The Effect of Internet-delivered Mindfulness Stress Reduction Combined with Acceptance and Commitment Therapy on Health Anxiety and Quality of Life of Caregiver of Patients Infected by COVID-19: A Randomized Clinical Trial

Coronavirus disease-19 (COVID-19) is a widespread disease all over the world that has causedmany psychological complications such as health anxiety (HA) and low quality of life (QOL). Mindfulnessbasedapproaches could improve these complications. Therefore, this study aimed to investigate the effect ofInternet-delivered mindfulness stress reduction combined with acceptance and commitment therapy (IMSRACT)on QOL and HA of caregivers of patients infected by COVID-19.

In this randomized clinical trial, 72 people from Golpayegan city, Iran, who had a patient with COVID-19 in their family were selected from March to June 2020. A caregiver with a score above 27 on the Health Anxietyinventory (HAI-18) was selected using simple random sampling. Participants were assigned in the interventionor control group by permuted block random allocation. The intervention group was trained by MSR and ACTtechniques for 9 weeks accomplished via WhatsApp. All participants completed the QOLQuestionnaire-12 (SF-12) items and HAI-18 before and after completing IMSR-ACT sessions. The data were analyzed through SPSS-23 software, using Chi square, independent and paired t-test, and analysis of covariance, and P-value<0.05 wasconsidered as significant.

The results showed that the intervention group compared to the control group had a significantdecrease in all subscales of HAI after the intervention including worry about consequences (5.78±2.66 vs.7.37±1.34, P=0.004) and awareness of bodily sensation or changes (8.90±2.77 vs. 11.75±2.30, P=0.001), worryabout health (10.94±2.38 vs. 13.09±1.92, P=0.001), and total score of HAI (25.62±4.93 vs. 32.25±3.93, P=0.001).Also, the intervention group compared to the control group had better QOL after the intervention in generalhealth perceptions (3.03±0.96 vs. 2.43±0.95, P=0.01), mental health (7.12±2.25 vs. 6.34±1.85 and P=0.01) andmental component summary) 16.78±3.75 vs. 15.43±3.05, P=0.01), physical component summary (16.06±2.66 vs.15.19±2.25, P=0.01), and total score of SF-12 (32.84±5.39 vs. 30.62±4.34, P=0.004).

Internet-delivered MSR combined with ACT could improve the HA and QOL of caregivers withpatients infected by COVID-19. Thus, it can used in other similar situations for now and future. Also, it seemsto be a useful approach for caregivers of the other illnesses.Trial Registration Number: IRCT20180909040974N5