Health Care Workers' Experience With a Psychological Self-Monitoring App During the COVID-19 Pandemic: Mixed Methods Study

Abstract

Background: Health care workers (HCWs) are at risk of experiencing psychological distress, particularly during the COVID-19 pandemic. Psychological self-monitoring apps may contribute to reducing symptoms of depression, anxiety, and trauma exposure by enhancing emotional self-awareness. This study focused on how a basic psychological self-monitoring app was experienced by HCWs during the COVID-19 pandemic in Quebec by exploring users' experience and factors contributing to their adherence.

Objective: This study aimed to explore HCWs' experiences with a psychological self-monitoring app, including if their satisfaction with the app, their perception of its contribution to self-awareness, and their experience of distress influenced their adherence to the app.

Methods: HCWs in Quebec were invited to respond weekly to questions about their well-being via a mobile app. A convergent mixed methods design was used. Sample data (N=424) were collected from the app, a postparticipation questionnaire was administered, and 30 semistructured interviews were conducted. Correlations and hierarchical multiple regression models were conducted to examine possible factors influencing participants' adherence, and a thematic analysis was used to further explore their experience.

Results: Over a 12-week-period, mean adherence to the psychological self-monitoring app was 74.5% (SD 29.4%) and mean satisfaction was 80% (SD 20%). Most participants perceived that the app contributed moderately (165/418, 39.5%) or a lot (140/418, 33.5%) to enhancing their self-awareness. The significant regression model (F_5,401=6.59; P<.001) suggested that around 7.6% of adherence variation could be explained by satisfaction (β=.16; t₄₀₁=3.14; P=.002) and the app's perceived contribution to self-awareness (β=.15; t₄₀₁=2.88; P=.004). Biological sex (369/419, 88.1% female and 50/419, 11.9% male), age (mean 40.8, SD 9.9 y), and the experience of psychological distress at least once in 12 weeks (228/420, 54.3%) were not statistically significant predictors of adherence. Emergent themes from the 30 interviews highlighted participants' experiences. Psychological self-monitoring was seen as an introspective practice, with reports of enhanced self-awareness and self-care practices. Interviewees generally considered the app as practical, but it did not suit everyone's preferences. Potential app enhancements were provided by the participants.

Conclusions: A simple psychological self-monitoring app could be an interesting tool for HCWs who wish to improve their self-awareness and prevent psychological distress, particularly in health crises such as pandemics.

Keywords: adherence; health care workers; psychological self-monitoring; self-monitoring app; user experience; well-being.