Improving nurses' mental health through an online Acceptance and Commitment Therapy intervention: an exploratory...

The COVID-19 pandemic negatively impacted healthcare workers' (HCWs) mental health, particularly nurses, due to their demanding frontline roles. Easily accessible psychological interventions are needed to support their well-being, especially during crises like lockdowns. This study aimed to support nurses during the pandemic through online-based Acceptance and Commitment Therapy (ACT) interventions. While ACT, a third-wave cognitive-behavioral approach, has shown effectiveness in reducing work-related stress, its impact on nurses across cultures remains unexplored.

We used a multi-stage process (Delphi Method) to develop online-based ACT interventions. This process included a needs assessment through semi-structured interviews with nurses (Hong Kong: n = 8; Switzerland: n = 20) and focus groups conducted to evaluate the interventions before implementation. The intervention - consisting of two half-day workshops - was then tested in a pilot study with nurses from Hong Kong (n = 7) and Switzerland (n = 10).

Levels of stress, emotional exhaustion, anxiety, and depression decreased, while levels of psychological flexibility increased over time. No regional interaction effects were observed, except for depression, which declined more significantly among Hong Kong nurses than Swiss nurses.

This was the first study to examine an online ACT intervention for nurses across different cultural backgrounds. Findings suggest ACT effectively improves nurses' mental health, but further research is needed to confirm its effectiveness in varied settings due to the study's exploratory design and limited sample size.

The study was prospectively registered at ClinicalTrials.gov on 10.03.2021 (ID: NCT04821037), prior to data collection. In addition, the study was retrospectively registered with the Open Science Framework (OSF; registration number tpgd6) on 12.06.2025 to provide additional documentation and materials.