Clinical trial NCT05122910: Assessing the Implementation and Feasibility of the SMART-MR
Official title: Assessing the Implementation and Feasibility of the Stress Management and Resilience Training - Moral Resilience Program (SMART-MR) With Frontline Clinical Staff at The Ottawa Hospital: A Non-randomized Pilot Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Moral Injury
Keywords: Moral Distress
Moral Resilience
Healthcare workers
COVID-19
Lead sponsor: University of Ottawa
Sponsor class: OTHER
First posted: 2021-11-17
Enrollment: 98
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: OTHER

Brief summary: The objective of the proposed pilot study is to assess the feasibility and implementation of the SMART-MR program, an integration of stress management, general resilience, and moral resilience skills, with frontline staff who provide direct patient care at The Ottawa Hospital (TOH).

Detailed description: Many of the sources of stress facing healthcare workers during the COVID-19 pandemic involve difficult ethical trade-offs that give rise to moral distress. Moral distress has personal consequences for healthcare workers, notably for their mental health, and wider consequences for the organization and health system as a whole as it negatively affects quality of care, patient satisfaction, and the recruitment, retention and satisfaction of staff. Moral resilience refers to the capacity of an individual to sustain or restore their integrity in response to moral adversity and has been raised as a potential way to mitigate moral distress.

The Stress Management and Resilience Training (SMART) program is one of the few evidence-based interventions designed to build resilience in healthcare workers. The SMART program is a brief, neuroscience-based intervention, typically delivered in a single 90-minute session. The structured program teaches self-care skills by developing intentional attention and the ability to reframe potentially stressful situations more quickly.

Recently, a modified version of the existing SMART program, SMART-Moral Resilience (SMART-MR), has been developed with an additional focus on reducing moral distress and building moral resilience for healthcare workers. The synergy of general resilience strategies with focus on the moral/ethical dimensions of clinical practice offer clinicians specific skills to address ethical challenges. We believe implementing the SMART-MR program with frontline staff during the COVID-19 pandemic is warranted. Therefore, we plan to pilot this innovative intervention at TOH to assess its feasibility and implementation.

Eligibility criteria: Inclusion Criteria:

• full-time or part-time TOH staff who provide direct patient care, including: attending physicians, nurses, allied health, social workers and spiritual care providers

Exclusion Criteria:

• TOH staff members who do not provide direct patient care

Primary outcomes:
measure: Change in the Measure of Moral Distress-Health Professionals (MMD-HP)
timeFrame: Baseline, 12 weeks follow-up
measure: Change in the Rushton Moral Resilience Scale (RMRS)
timeFrame: Baseline, 12 weeks follow-up
Secondary outcomes:
measure: Change in the Maslach Burnout Inventory-2 item version (MBI-2 item)
timeFrame: Baseline, 12 weeks follow-up
measure: Change in the Perceived Stress Scale-10 item (PSS-10)
timeFrame: Baseline, 12 weeks follow-up
measure: Change in the Generalized Anxiety Disorder 7-item (GAD-7) scale
timeFrame: Baseline, 12 weeks follow-up
Other outcomes:
Locations:
city: Ottawa
country: Canada
facility: The Ottawa Hospital
state: Ontario
Study officials:
affiliation: University of Ottawa
name: Edward Spilg, MBChB
role: PRINCIPAL_INVESTIGATOR
References: