A qualitative assessment of psycho-educational videos for frontline COVID-19 healthcare workers in Mexico

Rebeca Robles, Marcela Palacios, Nancy Rangel, Tania Real, Benjamín Becerra, Ana Fresán, Hamid Vega, Evelyn Rodríguez, Sol Durand, Eduardo Madrigal

DOI: https://doi.org/10.17711/SM.0185-3325.2020.042


Introduction. Frontline COVID-19 healthcare workers (FLHCWs) are at a high-risk of suffering occupational stress- and trauma-related mental health problems, including burnout and compassion fatigue (B&CF). Given the time limitations (due to their heavy workloads) and need to minimize face-to-face interventions (in order to avoid contagions), psychological interventions for FHCWs should be as brief and remote as possible.

Objective. To evaluate the usability and clarity of evidence-based psycho-educational videos to prevent B&CF, to deal with uncooperative, hostile, and anxious patients and relatives, and to use personal protective equipment (PPE), from the perspective of Mexican FLHCWs.

Method. Based on a convenience sampling by intensity approach, videos were distributed requesting feedback based on specific questions through WhatsApp to FLHCWs. Field notes were used to triangulate the information.

Results. Content analysis of feedback from a final sample of 24 participants ‒75% women, 42 ± 8.4 years old‒ yielded three general thematic categories and seven subthemes: 1. content evaluation, which included three subthemes: utility, pertinence, and practicality; 2. dissemination and other needs, with two subcategories: willingness to share and receive more videos (other needs); and 3. format aspects, also comprising two subthemes: attractiveness and duration. All participants found the videos content very beneficial, relevant, and applicable to the workplace and even in their everyday personal and family life, and were willing to share them and to receive more videos on other issues, including strategies to manage problems related to isolation.

Discussion and conclusion. Escalation of this remote preventive intervention to other COVID-19 centers and future similar epidemics is recommended.


Psychoeducation; telehealth; healthcare workers; COVID-19

Full Text:



Atherton, H., & Majeed, A. (2011). An information revolution: time for the NHS to step up to the challenge. Journal of the Royal Society of Medicine, 104(6), 228-230. doi: 10.1258/jrsm.2011.110062

Bandura, A. (1977). Social learning theory, (Vol. 1). Englewood Cliffs, NJ: Prentice-Hall. ISBN 0138167516 / 9780138167516 / 0138167443 / 9780138167448

Bernard, R. H. (2012). Social research methods: Qualitative and quantitative approaches, (2nd ed.). Thousand Oaks, CA: Sage Publications, Inc. ISBN 978-1412978545

Brenner, R. E., Engel, K. E., Vogel, D. L., Tucker, J. R., Yamawaki, N., & Lannin, D. G. (2018). Intersecting cultural identities and help-seeking attitudes: the role of religious commitment, gender, and self-stigma of seeking help. Mental Health, Religion & Culture, 21(6), 578-587. doi: 10.1080/13674676.2018.1519782

Cabrera, F. C. (2005). Categorización y triangulación como procesos de validación del conocimiento en investigación cualitativa. Theoria, 14(1), 61-71.

Casey, C. (2019). Management of aggressive patients: Results of an educational program for nurses in non-psychiatric settings. MedSurg Nursing, 28(1), 9-21.

Chen, Q., Liang, M., Li, Y., Guo, J., Fei, D., Wang, L., … Zhang, Z. (2020). Mental health care for medical staff in China during the COVID-19 outbreak. The Lancet Psychiatry, 7(4), e15-e16. doi: 10.1016/S2215-0366(20)30078-X

Chua, S. E., Cheung, V., Cheung, C., McAlonan, G. M., Wong, J. W., Cheung, E. P., … Tsang, K. W. (2004). Psychological effects of the SARS outbreak in Hong Kong on high-risk health care workers. The Canadian Journal of Psychiatry, 49(6), 391-393. doi: 10.1177/070674370404900609

Elliot, D. L., Lindemulder, S. J., Goldberg, L., Stadler, D. D., & Smith, J. (2013). Health promotion for adolescent childhood leukemia survivors: Building on prevention science and ehealth. Pediatric Blood & Cancer, 60(6), 905-910. doi: 10.1002/pbc.24372

Ferrer, A. R., & Vañó, A. C. (1990). Participación de médicos en encuestas sobre comportamiento y salud realizadas por correo. Gaceta Sanitaria, 4(20), 197-198.

Figley, C. R. (2002). Treating compassion fatigue. New York: Brunner-Routledge. ISBN 978-1583910535

Fusch, P. I., & Ness, L. R. (2015). Are we there yet? Data saturation in qualitative research. The Qualitative Report, 20(9), 1408-1416. Retrieved from http://www.nova.edu/ssss/QR/QR20/9/fusch1.pdf

Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59-82. doi: 10.1177/1525822X05279903

Harris, M. G., Baxter, A. J., Reavley, N., Diminic, S., Pirkis, J., & Whiteford, H. A. (2016). Gender-related patterns and determinants of recent help-seeking for past-year affective, anxiety and substance use disorders: findings from a national epidemiological survey. Epidemiology and Psychiatric Sciences, 25(6), 548-561. doi: 10.1017/S2045796015000876

Ho, C. S., Chee, C. Y., & Ho, R. C. (2020). Mental health strategies to combat the psychological impact of COVID-19 Beyond Paranoia and Panic. Annals of the Academy of Medicine, Singapore, 49(3), 155-160. Retrieved from http://www.annals.edu.sg/pdf/49VolNo3Mar2020/V49N3p155.pdf

Klompas, M. (2020). Coronavirus Disease 2019 (COVID-19): Protecting hospitals from the invisible. Annals of Internal Medicine, 172(9), 619-620. doi: 10.7326/M20-0751

Kvale, S. (1996). InterViews: An introduction to qualitative research interviewing. Thousand Oaks, CA: Sage Publications, Inc. ISBN 978-0803958203

Li, Z., Ge, J., Yang, M., Feng, J., Qiao, M., Jiang, R., … Yang, C. (2020). Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain, Behavior, and Immunity, 88, 916-919. doi: 10.1016/j.bbi.2020.03.007

Liddon, L., Kingerlee, R., & Barry, J. A. (2018). Gender differences in preferences for psychological treatment, coping strategies, and triggers to help-seeking. British Journal of Clinical Psychology, 57(1), 42-58. doi: 10.1111/bjc.12147

Liu, S., Yang, L., Zhang, C., Xiang, Y. T., Liu, Z., Hu, S., & Zhang, B. (2020). Online mental health services in China during the COVID-19 outbreak. The Lancet Psychiatry, 7(4), e17-e18. doi: 10.1016/s2215-0366(20)30077-8

Liu, Y. H., Yang, H. N., Liu, H. L., Wang, F., Hu, L. B., & Zheng, J. C. (2013). Medical rescue of China National Earthquake Disaster Emergency Search and Rescue Team in Lushan earthquake. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 25(5), 265-267. doi: 10.3760/cma.j.issn.2095-4352.2013.05.004

Low, J. G., & Wilder-Smith, A. (2005). Infectious respiratory illnesses and their impact on healthcare workers: A review. Ann Acad Med Singapore, 34(1), 105-110. Retrieved from http://annals.edu.sg/pdf200502/LowJGH.pdf

McAlonan, G. M., Lee, A. M., Cheung, V., Cheung, C., Tsang, K. W., Sham, P. C., … Wong, J. G. (2007). Immediate and sustained psychological impact of an emerging infectious disease outbreak on health care workers. The Canadian Journal of Psychiatry, 52(4), 241-247. doi: 10.1177/070674370705200406

Naushad, V. A., Bierens, J. J., Nishan, K. P., Firjeeth, C. P., Mohammad, O. H., Maliyakkal, A. M., ... Schreiber, M. D. (2019). A systematic review of the impact of disaster on the mental health of medical responders. Prehospital and Disaster Medicine, 34(6), 632-643. doi: 10.1017/S1049023X19004874

Pines, A., & Aronson, E. (1988). Career burnout: Causes and cures. New York: Free Press. ISBN 978-0029253519

Rothschild, B., & Rand, M. (2006). Help for the helper, self-care strategies for managing burnout and stress: The psychophysiology of compassion fatigue and vicarious trauma. New York: W. W. Norton & Company. ISBN 978-0393704228

Schatzman, L., & Straus, A. L. (1979). Field research. Strategies for natural sociology. Englewood Cliffs, NJ: Prentice-Hall, Inc. ISBN 13:978-0133143515

Suárez, E. E. A., & Arenas, J. F. R. (2013). La saturación teórica en la teoría fundamentada: su delimitación en el análisis de trayectorias de vida de víctimas del desplazamiento forzado en Colombia. Revista Colombiana de Sociología, 36(2), 93-114. doi: 10.15446/rcs

Taylor, S. J., & Bogdan R. (1987). Introducción a los métodos cualitativos de investigación. Barcelona: Ediciones Paidós Básica. ISBN 84-7509816-9

Theorell, T. (2000). Changing society: changing role of doctors. The stress must not be allowed to get too great. British Medical Journal, 320(7247), 1417-1418. doi: 10.1136/bmj.320.7247.1417

Wind, T. R., Rijkeboer, M., Andersson, G., & Riper, H. (2020). The COVID-19 pandemic: The “black swan” for mental health care and a turning point for e-health. Internet Interventions, 20, 100317. doi:10.1016/j.invent.2020.100317

Wu, P., Fang, Y., Guan, Z., Fan, B., Kong, J., Yao, Z., … Hoven, C. W. (2009). The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. The Canadian Journal of Psychiatry, 54(5), 302-311. doi: 10.1177/070674370905400504