Influence of general self-efficacy as a mediator in Taiji-induced stress reduction – Results from a randomized controlled trial

Stress reduction through taiji: a systematic review and meta-analysis

PURPOSE

In light of the mounting prevalence of stress in contemporary society and the growing interest in stress reduction methods, this review investigates the potential of taiji as a viable strategy for alleviating stress.

METHODS

MEDLINE, EMBASE, the Cochrane Controlled Trials Register (CENTRAL), PsycINFO, and Web of Science were searched up to April 2023 to identify randomized controlled trials of taiji. Studies in both patients and healthy populations were considered. They had to provide a measure of perceived stress and include a no treatment or placebo control group. Data were extracted by two reviewers. Pooled standardized mean differences (SMD) were calculated for perceived stress, biological stress markers, anxiety, depression, and quality of life (QoL). Meta-regression analyses were performed to identify sources of heterogeneity.

RESULTS

Eleven trials with a total of 1323 patients comparing taiji to no intervention met the inclusion criteria. The included studies varied strongly with regard to patient characteristics, taiji intervention, and methodological quality. The overall SMD for perceived stress was significant at -0.41 (95% confidence interval, CI, -0.63 to -0.19; I2 = 63%). Exclusion of studies with less than 100 participants yielded a diminished SMD at -0.26 (95% CI, -0.45 to -0.06). The SMD for perceived stress at follow-up was significant (-0.25, 95% CI -0.46 to -0.05). Secondary outcomes highlighted improvements in anxiety and physical QoL, while depression, mental QoL, and biological stress markers remained unchanged.

CONCLUSIONS

Results underscore taiji's potential in mitigating perceived stress in both patients and healthy populations, paralleled by enhancements in depressive symptoms, anxiety levels, and physical QoL.

Physical Activity and Academic Procrastination among Chinese University Students: A Parallel Mediation Model of Self-Control and Self-Efficacy

Previous studies have suggested that physical activity may decrease academic procrastination; however, few studies have explored the underlying mechanisms of how physical activity exerts an effect on academic procrastination. This study aimed to examine the mediating effects of self-control and self-efficacy in the relationship between physical activity and academic procrastination among Chinese university students. Methods: A cross-sectional design was used in this study. The sample comprised 564 university students from a university in Zhejiang, China. The physical activity rating scale-3 (PARS-3), self-control scale (SCS), generalized self-efficacy scale (GSES), and procrastination assessment scale-students (PASS) were used to investigate university students’ physical activity, self-control, self-efficacy, and academic procrastination respectively. The Percentile-Bootstrap technique was performed to examine the mediating effects of self-control and self-efficacy on the association between physical activity and academic procrastination. Results: Physical activity significantly predicted higher levels of self-control and self-efficacy, as well as lower levels of academic procrastination. Self-control and self-efficacy were significant mediators between physical activity and academic procrastination. Conclusion: This study indicated that physical activity interventions targeting the improvement of self-control and self-efficacy may reduce academic procrastination in university students.

Chronic stress, behavioral tendencies, and determinants of health behaviors in nurses: a mixed-methods approach

BACKGROUND

Nurses experience high, and often chronic, levels of occupational stress. As high-quality care requires a healthy workforce, individualized stress-alleviating interventions for nurses are needed. This study explored barriers and resources associated with health behaviors in nurses with different stress levels and work-related behavioral tendencies and identified health behavior determinants based on the Health Action Process Approach (HAPA) model.

METHODS

Applying a mixed methods transformative triangulation design, n = 43 nurses filled out chronic stress (SSCS) and work-related behavior and experience patterns (German acronym AVEM) questionnaires, and participated in semi-structured interviews. With content analysis, categories of health behavior-related barriers and resources emerged. Behavior determinants (self-efficacy, outcome expectancies), health behavior, and barriers and resources were quantified via frequency and magnitude coding and interrelated with SSCS and AVEM scores to link level of health behavior with potential influencing factors. Nonparametric tests explored differences in quantified variables for SSCS and AVEM scores and 4-step-hierarchical regression analysis identified predictors for health behavior.

RESULTS

Eighty-four percent of the nurses were chronically stressed while 49% exhibited unhealthy behavioral tendencies at the workplace. 16 personal and organizational themes (six resources, ten barriers) influenced health behaviors. Stress was associated with resource frequency (p = .027) and current health behaviors (p = .07). Self-efficacy significantly explained variance in health behaviors (p = .003).

CONCLUSION

Health promotion related barriers and resources should be considered in designing nurse health promotion campaigns. Practitioners need to individualize and tailor interventions toward stress and behavioral experiences for sustainable effects on adherence and health.

The Relationship between Physical Activity and Academic Procrastination in Chinese College Students: The Mediating Role of Self-Efficacy

Background: Academic procrastination (AP) has been a common problematic behavior in college students. While physical activity (PA) has been reported to increase self-efficacy and reduce AP, less is known about the potential relationships among them. Therefore, this study aimed to investigate the mediating effect of self-efficacy on the relationship between PA and AP. Methods: 687 Chinese college students (51% males, 49% females) aged 17–23 years (M = 19.59, SD = 0.89) participated in the study. PA, self-efficacy, and AP were assessed using the Physical Activity Rating Scale-3 (PARS-3), the Generalized Self-Efficacy Scale, and the Procrastination Assessment Scale-Students (PASS), respectively. Pearson correlation analysis, linear regression analysis, and mediation analysis were used to analyze the data. Results: (1) PA has a significant and negative impact on college students’ AP, (2) PA has a significant and positive impact on college students’ self-efficacy; (3) self-efficacy has a significant and negative impact on AP in college students; and (4) self-efficacy significantly mediates the relationship between PA and AP. Conclusions: PA is an effective intervention for directly and indirectly decreasing college students’ AP. Therefore, more intervention efforts should focus on the promotion of PA in higher education to improve students’ self-efficacy and thus, to reduce AP among college students.

The Effect of Tai Chi Chuan on Emotional Health: Potential Mechanisms and Prefrontal Cortex Hypothesis

Deep involvement in the negative mood over long periods of time likely results in emotional disturbances/disorders and poor mental health. Tai Chi Chuan (TCC) is regarded as a typical mind-body practice combining aerobic exercise and meditation to prevent and treat negative mood. Although there are an increasing number of TCC studies examining anxiety, depression, and mental stress, the mechanisms underlying these negative emotions are not fully understood. This review study examined TCC studies related to emotional health from both clinical patients and healthy individuals. Next, several potential mechanisms from physiological, psychological, and neurological perspectives were evaluated based on direct and indirect research evidence. We reviewed recent functional magnetic resonance imaging studies, which demonstrated changes in brain anatomy and function, mainly in the prefrontal cortex, following TCC practice. Finally, the effects of TCC on emotion/mental health is depicted with a prefrontal cortex hypothesis that proposed “an immune system of the mind” indicating the role of the prefrontal cortex as a flexible hub in regulating an individual's mental health. The prefrontal cortex is likely a key biomarker among the multiple complex neural correlates to help an individual manage negative emotions/mental health. Future research is needed to examine TCC effects on mental health by examining the relationship between the executive control system (mainly prefrontal cortex) and limbic network (including amygdala, insula, and hippocampal gyrus).

Effects of Tai Chi on Self-Efficacy: A Systematic Review

The purpose of this systematic review is to summarize and update the readers regarding clinical studies that have investigated the effects of Tai Chi on self-efficacy and to describe their limitations and biases. Nine electronic databases were searched from the establishment of the database until August 10, 2017. All randomized controlled trials (RCTs), nonrandomized controlled studies (NRSs), quasi-experimental studies, or studies with pre-post design were included if they clearly defined a Tai Chi intervention and evaluated self-efficacy outcomes. We categorized these 27 studies into the "disease category" and the "population category," based on the types of participants. This systematic review summarizes the effects of Tai Chi on self-efficacy in various populations and found that Tai Chi appeared to have positive effects on self-efficacy in some populations. Fifteen research studies showed that Tai Chi had significant positive effects on self-efficacy, while 11 studies did not; only one study found a negative outcome at the follow-up. In addition, it is unclear which type, frequency, and duration of Tai Chi intervention most effectively enhanced self-efficacy. Tai Chi appears to be associated with improvements in self-efficacy. Definitive conclusions were limited due to the variation in study designs, type of Tai Chi intervention, and frequency, and further high-quality studies are required.

Costs and benefits of self-efficacy: Differences of the stress response and clinical implications

Encounters with stressors induce diverse idiosyncratic neuroendocrine, behavioral and psychological reactions across people. Perceived self-efficacy can alter autonomic responses and their effects on mental health. The beneficial effects of self-efficacy in buffering physiological arousal, enhancing performance, and diminishing psychopathological symptoms have been observed in diverse contexts. We show that the role of self-efficacy is not uniformly beneficial, and that higher levels of self-efficacy can sometimes lead to increases in neuroendocrine and psychological stress responses and decreases in performance, a phenomenon that has been widely neglected. We discuss specific conditions under which self-efficacy effects do not uniformly ameliorate or prevent the consequences of stress. These conditions suggest that therapeutic interventions need not always promote self-efficacy in principal. Simultaneously, they to do suggest that keeping self-efficacy high might be disadvantageous or detrimental.

Investigating short- and long-term transfer effects of a Taiji beginner course in participants' daily life

OBJECTIVE

In recent years research investigating various health benefits of Taiji practice has markedly increased. Despite this growing scientific interest, essential questions such as to what extent a Taiji course may exert noticeable effects in participants' everyday life, what these effects are, and how and where potential transfer effects occur, have hardly been considered. The aim of our study was to explore transfer effects from a Taiji course into participants' daily lives.

METHODS

We conducted a longitudinal observational study in 45 healthy participants at the end of their three-month Taiji beginner course (tp1) and at two months (tp2) as well as one year after course completion (tp3). Participants were asked to report their Taiji practice behavior at all time points, as well as to rate and describe perceived transfer effects of Taiji course contents on their daily life at tp1 and tp3.

RESULTS

Transfer effects were reported by 91.1% of all respondents after course completion (tp1) and persisted in 73.3% at the one-year follow-up assessment (tp3), counting "increase of self-efficacy", "improvement of stress management", and "increase of body awareness" as the most frequently mentioned effects. Transfer effects predominantly occurred in participants' work and social environments, as well as during everyday activities in public areas. While self-reliant Taiji practice frequency significantly decreased from 82.2% at tp1 to 55.6% at tp3 (P < 0.001), the magnitude of self-reported transfer effects did not (P = 0.35). As explorative analyses revealed, regular Taiji course attendance was highly correlated with stronger transfer effects at tp1 (r = 0.51; P < 0.001) and tp3 (r = 0.35; P = 0.020). Participants reporting high self-reliant Taiji practice frequency at tp2 were likely to maintain a regular practice routine at tp3 (r = 0.42; P < 0.004), whereas self-reliant practice frequency and transfer effects at tp1 were positively correlated with self-reliant practice frequency at tp3 on a trend level (r < 0.27; P > 0.08).

CONCLUSION

Our data underline the importance of regular course participation for pronounced and long lasting transfer effects into participants' everyday life. We discuss that several context and process-related aspects of a Taiji intervention are potentially relevant factors for enhancement of transfer effect.