Effects of two types of smartphone-based stress management programmes on depressive and anxiety symptoms among hospital nurses in Vietnam: a protocol for three-arm randomised controlled trial

Kotaro Imamura, Thuy Thi Thu Tran, Huong Thanh Nguyen, Kazuto Kuribayashi, Asuka Sakuraya, Anh Quoc Nguyen, Thu Minh Bui, Quynh Thuy Nguyen, Kien Trung Nguyen, Giang Thi Huong Nguyen, Xuyen Thi Ngoc Tran, Tien Quang Truong, Melvyn W B Zhang, Harry Minas, Yuki Sekiya, Natsu Sasaki, Akizumi Tsutsumi, Norito Kawakami

Research output: Contribution to JournalArticleAcademicpeer-review


INTRODUCTION: Due to an increasing demand for healthcare in low-income and middle-income countries in Asia, it is important to develop a strategy to manage work-related stress in healthcare settings, particularly among nurses in these countries. The purpose of this three-arm randomised controlled trial (RCT) is to examine the effects of a newly developed smartphone-based multimodule stress management programme on reducing severity of depressive and anxiety symptoms as primary outcomes at 3-month and 7-month follow-ups among hospital nurses in Vietnam.

METHODS AND ANALYSIS: The target study population will be registered nurses working in a large general hospital (which employs approximately about 2000 nurses) in Vietnam. They will be invited to participate in this study. Participants who fulfil the eligibility criteria will be randomly allocated to the free-choice, multimodule stress management (intervention group A, n=360), the internet cognitive behavioural therapy (iCBT), that is, fixed-order stress management (intervention group B, n=360), or a treatment as usual control group (n=360). Two types (free-choice and fixed sequential order) of smartphone-based six-module stress management programmes will be developed. Participants in the intervention groups will be required to complete one of the programmes within 10 weeks after the baseline survey. The primary outcomes are depressive and anxiety symptoms, measured by using the Depression Anxiety and Stress Scales (DASS) at 3-month and 7 month follow-ups.

ETHICS AND DISSEMINATION: The study procedures have been approved by the Research Ethics Review Board of Graduate School of Medicine/Faculty of Medicine, the University of Tokyo (no 11991) and the Ethical Review Board for Biomedical Research of Hanoi University of Public Health (no 346/2018/YTCC-HD3). If a significant effect of the intervention programmes will be found in the RCT, the programmes will be made available to all nurses in the hospital including the control group. If the positive effects are found in this RCT, the e-stress management programmes will be disseminated to all nurses in Vietnam.


Original languageEnglish
Article numbere025138
Pages (from-to)e025138
JournalBMJ Open
Issue number4
Publication statusPublished - 8 Apr 2019

Bibliographical note

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.


Competing interests NK reports grants from Infocom Corp, Fujitsu Ltd, Fujitsu Software Technologies and TAK Ltd, personal fees from Occupational Health Foundation, Japan Dental Association, Sekisui Chemicals, Junpukai Health Care Center, Osaka Chamber of Commerce and Industry, outside the submitted work. Funding This research was supported by AMED under Grant Number JP17jk0110014 and JP18jk0110014.

FundersFunder number
Japan Agency for Medical Research and DevelopmentJP17jk0110014, JP18jk0110014
Japan Society for the Promotion of Science17K15849


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