Abstract:

Background:
Work-related stress (WRS) is people's response when they cannot cope with work demands and pressures. It affects workers in the healthcare sector and has substantial individual, organisational, and patient-adverse effects. The healthcare system in Saudi Arabia is different from other places, which can make nurses more stressed. Web-based interventions (WBI) have the potential to help nurses manage WRS.

Objectives:
This project aims to develop and evaluate the feasibility of a web-based intervention to help nurses self-manage WRS (WBI-WRS) in Saudi Arabia. The secondary objectives were to find out if there were any differences in how the outcome measures were used so that in a future research trial, the WBI-WRS toolkit could be given to nurses and evaluated.

Methods:
The study is structured in two parts, a scoping review and the development and testing of a novel WBI program. The second stage employs the Medical Research Centre (MRC) approach and is divided into three phases. The first exploratory phase identified the current needs of nurses on WBI for stress. The second phase, design, focused on creating a theory-based 6-week WBI that included a holistic approach to an educational package for work-related stress, its effects, and management techniques; the toolkit included practical relaxation exercises that participants could use on a weekly basis. The content of the WBI was informed by the scoping review, the wider literature, and the results of the first phase, which was fully tested by the target group in terms of content, fidelity of engagement and delivery and implementation qualities.
The final, third phase, was a one-group pre-post-intervention feasibility study. Based on a feasibility study approach, this study used a convergent parallel mixed-method research (MMR) design. The primary outcomes of the ultimate planned study were descriptive and were used to assess the feasibility of the study design, including recruitment rate, attrition rate, the feasibility of outcome measures, intervention adherence, and intervention component experiences. Subordinate outcomes include an exploratory examination of WRS-related indicators; stress, general mental well-being, presenteeism, and turnover intention. Quantitative data was collected through primary and secondary outcomes at baseline and six weeks following the intervention. Semi-structured interviews were employed to gather the nurses' perceptions on the usability of the WBI-WRS.

Data analysis:
Feasibility outcome measurements will be analysed with SPSS. Qualitative interviews will be analysed by thematic analysis.

Primary Results:
Immediate results of the recruitment stage; 70 participants have already completed the baseline questionnaire. A total of 45 completed the post-intervention questionnaire, which reflects the importance of the topic as the average sample size of the feasibility study is 30–50 participants based on the literature. Two out of five a priori feasibility criteria were met (recruitment rate and experience of the intervention), while the attrition rate needs modification. The remaining two outcomes (adherence and feasibility of outcome measures) will be evaluated after completing quantitative and qualitative data analysis.

Potential impact:
The development of a WBI for stress will have a positive impact on nurses and, by extension, patient outcomes. Results from this project can be used for a formal evaluation of effectiveness with a randomised controlled trial.

Keywords:

Digital Intervention, Web-based Intervention, WBI, Work-related Stress, WRS, Occupational Stress, Feasibility Study, Nurse.