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Abbasalizadeh M, Farsi Z, Sajadi SA, Atashi A, Fournier A. The effect of resilience training with mHealth application based on micro-learning method on the stress and anxiety of nurses working in intensive care units: a randomized controlled trial. BMC MEDICAL EDUCATION 2024; 24:442. [PMID: 38658914 PMCID: PMC11041025 DOI: 10.1186/s12909-024-05427-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Nurses in intensive care units (ICUs) face high stress and anxiety, impacting their well-being and productivity. Addressing this, this study evaluated the impact of resilience training via a mHealth application based on micro-learning on ICU nurses' stress and anxiety levels. MATERIALS AND METHODS This study, a single-blind randomized controlled trial conducted in 2022-23, involved sixty ICU nurses from two Tehran hospitals. Nurses were chosen through purposive sampling and divided into intervention and control groups by simple randomization. The intervention group was taught resilience via an educational mHealth application based on micro-learning, with data collected using the anxiety and stress subscales of DASS-21. RESULTS Before the intervention, there were no significant differences in stress and anxiety scores between the intervention and control groups (P > 0.05). Upon utilizing the mHealth application, the intervention group exhibited significant reductions in stress, from 10.77 ± 3.33 to 9.00 ± 1.66 (P = 0.001), and in anxiety, from 9.43 ± 3.35 to 7.93 ± 0.98 (P < 0.001). In contrast, the control group experienced a slight increase in stress levels, from 10.10 ± 2.19 to 10.73 ± 2.15 (P = 0.002), and in anxiety levels, from 9.10 ± 1.63 to 10.23 ± 1.65 (P < 0.0001). CONCLUSIONS The micro-learning-based mHealth application for resilience training significantly reduced ICU nurses' stress and anxiety, recommending its adoption as an innovative educational method. TRIAL REGISTRATION The study has been registered in the Iranian Registry of Clinical Trials (No. IRCT20221225056916N1, Date: 04/29/2023).
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Affiliation(s)
- Maryam Abbasalizadeh
- Critical Care Nursing Department, School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Zahra Farsi
- Medical-Surgical Nursing, Research and Ph.D. Nursing Departments, School of Nursing, Aja University of Medical Sciences, Kaj St., Shariati St., Tehran, Iran.
| | - Seyedeh Azam Sajadi
- Nursing Management Department, School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Afsaneh Atashi
- Department of Psychology, Central Branch, Islamic Azad University, Tehran, Iran
- Faculty of Psychology, Bangalore University, Bangalore, India
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Eva GF, Amo-Setién F, César LC, Concepción SS, Roberto MM, Jesús MM, Carmen OM. Effectiveness of intervention programs aimed at improving the nursing work environment: A systematic review. Int Nurs Rev 2024; 71:148-159. [PMID: 36646079 DOI: 10.1111/inr.12826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/29/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND The nursing work environment can be compromised due to workload, stress and many other issues. A good nursing work environment is needed to for the health and wellbeing of nurses and therefore measures are developed to improve nursing work environment. AIM To determine whether measures designed to improve the work environment for nursing professionals are effective. METHODOLOGY Online research in the Medline, Scopus, Web of Science, ERIC, CINHAL, PsycINFO, and American Doctoral Dissertations databases, along with manual search, was carried out. Primary experimental studies made up of intervention and control groups were included, with pre-/post-measure evaluation in the nursing team, based on the effects of the interventions. Risk of bias was calculated using the Cochrane tool. RESULTS A total of 1997 studies were examined; 19 clinical trials met the inclusion criteria. A total of 1427 nurses participated in the selected studies. The fields of application of the interventions were personal and environmental. Out of the fields targeting individuals, three methodologies were identified: cognitive-behavioral techniques, stress management, channeling anxiety and physical well-being; and those aimed at environmental fields: aromatization and organization. The most evaluated characteristic was teamwork, and the most analyzed symptom was stress. Most of the interventions concluded with at least one significant improvement. CONCLUSIONS Interventions aimed at enhancing the work environment are effective ways of increasing job satisfaction. The heterogeneity of the data did not allow us to determine which intervention is the most effective. The combination, type, and duration are variables that affect efficacy. IMPLICATION FOR NURSING AND NURSING POLICY This systematic review provides resources for improving the work environment that affects nursing staff, other professionals, and patients. Encouraging a healthy atmosphere leads to excellence in care and improved safety.
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Affiliation(s)
| | - Francisco Amo-Setién
- Faculty of Nursing, Nursing Department, IDIVAL Nursing group, University of Cantabria, Cantabria, Spain
| | | | | | - Martín-Melón Roberto
- Library assistant, Biosciences Library, University of Cantabria, Cantabria, Spain
| | - Molina-Mula Jesús
- Nursing and Physiotherapy Department, University of Illes Balears, Palma, Spain
| | - Ortego-Maté Carmen
- Nursing Department, IDIVAL Nursing group, University of Cantabria, Cantabria, Spain
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Macedo ABT, Vega EAU, Antoniolli L, Pinheiro JMG, Tavares JP, Souza SBCD. Effect of cardiovascular biofeedback on nursing staff stress: a randomized controlled clinical trial. Rev Bras Enferm 2023; 76:e20230069. [PMID: 38055492 DOI: 10.1590/0034-7167-2023-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/07/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE to assess the effect of cardiovascular biofeedback on nursing staff stress when compared to an activity without self-monitoring. METHOD a randomized controlled clinical trial, carried out with nursing professionals from a university hospital. The intervention group (n=58) performed cardiovascular biofeedback, and the control (n=57) performed an online puzzle without self-monitoring, totaling nine meetings over three weeks. The outcome was assessed using the Stress Symptoms and Work-Related Stress scales, and the biological marker heart rate variability. The generalized estimating equations method was used. RESULTS the intervention had no effect on self-reported instruments (p>0.050). However, there was an effect of time (p<0.050) on all heart rate variability indicators, demonstrating changes over the sessions. CONCLUSION cardiovascular biofeedback showed promising results in the biological marker, suggesting that it can be used in nursing staff as a complementary therapy by promoting better autonomic nervous system regulation.
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Affiliation(s)
| | | | - Liliana Antoniolli
- Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil
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Pirzadeh A, Abotalebi Z. The effect of relaxation education intervention on stress, anxiety, and depression in female teachers during the COVID-19 pandemic. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:348. [PMID: 38144031 PMCID: PMC10743839 DOI: 10.4103/jehp.jehp_1546_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/01/2022] [Indexed: 12/26/2023]
Abstract
BACKGROUND The high levels of job stress, anxiety, and depression among teachers, which affect their job and quality of life, necessitate using methods to cope with these issues. The present study aimed to determine the effect of relaxation education intervention on stress, anxiety, and depression in female teachers in 2020. MATERIALS AND METHODS This research is semi-experimental. Herein, 100 female teachers were studied. Data collection was performed using the Depression, Anxiety, and Stress Scale-42 items (DASS-42) questionnaire that was completed three times by the teachers: before the intervention, 10 days after the intervention, and 1 month following it. Relaxation education intervention was conducted online and offline based on the bioenergy economy model and by doing psychosomatic exercises. The data obtained from the questionnaire were analyzed by the independent t-test, paired t-test, and R. M. analysis of variance (ANOVA). RESULTS Before the intervention, there was no significant difference between the intervention and control groups in terms of stress (P = 0.385), anxiety (P = 0.168), and depression (P = 0.554) scores. The mean scores of stress, anxiety, and depression decreased significantly in the intervention group 10 days after the intervention; however, there was no significant change in the control group. The reduction in depression, stress, and anxiety remained constant in the intervention group during the 1-month follow-up. The results indicated that among the relaxation exercises, diaphragmatic breathing and meditation techniques were performed by the teachers for a longer period than other techniques. CONCLUSION Results obtained suggested teaching short-term relaxation techniques as highly recommended to all school teachers. These techniques include diaphragmatic breathing and meditation. They can reduce their stress, anxiety, and depression, improve their mental health, and empower them to control their tensions and negative emotions.
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Affiliation(s)
- Asiyeh Pirzadeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Abotalebi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Catapano P, Cipolla S, Sampogna G, Perris F, Luciano M, Catapano F, Fiorillo A. Organizational and Individual Interventions for Managing Work-Related Stress in Healthcare Professionals: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1866. [PMID: 37893584 PMCID: PMC10608642 DOI: 10.3390/medicina59101866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
The workplace represents a relevant source of stress for workers, being a risk factor for many mental disorders and psychological difficulties, including burn-out syndrome. Healthcare workers and other help-professions are particularly susceptible to work-related stress. The present systematic review aims to (1) identify available interventions for managing workplace-related stress symptoms; (2) assess their efficacy; and (3) discuss the current limitations of available interventions. A systematic review has been conducted, searching on PubMed, APA PsycInfo, and Scopus databases. Eighteen papers have been identified, which included different interventions for the management of work-related stress in healthcare professionals. These approaches can be grouped as follows: (1) interventions focusing on the individual level using cognitive-behavioral therapy (CBT) approaches; (2) interventions focusing on the individual level using relaxation techniques; and (3) interventions focusing on the organizational level. As regards interventions targeting the individual level using CBT approaches, mindfulness-based interventions were effective in reducing levels of burn-out, stress, and anxiety and in improving quality of life. As regards intervention using relaxation techniques, including art therapy, Emotional Freedom Techniques (ECT) and brief resilience retreats had a positive effect on the levels of anxiety, stress, and burnout. As regards interventions at the organizational level, we found no evidence for supporting its effectiveness in reducing the levels of burnout. Furthermore, available studies are heterogeneous in terms of assessment tools, target populations, and type of interventions, which limits the generalizability of findings.
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Affiliation(s)
| | | | - Gaia Sampogna
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Wang Q, Wang F, Zhang S, Liu C, Feng Y, Chen J. Effects of a mindfulness-based interventions on stress, burnout in nurses: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1218340. [PMID: 37599884 PMCID: PMC10434780 DOI: 10.3389/fpsyt.2023.1218340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background Stress in the healthcare environment causes negative effects in nurses such as burnout, anxiety, and depression. The COVID-19 pandemic has resulted in increased pressure on medical staff globally, highlighting the potential benefits of mindfulness-based interventions in reducing nurses' stress levels. Despite numerous studies exploring the effect of mindfulness-based training on nurses, the results remain inconclusive. Objective To systematically evaluate the impact of mindfulness training on nurse's performance and increase the certainty of existing evidence. Methods This study searched various databases, including EBSCO, Embase, Web of Science, PubMed, ProQuest, Scopus, Cochrane Online Library, Wanfang, SinoMed, CNKI, and VIP, for randomized controlled trials on the impact of mindfulness-based interventions for nurses up until 02 December 2022. Two investigators independently screened and extracted data from the articles, while also assessing the risk of bias. The data was analyzed using RevMan 5.4 software. Results This review identified 15 studies out of the 2,171 records retrieved, consisting of a total of 1,165 participants who were randomized. Post-intervention analysis provided very-low certainty evidence of moderate effectiveness of mindfulness-based training in reducing stress [standardized mean difference (SMD) = -0.81; 95% confidence interval (CI) = -1.11 to -0.52], with no significant effect on anxiety (SMD = -0.30; 95% CI = -0.72 to 0.13) or depression (SMD = -0.24; 95% CI = -0.55 to 0.07). However, the training was effective in reducing burnout, as demonstrated by the lower scores for emotional exhaustion (SMD = -4.27; 95% CI = -5.94 to -2.59) and depersonalization (SMD = -2.89; 95% CI = -4.24 to -1.54) and higher scores for personal accomplishment (SMD = 2.81; 95% CI = 0.12 to 5.50). There was a sustained improvement in stress levels in the short-term (≤3 months), with delayed benefits for burnout. However, only two studies were available for later follow-ups, and there was no significant evidence of long-term effects. Conclusion Mindfulness-based training may be a viable intervention for improving the psychological wellbeing of nurses, including reducing stress, burnout. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023387081.
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Affiliation(s)
- Qi Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Fang Wang
- Guang’an Hospital of Traditional Chinese Medicine, Guang’an, Sichuan, China
| | - Shurong Zhang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Chaofan Liu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yue Feng
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Junzhu Chen
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Shiri R, Nikunlaakso R, Laitinen J. Effectiveness of Workplace Interventions to Improve Health and Well-Being of Health and Social Service Workers: A Narrative Review of Randomised Controlled Trials. Healthcare (Basel) 2023; 11:1792. [PMID: 37372909 DOI: 10.3390/healthcare11121792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/30/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Health and social service workers face high levels of workload and job stressors, which can affect their health and well-being. Therefore, it is important to evaluate the effectiveness of workplace interventions that aim to improve their mental and physical health outcomes. This review summarizes the findings of randomized controlled trials (RCTs) that examined the impact of different types of workplace interventions on various health indicators among health and social service workers. The review searched the PubMed database from its inception to December 2022 and included RCTs that reported on the effectiveness of organizational-level interventions and qualitative studies that explored barriers and facilitators to participation in such interventions. A total of 108 RCTs were included in the review, covering job burnout (N = 56 RCTs), happiness or job satisfaction (N = 35), sickness absence (N = 18), psychosocial work stressors (N = 14), well-being (N = 13), work ability (N = 12), job performance or work engagement (N = 12), perceived general health (N = 9), and occupational injuries (N = 3). The review found that several workplace interventions were effective in improving work ability, well-being, perceived general health, work performance, and job satisfaction and in reducing psychosocial stressors, burnout, and sickness absence among healthcare workers. However, the effects were generally modest and short-lived. Some of the common barriers to participation in workplace interventions among healthcare workers were inadequate staff, high workload, time pressures, work constraints, lack of manager support, scheduling health programs outside work hours, and lack of motivation. This review suggests that workplace interventions have small short-term positive effects on health and well-being of healthcare workers. Workplace interventions should be implemented as routine programs with free work hours to encourage participation or integrate intervention activities into daily work routines.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, P.O. Box 18, 00032 Helsinki, Finland
| | - Risto Nikunlaakso
- Finnish Institute of Occupational Health, P.O. Box 18, 00032 Helsinki, Finland
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, P.O. Box 18, 00032 Helsinki, Finland
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Michaelsen MM, Graser J, Onescheit M, Tuma MP, Werdecker L, Pieper D, Esch T. Mindfulness-Based and Mindfulness-Informed Interventions at the Workplace: A Systematic Review and Meta-Regression Analysis of RCTs. Mindfulness (N Y) 2023; 14:1-34. [PMID: 37362186 PMCID: PMC10172073 DOI: 10.1007/s12671-023-02130-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2023] [Indexed: 06/28/2023]
Abstract
Objectives Positive effects of mindfulness-based interventions (MBIs) on occupational health have been demonstrated by several systematic review studies during the last two decades. So far, existing reviews excluded mindfulness-informed interventions (MIIs) that build on informal approaches or mixed techniques aiming at improving mindfulness indirectly. To address this research gap, the present comprehensive meta-analysis synthesizes the results of RCTs of MBIs and MIIs conducted in various workplace settings. Method A systematic literature search was conducted in five electronic databases complemented by manual search. Random-effects models were used to synthesize standardized mean differences (SMDs) for 25 outcomes and seven overarching categories of outcomes, and to detect various temporal effects. Meta-regressions were run to elucidate average SMDs between mindfulness intervention types and intervention and population characteristics, with the goal of detecting sources of heterogeneity and help guide the selection of the most appropriate mindfulness intervention type. Results Based on 91 eligible studies (from 92 publications), including 4927 participants and 4448 controls, the synthesis shows that MBIs and MIIs significantly improve mindfulness (SMD = 0.43; 95%-CI [0.33;0.52]), well-being (SMD = 0.63; 95%-CI [0.34;0.93]), mental health (SMD = 0.67; 95%-CI [0.48;0.86]), stress (SMD = 0.72; 95%-CI [0.54;0.90]), resilience (SMD = 1.06; 95%-CI [-0.22;2.34]), physical health (SMD = 0.45; 95%-CI [0.32;0.59]), and work-related factors (SMD = 0.62; 95%-CI [0.14;1.10]). Sensitivity analyses demonstrate a tendency towards smaller effect sizes due to extreme outliers. Effect sizes are stable in short-term follow-up assessments (1-12 weeks) for most outcomes, but not for long-term follow-up assessments (13-52 weeks). Meta-regressions suggest that observable intervention characteristics (e.g., online delivery) and population characteristics (e.g., age of participants), as well as study quality, do not explain the prevalence of heterogeneity in effect sizes. Conclusions Generally effective, mindfulness interventions are a useful tool to enhance aspects of employee health. However, because of heterogeneity and risk of bias, studies aiming at high-quality data collection and thorough reporting are necessary to draw firm conclusions. Preregistration A protocol of this systematic review was registered with PROSPERO (Registration-No. CRD42020159927). Supplementary Information The online version contains supplementary material available at 10.1007/s12671-023-02130-7.
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Affiliation(s)
- Maren M. Michaelsen
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Johannes Graser
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Miriam Onescheit
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Matthias P. Tuma
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Lena Werdecker
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Dawid Pieper
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School (Theodor Fontane), Institute for Health Services and Health System Research, Rüdersdorf, Germany
- Center for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rüdersdorf, Germany
| | - Tobias Esch
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, Witten/Herdecke University, Witten, Germany
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Lin JY, Cheng WJ, Wu CF, Chang TY. Associations of road traffic noise and its frequency spectrum with prevalent depression in Taichung, Taiwan. Front Public Health 2023; 11:1116345. [PMID: 36778576 PMCID: PMC9911801 DOI: 10.3389/fpubh.2023.1116345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction Exposure to road traffic noise has been reported to be associated with depression in many epidemiological studies, but the association between noise frequency spectrum and depression remains unclear. This community-based study investigated the associations between road traffic noise exposure and its frequency components with prevalent depression. Methods A total of 3,191 residents living in Taichung who participated in the Taiwan Biobank between 2010 and 2017, were included as study participants. The land-use regression models were used to evaluate individual annual average values of A-weighted equivalent sound level over 24 h (Leq,24h) and particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) using the geographic information system. Multiple logistic regression was applied to estimate the odds ratios (ORs) for depression after adjusting for potential risk factors and PM2.5. Results An interquartile range increase in Leq,24h at full frequency (4.7 dBA), 1,000 Hz (5.2 dB), and 2,000 Hz (4.8 dB) was significantly associated with an elevated risk for depression with ORs of 1.62 (95% confidence interval [CI]: 1.03, 2.55), 1.58 (95% CI: 1.05, 2.37), and 1.58 (95% CI:1.03, 2.43), respectively, by controlling for PM2.5. The high-exposure group (≥3rd quartile median of noise levels) at full frequency, 1,000 Hz, and 2,000 Hz had an increased risk for depression with ORs of 2.65 (95% CI: 1.16-6.05), 2.47 (95% CI: 1.07-5.70), and 2.60 (95% CI: 1.10-6.12), respectively, compared with the reference group (<1st quartile of noise levels) after adjustment for PM2.5. Significant exposure-response trends were observed between the prevalent depression and noise exposure by quartiles at full frequency, 1,000 Hz, and 2,000 Hz (all p < 0.05). Conclusion Exposure to road traffic noise may be associated with an increased prevalence of depression, particularly at 1,000 and 2,000 Hz.
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Affiliation(s)
- Jia-Yi Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Wan-Ju Cheng
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan,Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan,National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
| | - Chang-Fu Wu
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ta-Yuan Chang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan,*Correspondence: Ta-Yuan Chang ✉
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Alkhawaldeh JM. Psychoeducational interventional programme during the COVID-19 pandemic for nurses with severe occupational stress: A randomized controlled trial. Int J Nurs Pract 2023:e13129. [PMID: 36601722 DOI: 10.1111/ijn.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 12/05/2022] [Accepted: 12/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Occupational stress is generally acknowledged as a major issue in the health sector that may have a detrimental impact on nurses' psychological and physical health, particularly during the COVID-19 epidemic. AIM This study evaluated the effectiveness of a psychoeducational interventional programme in decreasing occupational stress and improving coping methods among nurses during the COVID-19 pandemic. METHODS This study used a cluster-randomized approach. Data were collected from 80 nurses working in two public health-care centres from May to August 2020 in Jordan. Two centres were assigned randomly to the intervention and control groups. The psychoeducational programme was delivered to the intervention group in six sessions over 6 days for 2 weeks. The collected data were analysed using SPSS through descriptive and inferential statistics. Occupational stress and coping strategies were measured. RESULTS Repeated-measures analysis of variance (ANOVA) indicated that the degrees of occupational stress and coping strategies significantly differed between study groups over the three points of data collection. CONCLUSION This psychoeducational interventional programme is a valuable noninvasive method that can improve individual coping strategies to manage stress in practice during the COVID-19 pandemic.
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Song N, Wang CL, Zhang LQ, Wang XM. A study on the correlation between work stressors and the coping styles of outpatients and emergency nurses in 29 pediatric specialty hospitals across China. Front Psychol 2022; 13:951671. [PMID: 36405188 PMCID: PMC9672805 DOI: 10.3389/fpsyg.2022.951671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/30/2022] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study aimed to better understand the current situation involving work stressors and the coping styles of outpatient and emergency nurses in 29 pediatric specialty hospitals across China. The study analyzed this correlation to provide a reference for the occupational stress management of pediatric nurses. METHODS From June to September 2020, 1,457 outpatient and emergency nurses in 29 pediatric specialty hospitals across China were selected as study participants, and a questionnaire survey was conducted using the Basic Information Questionnaire, the Chinese version of the Work Stressor Scale for Nurses, and the Simple Coping Style Scale. RESULTS The assessed stress level of outpatient and emergency nurses in 29 tertiary pediatric specialty hospitals nationwide is lower than the results of the survey of the 2007 domestic norm, p < 0.05. The stressors related to nurses' expectations, family conflicts, the nature of nursing work, patient factors, and workload were lower compared with the national norm (p < 0.05). The positive coping style score on the Simple Coping Style Scale for pediatric outpatient nurses was (36.66 ± 6.16), and work stressors were positively associated with negative coping styles (p < 0.01). Multiple regression analysis showed that the influencing factors of work stressors among pediatric outpatient and emergency nurses correlated with the authorized size, age, working years of nurses, work department, and negative coping styles. CONCLUSION Negative coping styles were present among pediatric outpatient and emergency nurses and were associated with work stressors. The influencing factors of stressors mainly correlated with the clinical establishment, age, years of employment as a nurse, work department, and negative coping styles.
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Affiliation(s)
- Nan Song
- Department of Nursing, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Workplace Meditation Interventions for Reducing Psychological Stress and Other Cardiovascular Risk Factors: Workplace Wellness Policy Implications. CURRENT CARDIOVASCULAR RISK REPORTS 2022. [DOI: 10.1007/s12170-022-00708-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kunzler AM, Chmitorz A, Röthke N, Staginnus M, Schäfer SK, Stoffers-Winterling J, Lieb K. Interventions to foster resilience in nursing staff: A systematic review and meta-analyses of pre-pandemic evidence. Int J Nurs Stud 2022; 134:104312. [PMID: 35853312 DOI: 10.1016/j.ijnurstu.2022.104312] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/30/2022] [Accepted: 06/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Given the chronic work-related stressors experienced by nursing staff in today's healthcare systems, international evidence suggests an elevated risk of developing stress-related mental symptoms. Therefore, identifying effective methods to foster resilience (i.e., maintenance or fast recovery of mental health despite stressor exposure) seems crucial. To date, little is known about the efficacy of these interventions in nurses. OBJECTIVE This systematic review aimed at summarizing the evidence on the pre-pandemic efficacy of psychological interventions to foster resilience, to improve mental symptoms and well-being as well as to promote resilience factors in nurses. Based on training programs with evidence for positive effects on resilience and mental health in meta-analyses, we aimed at identifying important and helpful intervention techniques. DESIGN Systematic review and meta-analyses based on a Cochrane review on pre-pandemic resilience interventions in healthcare professionals. DATA SOURCES MEDLINE, Embase, CENTRAL and 11 other databases were searched until June 2020 to identify eligible randomized controlled trials. Trial registers, reference lists and contact with authors were additional sources. REVIEW METHODS Two reviewers independently assessed study eligibility and extracted data. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias of included studies. We conducted random-effects pairwise meta-analyses for five primary outcomes, including resilience. The intervention contents and techniques were narratively synthesized. RESULTS Of 39,794 records retrieved, 24 studies were included in the review (N = 1879 randomized participants), 17 in meta-analyses (n = 1020 participants). At post-intervention, we found very-low certainty evidence of moderate effects in favor of resilience training for resilience (standardized mean difference [SMD] 0.39; 95% CI [confidence interval] 0.12-0.66) and well-being (SMD 0.44; 95% CI 0.15-0.72), while there was no evidence of effects on symptoms of anxiety, depression and stress. The improvement of well-being was sustained in the short-term (≤3 months), with additional delayed benefits for anxiety and stress. There was no evidence of effects at later follow-ups, with the caveat of only three available studies. Among nine programs with evidence of positive moderate effect sizes, intervention contents included mindfulness and relaxation, psychoeducation, emotion regulation, cognitive strategies, problem-solving and the strengthening of internal and external resources. CONCLUSIONS Given the chronic stressor exposure in nursing staff, our findings may guide both the design and implementation of nurse-directed resilience interventions. To improve the certainty of evidence, more rigorous high-quality research using improved study designs (e.g., larger sample sizes, longer follow-up periods) is urgently needed. REGISTRATION PROSPERO 2017 CRD42017082827.
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Affiliation(s)
- Angela M Kunzler
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
| | - Andrea Chmitorz
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Nikolaus Röthke
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Sarah K Schäfer
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Jutta Stoffers-Winterling
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany; Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany; Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
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14
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Kang MJ, Myung SK. Effects of Mindfulness-Based Interventions on Mental Health in Nurses: A Meta-Analysis of Randomized Controlled Trials. Issues Ment Health Nurs 2022; 43:51-59. [PMID: 34292840 DOI: 10.1080/01612840.2021.1949765] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Mindfulness as a positive mental health intervention approach has been increasingly applied to nurses. This meta-analysis evaluated the psychological effects of mindfulness-based interventions (MBIs) on mental health in nurses. We searched PubMed, EMBASE, Cochrane, and CINAHL up to February 2020. Randomized controlled trials (RCTs) evaluating the effects of MBIs for nurses were included. Data extraction and the risk of bias assessment were conducted by two authors independently. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using a random-effects meta-analysis. Of 370 studies retrieve from databases, nine RCTs, which involved 572 participants with 283 in an intervention group and 289 in a control group, were included in the final analysis. Compared to the control groups (no treatment, treatment as usual, or active control), MBIs reduced psychological distress such as anxiety, depression, or stress (SMD = -0.47; 95% CI, -0.67 to -0.32; I2 = 34.7; n = 17) in nurses. Also, MBIs slightly improved psychological wellbeing such as resilience, wellbeing, or quality of life (SMD = 0.28; 95% CI, 0.11 to 0.46; I2 = 0.00; n = 8). However, no statistically significant effects were found in Job related outcomes (SMD = 0.23; 95% CI, -0.01 to 0.47; I2 = 20.5; n = 6). This meta-analysis found that MBIs had beneficial effects on mental health such as psychological distress and wellbeing in nurses.
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Affiliation(s)
- Mi-Jung Kang
- College of Nursing, Department of Nursing, Eulji University, Daejeon, Republic of Korea
| | - Seung-Kwon Myung
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea.,Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, Goyang, Republic of Korea.,Department of Family Medicine and Center for Cancer Prevention and Detection, Hospital, National Cancer Center, Goyang, Republic of Korea
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15
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Korkut S, Ülker T, Çidem A, Şahin S. The effect of progressive muscle relaxation and nature sounds on blood pressure measurement skills, anxiety levels, and vital signs in nursing students. Perspect Psychiatr Care 2021; 57:1782-1790. [PMID: 33634488 DOI: 10.1111/ppc.12749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/06/2021] [Accepted: 02/06/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study was to determine the effect of progressive muscle relaxation (PMR) and nature sounds (NS) on students' blood pressure measurement skills, anxiety levels, and vital signs. DESIGN AND METHODS This randomized controlled study conducted at the nursing department of a university in February 2020. During skill training, one group was given PMR and one group was given PMR + NS. The routine teaching procedure was applied to the control group. FINDINGS The PMR (37.80 ± 10.1) and PMR + NS (31.19 ± 6.15) groups had lower mean postintervention anxiety scores compared with the control group (40.86 ± 9.13). The PMR + NS group had higher mean postintervention knowledge test score than other. PRACTICE IMPLICATIONS PMR + NS and PMR helped reduce nursing students' anxiety levels and pulse rates. PMR + NS helped increase their blood pressure knowledge test scores.
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Affiliation(s)
- Sevda Korkut
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Türkan Ülker
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Aysun Çidem
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Sevil Şahin
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
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16
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Badakhsh M, Dastras M, Sarchahi Z, Doostkami M, Mir A, Bouya S. Complementary and alternative medicine therapies and COVID-19: a systematic review. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:443-450. [PMID: 33838089 DOI: 10.1515/reveh-2021-0012] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Despite the high prevalence of coronavirus and various treatment approaches, including complementary and alternative medicine (CAM), there is still no definitive treatment for coronavirus. The present study aimed to evaluate the effect of CAM interventions on COVID-19 patients. CONTENT Four databases (Web of Science, PubMed, Scopus, and EMBASE) were searched from the inception of databases until July 16, 2020. Keywords included complementary and alternative medicine therapies and Coronavirus. SUMMARY AND OUTLOOK Of the 1,137 studies searched, 14 studies performed on 972 COVID-19 patients entered the systematic review final stage. The results showed that different CAM interventions (acupuncture, Traditional Chinese medicine [TCM], relaxation, Qigong) significantly improved various psychological symptoms (depression, anxiety, stress, sleep quality, negative emotions, quality of life) and physical symptoms (inflammatory factors, physical activity, chest pain, and respiratory function) in COVID-19 patients. The results showed that various CAM interventions have a positive effect on improving the various dimensions of coronavirus disease but since there are few studies in this regard, further studies using different CAM approaches are recommended.
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Affiliation(s)
- Mahin Badakhsh
- Department of Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Majid Dastras
- Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zohreh Sarchahi
- Department of Nursing, Faculty of Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mahboobe Doostkami
- Department of Operating Room, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Adel Mir
- Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Salehoddin Bouya
- Internal Medicine and Nephrology, Clinical Immunology Research Center, Ali-Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
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17
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Jung SE, Ha DJ, Park JH, Lee B, Kim MS, Sim KL, Choi YH, Kwon CY. The Effectiveness and Safety of Mind-Body Modalities for Mental Health of Nurses in Hospital Setting: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8855. [PMID: 34444604 PMCID: PMC8393251 DOI: 10.3390/ijerph18168855] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 12/18/2022]
Abstract
The mental health of nurses including burnout is an important issue. The purpose of this systematic review was to evaluate whether mind-body modalities improve burnout and other mental health aspects of nurses. A comprehensive search was conducted using six electronic databases. Randomized controlled trials using mind-body modalities on the mental health of nurses, up to January 2021, were included. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool. Seventeen studies were included in the review. Data on mindfulness-based interventions (MBIs) and yoga were available for burnout, and there was no evidence that multimodal resilience programs including MBIs statistically significantly improved burnout levels compared to no intervention or active control groups. However, one study reported that yoga could significantly improve emotional exhaustion and depersonalization, which are subscales of burnout, compared to usual care. In addition, the effects of MBIs, relaxation, yoga, and music on various mental health outcomes and stress-related symptoms have been reported. In conclusion, there was some evidence that yoga was helpful for improvement in burnout of nurses. However, due to the heterogeneity of interventions and outcomes of the studies included, further high-quality clinical trials are needed on this topic in the future.
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Affiliation(s)
- Su-Eun Jung
- Department of Clinical Korean Medicine, Graduate School, Dong-eui University, Busan 47227, Korea; (S.-E.J.); (D.-J.H.); (J.-H.P.)
| | - Da-Jung Ha
- Department of Clinical Korean Medicine, Graduate School, Dong-eui University, Busan 47227, Korea; (S.-E.J.); (D.-J.H.); (J.-H.P.)
| | - Jung-Hyun Park
- Department of Clinical Korean Medicine, Graduate School, Dong-eui University, Busan 47227, Korea; (S.-E.J.); (D.-J.H.); (J.-H.P.)
| | - Boram Lee
- Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Daejeon 34054, Korea;
| | - Myo-Sung Kim
- Department of Nursing, College of Nursing, Healthcare Sciences & Human Ecology, Dong-eui University, Busan 47340, Korea;
| | - Kyo-Lin Sim
- Department of Music, Graduate School, Pyeongtaek University, Pyeongtaeksi 17869, Gyeonggi-do, Korea;
| | - Yung-Hyun Choi
- Department of Biochemistry, College of Korean Medicine, Dong-eui University, Busan 47227, Korea;
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-eui University, Busan 47227, Korea
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18
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Velana M, Rinkenauer G. Individual-Level Interventions for Decreasing Job-Related Stress and Enhancing Coping Strategies Among Nurses: A Systematic Review. Front Psychol 2021; 12:708696. [PMID: 34349711 PMCID: PMC8326445 DOI: 10.3389/fpsyg.2021.708696] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/24/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Nurses are facing unprecedented amounts of pressure because of the ongoing global health challenges. Improving nurses' resilience to job-related stress and enhancing their strategies to cope effectively with stressors are key issues facing many health care institutions during the COVID-19 pandemic. This literature review aimed to: a) provide a thorough overview of individual-level interventions for stress management among nurses, b) identify measurement tools utilized to evaluate nurses' stress level, and c) provide the best evidence-based recommendations for future research and practice adapted to the current restrictions. Design: Systematic review. Data Sources: Studies published between January 2000 and October 2020 were retrieved from the following sources: EBSCOhost, Dortmund University Library, PubMed, Medline, Google Scholar, Applied Nursing Research, and reference lists from relevant articles. Review methods: Individual-level interventions with a control group or a placebo intervention were included in the final sample. Primary outcome was defined as a change in individual stress level or stress symptoms which were measured by objective or subjective instruments with evidence of validity. Articles published in English or German were included in the present review. Results: In total, 27 relevant studies were included into the current review. There are some indications that technology-delivered interventions with relaxation and stress management interventions comprising cognitive-behavioral components might be effective in decreasing stress among nurses and improving their well-being. Furthermore, although there were some attempts to collect objectively measured parameters for assessing the primary outcome of stress, the majority of the interventions utilized self-reported stress scales. Conclusion: A wide range of interventions are available for nurses. However, it is of utmost importance to develop and implement stress management programs that are conveniently accessible in the workplace and above all, meet the current restrictions for minimizing human contacts. To this end, innovative interventions delivered through digital technology, such as virtual reality, seem to be a promising solution for combating the detrimental impact of stress on nurses. Special attention should be also paid to applying standardized objective measurement tools to allow the assessment of sensitive physiological indices and the generalizability of scientific knowledge.
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Affiliation(s)
- Maria Velana
- Department of Ergonomics, Leibniz Research Center for Working Environment and Human Factors (IfADo) at Dortmund University of Technology, Dortmund, Germany
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19
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Jourabchi Z, Satari E, Mafi M, Ranjkesh F. Effects of Benson's relaxation technique on occupational stress in midwives. Nursing 2020; 50:64-68. [PMID: 32826681 DOI: 10.1097/01.nurse.0000694836.00028.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To examine the effect of Benson's relaxation technique on occupational stress in midwives working in a Labor and Delivery (L&D) unit. METHODS This pre- and post-quasi-experimental study involved 65 midwives with a minimum 1 year of experience using convenience sampling. After training, the participants performed Benson's relaxation technique twice a day for 4 weeks. RESULTS Occupational stress was measured using standard questionnaires of occupational stress. Data were analyzed using the Statistical Package for Social Sciences software. Statistical analysis was performed using the Kolmogorov-Smirnov goodness-of-fit test, Student's t-test, and Wilcoxon signed rank test. CONCLUSION This study demonstrated that Benson's relaxation technique may be effective in reducing occupational stress among midwives in L&D units.
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Affiliation(s)
- Zinat Jourabchi
- At Qazvin University of Medical Sciences in Qazvin, Iran, Zinat Jourabchi is an assistant professor of community health; Elaheh Satari is an MSc student in midwifery counseling; Maryam Mafi is an instructor of biostatistics; and Fatemeh Ranjkesh is an instructor of midwifery in the Children Growth Research Center and the Research Institute for Prevention of Non-Communicable Diseases
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20
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Alkhawaldeh JM, Soh KL, Mukhtar F, Peng OC, Alkhawaldeh HM, Al-Amer R, Anshasi HA. Stress management training program for stress reduction and coping improvement in public health nurses: A randomized controlled trial. J Adv Nurs 2020; 76:3123-3135. [PMID: 32856353 DOI: 10.1111/jan.14506] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/12/2020] [Accepted: 07/07/2020] [Indexed: 11/28/2022]
Abstract
AIMS This study aimed to evaluate the effect of the stress management interventional program in reducing occupational stress and improving coping strategies among public health nurses. DESIGN A double-blind, cluster-randomized approach was used as a randomization method for this study to evaluate the stress management interventional program. METHODS A cluster-randomized controlled trial was carried out in eight comprehensive healthcare centres in Amman city, Jordan; four centres were randomly assigned to each experimental and control group. One hundred and seventy nurses were selected randomly from March 2019 - August 2019 and data were collected by using the Nursing Stress Scale & brief COPE over three data collection times. Both descriptive and inferential statistics (repeated measure ANOVA, Independent t test, and chi-squared) were used to answer the research questions of this study. RESULTS The results showed that both the levels of occupational stress and coping strategies were significantly different between the two study groups over the three data collection points (p < 0.05). CONCLUSION Based on the findings of this study, the stress management program is an effective non-invasive method that can be used to reduce stress levels and improve coping strategies for public health nurses. The implementation of stress management interventions in health care is likely to help nurses manage occupational stress in practice. IMPACT Nurses suffer from a high level of occupational stress. In particular, approximately74% of nurses experience severe occupational stress, which can lead to many mental and physical disorders. However, nurses were less able to utilize the correct stress preventive strategies due to gaps in knowledge, skills, and awareness. This study contributed to the provision of empirical evidence of the effectiveness of the stress management program in reducing occupational stress and improving coping strategies among public health nurses. A stress management intervention program is a valuable non-invasive method that can be used by healthcare organizations to reduce stress levels and improve coping strategies for nurses in practice. CLINICAL TRIAL REGISTRATION NUMBER NCT03833986.
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Affiliation(s)
- Ja'far M Alkhawaldeh
- Faculty of Medicine and Health Sciences, Department of Nursing and Rehabilitation, University Putra Malaysia (UPM), Selangor, Malaysia.,Faculty of Nursing, Isra University, Amman, Jordan
| | - Kim Lam Soh
- Faculty of Medicine and Health Sciences, Department of Nursing and Rehabilitation, University Putra Malaysia (UPM), Selangor, Malaysia
| | - Firdaus Mukhtar
- Faculty of Medicines and Health Sciences, Department of Psychiatry, University Putra Malaysia (UPM), Selangor, Malaysia
| | - Ooi Cheow Peng
- Faculty of Medicines and Health Sciences, Department of Medicine, University Putra Malaysia (UPM), Selangor, Malaysia
| | | | - Rasmieh Al-Amer
- School of Nursing and Midwifery, Isra University/Western Sydney University, Amman, Jordan
| | - Huda A Anshasi
- School of Nursing, The University of Jordan, Amman, Jordan
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21
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Kunzler AM, Helmreich I, Chmitorz A, König J, Binder H, Wessa M, Lieb K. Psychological interventions to foster resilience in healthcare professionals. Cochrane Database Syst Rev 2020; 7:CD012527. [PMID: 32627860 PMCID: PMC8121081 DOI: 10.1002/14651858.cd012527.pub2] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes. OBJECTIVES To assess the effects of interventions to foster resilience in healthcare professionals, that is, healthcare staff delivering direct medical care (e.g. nurses, physicians, hospital personnel) and allied healthcare staff (e.g. social workers, psychologists). SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results. SELECTION CRITERIA Randomised controlled trials (RCTs) in adults aged 18 years and older who are employed as healthcare professionals, comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, wait-list, usual care, active or attention control. Primary outcomes were resilience, anxiety, depression, stress or stress perception and well-being or quality of life. Secondary outcomes were resilience factors. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only). MAIN RESULTS We included 44 RCTs (high-income countries: 36). Thirty-nine studies solely focused on healthcare professionals (6892 participants), including both healthcare staff delivering direct medical care and allied healthcare staff. Four studies investigated mixed samples (1000 participants) with healthcare professionals and participants working outside of the healthcare sector, and one study evaluated training for emergency personnel in general population volunteers (82 participants). The included studies were mainly conducted in a hospital setting and included physicians, nurses and different hospital personnel (37/44 studies). Participants mainly included women (68%) from young to middle adulthood (mean age range: 27 to 52.4 years). Most studies investigated group interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face-to-face (29 studies). Of the included studies, 19 compared a resilience training based on combined theoretical foundation (e.g. mindfulness and cognitive-behavioural therapy) versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify the source of their funding, and one study received no funding support. Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare professionals receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.45, 95% confidence interval (CI) 0.25 to 0.65; 12 studies, 690 participants), lower levels of depression (SMD -0.29, 95% CI -0.50 to -0.09; 14 studies, 788 participants), and lower levels of stress or stress perception (SMD -0.61, 95% CI -1.07 to -0.15; 17 studies, 997 participants). There was little or no evidence of any effect of resilience training on anxiety (SMD -0.06, 95% CI -0.35 to 0.23; 5 studies, 231 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.14, 95% CI -0.01 to 0.30; 13 studies, 1494 participants; very-low certainty evidence). Effect sizes were small except for resilience and stress reduction (moderate). Data on adverse effects were available for three studies, with none reporting any adverse effects occurring during the study (very-low certainty evidence). AUTHORS' CONCLUSIONS For healthcare professionals, there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression, stress or stress perception, and higher levels of certain resilience factors at post-intervention. The paucity of medium- or long-term data, heterogeneous interventions and restricted geographical distribution limit the generalisability of our results. Conclusions should therefore be drawn cautiously. The findings suggest positive effects of resilience training for healthcare professionals, but the evidence is very uncertain. There is a clear need for high-quality replications and improved study designs.
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Affiliation(s)
| | | | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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22
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Alkhawaldeh JMA, Soh KL, Mukhtar FBM, Ooi CP. Effectiveness of stress management interventional programme on occupational stress for nurses: A systematic review. J Nurs Manag 2020; 28:209-220. [PMID: 31887233 DOI: 10.1111/jonm.12938] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 12/07/2019] [Accepted: 12/20/2019] [Indexed: 02/03/2023]
Abstract
AIM The purpose of this systematic review is to evaluate the effectiveness of stress management interventional programme in reducing occupational stress among nurses. BACKGROUND Nursing professionals are placed continuously at the forefront in the area of health care which makes them highly exposed to professional stress. EVALUATION Randomized controlled trial studies (RCTs) were systematically searched in eight different databases for works published in English from 2011 to 2019; inclusion criteria were applied by two reviewers critically and assessed the risk of bias using Consolidated Standards of Reporting Trials (CONSORT). KEY ISSUES The systematic search contributed to the extraction of approximately 10 most relevant RCTs. Most of the RCTs considered in this systematic review revealed that the stress reduction interventions and strategies were effective in reducing the levels of occupational stress experienced by nurses. CONCLUSIONS Current review shows that stress management interventional programme tends to be effective, but additional well-designed RCTs are needed to confirm their effectiveness. IMPLICATIONS FOR NURSING MANAGEMENT Implementing stress management interventions within health care organisations are likely to assist nurses in reducing occupational stress and in improving coping strategies used by nurses for dealing with stress.
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Affiliation(s)
- Ja'far Mohammad Aqeel Alkhawaldeh
- Department of Nursing and Rehabilitation, Faculty of Medicines and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia.,Faculty of Nursing, Isra University, Amman, Jordan
| | - Kim Lam Soh
- Department of Nursing and Rehabilitation, Faculty of Medicines and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
| | - Firdaus Binti Mamat Mukhtar
- Department of Psychiatry, Faculty of Medicines And Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
| | - Cheow Peng Ooi
- Department of Medicine, Faculty of Medicines and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
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