-being marked by a lower in stress ranges.

This intervention serves to extend resilience by the medium of photos or quick movies.44 The coaching was carried out for quarter-hour together with studying the directions and doing the workout routines. Each week there might be suggestions from psychologists through WeChat relating to the analysis of members’ workout routines. Members are ensured to participate in coaching within the type of psychoeducation and resistance-building remedy. After the intervention, it was discovered that the endurance coaching program by cellular gadgets can successfully enhance resilience and cut back stress signs in order that it may form psychological well being.

The m-health-based mindfulness coaching program was carried out for 10 minutes within the first 10 days, quarter-hour for the subsequent 15 days, and 20 minutes for all subsequent classes.45 Every session might be guided through audio on the app. Directions are workout routines to concentrate to the physique at relaxation, take deep breaths, really feel feelings, and settle for all the pieces that has occurred. M-health-based mindfulness workout routines are included within the studying curriculum so as to get most outcomes. After being given the intervention, college students skilled a major discount in fatigue, nervousness, and despair.

Internet-Primarily based Intervention

This program is web-based which lasts 20–half-hour.46 This program comprises modules for utilizing psychological ideas in coping with stress. The “House for Resilience” program comprises seven web-based modules: Constructing Resilience, Objective, Self, Connection, Physique, Thoughts, and progress. After every module is accomplished, members are requested to specific their emotions and do attention-focusing workout routines. As well as, members have been additionally taught grief remedy by internet directions. Self-therapy through the online can enhance resilience and cut back stress and despair.

Upa Yoga observe is finished by educational movies.47 Every observe is guided by Yoga trainer Isha Hatha by movies embedded in redcap. Members are ensured to look at the video, comply with the guided observe, and are in a position to correctly perform the video directions. This mobile-based train is carried out for 25 minutes. After doing the video train, members will obtain an e-mail containing a hyperlink containing a 17-minute audio containing a observe information for the three cycles of Yoga Namaskar and 4 minutes for Nadi Shuddhi. These interventions can successfully cut back the influence of psychological well being issues by decreasing stress and enhancing well-being.

The SilverCloud Well being program combines cognitive conduct which incorporates parts of cognitive flexibility, optimism, self-reflection, behavioral activation, and lively coping.48 As well as, members may even be supplied with data through the online relating to social help, life-style elements, and values. The coaching modules embrace introductory movies, quizzes, psycho-educational content material, private tales from different customers, interactive actions, mindfulness workout routines, every day exercise recommendations, and aim setting. This intervention was carried out for 8 weeks. After being given the intervention, there was a major enhance in resilience.

Internet-based interventions can use video and audio clips, movies, animations, textual content messages, storytelling, and interactive discussions.49 Training is given utilizing an influence level that is supplied with audio. After being given the intervention, college students skilled a major enhance in self-efficacy and resilience. In order that college students can stop social and psychological risks which will come up.

Internet-based interventions might be supplied in an audio-visual format. Interventions are carried out by offering schooling and challenges.50 The intervention was carried out for half-hour utilizing audio-visual media, and a every day efficiency e book. The intervention emphasised the experiences by writing them in a diary and the challenges they’d achieved. The intervention was carried out for 10 weeks. As well as, a web-based psychological well being promotion is supplied. After being given the intervention, members have been in a position to enhance psychological well being marked by decreasing despair and rising resilience.

The intervention is within the type of mindfulness remedy for eight weeks on-line through Zoom Assembly inside 90 minutes.51 The observe is within the type of mindfulness meditation. Self-reflection, and interactive workout routines are acceptable for cognitive remedy. Members have been requested to repeat the train independently for 20–half-hour per day. On-line mindfulness packages have been proven to be efficient in decreasing nervousness in college students.


From the scoping assessment carried out, digital-based nursing interventions make the most of two-way communication and one-way communication. Two-way communication is carried out by using social media reminiscent of WeChat and the zoom utility. Whereas the one-way communication is finished by giving modules, instructions within the type of video, and instructions within the type of audio. The 2 strategies might be mixed for optimum psychological well being outcomes.

This research reveals that digital-based nursing intervention can successfully cut back signs of stress and despair in adolescents throughout the Covid-19 pandemic. On-line nursing interventions are carried out comprehensively by listening to the bodily, psychological, religious and cultural elements of adolescents. Mother and father are additionally concerned to extend help throughout adolescent nursing interventions. Earlier research have proven that interventions that take note of the bodily and psychological elements of adolescents can successfully enhance psychological well being.52,53 That is consistent with different research which present {that a} cultural and psychological method to youth can successfully cut back stress as a result of co-19 pandemic.54 In order that the implementation of nursing should take note of all elements of adolescents holistically to enhance adolescent psychological well being.

Digital-based interventions are carried out for five–32 weeks. The period of the exercise implementation was carried out to cut back signs of despair and stress in adolescents throughout the Covid-19 pandemic. Content material on the web site might be accessed eternally for re-calls concerning the interventions carried out. That is consistent with earlier research which confirmed that digital-based counseling interventions have been carried out for 10 weeks to cut back stress signs in faculty college students.14,36 The size of time the intervention goals to observe the members’ progress in a posh method in decreasing signs of stress and despair. One other research additionally confirmed that digital intervention was carried out for 16 weeks by the zoom utility as a way of counseling to resolve issues skilled by members.55,56 Actions are carried out with schooling then meditation on-line in order that it takes longer time than offline interventions.

Digital-based interventions have optimistic and adverse impacts. The optimistic impacts of utilizing expertise in nursing interventions are workers effectiveness, elevated productiveness, optimization of workers time administration, and utilization of assets. By way of this optimistic influence, nursing care might be carried out successfully and effectively.57,58 Not solely that, the usage of expertise has a adverse influence, specifically affecting the standard of nursing care supplied, together with the standard of documentation, evaluation, care planning, and analysis which remains to be missing.59,60

The outcomes of this research point out that the adverse influence of utilizing expertise in nursing interventions. Know-how-based nursing interventions may even have an effect on communication and coordination of care in offering nursing care to sufferers who’re lower than optimum. Earlier research have proven that the adverse influence of digital-based nursing interventions is that members are much less centered on taking part in on-line actions.26 This is because of distraction from actions at house or constrained by the web community. Different research have proven that the adverse influence of utilizing expertise within the implementation of counseling is that the counseling schedule doesn’t match and there’s web interference, in order that members can not absolutely take part in counseling actions.14,25

If seen from a well being care perspective, technology-based nursing interventions will go well with the flexibility of workers to make use of and mobilize their talents to make use of expertise. So nurses want to concentrate to the usage of expertise in offering nursing care by contemplating affected person wants. Though within the provision of nursing care, specifically evaluation, remedy planning, and analysis that are thought of lower than optimum if given by expertise.61,62 Nonetheless, the method of educating sufferers and households and communication and coordination of care can nonetheless be optimized by the usage of expertise. Regardless of these outcomes, the transformation of nursing care by expertise would require the nurse’s position in drawback and symptom administration, well being promotion and illness prevention, and discharge planning. As a result of the principle consider the usage of expertise shouldn’t be solely within the gear, however within the potential of nurses to function technological instruments in offering nursing care.60,63 This reveals that technology-based nursing interventions nonetheless must be tailored to the wants and readiness of assets in every well being service.

Digital-based nursing intervention to enhance psychological well being might be achieved by mobile-based coaching and web-based coaching. Varied interventions that may be given are mindfulness, coaching, yoga, and resilience packages. Digital interventions have been proven to be efficient in enhancing adolescent psychological well being by decreasing stress, nervousness, despair, and rising resilience, well-being, and self-efficacy. That is consistent with earlier analysis, specifically cognitive processing remedy (CPT) and extended publicity (PE) primarily based on m-health which might cut back the influence of post-traumatic syndrome dysfunction.64

The usage of digital-based nursing intervention brings many advantages to well being care recipients with out the necessity to go far to the hospital for remedy. Sufferers might be given remedy though the affected person is at house, this could cut back prices and likewise the affected person’s time to come back to the hospital.65 Earlier analysis has revealed that the applying of video telehealth to house (VTH) permits sufferers and repair suppliers to beat many obstacles to care.33,66 In step with analysis on house primarily based telehealth, his analysis revealed that house primarily based telehealth is efficient, protected and possible.67 The existence of expertise could make it simpler for sufferers to not must go far (eg residing in rural areas and much from transportation, who’ve bodily disabilities making it troublesome to maneuver). Dwelling primarily based telehealth presents flexibility and comfort to keep up constant attendance in remedy.


This analysis is proscribed within the variety of articles that debate digital-based nursing interventions for decreasing signs of stress and despair on adolescents throughout covid-19 pandemic. That is as a result of lack of analysis that focuses on the remedy of psychological well being by nurses. So this research can not comprehensively focus on digital-based nursing interventions in enhancing psychological well being. Even so, it describes the interventions and the influence of digital-based nursing interventions in enhancing psychological well being.


There are 11 articles that debate digital-based nursing interventions to take care of psychological well being issues in adolescents. This research classifies it into 2 important interventions, specifically mobile-based intervention and web-based intervention. Each interventions are efficient in coping with psychological well being issues reminiscent of rising resilience, well-being, self-efficacy, and high quality of life, and may cut back stress, despair, and nervousness. On-line nursing care supplied to adolescents is carried out by taking into consideration the bodily and psychological situations of adolescents to extend the protection and luxury of adolescents throughout the on-line nursing implementation course of. The 2 interventions might be mixed in order that they’ll attain extra individuals and are simply accessible in order that they’re efficient in coping with psychological well being issues in adolescents.

The implication on this research is that there’s a basis for nurses in offering nursing care on-line to cut back signs of stress and despair in adolescents to be more practical and environment friendly. As well as, the outcomes of this research may also be a foundation for the federal government in making insurance policies for colleges and well being employees in offering on-line nursing interventions to cut back psychological well being issues reminiscent of stress and despair. A suggestion for future analysis is the necessity for a research with a scientific assessment design and meta-analysis to find out the effectiveness of online-based nursing interventions in decreasing signs of stress and despair in adolescents.


All authors thank to Universitas Padjadjaran, Bandung, West Java, Indonesia, who has facilitated the database for us on this research.


There was no exterior funding on this analysis.


The authors had no conflicts of curiosity on this analysis.


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