STEP: Building Trauma Resilience Among Nurses and Personal Support Workers During and Beyond COVID-19

NCT04682561 | Completed

• 1 other identifier: STP-01
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

The COVID-19 pandemic has amplified the need for skills training and mental health support for healthcare workers who are exposed to the numerous stressors and potential trauma of a high-risk environment. This context is associated with significant impacts on mental health, including depression, anxiety, and post-traumatic stress, with nurses and personal support workers (PSWs) being disproportionately impacted. The proposed STEP program is an intervention that aims to equip nurses and PSWs with the skills and support needed to promote their wellness and navigate the challenges of experiencing trauma in a high-risk, high-stress environment, which has been exacerbated by the pandemic. As such, the STEP intervention has the potential to improve trauma resilience and mental health among nurses and PSW, which may ultimately improve patient care and benefit the hospital system during and even beyond the pandemic. The results from this study will also provide vital insight into promising interventions for healthcare workers that are accessible and scalable.

Conditions

Stress; Trauma; Mental Health Issue; Healthcare Workers

Keywords

Stress Prevention; Trauma Coping; Psychotherapy; COVID-19; Nurse; Personal Support Worker

Outcome Measures

Primary Outcomes (1)

• Changes from baseline to post-intervention in healthcare worker burnout using Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL) burnout subscale

  The ProQOL is a 30-item self-report questionnaire assessing negative and positive effects of helping others who experience suffering and trauma, with subscales for compassion satisfaction, burnout and compassion fatigue. Focus will be paid to the burnout subscale score.

  Baseline, week 4, week 8 and 3 months

Secondary Outcomes (7)

• Changes in healthcare worker resilience using Connor-Davidson Resilience Scale 10 item (CD-RISC 10)

  Baseline, week 8, and 3 months

• Changes in healthcare worker depression symptoms using Patient Health Questionnaire - 9 item (PHQ-9)

  Baseline, weeks 2-8, and 3 months

• Changes in healthcare worker anxiety symptoms using Generalized Anxiety Disorder 7-item scale (GAD-7)

  Baseline, weeks 2-8, and 3 months

• Changes in healthcare worker compassion satisfaction and secondary traumatic stress subscales of the Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL)

  Baseline, week 4, week 8 and 3 months

• Changes in healthcare worker perceived quality of patient care

  Baseline, weeks 2-8, and 3 months

Other Outcomes (1)

• Participant feedback on their experiences with specific aspects of the STEP program

  3 months

Study Arms (1)

Supportive Trauma Exposure Preparation (STEP) Program

EXPERIMENTAL

Nurses or personal support workers in Ontario will undergo the STEP Program Psychotherapy

Behavioral: Supportive Trauma Exposure Preparation Program

Interventions

Supportive Trauma Exposure Preparation Program BEHAVIORAL

The Supportive Trauma Exposure Preparation Program is based on the theory that the ability to set compassionate boundaries will enhance acceptance of the reality of trauma in the workplace, and will also increase the cognitive/emotional/physical energy needed to engage in adaptive emotional strategies in response to trauma exposure. Therefore, the goal of therapy is to learn to set compassionate boundaries and engage with oneself and others from a perspective of self-empowerment and acceptance of life events. Concepts and skills will be addressed through the following modules: 1) understanding of trauma and its effects, 2) personal rights and boundaries, 3) emotional literacy, 4) distress tolerance and emotion regulation skills building, 5) communication skills building, 6) self-compassion and acceptance, and 7) enhancing self-care.

Also known as: STEP Program

Supportive Trauma Exposure Preparation (STEP) Program

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Employed as a nurse or personal support worker in Ontario
• years or older
• Access to a computer with a camera or a mobile phone with a camera
• Access to internet
• Not receiving other psychotherapy concurrently
• Follow-up visits with a psychiatrist or family doctor where a psychotherapeutic modality (e.g. cognitive-behavioural therapy, etc.) is not being used are allowable.
• Able to undergo psychotherapy in English
• Working a minimum of 1 shift per week in a hospital setting or community long term care home

You may not qualify if:

• Unable to commit to 1-hour weekly psychotherapy session for the 8 weeks duration of the study
• Individuals with current high risk for suicide, alcohol or substance use, or active psychosis at the time of screening will not be eligible. Recommendations will be made to appropriate mental health services (e.g., Employee Assistance Program, physician referral to psychiatrist, Ontario COVID-19 Mental Health Network) in order to connect the individual to more targeted support and intervention.
• The presence of cognitive impairment (based on clinical judgment) that would limit consent or understanding of STEP

Sponsors & Collaborators

• Unity Health Toronto: lead
• Providence Healthcare: collaborator

Study Sites (1)

St. Michael's Hospital

Toronto, Ontario, M5B 1M8, Canada

Location

Related Publications (1)

• Lalovic A, Hyde M, Bergmans Y, Kiriakidis A, Ebegbare N, Verduyn A, Rizvi SJ. Enhancing Trauma Resilience in Nurses and Personal Support Workers: A Feasibility Study of an 8-Week Supportive Trauma Exposure Preparation Intervention. Can J Nurs Res. 2025 Dec;57(4):580-591. doi: 10.1177/08445621251354918. Epub 2025 Jun 30.

  PMID: 40589165 DERIVED

MeSH Terms

Conditions

Wounds and Injuries; COVID-19

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases

Study Officials

• Sakina Rizvi, PhD

  Unity Health Toronto

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: 3 month, within-subjects longitudinal study, with each participant receiving 8 weekly sessions of the STEP psychotherapy intervention designed to help mitigate the effects of stress and trauma on their ability to provide patient care.

Study Record Dates

• First Submitted: December 22, 2020
• First Posted: December 23, 2020
• Study Start: January 1, 2022
• Primary Completion: August 30, 2024
• Study Completion: December 20, 2024
• Last Updated: April 25, 2025

Record last verified: 2024-08

Locations

CA (1)