Trial reportJournal of medical Internet research2023
Effects and Mechanisms of a Web- and Mobile-Based Acceptance and Commitment Therapy Intervention for Anxiety and Depression Symptoms in Nurses: Fully Decentralized Randomized Controlled Trial.
Trial report in Journal of medical Internet research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- The effect of internet-based acceptance and commitment therapy on sleep quality and insomnia in adults: a systematic review and meta-analysis.Scientific reports · 2026Pooled it
- Digital health interventions for reducing occupational burnout in nurses: a systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- Digital Psychotherapies for Adults Experiencing Depressive Symptoms: Systematic Review and Meta-Analysis.JMIR mental health · 2024Pooled it
- Alleviating Nurse Burnout With an Artificial Intelligence-Selected Mobile Cognitive Behavioral Therapy-Based Intervention: Mixed Methods Randomized Controlled Trial.JMIR mHealth and uHealth · 2026Trial
- Effectiveness and Mechanisms of a Digital Mindfulness-Based Intervention for Subthreshold to Clinical Insomnia Symptoms in Pregnant Women: Randomized Controlled Trial.Journal of medical Internet research · 2025Trial
- Effectiveness of a Web-Based Self-Guided Intervention (MINDxYOU) for Reducing Stress and Promoting Mental Health Among Health Professionals: Results From a Stepped-Wedge Cluster Randomized Trial.Journal of medical Internet research · 2025Trial
- Effectiveness of an Internet-Based Acceptance and Commitment Therapy Intervention for Reducing Psychological Distress in Health Care Professionals: Randomized Controlled Trial.Journal of medical Internet research · 2024Trial
- Personalised graded psychological intervention on negative emotion and quality of life in patients with breast cancer.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024Trial
- The effectiveness of online acceptance and commitment therapy-based interventions on depression, burnout, anxiety and stress in occupational contexts: A systematic narrative review.Internet interventions · 2026Review
- Effectiveness of digital and mobile-based interventions on sleep quality among nurses: a systematic review and meta-analysis.Frontiers in digital health · 2026Review
- Trial characteristics, methods and reported challenges of decentralised clinical trials: a scoping review.BMJ open · 2025Article
- Associations of psychological flexibility, mindfulness, and valued living with psychological distress among nursing students.BMC psychology · 2025Article
- Mobile apps, AI, and teletherapy: a comprehensive review of digital mental health tools for nurses.Frontiers in public health · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcceptance and commitment therapy (ACT) is a promising intervention for improving mental health. However, there is limited evidence on its effectiveness for nurses, particularly in web- and mobile-based intervention forms, in mitigating anxiety and depression symptoms.
objectiveIn this study, we aimed to examine the effect and underlying psychological mechanisms of a web- and mobile-based ACT intervention on nurses' anxiety and depression symptoms.
methodsIn this fully decentralized randomized controlled trial, nurses were recruited nationwide across China through advertisements and posters. They were randomly assigned to either the 5-week fully automated intervention or the waiting group. Primary outcomes (anxiety and depression symptoms); secondary outcomes (sleep quality, burnout, and work performance); and mediators (psychological flexibility, cognitive defusion, mindfulness, and values) were assessed using the Wenjuanxing platform. Data collectors were blinded to the group assignments throughout the study period.
resultsA total of 145 nurses with anxiety or depression symptoms were randomly assigned to either the intervention group (n=72, 49.7%) or the control group (n=73, 50.3%); 97.2% (n=141) were female. During the study, 36 (24.8%) nurses were lost to follow-up, and 53 (73.6%) completed the entire intervention. Nurses in the intervention group showed significant improvement in anxiety (d=0.67, 95% CI 0.33-1.00) and depression symptoms (d=0.58, 95% CI 0.25-0.91), and the effects were sustained for 3 months after the intervention (anxiety: d=0.55, 95% CI 0.22-0.89; depression: d=0.66, 95% CI 0.33-1.00). Changes in psychological flexibility, cognitive defusion, and values mediated the effect of the intervention on anxiety and depression symptoms, while mindfulness did not have a mediating effect.
conclusionsThe web- and mobile-based ACT intervention used in this study significantly improved nurses' anxiety and depression symptoms by improving psychological flexibility, cognitive defusion, and values. The results provide new ideas for hospital administrators to prevent and intervene in nurses' psychological issues.
trial registrationChinese Clinical Trial Register ChiCTR2200059218; https://tinyurl.com/4mb4t5y9.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.