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Ji X, Guo X, Soh KL, Japar S, He L. Effectiveness of stress management interventions for nursing students: A systematic review and meta-analysis. Nurs Health Sci 2024; 26:e13113. [PMID: 38566439 DOI: 10.1111/nhs.13113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 04/04/2024]
Abstract
Elevated stress levels are related to diminished mental health, potentially leading to decreased well-being and performance of nursing students. While researchers have focused on developing stress management interventions, there is a need to synthesize the evidence. A systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of stress management interventions in nursing students. A systematic literature search identified controlled stress management interventions employing a validated psychological or physiological stress measure. Forty-one studies were included, with 36 forming a pool of 2715 participants in the meta-analysis. The overall effect on psychological stress was positive. Intervention type, delivery modality, intervention duration in weeks, and number of sessions were moderators of intervention effectiveness, with more significant effects for mind-body programs, on-site delivery methods, durations of 9-12 weeks, and 15-30 sessions. For physiological stress, the biomarkers of blood pressure, heart rate, and cortisol levels decreased significantly. Future research is necessary for promising outcomes related to currently underrepresented indicators and to investigate the long-term effects of interventions.
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Affiliation(s)
- Xuan Ji
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
- Department of Nursing, Changzhi Medical College, Changzhi, China
| | - Xiaoyan Guo
- Department of Nursing, Changzhi Medical College, Changzhi, China
| | - Kim Lam Soh
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
| | - Salimah Japar
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
| | - Liping He
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
- Department of Nursing, Changzhi Medical College, Changzhi, China
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Juhasz G, Gecse K, Baksa D. Towards precision medicine in migraine: Recent therapeutic advances and potential biomarkers to understand heterogeneity and treatment response. Pharmacol Ther 2023; 250:108523. [PMID: 37657674 DOI: 10.1016/j.pharmthera.2023.108523] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/11/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023]
Abstract
After 35 years since the introduction of the International Classification of Headache Disorders (ICHD), we are living in the era of the second great revolution in migraine therapies. First, discoveries of triptans provided a breakthrough in acute migraine treatment utilizing bench-to-bedside research results on the role of serotonin in migraine. Next, the discovery of the role of neuropeptides, more specifically calcitonin gene-related peptide (CGRP) in migraine attack led to the development of anti-CGRP therapies that are effective both in acute and preventive treatment, and are also able to reduce migraine-related burden. Here, we reviewed the most recent clinical studies and real-world data on available migraine-specific medications, including triptans, ditants, gepants and anti-CGRP monoclonal antibodies. Novel drug targets, such as PACAP and amylins were also discussed. To address the main challenges of migraine therapy, the high heterogeneity of people with migraine, the prevalent presence of various comorbid disorders, and the insufficient medical care of migraine patients were covered. Promising novel approaches from the fields of omics, blood and saliva biomarker, imaging and provocation studies might bring solutions for these challenges with the potential to identify further drug targets, distinguish more homogeneous patient subgroups, contribute to more optimal drug selection strategies, and detect biomarkers in association with headache features or predicting treatment efficacy. In the future, the combined analysis of data of different biomarker modalities with machine learning algorithms may serve precision medicine in migraine treatment.
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Affiliation(s)
- Gabriella Juhasz
- Department of Pharmacodynamics, Faculty of Pharmaceutical Sciences, Semmelweis University, Budapest, Hungary; NAP3.0 Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary.
| | - Kinga Gecse
- Department of Pharmacodynamics, Faculty of Pharmaceutical Sciences, Semmelweis University, Budapest, Hungary; NAP3.0 Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Daniel Baksa
- Department of Pharmacodynamics, Faculty of Pharmaceutical Sciences, Semmelweis University, Budapest, Hungary; NAP3.0 Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary; Department of Personality and Clinical Psychology, Institute of Psychology, Faculty of Humanities and Social Sciences, Pazmany Peter Catholic University, Budapest, Hungary
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Feruglio S, Pascut S, Matiz A, Paschetto A, Crescentini C. Effects of Mind-Body Interventions on Adolescents’ Cooperativeness and Emotional Symptoms. Behav Sci (Basel) 2022; 12:bs12020033. [PMID: 35200284 PMCID: PMC8869189 DOI: 10.3390/bs12020033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/20/2022] [Accepted: 01/28/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Mind-body interventions may support the development of adolescents’ self-regulation and provide a protective effect against maladaptive outcomes, e.g., internalizing and externalizing problems. The present study aimed at evaluating the effects of mindfulness-oriented meditation training (MOM) and autogenic training (AT) on a group of healthy Italian adolescents’ character dimensions, emotional and behavioral difficulties. Methods: 72 adolescents were randomly assigned to MOM/AT conditions and tested before and after the 8-week trainings through self-report measures (Temperament and Character Inventory 125, TCI; Strengths and Difficulties Questionnaire for Adolescents, SDQ-A). Main analyses involved robust and repeated measures ANOVAs, carried out separately for character TCI and SDQ-A scales. Results: After trainings, we found increased levels of cooperativeness and reduced emotional symptoms. Changes in these dimensions were negatively correlated: the more participants increased in their cooperativeness the greater decrease they showed in emotional symptoms. Conclusion: Both MOM and AT enhanced a cooperative attitude in adolescents and helped reducing their emotional problems. Therefore, it may be useful to apply these mind-body interventions in school settings as they can have a protective effect on the well-being and psychosocial adjustment of youths, through fostering their character maturity and helping them to better regulate their emotions.
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Affiliation(s)
- Susanna Feruglio
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (S.P.); (A.M.); (A.P.); (C.C.)
- Department of Psychology, Sapienza University of Rome, 00118 Rome, Italy
- Correspondence:
| | - Stefania Pascut
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (S.P.); (A.M.); (A.P.); (C.C.)
- Department of Psychology, Sapienza University of Rome, 00118 Rome, Italy
- WHO Healthy City Project—Municipality of Udine, 33100 Udine, Italy
| | - Alessio Matiz
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (S.P.); (A.M.); (A.P.); (C.C.)
- Department of Psychology, Sapienza University of Rome, 00118 Rome, Italy
| | - Andrea Paschetto
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (S.P.); (A.M.); (A.P.); (C.C.)
| | - Cristiano Crescentini
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy; (S.P.); (A.M.); (A.P.); (C.C.)
- Institute of Mechanical Intelligence, Scuola Superiore Sant’Anna di Pisa, 56010 Pisa, Italy
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Pach D, Blödt S, Wang J, Keller T, Bergmann B, Rogge AA, Barth J, Icke K, Roll S, Witt CM. App-Based Relaxation Exercises for Patients With Chronic Neck Pain: Pragmatic Randomized Trial. JMIR Mhealth Uhealth 2022; 10:e31482. [PMID: 34994708 PMCID: PMC8783271 DOI: 10.2196/31482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/11/2021] [Accepted: 11/12/2021] [Indexed: 12/05/2022] Open
Abstract
Background Chronic neck pain is a highly prevalent condition. Learning a relaxation technique is recommended by numerous guidelines for chronic neck pain. Smartphone apps can provide relaxation exercises; however, their effectiveness, especially in a self-care setting, is unclear. Objective The aim of this pragmatic randomized trial is to evaluate whether app-based relaxation exercises, including audio-based autogenic training, mindfulness meditation, or guided imagery, are more effective in reducing chronic neck pain than usual care alone. Methods Smartphone owners aged 18 to 65 years with chronic (>12 weeks) neck pain and the previous week’s average neck pain intensity ≥4 on the Numeric Rating Scale (0=no pain to 10=worst possible pain) were randomized into either an intervention group to practice app-based relaxation exercises or a control group (usual care and app for data entry only). For both groups, the follow-up data were collected using app-based diaries and questionnaires. The primary outcome was the mean neck pain intensity during the first 3 months based on daily measurements. Secondary outcomes included neck pain based on weekly measurements, pain acceptance, neck pain–related stress, sick-leave days, pain medication intake, and adherence, which were all measured until the 6-month follow-up. For the primary analysis, analysis of covariance adjusted for baseline neck pain intensity was used. Results We screened 748 participants and enrolled 220 participants (mean age 38.9, SD 11.3 years; mean baseline neck pain 5.7, SD 1.3 points). The mean neck pain intensity in both groups decreased over 3 months; however, no statistically significant difference between the groups was found (intervention: 4.1 points, 95% CI 3.8-4.4; control: 3.8 points, 95% CI 3.5-4.1; group difference: 0.3 points, 95% CI −0.2 to 0.7; P=.23). In addition, no statistically significant between-group differences regarding neck pain intensity after 6 months, responder rate, pain acceptance, pain medication intake, or sick-leave days were observed. There were no serious adverse events that were considered related to the trial intervention. In week 12, only 40% (44/110) of the participants in the intervention group continued to practice the exercises with the app. Conclusions The study app did not effectively reduce chronic neck pain or keep the participants engaged in exercising in a self-care setting. Future studies on app-based relaxation interventions should take into account the most recent scientific findings for behavior change techniques. Trial Registration ClinicalTrials.gov NCT02019134; https://clinicaltrials.gov/ct2/show/NCT02019134 International Registered Report Identifier (IRRID) RR2-10.1186/1745-6215-15-490
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Affiliation(s)
- Daniel Pach
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Susanne Blödt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jiani Wang
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Theresa Keller
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany
| | - Beatrice Bergmann
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alizé A Rogge
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Katja Icke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia M Witt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
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Karl A, Carnelley KB, Arikan G, Baldwin DS, Heinrichs M, Stopa L. The effect of attachment security priming and oxytocin on physiological responses to trauma films and subsequent intrusions. Behav Res Ther 2021; 141:103845. [PMID: 33780748 DOI: 10.1016/j.brat.2021.103845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 02/19/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
To further understand protective mechanisms to prevent post-traumatic stress disorder or assist recovery from psychological trauma, this study investigated whether pharmacological and psychological activation of a secure attachment representation elicits higher felt-security and a related response pattern of reduced physiological arousal and increased parasympathetic activation; and whether it protects individuals from developing intrusions and experiencing distress in the week following exposure to a trauma film. Using a double-blind, experimental mixed factorial design, 101 volunteers received either oxytocin or placebo and either secure attachment or neutral priming before watching a trauma film. We measured felt security as an indicator of the strength of activation of a secure attachment representation, skin conductance and heart rate as indicators of physiological arousal, and high frequency heart rate variability as an indicator of parasympathetic activation during the priming and the film. Participants then completed a seven-day intrusion diary. Secure attachment priming, but not oxytocin administration or the combination of both, was associated with reduced physiological arousal and increased parasympathetic activity during priming. Although secure attachment priming was not related to the absolute number of intrusions or to less perceived distress or physiological arousal during the trauma film, it was associated with lower intrusion-related distress in the 7-days post-testing. Our findings extend previous research that suggests the importance of interventions that address intrusion-related distress for recovery from trauma, and suggest a promising role for secure attachment priming in trauma-focused psychological therapies. We contribute to the growing literature that finds that higher subjective distress during a trauma is associated with higher intrusion-related distress. We discuss theoretical implications and possible mechanisms through which secure attachment priming may exert potential beneficial effects.
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Affiliation(s)
- Anke Karl
- Psychology, University of Exeter, Exeter, UK.
| | | | - Gizem Arikan
- Department of Psychology, Ozyegin University, Istanbul, Turkey
| | - David S Baldwin
- Faculty of Medicine, University of Southampton, UK; Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | | | - Lusia Stopa
- School of Psychology, University of Southampton, Southampton, UK
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Barnett P, Arundell LL, Saunders R, Matthews H, Pilling S. The efficacy of psychological interventions for the prevention and treatment of mental health disorders in university students: A systematic review and meta-analysis. J Affect Disord 2021; 280:381-406. [PMID: 33227669 DOI: 10.1016/j.jad.2020.10.060] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/30/2020] [Accepted: 10/28/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Mental health problems are becoming increasingly prevalent among students and adequate support should be provided to prevent and treat mental health disorders in those at risk. METHODS This systematic review and meta-analysis examined the efficacy of psychological interventions for students, with consideration of how adaptions to intervention content and delivery could improve outcomes. We searched for randomised controlled trials (RCTs) of interventions in students with or at risk of mental health problems and extracted data for study characteristics, symptom severity, wellbeing, educational outcomes, and attrition. Eighty-four studies were included. RESULTS Promising effects were found for indicated and selective interventions to treat anxiety disorders, depression and eating disorders. PTSD and self-harm data was limited, and did not demonstrate significant effects. Relatively few trials adapted intervention delivery to student-specific concerns, and overall adapted interventions showed no benefit over non-adapted interventions. There was some suggestion that adaptions based on empirical evidence and provision of additional sessions, and transdiagnostic models may yield some benefits. LIMITATIONS The review is limited by the often poor quality of the literature and exclusion of non-published data. CONCLUSIONS Interventions for students show benefit though uncertainty remains around how best to optimise treatment delivery and content for students. Additional research into content targeting specific underlying mechanisms of problems and transdiagnostic approaches to provision could be promising avenues for further research.
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Affiliation(s)
- Phoebe Barnett
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Laura-Louise Arundell
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK; National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
| | - Rob Saunders
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | - Stephen Pilling
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK; National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK; Camden and Islington NHS Foundation Trust, London, UK
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Horváth Á, Vig L, Ferentzi E, Köteles F. Cardiac and Proprioceptive Accuracy Are Not Related to Body Awareness, Perceived Body Competence, and Affect. Front Psychol 2021; 11:575574. [PMID: 33519590 PMCID: PMC7840531 DOI: 10.3389/fpsyg.2020.575574] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/22/2020] [Indexed: 11/25/2022] Open
Abstract
Interoception in the broader sense refers to the perception of internal states, including the perception of the actual state of the internal organs (visceroception) and the motor system (proprioception). Dimensions of interoception include (1) interoceptive accuracy, i.e., the ability to sense internal changes assessed with behavioral tests, (2) confidence rating with respect to perceived performance in an actual behavioral test, and (3) interoceptive sensibility, i.e., the self-reported generalized ability to perceive body changes. The relationship between dimension of cardioceptive and proprioceptive modalities and their association with affect are scarcely studied. In the present study, undergraduate students (N = 105, 53 males, age: 21.0 ± 1.87 years) filled out questionnaires assessing positive and negative affect (Positive and Negative Affect Schedule), interoceptive sensibility (Body Awareness Questionnaire), and body competence (Body Competence Scale of the Body Consciousness Questionnaire). Following this, they completed a behavioral task assessing cardioceptive accuracy (the mental heartbeat tracking task by Schandry) and two tasks assessing proprioceptive accuracy with respect to the tension of arm flexor muscles (weight discrimination task) and the angular position of the elbow joint (joint position reproduction task). Confidence ratings were measured with visual analog scales after the tasks. With the exception of a weak association between cardioceptive accuracy and the respective confidence rating, no associations between and within modalities were found with respect to various dimensions of interoception. Further, the interoceptive dimensions were not associated with state and trait positive and negative affect and perceived body competence. In summary, interoceptive accuracy scores do not substantially contribute to conscious representations of cardioceptive and proprioceptive ability. Within our data, non-pathological affective states (PANAS) are not associated with the major dimensions of interoception for the cardiac and proprioceptive modalities.
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Affiliation(s)
- Áron Horváth
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Luca Vig
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Eszter Ferentzi
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary
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Stress management training and gratitude journaling in the classroom: an initial investigation in Indian context. CURRENT PSYCHOLOGY 2021; 40:5737-5748. [PMID: 34522074 PMCID: PMC8430282 DOI: 10.1007/s12144-020-01242-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2020] [Indexed: 01/07/2023]
Abstract
Stress and allied difficulties are pervasive among school students in present times. This concern is further magnified in the Indian context with the large represention of young people in the population and limited resources to match. The present study aimed to evaluate the impact of a classroom based stress management training and gratitude journaling intervention (Flinchbaugh et al., 2012) among Indian adolescents. The intervention curriculum was adapted to suit the study context. A total of 238 students (57% males) from Grades 7–9 participated in this study. Participants were recruited from two schools, and their age ranged from 11 to 14 years. In each participating school, students were randomised at the classroom level into three intervention groups (Stress Management Training, Gratitude Journaling, combination of both), and one control group. Using a pre-test – post-test design, intervention impact on measures of well-being, life satisfaction, perceived stress, meaning, and engagement in the classroom was evaluated. Results suggested limited effectiveness of stress management training and gratitude journaling among participants in the present context. Plausible explanations for these findings are discussed. The study emphasizes the need for customised interventions to obtain optimal outcomes among diverse populations.
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Allison S, Irwin Hamilton K, Yuan Y, Wallis Hague G. Assessment of Progressive Muscle Relaxation (PMR) as a Stress-Reducing Technique for First-Year Veterinary Students. JOURNAL OF VETERINARY MEDICAL EDUCATION 2020; 47:737-744. [PMID: 31738679 DOI: 10.3138/jvme.2018-0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The veterinary profession continually strives to address wellness issues such as compassion fatigue, burnout, stress, anxiety, and depression. Wellness issues may begin during the professional curriculum when students experience intense academic, clinical, social, and personal demands on their time. The purpose of this article was to assess the use of progressive muscle relaxation (PMR) as a simple, non-invasive stress reduction technique for first-year veterinary students (n = 101) at a US veterinary college. Students completed a 38-item questionnaire, the Smith Relaxation States Inventory 3 (SRSI3), both before and after performing PMR. Scores for the categories of basic relaxation, mindfulness, positive energy, transcendence, and stress were assessed. Female students (n = 92) had significant (p < .05) improvement in basic relaxation, mindfulness, and stress after completing PMR. Male students (n = 9) had significant (p < .05) improvement in basic relaxation and stress after completing PMR. When grouped according to age, all students had significant (p < .05) improvement in the categories of basic relaxation and stress. Students in the 22-year-old (n = 31), 23-year-old (n = 29), 24-year-old (n = 15), and 25-year-old or greater (n = 17) groups also had significant improvement (p < .05) in mindfulness. Additionally, students in the 23-year-old group had significant (p < .05) improvement in positive energy. These results support the use of PMR as a potential self-care strategy for students to implement during their academic and professional careers.
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Hashimoto K, Takeuchi T, Koyama A, Hiiragi M, Suka S, Hashizume M. Effect of relaxation therapy on benzodiazepine use in patients with medically unexplained symptoms. Biopsychosoc Med 2020; 14:13. [PMID: 32670396 PMCID: PMC7346372 DOI: 10.1186/s13030-020-00187-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 07/03/2020] [Indexed: 12/31/2022] Open
Abstract
Background The change in the benzodiazepine (BZD) use of patients with medically unexplained symptoms (MUS) following the application of relaxation therapy were examined. Methods Of the 221 outpatients with MUS using BZD, 42 received relaxation therapy. Change in BZD use was compared using a relaxation group (n = 42) and a control group that had 84 MUS patients whose baseline was matched by optimal matching algorithms. Logistic regression analysis was done to evaluate the effect of BZD-dependent factors on the BZD dose of the relaxation group. Results Compared with the control group, the number of patients who decreased the amount of BZD and the number of patients whose subjective symptoms of MUS improved were significantly higher in the relaxation group (p < 0.05). In addition, a factor that made it difficult to reduce the BZD of MUS patients who had undergone relaxation was a long history of BZD use, for more than 6 months (odds ratio, 0.06, 95% confidence interval, 0.01–0.36). Conclusions Relaxation therapy for patients with MUS may help reduce BZD use; however, early intervention is important to prevent BZD dependence.
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Affiliation(s)
- Kazuaki Hashimoto
- Department of Psychosomatic Medicine, Toho University Graduate School of Medicine, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540 Japan
| | - Takeaki Takeuchi
- Department of Psychosomatic Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Akiko Koyama
- Department of Psychosomatic Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Miki Hiiragi
- Department of Psychosomatic Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Shunsuke Suka
- Department of Psychosomatic Medicine, Toho University School of Medicine, Tokyo, Japan
| | - Masahiro Hashizume
- Department of Psychosomatic Medicine, Toho University Graduate School of Medicine, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540 Japan
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Amanvermez Y, Rahmadiana M, Karyotaki E, de Wit L, Ebert DD, Kessler RC, Cuijpers P. Stress management interventions for college students: A systematic review and meta-analysis. ACTA ACUST UNITED AC 2020. [DOI: 10.1111/cpsp.12342] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Ramirez-Garcia MP, Leclerc-Loiselle J, Genest C, Lussier R, Dehghan G. Effectiveness of autogenic training on psychological well-being and quality of life in adults living with chronic physical health problems: a protocol for a systematic review of RCT. Syst Rev 2020; 9:74. [PMID: 32264955 PMCID: PMC7137438 DOI: 10.1186/s13643-020-01336-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 03/17/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Autogenic training is a relaxation technique that uses systematic exercises to induce a general disconnection of the organism. It is used in conjunction with conventional medical care as part of disease management to relieve symptoms associated with chronic health problems and to improve well-being. The purpose of this systematic review is to evaluate the efficacy of autogenic training on psychological well-being, quality of life, and adverse effects in people living with chronic physical health problems. METHODS The methodology used follows the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Studies, published up to December 31, 2019, will be identified through searches in the following databases: MEDLINE, Web of Science, EMBASE, SCOPUS, PsychINFO, CINAHL, EBM Reviews, Google Scholar, Dissertations & Theses Global, Open Access Theses and Dissertations, OpenGrey, E-Theses Online Service, Grey Literature Report, eScholarship@McGill, Papyrus, and CorpusUL. All studies of randomized controlled trials that assess autogenic training as an intervention to improve psychological well-being and quality of life in adults aged 18 and older living with one or more chronic physical health problem will be considered eligible. The study selection, the data collection, and the evaluation of the risk of bias will be conducted independently and in duplicate by two reviewers. RoB 2 tool will be used to assess the risk of bias. Discrepancies will be resolved through discussion. A tabular and narrative synthesis of data is planned, and a meta-analysis will be done according to the quality of data. The primary outcomes will be general psychological distress, depression, and anxiety, and the secondary outcomes will be quality of life and adverse effects. The present protocol of systematic review is reporting following MECIR standards for the reporting of protocols and the PRISMA-P recommendations. DISCUSSION Autogenic training appears to be a promising therapy to improve psychological well-being and quality of life in people living with chronic physical health problems, but no recent reports have synthesized the available evidence in this population. The results of this review will examine and synthesize the evidence on the benefits and harms of autogenic training on psychological well-being and quality of life in people living with chronic physical health problems, thus supporting the development of best practices for complementary approaches. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018105347.
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Affiliation(s)
- Maria Pilar Ramirez-Garcia
- Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1A8, Canada. .,Research Centre of the Centre Hospitalier de l'Université de Montréal, Montréal, Canada.
| | - Jérôme Leclerc-Loiselle
- Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1A8, Canada
| | - Christine Genest
- Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1A8, Canada
| | | | - Golsa Dehghan
- Applied Clinical Research Unit of the CHU Sainte-Justine, Montréal, Canada
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Fradelos EC, Kapsiocha E, Tzavella F, Kastanidou S, Tsaras K, Papagiannis D, Papathanasiou IV. Factors Associated with Psychological Distress in University Students and the Relation to Emotional Intelligent and Spirituality: a Cross-sectional Study. Mater Sociomed 2020; 31:262-267. [PMID: 32082090 PMCID: PMC7007606 DOI: 10.5455/msm.2019.31.262-267] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction: Psychological health is the expression of harmonic expression of human’s personality and is often disrupted by multiple factors. Especially during academic years, human has to confront various stressful situations that endanger his Psychological health. Enhanced levels of Emotional Intelligence and Spirituality may act protectively enhancing his ability to manipulate his emotions and his existential anxieties. Aim: The present study aims to assess psychological distress in university students and test if emotional intelligence and spirituality are related. Methods: A cross-sectional study design was employed. The sample comprised 206 students attending in different Departments of the University of Thessaly. Results: From the total of 206 students the majority were women (n=157, 76,2%) while 23,8% were men. Regarding the mean of age of the participants was found to be 30.1 ±7.15 with a minimum 18 and maximum at 44 years. Factors such as gender, living arrangement and financial frustration can affect psychological distress. The results indicated, a positive link was found among Emotional Intelligence and various factors of Spirituality and Psychological health. Conclusions: The contribution of Emotional Intelligence and Spirituality is crucial to the acquisition of well-being, happiness and meaning in life.
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Affiliation(s)
- Evangelos C Fradelos
- Psychiatric Department, "Sotiria" Athens General Hospital for Chest Diseases, Athens, Greece.,Department of Nursing, University of Peloponnese, Sparta, Greece
| | | | - Foteini Tzavella
- Department of Nursing, University of Peloponnese, Sparta, Greece
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14
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Seo E, Kim S. [Effect of Autogenic Training for Stress Response: A Systematic Review and Meta-Analysis]. J Korean Acad Nurs 2020; 49:361-374. [PMID: 31477667 DOI: 10.4040/jkan.2019.49.4.361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/25/2019] [Accepted: 05/21/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was conducted to evaluate the effectiveness of autogenic training on stress responses through a systematic review and meta-analysis. METHODS A systematic search was conducted using eight core electronic databases (Embase, CENTRAL, Medline, CINAHL, PsycInfo, DBpia, KISS, and RISS). To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3.5 program. RESULTS A total 21 studies out of 950 studies were included in the review, and 11 were included for meta-analysis. These studies showed that autogenic training decreased anxiety and depression, and increased the high frequency of heart rate variability. Calculations to understand the effect of autogenic training on anxiety, through a meta-analysis, observed a reduction effect of anxiety score by 1.37 points (n=85, SMD=-1.37: 95% CI -2.07 to -0.67), in the studies on short-term intervention targeting healthy adults. On the other hand, similar calculations to understand the effect of autogenic training on depression observed, a reduction effect on the depression score by 0.29 point (n=327, SMD=-0.29: 95% CI -0.50 to -0.07), in the studies on long term intervention targeting the patient group. CONCLUSION Autogenic training is effective for adults' stress management, and nurses will be able to effectively perform autogenic training programs for workers' stress relief at the workplace.
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Affiliation(s)
- Eunju Seo
- Department of Nursing, Shinsung University, Dangjin, Korea
| | - Soukyoung Kim
- College of Nursing, Eulji University, Daejeon, Korea.
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15
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Rith-Najarian LR, Boustani MM, Chorpita BF. A systematic review of prevention programs targeting depression, anxiety, and stress in university students. J Affect Disord 2019; 257:568-584. [PMID: 31326690 DOI: 10.1016/j.jad.2019.06.035] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/05/2019] [Accepted: 06/29/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Given the prevalence of anxiety, depression, and stress among university students, it is important to assess the effectiveness of prevention programs for these problems. Beyond examining effect sizes, applying a common elements approach can enhance our understanding of which practice elements are most frequently included in symptom-reducing programs. METHOD This review examined effective (i.e., outcome-producing) prevention programs targeting depression, anxiety, and/or stress in university students. Programs could be delivered in a group-based, online/computer-delivered, or self-administered format and at the universal, selective, or indicated prevention level. RESULTS The resulting sample of 62 articles covered 68 prevention programs for college, graduate, or professional students across 15 countries. Average effect sizes for programs were moderate (overall g = 0.65), regardless of delivery format or prevention level. The most common practice elements (overall and for programs producing large effects) were: psychoeducation (72%), relaxation (69%), and cognitive monitoring/restructuring (47%). Many programs were limited by: (a) symptom target-outcome mismatches, (b) disproportionately female samples, and (c) inconsistently reported adherence data. LIMITATIONS Commonness of practice elements across outcome-producing interventions does not imply their extensiveness nor unique contribution to effectiveness. Coding was based on information in articles rather than manuals, and inter-rater reliability was moderate for some practice elements. CONCLUSION The outcome-producing prevention programs in our sample had common practice elements and produced moderate reduction in symptoms overall. Future research of depression, anxiety, and stress prevention programs for university students can investigate practice elements' unique and combined impact on outcomes, further explore under-tested practice elements, and use findings to inform intervention design.
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Affiliation(s)
| | - Maya M Boustani
- Department of Psychology, Loma Linda University, United States
| | - Bruce F Chorpita
- Department of Psychology, University of California, Los Angeles, United States
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16
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Manansingh S, Tatum SL, Morote ES. Effects of Relaxation Techniques on Nursing Students' Academic Stress and Test Anxiety. J Nurs Educ 2019; 58:534-537. [DOI: 10.3928/01484834-20190819-07] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/21/2019] [Indexed: 12/16/2022]
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17
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Watanabe N, Horikoshi M, Shinmei I, Oe Y, Narisawa T, Kumachi M, Matsuoka Y, Hamazaki K, Furukawa TA. Brief mindfulness-based stress management program for a better mental state in working populations - Happy Nurse Project: A randomized controlled trial ✰✰. J Affect Disord 2019; 251:186-194. [PMID: 30927579 DOI: 10.1016/j.jad.2019.03.067] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/15/2019] [Accepted: 03/21/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The efficacy of the mindfulness-based stress management program for maintaining a better mental state has not been examined among working populations. We aimed to explore the effectiveness of the brief mindfulness-based stress management program for hospital nurses. METHODS In a multi-center randomized trial, 80 junior nurses working in hospitals were randomly allocated either to the brief mindfulness-based stress management program or psychoeducation using a leaflet. The program consisted of four 30 min individual sessions conducted by trained senior nurses using a detailed manual. The primary outcome was the total score of the Hospital Anxiety and Depression Scale (HADS) at week 26. Secondary outcomes included presence of a major depressive episode; severity of depression, anxiety, insomnia, burnout, and presenteeism; utility scores; and adverse events up to 52 weeks. RESULTS The mean HADS score of all the participants at baseline was 7.2. At 26 weeks, adjusted mean scores on the HADS score were 7.2 (95% confidence intervals: 5.9, 8. 5) in the program group and 6.0 (4.8, 7.2) in the leaflet group, respectively. The coefficient of the group by time interaction was not statistically significant at -1.41 (-3.35, 0.54; P = 0.156). No significant superiority or inferiority was observed on the other outcomes. LIMITATIONS We did not manage to recruit the number of participants we initially set out, although our post-hoc analyses showed that this did not lead to changes in our conclusions. CONCLUSIONS The additive value of the brief mindfulness-based stress management program was not confirmed in mental state and self-evaluated work efficiency.
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Affiliation(s)
- Norio Watanabe
- Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Japan.
| | - Masaru Horikoshi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Issei Shinmei
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Yuki Oe
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Tomomi Narisawa
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
| | - Mie Kumachi
- Psychiatric Mental Health Nursing, Japanese Red Cross Akita College of Nursing, Akita, Japan.
| | - Yutaka Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan.
| | - Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan.
| | - Toshi A Furukawa
- Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan.
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18
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Kirschner H, Kuyken W, Wright K, Roberts H, Brejcha C, Karl A. Soothing Your Heart and Feeling Connected: A New Experimental Paradigm to Study the Benefits of Self-Compassion. Clin Psychol Sci 2019; 7:545-565. [PMID: 32655984 PMCID: PMC7324152 DOI: 10.1177/2167702618812438] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 09/06/2018] [Indexed: 12/04/2022]
Abstract
Self-compassion and its cultivation in psychological interventions are associated with improved mental health and well-being. However, the underlying processes for this are not well understood. We randomly assigned 135 participants to study the effect of two short-term self-compassion exercises on self-reported-state mood and psychophysiological responses compared to three control conditions of negative (rumination), neutral, and positive (excitement) valence. Increased self-reported-state self-compassion, affiliative affect, and decreased self-criticism were found after both self-compassion exercises and the positive-excitement condition. However, a psychophysiological response pattern of reduced arousal (reduced heart rate and skin conductance) and increased parasympathetic activation (increased heart rate variability) were unique to the self-compassion conditions. This pattern is associated with effective emotion regulation in times of adversity. As predicted, rumination triggered the opposite pattern across self-report and physiological responses. Furthermore, we found partial evidence that physiological arousal reduction and parasympathetic activation precede the experience of feeling safe and connected.
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Affiliation(s)
- Hans Kirschner
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter.,Institute of Psychology, Otto-von-Guericke University
| | - Willem Kuyken
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter.,Department of Psychiatry, University of Oxford
| | - Kim Wright
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter
| | - Henrietta Roberts
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter
| | - Claire Brejcha
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter
| | - Anke Karl
- Mood Disorder Centre, College of Life and Environmental Sciences, University of Exeter
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19
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Kinsella EA, Smith K, Bhanji S, Shepley R, Modor A, Bertrim A. Mindfulness in allied health and social care professional education: a scoping review. Disabil Rehabil 2018; 42:283-295. [PMID: 30517835 DOI: 10.1080/09638288.2018.1496150] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Investigations into the use of mindfulness with allied health and social care students, many of whom ultimately work in rehabilitation settings, is in the nascent stages and no systematic mapping of the literature has occurred. The purpose of this scoping review was to identify, summarise, and describe the current state of knowledge on mindfulness in allied health and social care professional education.Methods: Arksey and O'Malley's scoping review methodology was adopted. Five data bases were searched; inclusion and exclusion criteria were applied; and 50 papers were identified for inclusion in the study.Results: Quantitative studies depicted mindfulness interventions as contributing to: improved capacities for mindfulness; decreases in stress, anxiety, and depression; improvements in academic skills, quality of life and well-being, and empathy; improved physiological measures and emotional regulation; and mixed effects on burn-out. Qualitative studies highlighted: 1) mindfulness and self-care, 2) mindfulness within professional practice placements, 3) mindfulness in the classroom, and 4) the cultivation of mindful qualities.Conclusions: The study has important implications for the education of future rehabilitation professions and suggests that learning about mindfulness may be useful in assisting students to: manage academic stress, anxiety, and depression; cultivate a physical and mental state of calm; be more present and empathetic with clients; and be more focused and attentive in professional practice settings.Implications for rehabilitationFurther exploration of mindfulness as a promising educational intervention for the professional preparation of future rehabilitation practitioners in allied health and social care fields is recommended.Education and research about mindfulness and its potential opportunities for students in terms of the mediation of stress, anxiety, depression, and the cultivation of empathy, academic skills, quality of life, and resilience are recommended.Education and research about mindfulness and its potential for the cultivation of beneficial qualities of mind such as attention, self-awareness, compassion, non-judgment, and acceptance are recommended.Education and research about mindfulness as a potential means to develop capacities related to self-care, professional practice placements, and classroom performance in students is recommended.
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Affiliation(s)
- Elizabeth Anne Kinsella
- School of Occupational Therapy, Western University, London, Canada.,Graduate Program in Health and Rehabilitation Science, Western University, London, Canada
| | - Kirsten Smith
- School of Occupational Therapy, Western University, London, Canada.,Graduate Program in Health and Rehabilitation Science, Western University, London, Canada
| | - Saara Bhanji
- School of Occupational Therapy, Western University, London, Canada
| | - Rachelle Shepley
- School of Occupational Therapy, Western University, London, Canada
| | - Andreja Modor
- School of Occupational Therapy, Western University, London, Canada
| | - Andrew Bertrim
- School of Occupational Therapy, Western University, London, Canada
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20
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Li C, Yin H, Zhao J, Shang B, Hu M, Zhang P, Chen L. Interventions to promote mental health in nursing students: A systematic review and meta‐analysis of randomized controlled trials. J Adv Nurs 2018; 74:2727-2741. [DOI: 10.1111/jan.13808] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 04/28/2018] [Accepted: 05/09/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Chen Li
- School of Nursing Jinlin University Changchun China
| | - Huiru Yin
- Department of Pediatrics School of Nursing Jinlin University Changchun China
| | - Jinping Zhao
- School of Nursing Jinlin University Changchun China
| | | | - Mingyue Hu
- School of Nursing Jinlin University Changchun China
| | - Ping Zhang
- Department of Rehabilitation, School of Nursing Jinlin University Changchun China
| | - Li Chen
- School of Nursing Jinlin University Changchun China
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21
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Lo K, Waterland J, Todd P, Gupta T, Bearman M, Hassed C, Keating JL. Group interventions to promote mental health in health professional education: a systematic review and meta-analysis of randomised controlled trials. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:413-447. [PMID: 28299475 DOI: 10.1007/s10459-017-9770-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 03/08/2017] [Indexed: 05/12/2023]
Abstract
Effects of interventions for improving mental health of health professional students has not been established. This review analysed interventions to support mental health of health professional students and their effects. The full holdings of Medline, PsycINFO, EBM Reviews, Cinahl Plus, ERIC and EMBASE were searched until 15th April 2016. Inclusion criteria were randomised controlled trials of undergraduate and post graduate health professional students, group interventions to support mental health compared to alternative education, usual curriculum or no intervention; and post-intervention measurements for intervention and control participants of mindfulness, anxiety, depression, stress/distress or burnout. Studies were limited to English and short term effects. Studies were appraised using the PEDro scale. Data were synthesised using meta-analysis. Four comparisons were identified: psychoeducation or cognitive-behavioural interventions compared to alternative education, and mindfulness or relaxation compared to control conditions. Cognitive-behavioural interventions reduced anxiety (-0.26; -0.5 to -0.02), depression (-0.29; -0.52 to -0.05) and stress (0.37; -0.61 to -0.13). Mindfulness strategies reduced stress (-0.60; -0.97 to -0.22) but not anxiety (95% CI -0.21 to 0.18), depression (95% CI -0.36 to 0.03) or burnout (95% CI -0.36 to 0.10). Relaxation strategies reduced anxiety (SMD -0.80; 95% CI -1.03 to -0.58), depression (-0.49; -0.88 to -0.11) and stress (-0.34; -0.67 to -0.01). Method quality was generally poor. Evidence suggests that cognitive-behavioural, relaxation and mindfulness interventions may support health professional student mental health. Further high quality research is warranted.
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Affiliation(s)
- Kristin Lo
- Department of Physiotherapy, Monash University, Monash University Peninsula Campus Building B, McMahons Road Frankston, Melbourne, VIC, 3199, Australia.
| | - Jamie Waterland
- Department of Physiotherapy, Monash University, Monash University Peninsula Campus Building B, McMahons Road Frankston, Melbourne, VIC, 3199, Australia
| | - Paula Todd
- Subject Librarian, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Tanvi Gupta
- South Eastern Private Hospital, Melbourne, Australia
| | | | - Craig Hassed
- Department of General Practice, Monash University, Melbourne, Australia
| | - Jennifer L Keating
- Department of Physiotherapy, Monash University, Monash University Peninsula Campus Building B, McMahons Road Frankston, Melbourne, VIC, 3199, Australia
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22
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Winzer R, Lindberg L, Guldbrandsson K, Sidorchuk A. Effects of mental health interventions for students in higher education are sustainable over time: a systematic review and meta-analysis of randomized controlled trials. PeerJ 2018; 6:e4598. [PMID: 29629247 PMCID: PMC5885977 DOI: 10.7717/peerj.4598] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 03/20/2018] [Indexed: 11/20/2022] Open
Abstract
Background Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-matched peers. Mental ill health among students is associated with impaired academic achievement, worse occupational preparedness, and lower future occupational performance. Research on mental health promoting and mental ill health preventing interventions has shown promising short-term effects, though the sustainability of intervention benefits deserve closer attention. We aimed to identify, appraise and summarize existing data from randomized control trials (RCTs) reporting on whether the effects of mental health promoting and mental ill health preventing interventions were sustained at least three months post-intervention, and to analyze how the effects vary for different outcomes in relation to follow-up length. Further, we aimed to assess whether the effect sustainability varied by intervention type, study-level determinants and of participant characteristics. Material and Methods A systematic search in MEDLINE, PsycInfo, ERIC, and Scopus was performed for RCTs published in 1995-2015 reporting an assessment of mental ill health and positive mental health outcomes for, at least, three months of post-intervention follow-up. Random-effect modeling was utilized for quantitative synthesis of the existing evidence with standardized mean difference (Hedges' g) used to estimate an aggregated effect size. Sustainability of the effects of interventions was analyzed separately for 3-6 months, 7-12 months, and 13-18 months of post-intervention follow-up. Results About 26 studies were eligible after reviewing 6,571 citations. The pooled effects were mainly small, but significant for several categories of outcomes. Thus, for the combined mental ill health outcomes, symptom-reduction sustained up to 7-12 months post-intervention (standardized mean difference (Hedges' g) effect size (ES) = -0.28 (95% CI [-0.49, -0.08])). Further, sustainability of symptom-reductions were evident for depression with intervention effect lasting up to 13-18 months (ES = -0.30 (95% CI [-0.51, -0.08])), for anxiety up to 7-12 months (ES = -0.27 (95% CI [-0.54, -0.01])), and for stress up to 3-6 months (ES = -0.30 (95% CI [-0.58, -0.03])). The effects of interventions to enhance positive mental health were sustained up to 3-6 months for the combined positive mental health outcomes (ES = 0.32 (95% CI [0.05, 0.59])). For enhanced active coping, sustainability up to 3-6 months was observed with a medium and significant effect (ES = 0.75 (95% CI [0.19, 1.30])). Discussion The evidence suggests long-term effect sustainability for mental ill health preventive interventions, especially for interventions to reduce the symptoms of depression and symptoms of anxiety. Interventions to promote positive mental health offer promising, but shorter-lasting effects. Future research should focus on mental health organizational interventions to examine their potential for students in tertiary education.
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Affiliation(s)
- Regina Winzer
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Living Conditions and Lifestyles, The Public Health Agency of Sweden, Solna, Sweden
| | - Lene Lindberg
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Karin Guldbrandsson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Living Conditions and Lifestyles, The Public Health Agency of Sweden, Solna, Sweden
| | - Anna Sidorchuk
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
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Abstract
AIM The aim of this research was to investigate videogame-based learning in nursing education and establish how videogames are currently employed and how they link to the development of decision-making, motivation, and other benefits. BACKGROUND Although digital game-based learning potentially offers a safe and convenient environment that can support nursing students developing essential skills, nurse educators are typically slow to adopt such resources. METHOD A comprehensive search of electronic databases was conducted, followed by a thematic analysis of the literature. RESULTS Evaluations of identified games found generally positive results regarding usability and effectiveness of videogames in nursing education. Analysis of advantages of videogames in nursing education identified potential benefits for decision-making, motivation, repeated exposure, logistical, and financial value. CONCLUSION Despite the paucity of games available and the methodological limitations identified, findings provide evidence to support the potential effectiveness of videogames as a learning resource in nursing education.
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Affiliation(s)
- Leeanne Pront
- About the Authors Leeanne Pront, BNg (Hons), RN, is a PhD candidate and associate lecturer, School of Nursing and Midwifery, Flinders University, Adelaide, Australia. Amanda Müller, PhD, is a senior lecturer, English for Special Purposes, School of Nursing and Midwifery, Flinders University. Adam Koschade, MA, BA, is a PhD candidate, School of Nursing and Midwifery, Flinders University. Alison Hutton, PhD, RN, is a professor, University of Newcastle, Australia. Funding for this research was received from the Flinders University School of Nursing and Midwifery: Start-up grant. For more information, contact Leeanne Pront at
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Stanton A, Meston C. A Single Session of Autogenic Training Increases Acute Subjective and Physiological Sexual Arousal in Sexually Functional Women. JOURNAL OF SEX & MARITAL THERAPY 2017; 43:601-617. [PMID: 27400285 DOI: 10.1080/0092623x.2016.1211206] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Heart rate variability (HRV) has recently been associated with female sexual function (Stanton, Lorenz, Pulverman, & Meston, 2015). Below-average HRV was identified as a possible risk factor for sexual arousal dysfunction and overall sexual dysfunction in women. Based on this newly established relationship between HRV and female sexual function, the present study examined the effect of autogenic training to increase HRV on acute physiological and subjective sexual arousal in women. Specifically, vaginal pulse amplitude (VPA), an index of genital sexual arousal, and subjective sexual arousal were assessed in 33 sexually functional women, aged 18 to 27, before and after a short session of autogenic training. Autogenic training, a relaxation technique that restores the balance between the activity of the sympathetic and the parasympathetic branches of the autonomic nervous system, has been shown to significantly increase HRV (Miu, Heilman, & Miclea, 2009). After autogenic training, significant increases in both VPA (p <.05) and subjective sexual arousal (p <.005) were observed. Moreover, change in HRV from pre- to postmanipulation significantly moderated changes in subjective sexual arousal (p <.05) when it was measured continuously during the presentation of the erotic stimulus. This cost-effective, easy-to-administer behavioral intervention may have important implications for increasing sexual arousal in women.
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Affiliation(s)
- Amelia Stanton
- a Department of Psychology , The University of Texas at Austin , Austin , Texas , USA
| | - Cindy Meston
- a Department of Psychology , The University of Texas at Austin , Austin , Texas , USA
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Holland B, Gosselin K, Mulcahy A. The Effect of Autogenic Training on Self-Efficacy, Anxiety, and Performance on Nursing Student Simulation. Nurs Educ Perspect 2017; 38:87-89. [PMID: 29194303 DOI: 10.1097/01.nep.0000000000000110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The increased anxiety experienced by nursing students during simulations can serve as a significant barrier to learning. The use of anxiety-reducing techniques such as autogenic training (AT) can mitigate the negative effects of anxiety and improve the overall learning experience. The investigators in this study sought to understand the effect of AT on student performance and self-efficacy during simulation experiences. The use of AT was an effective technique to decrease anxiety and increase performance among nursing students during nursing simulations. Reducing anxiety during simulations can improve the student learning experience.
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Affiliation(s)
- Brian Holland
- About the Authors Brian Holland, PhD, RN, is an assistant dean for undergraduate studies, Texas A&M Health Science Center College of Nursing, Bryan. Kevin Gosselin, PhD, is an associate professor, Texas A&M Health Science Center College of Nursing, Bryan. Angela Mulcahy, MS, RN, CMSRN, is a clinical assistant professor, Texas A&M Health Science Center College of Nursing, Bryan. For more information, contact Dr. Holland at
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Guillaumie L, Boiral O, Champagne J. A mixed-methods systematic review of the effects of mindfulness on nurses. J Adv Nurs 2016; 73:1017-1034. [DOI: 10.1111/jan.13176] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Laurence Guillaumie
- Faculty of Nursing; Université Laval; Centre de Recherche du CHU de Québec; Québec Québec Canada
| | - Olivier Boiral
- Faculty of Administration; Université Laval; Québec Québec Canada
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Torabizadeh C, Bostani S, Yektatalab S. Comparison between the effects of muscle relaxation and support groups on the anxiety of nursing students: A randomized controlled trial. Complement Ther Clin Pract 2016; 25:106-113. [PMID: 27863599 DOI: 10.1016/j.ctcp.2016.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 08/31/2016] [Accepted: 09/01/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To compare the effects of the two methods of muscle relaxation and support group on the anxiety levels of the nursing students. METHODS In this randomized controlled trial, 150 nursing students who met the inclusion criteria were divided into three equal groups-muscle relaxation, support group, and control-using the permuted-block randomization method. The experimental groups received 5 sessions of intervention, while the control group did not receive any intervention at all. Using Spielberger's inventory, the researchers measured the anxiety levels of all three groups before and after the intervention. RESULTS The results showed that both methods had a significant impact on anxiety levels of the nursing students; however, a comparison between their effects revealed that muscle relaxation had been more effective than support group. CONCLUSIONS Considering the seriousness of the issue of anxiety for nursing students, it is important that measures be taken to reduce anxiety in this group.
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Affiliation(s)
- Camellia Torabizadeh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sanaz Bostani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shahrzad Yektatalab
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
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Pelka M, Kölling S, Ferrauti A, Meyer T, Pfeiffer M, Kellmann M. Acute effects of psychological relaxation techniques between two physical tasks. J Sports Sci 2016; 35:216-223. [DOI: 10.1080/02640414.2016.1161208] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Conley CS, Durlak JA, Kirsch AC. A Meta-analysis of universal mental health prevention programs for higher education students. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2015; 16:487-507. [PMID: 25744536 DOI: 10.1007/s11121-015-0543-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This meta-analysis investigated the effectiveness of universal mental health prevention programs for higher education students on a range of adjustment outcomes. A systematic literature search identified 103 controlled published and unpublished interventions involving college, graduate, or professional students. As hypothesized, skill-training programs that included a supervised practice component were significantly more effective overall (mean effect size = 0.45, confidence interval (CI) = 0.39 to 0.52) compared to skill-training programs without supervised practice (0.11, CI = -0.01 to 0.22) and psychoeducational (information-only) programs (0.13, CI = 0.06 to 0.21). When comparisons on specific outcomes were possible, skill-training programs including supervised practice were significantly more effective than the other two groups of programs in reducing symptoms of depression, anxiety, stress, and general psychological distress, and in improving social-emotional skills, self-perceptions, and academic behaviors and performance. The magnitude of effects achieved in several outcome areas is comparable to or higher than that reported in other reviews of universal programs, suggesting that skill-training programs for higher education students that incorporate supervised practice now join the ranks of other effective preventive mental health interventions. This review offers several recommendations to improve the experimental rigor of future research.
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Affiliation(s)
- Colleen S Conley
- Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Road, Chicago, IL, 60660, USA,
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Klainin-Yobas P, He HG, Lau Y. Physical fitness, health behaviour and health among nursing students: A descriptive correlational study. NURSE EDUCATION TODAY 2015; 35:1199-1205. [PMID: 26154132 DOI: 10.1016/j.nedt.2015.06.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 05/21/2015] [Accepted: 06/22/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Health behaviour is of great importance for nursing students to achieve optimal health. Healthy students tend to complete their study and remain in the nursing workforce. They will also serve as a role model of for patients. However, there is limited research concerning physical fitness and health behaviour (such as sleep problems) in this population. OBJECTIVES This study aims to examine the relationships among health behaviour, personal variables, physical fitness, perceived physical health and psychological health. DESIGN A cross-sectional descriptive correlational study was used. PARTICIPANTS A total of 335 nursing students who were enrolled in a university in Thailand. METHODS Data were collected by self-administered questionnaires and physical fitness tests. Independent variables were personal variables and health behaviour. Outcome variables included physical fitness, perceived physical health and psychological health. Descriptive statistics and path analyses were used to analyse data. RESULTS Nursing students had poor to moderate levels of total physical fitness, with cardiovascular fitness and body flexibility components having the lowest scores. Students who exercised regularly tended to have better physical fitness, perceived physical health and psychological health. Those who did not have sleep problems had better psychological health. CONCLUSION Some personal variables and health behaviours were associated with health among nursing students. Appropriate interventions are required to promote positive health behaviour in this population.
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Affiliation(s)
- Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre Block MD11, 10 Medical Drive, Singapore 117597.
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre Block MD11, 10 Medical Drive, Singapore 117597.
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre Block MD11, 10 Medical Drive, Singapore 117597.
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Ryu KH, Shin HS, Yang EY. Effects of Laughter Therapy on Immune Responses in Postpartum Women. J Altern Complement Med 2015; 21:781-8. [PMID: 26496141 DOI: 10.1089/acm.2015.0053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To examine the effects of laughter therapy on secretory IgA (sIgA) in postpartum women. METHODS The study used a nonequivalent control group with nonsynchronized design. The participants were 76 postpartum women who agreed to participate in this study and were selected by convenience sampling (experimental group, n = 38; control group, n = 38). The data were collected from December 15, 2009, to April 8, 2010. The experimental group participated in a postpartum laughter program from a laughter therapy expert for 60 minutes per session, twice a week for 2 weeks, for a total of four sessions. To evaluate the effects of the postpartum laughter program, sIgA levels in breast milk were measured. The data were analyzed using SPSS WIN 20.0 software. RESULTS Immune response (sIgA) significantly differed between the experimental and control groups. CONCLUSION A postpartum laughter program can be applied as a complementary and alternative intervention to postpartum women in a transitional mother-infant care center.
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Affiliation(s)
- Kyung Hee Ryu
- 1 Department of Nursing, Seojeong College at Korea , Gyeonggi Province, Korea
| | - Hye Sook Shin
- 2 College of Nursing Science, Kyung Hee University at Korea , Seoul, Korea
| | - Eun Young Yang
- 3 Department of Nursing, Sahmyook Health College at Korea , Seoul, Korea
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Effects of autogenic training on stress response and heart rate variability in nursing students. Asian Nurs Res (Korean Soc Nurs Sci) 2014; 8:286-92. [PMID: 25529912 DOI: 10.1016/j.anr.2014.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 05/07/2014] [Accepted: 06/23/2014] [Indexed: 12/18/2022] Open
Abstract
PURPOSE This study was undertaken to confirm the effects of autogenic training (AT) on stress response and heart rate variability in nursing school students experiencing stress related to clinical training. METHODS The study was carried out from September 2012 to April 2013 in a quasi-experimental nonequivalent control group using a pretest-posttest design. The participants were 40 nursing students in their third year at either of two nursing colleges. All consented to participate. Nineteen nursing students at one college were assigned to the experimental group and underwent the 8-week AT program, and the other 21 were assigned to the control group and did not undergo any training. Stress response was assessed by questionnaire and HRV was measured three times, that is, before the program, at the end of the program, and 6 months after the end of the AT program. RESULTS A significant time/group interaction was found for stress response (F = 4.68, p = .012), a subjective indicator. However, no significant interaction was found for the objective indicators of heart rate variability, normalized low frequency (F = 2.59, p = .090), normalized high frequency (F = 2.59, p = .090), or low frequency to high frequency ratio (F = 1.38, p = .257). CONCLUSION The results suggest that AT provides an acceptable approach to stress reduction in nursing students.
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Montgomery A. The inevitability of physician burnout: Implications for interventions. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.burn.2014.04.002] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Lee C, Crawford C, Hickey A. Mind–Body Therapies for the Self-Management of Chronic Pain Symptoms. PAIN MEDICINE 2014; 15 Suppl 1:S21-39. [DOI: 10.1111/pme.12383] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Hammond DC. Hypnosis in the treatment of anxiety- and stress-related disorders. Expert Rev Neurother 2014; 10:263-73. [DOI: 10.1586/ern.09.140] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Bryer J, Cherkis F, Raman J. Health-promotion behaviors of undergraduate nursing students: a survey analysis. Nurs Educ Perspect 2013; 34:410-415. [PMID: 24475604 DOI: 10.5480/11-614] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM To examine health promotion behaviors and barriers to health promotion in traditional and nontraditional nursing students in an associate degree nursing program in the northeastern United States. BACKGROUND Nursing students are exposed to concepts of health promotion in the nursing curriculum, but do not necessarily apply them to their own lives. Examining the variables affecting the health behaviors of nursing students may provide the information required to motivate lifestyle changes in this population. METHOD A cross-sectional descriptive design was used to examine the relationship between study variables. RESULTS Nontraditional nursing students participate in health promoting behaviors less often than traditional nursing students and experience more barriers to health promotion. CONCLUSION Implementation of health promotion programs targeting nontraditional students may lead to improved health among these individuals, which may result in increased success in nursing programs.
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Affiliation(s)
- Jennifer Bryer
- Farmingdale State College, Department of Nursing, New York, USA
| | - Fran Cherkis
- Farmingdale State College, Department of Nursing, New York, USA
| | - Janet Raman
- Adelphi University College of Nursing and Public Health, Garden City, New York, USA
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Crawford C, Wallerstedt DB, Khorsan R, Clausen SS, Jonas WB, Walter JAG. A systematic review of biopsychosocial training programs for the self-management of emotional stress: potential applications for the military. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:747694. [PMID: 24174982 PMCID: PMC3794660 DOI: 10.1155/2013/747694] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 06/26/2013] [Accepted: 07/22/2013] [Indexed: 11/17/2022]
Abstract
Combat-exposed troops and their family members are at risk for stress reactions and related disorders. Multimodal biopsychosocial training programs incorporating complementary and alternative self-management techniques have the potential to reduce stress-related symptoms and dysfunction. Such training can preempt or attenuate the posttraumatic stress response and may be effectively incorporated into the training cycle for deploying and redeploying troops and their families. A large systematic review was conducted to survey the literature on multimodal training programs for the self-management of emotional stress. This report is an overview of the randomized controlled trials (RCTs) identified in this systematic review. Select programs such as mindfulness-Based Stress Reduction, Cognitive Behavioral Stress Management, Autogenic Training, Relaxation Response Training, and other meditation and mind-body skills practices are highlighted, and the feasibility of their implementation within military settings is addressed.
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Affiliation(s)
- Cindy Crawford
- Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA 22314, USA
| | | | - Raheleh Khorsan
- Samueli Institute, 2101 East Coast Highway, Suite 300, Corona Del Mar, CA 92625, USA
| | - Shawn S. Clausen
- Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Building 8, Room 5106, Bethesda, MD 20889, USA
| | - Wayne B. Jonas
- Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA 22314, USA
| | - Joan A. G. Walter
- Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA 22314, USA
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Conley CS, Durlak JA, Dickson DA. An evaluative review of outcome research on universal mental health promotion and prevention programs for higher education students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2013; 61:286-301. [PMID: 23768226 DOI: 10.1080/07448481.2013.802237] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This review is the first large-scale attempt to evaluate the effectiveness of universal promotion and prevention programs for higher education students on a range of adjustment outcomes. PARTICIPANTS/METHODS The current review examined 83 controlled interventions involving college, graduate, and professional students, with a focus on 3 main outcomes: social and emotional skills, self-perceptions, and emotional distress. RESULTS/CONCLUSIONS Skill-oriented programs that included supervised practice demonstrated the strongest benefits, thus showing promise as a successful mental health promotion and preventive intervention. In comparing different intervention strategies, mindfulness training and cognitive-behavioral techniques appear to be the most effective. Furthermore, interventions conducted as a class appear to be effective, suggesting the potential for exposing higher education students to skill training through routine curricula offerings. This review offers recommendations for improving the experimental rigor of future research, and implications for enhancing campus services to optimize student success in psychosocial--and thus ultimately academic--domains.
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Affiliation(s)
- Colleen S Conley
- Department of Psychology, Loyola University Chicago, Chicago, Illinois 60626, USA.
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Conley CS, Travers LV, Bryant FB. Promoting psychosocial adjustment and stress management in first-year college students: the benefits of engagement in a psychosocial wellness seminar. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2013; 61:75-86. [PMID: 23409857 DOI: 10.1080/07448481.2012.754757] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE/METHODS This research evaluates the effectiveness of a psychosocial wellness seminar for first-year college students, from 2009 to 2011, using an 8-month prospective quasi-experimental design. PARTICIPANTS/RESULTS Compared with controls (n = 22) involved in an alternative seminar, intervention participants (n = 29) showed no differences at baseline, but reported significantly greater perceived improvements over the course of the intervention, in psychosocial adjustment and stress management. Furthermore, specific aspects of intervention engagement (attendance and student-rated skills practice, but not didactic mastery or facilitator-rated skills practice) differentially predicted beneficial outcomes: (1) psychosocial adjustment (increases in psychosocial well-being, decreases in psychological distress), after adjusting for baseline levels of these outcomes; (2) college-related stress management (lower college-related stress, greater adaptation to college); and (3) perceived improvements in psychosocial adjustment and stress management. CONCLUSIONS This research indicates promising avenues for programmatic efforts to promote psychosocial adjustment and stress management in college students, during this critical developmental juncture.
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Affiliation(s)
- Colleen S Conley
- Department of Psychology, Loyola University Chicago, Chicago, Illinois 60626, USA.
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Hutchinson TL, Janiszewski Goodin H. Nursing student anxiety as a context for teaching/learning. J Holist Nurs 2012; 31:19-24. [PMID: 23065057 DOI: 10.1177/0898010112462067] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Experiential learning in nursing programs includes role-play, simulation, and live clinical experiences. Anxiety levels can heighten during experiential learning as students attempt to gain psychomotor skills and transfer knowledge into critical thinking. Nursing students may experience anxiety that can interfere with learning and critical thinking. However, the presence of student anxiety can be used to initiate a purposeful caring transaction between nursing faculty and student. The caring transaction is a way for faculty to model both caring and presence, create experiential learning of caring by students, and lead students to initiate self-care interventions to manage anxiety through the nursing program and beyond. Multiple learning outcomes can be achieved as the students integrate faculty-modeled concepts of caring and presence into simulated or real clinical situations, reduce or manage their anxiety, and improve their clinical judgment and critical thinking skills.
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Ratanasiripong P, Ratanasiripong N, Kathalae D. Biofeedback Intervention for Stress and Anxiety among Nursing Students: A Randomized Controlled Trial. ISRN NURSING 2012; 2012:827972. [PMID: 22811932 PMCID: PMC3395228 DOI: 10.5402/2012/827972] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 05/07/2012] [Indexed: 11/23/2022]
Abstract
Purpose. It has been well documented that nursing students across the world experience stress and anxiety throughout their education and training. The purpose of this randomized controlled study is to investigate the impact of biofeedback intervention program on nursing students' levels of stress and anxiety during their first clinical training. Methods. Participants consisted of 60 second-year baccalaureate nursing students. The 30 participants in the biofeedback group received training on how to use the biofeedback device to assist in stress and anxiety management for 5 weeks while the 30 in the control group did not receive any training. Findings. Results indicated that the biofeedback group was able to maintain the stress level while the control group had a significant increase in the stress level over the 5-week period of clinical training. Additionally, the biofeedback group had a significant reduction in anxiety, while the control group had a moderate increase in anxiety. Conclusions. The better the nursing students can manage their stress and anxiety, the more successful they can be in their clinical training. Ultimately, the more psychologically healthy the nursing students are, the more likely they will flourish and graduate to become productive and contributing members of the nursing profession.
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Affiliation(s)
- Paul Ratanasiripong
- Department of Advanced Studies in Education and Counseling, California State University, Long Beach, CA 90840, USA
| | - Nop Ratanasiripong
- Student Health Services, California State University, Long Beach, CA 90840, USA
| | - Duangrat Kathalae
- Department of Nursing, Boromarajonani College of Nursing, Nakhornratchasima 30000, Thailand
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Naglatzki RP, Schlamann M, Gasser T, Ladd ME, Sure U, Forsting M, Gizewski ER. Cerebral somatic pain modulation during autogenic training in fMRI. Eur J Pain 2012; 16:1293-301. [PMID: 22461412 DOI: 10.1002/j.1532-2149.2012.00138.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2012] [Indexed: 11/05/2022]
Abstract
BACKGROUND Functional magnetic resonance imaging (fMRI) studies are increasingly employed in different conscious states. Autogenic training (AT) is a common clinically used relaxation method. The purpose of this study was to investigate the cerebral modulation of pain activity patterns due to AT and to correlate the effects to the degree of experience with AT and strength of stimuli. METHODS Thirteen volunteers familiar with AT were studied with fMRI during painful electrical stimulation in a block design alternating between resting state and electrical stimulation, both without AT and while employing the same paradigm when utilizing their AT abilities. The subjective rating of painful stimulation and success in modulation during AT was assessed. RESULTS During painful electrical stimulation without AT, fMRI revealed activation of midcingulate, right secondary sensory, right supplementary motor, and insular cortices, the right thalamus and left caudate nucleus. In contrast, utilizing AT only activation of left insular and supplementary motor cortices was revealed. The paired t-test revealed pain-related activation in the midcingulate, posterior cingulate and left anterior insular cortices for the condition without AT, and activation in the left ventrolateral prefrontal cortex under AT. Activation of the posterior cingulate cortex and thalamus correlated with the amplitude of electrical stimulation. CONCLUSIONS This study revealed an effect on cerebral pain processing while performing AT. This might represent the cerebral correlate of different painful stimulus processing by subjects who are trained in performing relaxation techniques. However, due to the absence of a control group, further studies are needed to confirm this theory.
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Affiliation(s)
- R P Naglatzki
- Department of Neurosurgery, University Hospital Essen, University Duisburg-Essen, Germany
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Dehghan-nayeri N, Adib-Hajbaghery M. Effects of progressive relaxation on anxiety and quality of life in female students: A non-randomized controlled trial. Complement Ther Med 2011; 19:194-200. [DOI: 10.1016/j.ctim.2011.06.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 05/27/2011] [Accepted: 06/17/2011] [Indexed: 10/18/2022] Open
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Shin HS, Ryu KH, Song YA. Effects of Laughter Therapy on Postpartum Fatigue and Stress Responses of Postpartum Women. J Korean Acad Nurs 2011; 41:294-301. [DOI: 10.4040/jkan.2011.41.3.294] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hye Sook Shin
- Professor, College of Nursing Scienc, Kyung Hee University, Seoul, Korea
| | - Kyung Hee Ryu
- Full-time Lecturer, Department of Nursing, Seojeong College, Yangju, Korea
| | - Young A Song
- Full-time Lecturer, Department of Nursing, Ansan College, Ansan, Korea
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Effect of autogenic training on general improvement in patients with irritable bowel syndrome: a randomized controlled trial. Appl Psychophysiol Biofeedback 2010; 35:189-98. [PMID: 19997775 DOI: 10.1007/s10484-009-9125-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Autogenic training (AT) is a useful and comprehensive relaxation technique. However, no studies have investigated the effects of AT on irritable bowel syndrome (IBS). In this study we tested the hypothesis that AT improves symptoms of IBS. Twenty-one patients with IBS were randomly assigned to AT (n = 11, 5 male, 6 female) or control therapy (n = 10, 5 male, 5 female). AT patients were trained intensively, while the control therapy consisted of discussions about patients' meal habits and life styles. All patients answered a question related to adequate relief (AR) of IBS symptoms and four questionnaires: Self-induced IBS Questionnaire (SIBSQ), Self-reported Depression Scale (SDS), State-Trait Anxiety Inventory (STAI), and Medical Outcome Short Form 36 Health Survey (SF-36). The proportion of AR in the last AT session in the AT group (9/11, 81.8%) was significantly higher than that in the controls (3/10, 30.0%, Chi-square test, p = 0.048). Two subscales of the SF-36, i.e., social functioning and bodily pain, were significantly improved in the AT group (p < 0.05) as compared to the control group. Role emotional (p = 0.051) and general health (p = 0.068) showed a tendency for improvement in the AT group. AT may be useful in the treatment of IBS by enhancing self-control.
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Wedekind D, Broocks A, Weiss N, Engel K, Neubert K, Bandelow B. A randomized, controlled trial of aerobic exercise in combination with paroxetine in the treatment of panic disorder. World J Biol Psychiatry 2010; 11:904-13. [PMID: 20602575 DOI: 10.3109/15622975.2010.489620] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Regular aerobic exercise (running) has been shown to be superior to a pill placebo in the treatment of panic disorder. Combined drug and exercise treatment has not been investigated in randomized controlled studies to date. METHODS This is a randomized, 10-week, controlled, parallel group, pilot study. A total of 75 outpatients with panic disorder with or without agoraphobia (DSM-IV and ICD-10) received either (1) exercise plus paroxetine 40 mg/day (n=21), (2) relaxation plus paroxetine (n=17), (3) exercise plus pill placebo (n=20), or (4) relaxation plus pill placebo (n=17). Changes in the Panic and Agoraphobia Scale (P&A), and the Clinical Global Impression Scale (CGI) underwent repeated measure analysis. RESULTS Effects sizes were large for all groups (d=1.53-3.87), however not significantly different. Paroxetine-treated patients were significantly more improved than placebo-treated patients. On the CGI, patients in the exercise groups (plus paroxetine or placebo) had a trend toward better improvement compared to relaxation (P=0.06). Response and remission rates were higher in the paroxetine compared to pill placebo groups. CONCLUSIONS While paroxetine was superior to placebo, aerobic exercise did not differ from relaxation training in most efficacy measures.
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Affiliation(s)
- Dirk Wedekind
- Department of Psychiatry and Psychotherapy, University of Goettingen, Goettingen, Germany.
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Schlamann M, Naglatzki R, de Greiff A, Forsting M, Gizewski ER. Autogenic training alters cerebral activation patterns in fMRI. Int J Clin Exp Hypn 2010; 58:444-56. [PMID: 20799123 DOI: 10.1080/00207144.2010.499347] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cerebral activation patterns during the first three auto-suggestive phases of autogenic training (AT) were investigated in relation to perceived experiences. Nineteen volunteers trained in AT and 19 controls were studied with fMRI during the first steps of autogenic training. FMRI revealed activation of the left postcentral areas during AT in those with experience in AT, which also correlated with the level of AT experience. Activation of prefrontal and insular cortex was significantly higher in the group with experience in AT while insular activation was correlated with number years of simple relaxation exercises. Specific activation in subjects experienced in AT may represent a training effect. Furthermore, the correlation of insular activation suggests that these subjects are different from untrained subjects in emotional processing or self-awareness.
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Affiliation(s)
- Marc Schlamann
- University Hospital Essen and University Duisburg-Essen, Germany
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Awa WL, Plaumann M, Walter U. Burnout prevention: a review of intervention programs. PATIENT EDUCATION AND COUNSELING 2010; 78:184-190. [PMID: 19467822 DOI: 10.1016/j.pec.2009.04.008] [Citation(s) in RCA: 331] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Revised: 04/10/2009] [Accepted: 04/16/2009] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of intervention programs at the workplace or elsewhere aimed at preventing burnout, a leading cause of work related mental health impairment. METHODS A systematic search of burnout intervention studies was conducted in the databases Medline, PsycINFO and PSYNDEX from 1995 to 2007. Data was also extracted from papers found through a hand search. RESULTS A total of 25 primary intervention studies were reviewed. Seventeen (68%) were person-directed interventions, 2 (8%) were organization-directed and 6 (24%) were a combination of both interventions types. Eighty percent of all programs led to a reduction in burnout. Person-directed interventions reduced burnout in the short term (6 months or less), while a combination of both person- and organization-directed interventions had longer lasting positive effects (12 months and over). In all cases, positive intervention effects diminished in the course of time. CONCLUSION Intervention programs against burnout are beneficial and can be enhanced with refresher courses. Better implemented programs including both person- and organization-directed measures should be offered and evaluated. PRACTICE IMPLICATIONS A combination of both intervention types should be further investigated, optimized and practiced. Institutions should recognize the need for and make burnout intervention programs available to employees.
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Affiliation(s)
- Wendy L Awa
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health System Research, Endowed Chair Prevention and Rehabilitation in Health System and Health Services Research, 30625 Hannover, Germany.
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