Effectiveness of a Chatbot-Based Internet-Support-Coping-Caring Intervention in Improving Sleep Quality and Work-Related Outcomes Among Nurses in Taiwan During the COVID-19 Pandemic: A Pilot Study

Background: Work-related stress has long been a significant concern in the nursing profession. The pressures faced by nurses in the current health care climate have been further exacerbated by the COVID-19 pandemic. Interventions using chatbot to support nurses may help improve nurse health during the pandemic. Given the rising health care costs and the current crisis, exploring and developing innovative interventions to support nurses and promote their health are essential. Purpose: This research was designed to investigate the effectiveness of the Internet-Support-Coping-Caring with Chatbot (ISCC Chatbot) on sleep quality, perceived stress, anxiety, and depressive symptoms among nurses in Taiwan. Measurements were taken at baseline (T1) and at 3-week (T2) and 6-week (T3) follow-ups. Methods: An experimental research design was used. To minimize bias, eligible participants who met the inclusion criteria were assigned randomly to either the intervention or control group ( n = 40 per group). The intervention group received 6 weeks of the ISCC Chatbot intervention, while the control group was placed on a waiting list and received regular care. A general estimation equation was used to analyze the impact of the intervention on perceived stress, sleep quality, anxiety, and depressive symptoms. Results: At T2, perceived stress and depressive symptom scores (with the exception of anxiety and sleep quality) were significantly better in the intervention group than the control group. At T3, perceived stress, sleep quality, anxiety, and depressive symptom scores were all significantly better in the intervention group than the control group. While the intervention group improved significantly in sleep quality, perceived stress, and anxiety between T1 and T2 and between T2 and T3, the control group improved significantly in sleep quality and depressive symptoms only between T1 and T2. At T3, sleep quality, perceived stress, and depressive symptoms in the control group had significantly worsened. Conclusions/Implications for Practice: Based on the results, combining ISCC with a chatbot provide to supervisors a potentially effective approach to enhancing nurse health. Participants noted the efficacy of the chatbot, particularly when working alone, in reducing work-related stress. Integrating ISCC Chatbot into the nursing workplace is recommended to provide support and safeguard the welfare of nurses, particularly during challenging times.