Enhancing Mental Resilience Among Frontline Nurses Post-COVID-19: A Non-Randomized Study of mHealth-Based Group Coping Skills Training

Abstract

Introduction: While the psychological impact on healthcare workers has been widely acknowledged, accessible interventions tailored to address these mental health challenges in the post-pandemic context remain limited. Objectives: This study aimed to assess the impact of a mHealth-based group coping skills training on the level of stress, anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms of frontline nurses post-COVID 19. Methods: A non-randomized pretest-posttest design was conducted. Ninety nurses who had direct contact with COVID-19 patients were selected through convenience sampling. The intervention group received access to a 2-week online multimedia psychoeducational program through a WhatsApp group, while the control group received standard educational content (text based). The Generalized Estimating Equation (GEE) analysis was applied to evaluate the intervention's effects on the scores for depression, anxiety, stress, and PTSD across the follow-up. Results: The intervention group showed lower PTSD symptoms (−4.40; 95% CI: −7.07 to −1.66), depression (−1.60; 95% CI: −2.58 to −0.80), anxiety (−1.91; 95% CI: −3.06 to −0.77), and stress scores (−2.29; 95% CI: −3.61 to −0.97) compared to the control group, after adjusting for time points. GEE analysis confirmed that the intervention group had significantly lower PTSD symptoms (−5.54; 95% CI: −8.47 to −2.61), depression (−1.78; 95% CI: −2.73 to −0.83), anxiety (−2.52; 95% CI: −3.77 to −1.28), and stress scores (−2.96; 95% CI: −4.37 to −1.55) after adjusting for characteristic variables. Conclusion: The mHealth-based group coping skills training intervention significantly reduced PTSD symptoms, depression, anxiety, and stress scores among frontline nurses, with persistent benefits over time. These results highlight the potential of scalable, app-based and smartphone-enabled interventions delivered within an online group format to support the mental resilience of healthcare workers, underscoring the need for healthcare organizations to prioritize the implementation of such mobile-delivered programs to promote the well-being and retention of critical nursing staff.