Vickybot, a Chatbot for Anxiety-Depressive Symptoms and Work-Related Burnout in Primary Care and Health Care Professionals: Development, Feasibility, and Potential Effectiveness Studies
BackgroundMany people attending primary care (PC) have anxiety-depressive symptoms and work-related burnout compounded by a lack of resources to meet their needs. The COVID-19 pandemic has exacerbated this problem, and digital tools have been proposed as a solution....
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2023-04-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2023/1/e43293 |
| _version_ | 1797734277115281408 |
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| author | Gerard Anmella Miriam Sanabra Mireia Primé-Tous Xavier Segú Myriam Cavero Ivette Morilla Iria Grande Victoria Ruiz Ariadna Mas Inés Martín-Villalba Alejandro Caballo Julia-Parisad Esteva Arturo Rodríguez-Rey Flavia Piazza Francisco José Valdesoiro Claudia Rodriguez-Torrella Marta Espinosa Giulia Virgili Carlota Sorroche Alicia Ruiz Aleix Solanes Joaquim Radua María Antonieta Also Elisenda Sant Sandra Murgui Mireia Sans-Corrales Allan H Young Victor Vicens Jordi Blanch Elsa Caballeria Hugo López-Pelayo Clara López Victoria Olivé Laura Pujol Sebastiana Quesada Brisa Solé Carla Torrent Anabel Martínez-Aran Joana Guarch Ricard Navinés Andrea Murru Giovanna Fico Michele de Prisco Vicenzo Oliva Silvia Amoretti Casimiro Pio-Carrino María Fernández-Canseco Marta Villegas Eduard Vieta Diego Hidalgo-Mazzei |
| author_facet | Gerard Anmella Miriam Sanabra Mireia Primé-Tous Xavier Segú Myriam Cavero Ivette Morilla Iria Grande Victoria Ruiz Ariadna Mas Inés Martín-Villalba Alejandro Caballo Julia-Parisad Esteva Arturo Rodríguez-Rey Flavia Piazza Francisco José Valdesoiro Claudia Rodriguez-Torrella Marta Espinosa Giulia Virgili Carlota Sorroche Alicia Ruiz Aleix Solanes Joaquim Radua María Antonieta Also Elisenda Sant Sandra Murgui Mireia Sans-Corrales Allan H Young Victor Vicens Jordi Blanch Elsa Caballeria Hugo López-Pelayo Clara López Victoria Olivé Laura Pujol Sebastiana Quesada Brisa Solé Carla Torrent Anabel Martínez-Aran Joana Guarch Ricard Navinés Andrea Murru Giovanna Fico Michele de Prisco Vicenzo Oliva Silvia Amoretti Casimiro Pio-Carrino María Fernández-Canseco Marta Villegas Eduard Vieta Diego Hidalgo-Mazzei |
| author_sort | Gerard Anmella |
| collection | DOAJ |
| description |
BackgroundMany people attending primary care (PC) have anxiety-depressive symptoms and work-related burnout compounded by a lack of resources to meet their needs. The COVID-19 pandemic has exacerbated this problem, and digital tools have been proposed as a solution.
ObjectiveWe aimed to present the development, feasibility, and potential effectiveness of Vickybot, a chatbot aimed at screening, monitoring, and reducing anxiety-depressive symptoms and work-related burnout, and detecting suicide risk in patients from PC and health care workers.
MethodsHealthy controls (HCs) tested Vickybot for reliability. For the simulation study, HCs used Vickybot for 2 weeks to simulate different clinical situations. For feasibility and effectiveness study, people consulting PC or health care workers with mental health problems used Vickybot for 1 month. Self-assessments for anxiety (Generalized Anxiety Disorder 7-item) and depression (Patient Health Questionnaire-9) symptoms and work-related burnout (based on the Maslach Burnout Inventory) were administered at baseline and every 2 weeks. Feasibility was determined from both subjective and objective user-engagement indicators (UEIs). Potential effectiveness was measured using paired 2-tailed t tests or Wilcoxon signed-rank test for changes in self-assessment scores.
ResultsOverall, 40 HCs tested Vickybot simultaneously, and the data were reliably transmitted and registered. For simulation, 17 HCs (n=13, 76% female; mean age 36.5, SD 9.7 years) received 98.8% of the expected modules. Suicidal alerts were received correctly. For the feasibility and potential effectiveness study, 34 patients (15 from PC and 19 health care workers; 76% [26/34] female; mean age 35.3, SD 10.1 years) completed the first self-assessments, with 100% (34/34) presenting anxiety symptoms, 94% (32/34) depressive symptoms, and 65% (22/34) work-related burnout. In addition, 27% (9/34) of patients completed the second self-assessment after 2 weeks of use. No significant differences were found between the first and second self-assessments for anxiety (t8=1.000; P=.34) or depressive (t8=0.40; P=.70) symptoms. However, work-related burnout scores were moderately reduced (z=−2.07, P=.04, r=0.32). There was a nonsignificant trend toward a greater reduction in anxiety-depressive symptoms and work-related burnout with greater use of the chatbot. Furthermore, 9% (3/34) of patients activated the suicide alert, and the research team promptly intervened with successful outcomes. Vickybot showed high subjective UEI (acceptability, usability, and satisfaction), but low objective UEI (completion, adherence, compliance, and engagement). Vickybot was moderately feasible.
ConclusionsThe chatbot was useful in screening for the presence and severity of anxiety and depressive symptoms, and for detecting suicidal risk. Potential effectiveness was shown to reduce work-related burnout but not anxiety or depressive symptoms. Subjective perceptions of use contrasted with low objective-use metrics. Our results are promising but suggest the need to adapt and enhance the smartphone-based solution to improve engagement. A consensus on how to report UEIs and validate digital solutions, particularly for chatbots, is required. |
| first_indexed | 2024-03-12T12:41:54Z |
| format | Article |
| id | doaj.art-f2b0c71895dd4e24a0f7418d76017ecb |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T12:41:54Z |
| publishDate | 2023-04-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-f2b0c71895dd4e24a0f7418d76017ecb2023-08-28T23:50:17ZengJMIR PublicationsJournal of Medical Internet Research1438-88712023-04-0125e4329310.2196/43293Vickybot, a Chatbot for Anxiety-Depressive Symptoms and Work-Related Burnout in Primary Care and Health Care Professionals: Development, Feasibility, and Potential Effectiveness StudiesGerard Anmellahttps://orcid.org/0000-0002-6798-4054Miriam Sanabrahttps://orcid.org/0000-0003-2206-2264Mireia Primé-Toushttps://orcid.org/0000-0002-4940-6402Xavier Segúhttps://orcid.org/0000-0003-4376-9680Myriam Caverohttps://orcid.org/0000-0002-5283-5523Ivette Morillahttps://orcid.org/0000-0002-9029-8933Iria Grandehttps://orcid.org/0000-0002-0137-0666Victoria Ruizhttps://orcid.org/0000-0001-9198-4663Ariadna Mashttps://orcid.org/0000-0002-8738-8655Inés Martín-Villalbahttps://orcid.org/0000-0003-4301-7913Alejandro Caballohttps://orcid.org/0000-0001-5239-3457Julia-Parisad Estevahttps://orcid.org/0000-0003-1489-6760Arturo Rodríguez-Reyhttps://orcid.org/0000-0001-8964-9612Flavia Piazzahttps://orcid.org/0000-0002-7012-0329Francisco José Valdesoirohttps://orcid.org/0000-0002-3272-2142Claudia Rodriguez-Torrellahttps://orcid.org/0000-0002-6106-2497Marta Espinosahttps://orcid.org/0000-0002-5597-3868Giulia Virgilihttps://orcid.org/0000-0001-5550-8272Carlota Sorrochehttps://orcid.org/0000-0002-1818-4974Alicia Ruizhttps://orcid.org/0000-0002-3538-0838Aleix Solaneshttps://orcid.org/0000-0002-2491-200XJoaquim Raduahttps://orcid.org/0000-0003-1240-5438María Antonieta Alsohttps://orcid.org/0000-0002-7098-5146Elisenda Santhttps://orcid.org/0000-0002-0767-1507Sandra Murguihttps://orcid.org/0000-0003-1072-4435Mireia Sans-Corraleshttps://orcid.org/0000-0002-1394-4508Allan H Younghttps://orcid.org/0000-0003-2291-6952Victor Vicenshttps://orcid.org/0000-0002-1920-0446Jordi Blanchhttps://orcid.org/0000-0003-2597-8454Elsa Caballeriahttps://orcid.org/0000-0003-4361-6422Hugo López-Pelayohttps://orcid.org/0000-0002-3850-8374Clara Lópezhttps://orcid.org/0000-0001-8104-5291Victoria Olivéhttps://orcid.org/0000-0002-2015-4678Laura Pujolhttps://orcid.org/0000-0003-1089-4047Sebastiana Quesadahttps://orcid.org/0009-0004-9091-2624Brisa Soléhttps://orcid.org/0000-0003-1673-8248Carla Torrenthttps://orcid.org/0000-0003-0335-582XAnabel Martínez-Aranhttps://orcid.org/0000-0002-0623-6263Joana Guarchhttps://orcid.org/0000-0002-4787-2557Ricard Navinéshttps://orcid.org/0000-0002-6999-7510Andrea Murruhttps://orcid.org/0000-0001-6320-4420Giovanna Ficohttps://orcid.org/0000-0003-1785-7126Michele de Priscohttps://orcid.org/0000-0003-3503-8626Vicenzo Olivahttps://orcid.org/0000-0002-5961-6032Silvia Amorettihttps://orcid.org/0000-0001-6017-2734Casimiro Pio-Carrinohttps://orcid.org/0000-0002-3531-8620María Fernández-Cansecohttps://orcid.org/0000-0001-7855-2946Marta Villegashttps://orcid.org/0000-0003-0711-0029Eduard Vietahttps://orcid.org/0000-0002-0548-0053Diego Hidalgo-Mazzeihttps://orcid.org/0000-0002-2693-6849 BackgroundMany people attending primary care (PC) have anxiety-depressive symptoms and work-related burnout compounded by a lack of resources to meet their needs. The COVID-19 pandemic has exacerbated this problem, and digital tools have been proposed as a solution. ObjectiveWe aimed to present the development, feasibility, and potential effectiveness of Vickybot, a chatbot aimed at screening, monitoring, and reducing anxiety-depressive symptoms and work-related burnout, and detecting suicide risk in patients from PC and health care workers. MethodsHealthy controls (HCs) tested Vickybot for reliability. For the simulation study, HCs used Vickybot for 2 weeks to simulate different clinical situations. For feasibility and effectiveness study, people consulting PC or health care workers with mental health problems used Vickybot for 1 month. Self-assessments for anxiety (Generalized Anxiety Disorder 7-item) and depression (Patient Health Questionnaire-9) symptoms and work-related burnout (based on the Maslach Burnout Inventory) were administered at baseline and every 2 weeks. Feasibility was determined from both subjective and objective user-engagement indicators (UEIs). Potential effectiveness was measured using paired 2-tailed t tests or Wilcoxon signed-rank test for changes in self-assessment scores. ResultsOverall, 40 HCs tested Vickybot simultaneously, and the data were reliably transmitted and registered. For simulation, 17 HCs (n=13, 76% female; mean age 36.5, SD 9.7 years) received 98.8% of the expected modules. Suicidal alerts were received correctly. For the feasibility and potential effectiveness study, 34 patients (15 from PC and 19 health care workers; 76% [26/34] female; mean age 35.3, SD 10.1 years) completed the first self-assessments, with 100% (34/34) presenting anxiety symptoms, 94% (32/34) depressive symptoms, and 65% (22/34) work-related burnout. In addition, 27% (9/34) of patients completed the second self-assessment after 2 weeks of use. No significant differences were found between the first and second self-assessments for anxiety (t8=1.000; P=.34) or depressive (t8=0.40; P=.70) symptoms. However, work-related burnout scores were moderately reduced (z=−2.07, P=.04, r=0.32). There was a nonsignificant trend toward a greater reduction in anxiety-depressive symptoms and work-related burnout with greater use of the chatbot. Furthermore, 9% (3/34) of patients activated the suicide alert, and the research team promptly intervened with successful outcomes. Vickybot showed high subjective UEI (acceptability, usability, and satisfaction), but low objective UEI (completion, adherence, compliance, and engagement). Vickybot was moderately feasible. ConclusionsThe chatbot was useful in screening for the presence and severity of anxiety and depressive symptoms, and for detecting suicidal risk. Potential effectiveness was shown to reduce work-related burnout but not anxiety or depressive symptoms. Subjective perceptions of use contrasted with low objective-use metrics. Our results are promising but suggest the need to adapt and enhance the smartphone-based solution to improve engagement. A consensus on how to report UEIs and validate digital solutions, particularly for chatbots, is required.https://www.jmir.org/2023/1/e43293 |
| spellingShingle | Gerard Anmella Miriam Sanabra Mireia Primé-Tous Xavier Segú Myriam Cavero Ivette Morilla Iria Grande Victoria Ruiz Ariadna Mas Inés Martín-Villalba Alejandro Caballo Julia-Parisad Esteva Arturo Rodríguez-Rey Flavia Piazza Francisco José Valdesoiro Claudia Rodriguez-Torrella Marta Espinosa Giulia Virgili Carlota Sorroche Alicia Ruiz Aleix Solanes Joaquim Radua María Antonieta Also Elisenda Sant Sandra Murgui Mireia Sans-Corrales Allan H Young Victor Vicens Jordi Blanch Elsa Caballeria Hugo López-Pelayo Clara López Victoria Olivé Laura Pujol Sebastiana Quesada Brisa Solé Carla Torrent Anabel Martínez-Aran Joana Guarch Ricard Navinés Andrea Murru Giovanna Fico Michele de Prisco Vicenzo Oliva Silvia Amoretti Casimiro Pio-Carrino María Fernández-Canseco Marta Villegas Eduard Vieta Diego Hidalgo-Mazzei Vickybot, a Chatbot for Anxiety-Depressive Symptoms and Work-Related Burnout in Primary Care and Health Care Professionals: Development, Feasibility, and Potential Effectiveness Studies Journal of Medical Internet Research |
| title | Vickybot, a Chatbot for Anxiety-Depressive Symptoms and Work-Related Burnout in Primary Care and Health Care Professionals: Development, Feasibility, and Potential Effectiveness Studies |
| title_full | Vickybot, a Chatbot for Anxiety-Depressive Symptoms and Work-Related Burnout in Primary Care and Health Care Professionals: Development, Feasibility, and Potential Effectiveness Studies |
| title_fullStr | Vickybot, a Chatbot for Anxiety-Depressive Symptoms and Work-Related Burnout in Primary Care and Health Care Professionals: Development, Feasibility, and Potential Effectiveness Studies |
| title_full_unstemmed | Vickybot, a Chatbot for Anxiety-Depressive Symptoms and Work-Related Burnout in Primary Care and Health Care Professionals: Development, Feasibility, and Potential Effectiveness Studies |
| title_short | Vickybot, a Chatbot for Anxiety-Depressive Symptoms and Work-Related Burnout in Primary Care and Health Care Professionals: Development, Feasibility, and Potential Effectiveness Studies |
| title_sort | vickybot a chatbot for anxiety depressive symptoms and work related burnout in primary care and health care professionals development feasibility and potential effectiveness studies |
| url | https://www.jmir.org/2023/1/e43293 |
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