Progressive muscle relaxation to decrease anxiety in clinical simulations

The effect of laughter yoga applied before simulation training on state anxiety, perceived stress levels, self-confidence and satisfaction in undergraduate nursing students: A pragmatic randomized controlled trial

AIM

This study aimed to examine the effect of laughter yoga applied before simulation training on state anxiety, perceived stress levels, self-confidence and satisfaction in undergraduate nursing students.

BACKGROUND

Clinical simulation-based teaching implied a revolution in nursing education. Along with the many opportunities that simulation offers, some disadvantages, such as anxiety and stress experienced during simulation scenarios, could affect students' satisfaction and self-confidence in learning. Therefore, laughter yoga could be an alternative method that reduces students' anxiety and stress levels and increases their self-confidence and satisfaction with simulation training.

DESIGN

The study was designed as a pragmatic randomized controlled trial.

SETTING

This study was conducted at a university in Turkey.

PARTICIPANTS

A total of 88 undergraduate nursing students were randomized to the intervention group (n = 44) or control group (n = 44).

METHODS

The intervention group participated in the laughter yoga sessions just before the clinical simulation scenario, while the control group only performed the simulation training. The researchers examined the effect of laughter yoga on state anxiety, perceived stress levels, self-confidence and satisfaction in learning before and after the intervention. Data were collected between January - February 2022.

RESULTS

This study showed that the mean scores of state anxiety, perceived stress, mean pulse rate and arterial pressure of the intervention group were significantly lower than those of the control group (p < 0.05). In addition, there was also a significant group*time interaction between the groups on state anxiety, perceived stress, pulse, respiratory and mean arterial pressure scores (p < 0.05). Moreover, the mean scores of student satisfaction and self-confidence in the learning of the intervention group were significantly higher than those of the control group (p < 0.05).

CONCLUSION

The findings showed that laughter yoga helped nursing students reduce their state anxiety and perceived stress levels related to simulation training and improved their self-confidence and satisfaction with learning. Additionally, it enhanced the students' vital signs (including mean pulse rate and mean arterial pressure). These positive results are promising for using LY as an easy, safe and effective method to reduce undergraduate nursing students' stress and anxiety levels and to improve their learning satisfaction and self-confidence levels in clinical skills training such as simulation training.

Work-related Stress Management Behaviors of Nurses During COVID-19 Pandemic in the United Arab Emirates

Introduction

Intense psychological and emotional stress experienced by nurses during the COVID-19 pandemic interferes with their wellbeing and work efficiency. Stress-management behaviors are required to enhance coping and ameliorate stress effects. Therefore, it is necessary to examine the management behavior of nurses during the pandemic to suggest ways to improve their wellbeing.

Objective

The study aimed to examine nurses’ work-related stress management behaviors during the COVID-19 pandemic in UAE.

Methods

This was a cross-sectional survey of 64 nurses working in the Isolation and Intensive care units of two selected hospitals in the United Arab Emirates. A convenience sampling technique was used for sample selection. Each participant completed an online survey via Google forms of two validated instruments: a 10-item scale to measure perceived stress levels and a 15-item Stress management inventory. The completed questionnaires were analyzed on SPSS version 25.

Results

Respondents (78.1%) reported a moderate level of stress (Mean = 18.03 and SD = 5.33). Stress management behaviors utilized included four elements (eliminating stressors, developing resilience, using short-term coping, and effective delegating) and the mean and SD were 17.62 ± 2.6, 17.42 ± 3.3, 8.88 ± 1.47, and 23.98 ± 3.54 respectively. There was a significant positive correlation between these four elements of stress management inventory (p = 0.00). Findings also showed a significant inverse correlation between the scores on perceived stress, short-term coping, and effective delegation. The overall regression of demographic covariates on stress management behaviors was not statistically significant [F = (1.015), (0.602), (0.909), (1.286), p >0.05].

Conclusions

Effective delegating and developing resilience were effective stress management behavior among nurses. Regular assessment of the psychological needs of nurses is essential to enhance overall wellbeing during stressful situations.

Stress Reduction Techniques for Health Care Providers Dealing With Severe Coronavirus Infections (SARS, MERS, and COVID-19): A Rapid Review

OBJECTIVE

A rapid review was conducted to identify the most effective stress reduction techniques for health care providers dealing with patients infected with severe coronavirus (SARS, MERS, and COVID-19).

METHODS

PubMed, PsychInfo, Embase, and CINAHL databases were searched to identify relevant studies. Searches were restricted by date (2000 until present). All empirical quantitative and qualitative studies in which relaxation techniques of various types implemented on health care providers caring for patients during severe coronavirus pandemics and articles that consider the implementation of mental health care services considered to be pertinent, such as commentaries, were included.

RESULTS

Fourteen studies met the selection criteria, most of which were recommendations. Only one study described a digital intervention, and user satisfaction was measured. In the recommendations, both organizational and individual self-care interventions were suggested.

CONCLUSIONS

Further research is necessary to establish tailor-made effective stress reduction interventions for this population, during these challenging and particular times.

The effect of progressive muscle relaxation on anxiety and sleep quality in burn patients: A randomized clinical trial

BACKGROUND AND OBJECTIVES

Burn patients experience a high level of anxiety and poor sleep quality due to their special physical and psychological conditions. The present study aimed to investigate the effect of progressive muscle relaxation on anxiety and sleep quality in burn patients.

METHODOLOGY AND PARTICIPANTS

In this randomized controlled clinical trial, a total of 80 patients admitted to burn ward were enrolled using convenient sampling and randomly assigned to one of the experimental or control groups. In the experimental group, patients were intervened using Jacobson's relaxation technique 20-30min daily for three consecutive days. During this period, the control group received only routine care and treatment. Patients' anxiety and their sleep quality were measured and recorded before and after the intervention using the Spielberger State-Trait Anxiety Inventory (STAI) and St Mary's Hospital Sleep Quality Questionnaire (SMHSQ) respectively. Eventually, data analysis was conducted using SPSS version 20.0 software (IBM Corp., Armonk, N.Y., USA).

RESULTS

The findings of the present study showed a statistically significant decrease in anxiety and improvement in sleep quality in the experimental group compared to the control group (P<0.05).

CONCLUSION

Relaxation as a complementary method can be used along with modern medicine to reduce anxiety and improve sleep quality in burn patients.

The effectiveness of progressive muscle relaxation on the postpartum quality of life

PURPOSE

This study aimed to determine the effectiveness of progressive muscle relaxation (PMR) on the quality of life women during postpartum period.

METHODS

A quasi-experimental design was used. The participants consisted of primiparous women who had experienced a vaginal birth in the obstetrics department of a hospital. Thirty women in the intervention group and 30 women in the control group were included. Data were collected by questionnaire and Maternal Postpartum Quality of Life Questionnaire (MAPP-QoL) between June 2016 and April 2017. Progressive muscle relaxation were applied to the intervention group. PMR were performed as contracting a muscle group, then relaxing it, moving (or progressing) from one muscle group to another.

RESULTS

The mean pre-test and post-test scores of the MAPP-QoL in the intervention group were 24.43 ± 4.58 and 26.07 ± 4.58, respectively (t = -2.73, p < .05). The mean pre-test and post-test scores of the MAPP-QoL in the control group were 23.29 ± 4.37 and 21.99 ± 5.58, respectively (t = 2.23, p < .05). The difference between the mean scores of the women in the intervention and control groups before PMR was not statistically significant (t = 0.99, p > .05), whereas the difference between the groups after PMR was found to be statistically significant (t = 3.09, p < .05.

CONCLUSIONS

Postpartum quality of life of women was increased after PMR. Progressive muscle relaxation should be taught to women who are admitted to obstetrics and outpatient clinics, that home visits be completed in order to expand the use of PMR.

Stress and anxiety management strategies in health professions' simulation training: a review of the literature

Introduction

Simulation training has been used to teach clinical skills to health profession trainees. Stress and/or anxiety occur in high-acuity scenarios in the clinical environment, and affect clinician performance and patient outcomes. To date, strategies that have been used in conjunction with simulation training for healthcare professionals that address stress management are limited. This paper reports a literature review conducted to explore strategies used with simulations to enhance the ability of health profession trainees in reducing acute stress and/or anxiety during high-acuity clinical events.

Methods

Databases searched included Scopus, PubMed, CINAHL, Web of Knowledge and Science Direct. The examples of the literature chosen were those published in the English language from January 2005 to March 2015, and were peer-reviewed empirical papers that focused on the strategies addressing stress and/or anxiety during simulation training for healthcare profession trainees.

Results

Eight studies using various forms of stress/anxiety management strategies with simulations demonstrated varying degrees of effectiveness. Themes that emerged from these eight studies were excessive stress and clinical performance in simulation, emotional training strategies in simulation, and factors contributing to stress and anxiety reduction during simulation.

Conclusions

Excessive stress and/or anxiety in the clinical setting have been shown to affect performance and could compromise patient outcomes. Health profession training curricula might benefit from a stress/anxiety reduction strategy integrated into the simulation programmes. This review showed that the stress/anxiety management strategies that have been used with simulations, mostly in surgical training, have various degrees of effectiveness.