Nurse-Guided Maternal Interventional Package for Neonatal Stress - A Randomized Controlled Trial.

OBJECTIVE: To assess the role of nurse-guided maternal interventional package for reducing stress behaviour among preterm neonates admitted in neonatal intensive care unit (NICU). METHODS: A randomized controlled trial was conducted among 100 mothers and their newborns delivered preterm and admitted consecutively in the NICU over 4 months. Mothers in the intervention group (n = 50) received education and demonstration regarding the use of maternal touch, facilitated tucking, kangaroo mother care (KMC), non-nutritive sucking (NNS), nesting and maternal voice alongwith a handout in local language for five consecutive days, while those in the control group (n = 50) received routine care including KMC and NNS for five consecutive days. Neonates were assessed before and five days after enrolment or intervention by using modified Infant Positioning Assessment Tool (IPAT), Neonatal Stress Scale and Preterm Neonate's Behaviour Assessment Scale. RESULTS: The mean (SD) score of positioning was significantly higher in the intervention group as compared to control group [9.62 (1.17) vs 6.58 (1.72), P < 0.001]. The median (IQR) score of stress was significantly lower in the intervention group compared to the control group [7 (7,10) vs 11(8,12.75), P = 0.004]. The mean (SD) scores for the autonomic and visceral subsystem behavioral response were significantly higher in the intervention group [5.28 (1.4) vs 3.25 (1.0), P < 0.001]. Mean (SD) attention interaction subsystem behavioral response score in the intervention group was significantly higher compared to the control group [2.96 (1.2) vs 1.85 (0.9), P = 0.001]. CONCLUSION: Mothers can be guided by nurses on neonatal stress behaviour and how to handle neonates in NICU, which significantly improves positioning and behavioral scores and reduces stress scores.

Midwife-led psycho-education intervention to reduce childbirth fear: a quasi-experimental study.

This quasi-experimental study aimed to assess the impact of a midwife-led psycho-education intervention on reducing fear of childbirth (FOC) and perceived stress (PS) in pregnant women. The present study involved 96 pregnant women. The intervention group received three 30-45 min telephone sessions using 'BELIEF' (Birth Emotion-Looking to Improve Expectant Fear) psycho-education approach. The outcomes were assessed using questionnaires on childbirth attitudes and PS. Data analysis was performed using Stata version 17. In the intervention group, the mean score for FOC decreased from 39.41 ± 7.02 to 29.91 ± 5.60 (9.5; 24.1%). The mean difference (MD) of 28.22% was statistically significant (adjusted MD: -10.51, 95% CI: -11.60, -9.41, P < 0.001). In the intervention group, mean scores for PS decreased from 22.77 ± 6.94 to 18.23 ± 5.69 (4.54; 19.93%). In the control group, scores increased from 22.68 ± 6.76 to 24.82 ± 6.58 (2.14; 9.43%). The 29.36% MD was statistically significant (aMD: -6.95, 95% CI: -8.73, -5.18, P < 0.001). The findings of this study indicate that the midwife-led psycho-education intervention, utilizing the 'BELIEF' protocol over the telephone, has a significant effect on reducing FOC and PS, as well as increasing the preference for vaginal birth.

What can we learn about stress and sleep from COVID-19 pandemic-perspective from the theory of preventive stress management.

Background: The COVID-19 pandemic has presented unique challenges to individuals worldwide, with a significant focus on the impact on sleep. However, the precise mechanisms through which emotional and cognitive variables mediate this relationship remain unclear. To expand our comprehensive understanding of variables, the present study utilizes the Preventive Stress Management theory, to test the relationship between perceived social support and sleep quality, as well as the effect of perceived COVID-19 stress, hope, negative emotions and coping styles. Methods: Data were collected in March 2022 from 1,034 college students in two universities located in Liaoning Province, China, using an online survey platform regarding perceived social support, perceived COVID-19 stress, sleep quality, hope, negative emotions and coping styles. The moderated mediation model were conducted using Process macro program (Model 6) and the syntax in SPSS. Results: The results revealed perceived COVID-19 stress and negative emotions sequentially mediated the negative relationship between perceived social support and sleep quality. Furthermore, hope and coping styles were found to moderate the sequential mediating effect. Conclusion: The present study sheds light on the pathways that affect sleep quality among college students during the COVID-19 pandemic. Findings highlight the protective roles played by positive social and personal resources, such as perceived social support, hope, and effective coping styles, against sleep problems. These insights have important implications for the development of targeted interventions to improve sleep outcomes during this challenging time.

Combat and operational stress programs and interventions: A scoping review using a tiered prevention framework.

Beginning in 1999, Department of Defense policy directed the military services to develop Combat and Operational Stress Control (COSC) programs to address prevention, early identification, and management of the negative effects of combat and operational stress. The aim of this study is to provide a narrative review of COSC programs and organize them into a prevention framework to clarify gaps and future directions. A systematic search was conducted to identify studies between 2001 and 2020 in peer-reviewed articles or government-sponsored reports describing an evaluation of COSC programs. The target population of these programs was US service members who had participated in an intervention designed to address combat or operational stress in a deployed, operational, or field setting. These programs then were rated for level of evidence and categorized using a tiered prevention model. This search identified 36 published evaluations of 19 COSC programs and interventions from. Most programs were described as effective in addressing target outcomes, with behavioral health outcomes reported for 13 of the 19 identified programs; the remaining six focused on knowledge base and behavior changes. Delivery of these prevention programs also ranged from peer-based implementation to formal treatment, including programs at all prevention levels. COSC interventions show promise for helping service members manage stress, with more than half of the programs showing evidence from studies using randomized designs. Future iterations of COSC program evaluations should explore the development of a joint curriculum using existing content in a tiered prevention framework.

The effect of peer mentoring program on clinical academic progress and psychological characteristics of operating room students: a parallel randomized controlled trial.

BACKGROUND: One of the new educational systems is the mentorship method. This study aimed to investigate the effect of peer mentoring program on clinical academic progress and psychological characteristics of operating room students. METHODS: This research was a randomized controlled trial that was conducted on undergraduate students in the operating room department of Khomein Faculty of Medical Sciences, Markazi Province in Iran. The number of operating room students were 70 that were divided into intervention and control groups by random allocation using Permuted Block Randomization. Inclusion criteria included all operating room students who were in internship, and exclusion criteria included failure to complete the questionnaires. The data collection tools were the demographic questionnaire, Depression Anxiety Stress Scale, Rosenberg Self-Esteem Scale and Situational Motivational Scale. In the control group, clinical training was done in the traditional way. In the intervention group, training was done by peer mentoring method. The obtained data were analyzed using descriptive statistics, independent t-test, paired t-test, chi-square test, ANCOVA, univariable and multivariable linear regression. RESULTS: The study revealed significant differences between the intervention and control groups. Post-intervention, the intervention group demonstrated substantial increases in self-confidence (mean difference = 5.97, p < 0.001) and significant reductions in stress levels (mean difference = -3.22, p < 0.001). Conversely, minimal changes were noted in the control group for both self-confidence (mean difference = 0.057, p = 0.934) and stress levels (mean difference = 0.142, p = 0.656). Although both groups experienced decreases in anxiety and depression levels, these changes were not statistically significant (p > 0.05). Furthermore, the intervention significantly enhanced academic progress in the intervention group compared to the control group (mean difference = 20.31, p < 0.001). CONCLUSION: The results showed that the implementation of the peer mentoring program was effective in improving academic progress, self-confidence, and reducing the stress of operating room students. Therefore, this educational method can be used in addition to the usual methods to improve the education of operating room students.

[Occupational stress and stress management among female and male trainees]. / Berufsbelastung und Stressbewältigung von weiblichen und männlichen Auszubildenden.

BACKGROUND: The transition from school to professional life is a significant event for adolescents and young adults. It is not uncommon for fears or feelings of being overwhelmed to arise during this transitional period. Against this backdrop, the article examines the subjective stress experiences of trainees, with special consideration given to gender and various occupational settings. METHODS: From seven Bavarian vocational schools, 1209 students were surveyed. Stress experiences, coping strategies, psychological and physical complaints, as well as occupational burdens were assessed. Relationships between demographic characteristics, professional settings, and stress experiences were investigated through bivariate and multivariate analyses. RESULTS: Female students report higher levels of stress and are more likely to use emotion-regulating stress coping strategies. Men more frequently attempt to compensate for stress through alcohol and drugs. Differences in stress burden between occupational groups are only evident in bivariate analysis. In multivariate analyses, the gender effect remains highly significant. Negative occupational demands and maladaptive coping strategies significantly promote the experience of stress. DISCUSSION: The results suggest that a significant proportion of respondents perceive the training conditions as burdensome, are exposed to health risks, and respond inadequately to stress. The establishment of additional prevention programs in both the training company and in vocational school would be desirable.

Effects of Two Group Prenatal Care Interventions on Mental Health: An RCT.

INTRODUCTION: Perinatal depression and anxiety cost the U.S. health system $102 million annually and result in adverse health outcomes. Research supports that cognitive behavioral therapy improves these conditions, but barriers to obtaining cognitive behavioral therapy have prevented its success in pregnant individuals. In this study, the impact of a cognitive behavioral therapy-based intervention on anxiety, depression, stress, healthy lifestyle beliefs, and behaviors in pregnant people was examined. STUDY DESIGN: This study used a 2-arm RCT design, embedded in group prenatal care, with one arm receiving a cognitive behavioral therapy-based Creating Opportunities for Personal Empowerment program and the other receiving health promotion content. SETTING/PARTICIPANTS: Black and Hispanic participants (n=299) receiving prenatal care from 2018 to 2022 in New York and Ohio who screened high on 1 of 3 mental health measures were eligible to participate. INTERVENTION: Participants were randomized into the manualized Creating Opportunities for Personal Empowerment cognitive behavioral therapy-based program, with cognitive behavioral skill-building activities delivered by advanced practice nurses in the obstetrical setting. MAIN OUTCOME MEASURES: Outcomes included anxiety, depression, and stress symptoms using valid and reliable tools (Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale, and Perceived Stress Scale). The Healthy Lifestyle Beliefs and Behaviors Scales examined beliefs about maintaining a healthy lifestyle and reported healthy behaviors. RESULTS: There were no statistically significant differences between groups in anxiety, depression, stress, healthy beliefs, and behaviors. There were significant improvements in all measures over time. There were statistically significant decreases in anxiety, depression, and stress from baseline to intervention end, whereas healthy beliefs and behaviors significantly increased. CONCLUSIONS: Both cognitive behavioral therapy and health promotion content embedded in group prenatal care with advanced practice nurse delivery improved mental health and healthy lifestyle beliefs and behaviors at a time when perinatal mood generally worsens. TRIAL REGISTRATION: This study is registered with clinicaltrials.gov NCT03416010.

Nature's therapeutic power: a study on the psychophysiological effects of touching ornamental grass in Chinese women.

The health of city residents is at risk due to the high rate of urbanization and the extensive use of electronics. In the context of urbanization, individuals have become increasingly disconnected from nature, resulting in elevated stress levels among adults. The goal of this study was to investigate the physical and psychological benefits of spending time in nature. The benefits of touching real grass and artificial turf (the control activity) outdoors with the palm of the hand for five minutes were measured. Blood pressure and electroencephalography (EEG) as well as State-trait Anxiety Inventory (STAI) scores, and the semantic differential scale (SDM) were used to investigate psychophysiological responses. Touching real grass was associated with significant changes in brainwave rhythms and a reduction in both systolic and diastolic blood pressure compared to touching artificial turf. In addition, SDM scores revealed that touching real grass increased relaxation, comfort, and a sense of naturalness while decreasing anxiety levels. Compared to the control group, the experimental group had higher mean scores in both meditation and attentiveness. Our findings indicate that contact with real grass may reduce physiological and psychological stress in adults.

Analyzing the stress management intervention impacting the mindfulness and well-being of employees.

BACKGROUND: Developing employee well-being as well as lowering stress may have several benefits for organizations. Stress management intervention techniques utilized via organizations help to develop worker mindfulness and well-being, and reduce stress. OBJECTIVE: To review stress management interventions to determine the effectiveness of diverse interventions in improving the mindfulness and well-being of employees working in an organization. METHODS: This work is split into two main sections: collection of data and analysis of data. First, data collection is carried out. The structured questionnaire was organized and distributed to managers and working employees of an organization. Based on the developed hypothesis, the questionnaire was arranged and all queries were compulsory. Subsequently, the collected data were performed by Structural Equation Modeling (SEM) and One Way Analysis of Variance (ANOVA) analysis. RESULTS: The Standard Mean Residual Root Square for the baseline model of mindfulness and well-being of employees working in an organization is 0.2156, which is better than threshold value. CONCLUSION: From the analysis, the goodness of fit and significant relation among the stress intervention techniques as well as mindfulness and well-being of employees in an organization has been found.

Boabom: A Feasible and Acceptable Approach to Helping College Students Manage Stress.

Objective: College students in the United States report high rates of psychological health concerns. Psychological and physical complementary health approaches have been found to be protective for college students. The aims of this study were to assess the feasibility and acceptability of Boabom, a martial art, with college students and to explore any changes in psychosocial outcomes. Participants: Twenty-six college students (25 females; mean age 21.73 years) participated in an 8-week Boabom intervention. Methods: Feasibility measures were attendance and retention of participants; acceptability was based on participants' cognitive and emotional responses to Boabom and was determined through analysis of focus group data. Psychosocial outcomes were assessed through analyses of pre- and postintervention measures of mindfulness, perceived stress, anxiety, depression, resilience, perceived health, and life satisfaction. Results: The Boabom intervention was feasible as 23 of 26 participants attended at least six of eight classes, and 22 participants attended the last class. Students found the intervention acceptable, with three themes emerging from the focus group data to describe the participants' experience with Boabom: (1) disengaging from constant, daily stress and breathing and moving as a group leads to sense of calm, (2) empowerment through incremental mastery of skills, and (3) recognition of the value of health benefits to be gained. Participants reported positive changes in mindfulness, perceived stress, anxiety, depression, resilience, perceived health, and life satisfaction from pre- to postintervention. Conclusions: Boabom may be a feasible and acceptable offering for college students; still, further piloting with other college student populations is recommended.

The Effects of Mindfulness Meditation on Nursing Students' Stress and Anxiety Levels.

AIM: The aim of this study was to evaluate the effects of a virtual mindfulness meditation intervention on stress and anxiety levels of 145 nursing students. BACKGROUND: Because of the twin demands of classroom and clinical workloads, nursing students experience greater amounts of stress and anxiety than the average college student. Mindfulness meditation is a promising method to alleviate stress and anxiety. METHOD: A pretest-posttest randomized controlled design was used. Participants received either weekly mindfulness meditation recordings or recordings on nursing information. Participants completed the Perceived Stress Scale and the Generalized Anxiety Disorder-7 Scale. RESULTS: A two-way mixed analysis of variance and follow-up simple main effects tests revealed that participants in the experimental group, who received meditation recordings, experienced significantly lower levels of stress and anxiety on posttest surveys than the control group. CONCLUSION: Mindfulness meditation can reduce stress and anxiety levels in nursing students. This can improve students' overall mental and physical well-being.

A brief intervention decreases student distress.

PURPOSE OF THE ARTICLE: Health professions graduate students have experienced substantial increases in stress and anxiety in recent years. This can result in decreased academic performance, poor retention, and burnout. Interventions to help students cope are therefore a critical need for academic institutions. The current study sought to demonstrate the effectiveness of a brief multimodal intervention in reducing student distress. METHOD: The study was a randomised controlled design that evaluated a brief intervention of cognitive-behavioural therapy, mindfulness, and healthy lifestyle choices. The Depression Anxiety Stress Scale-21 was administered to participants at baseline and two post-intervention time points. Control participants did not participate in any intervention. Participants were recruited from graduate students in first-year classes within the School of Health Professions at UT Southwestern Medical Center. RESULTS: Analysis revealed an overall mild to moderate decline in Depression Anxiety Stress Scale-21 total scores over three assessment periods for both treatment and control groups, with no statistical differences noted between groups; however, the treatment group's scores declined approximately 6 weeks before the control participants' scores declined. CONCLUSION: The pattern of change in the two groups suggests that our intervention facilitated the reduction in student anxiety more quickly than would have occurred normally and with sustained results.

Cognitive-behavioral stress management program reduces postoperative psychological pressure and improves life quality in prostate cancer patients.

OBJECTIVE: Cognitive-behavioral stress management (CBSM) improves mental status and quality of life (QoL) in cancer patients, while its impact on prostate cancer (PC) patients remains unknown. Thus, the study aimed at investigating the potency of CBSM program in ameliorating postoperative anxiety, depression, and QoL in PC patients. METHODS: Totally, 160 postoperative PC patients were consecutively recruited followed by random assignments to either CBSM (N = 81) or usual care (UC) (N = 79) group as a 1:1 ratio. The patients received the corresponding interventions for 10 weeks then were followed up for 6 months. RESULTS: CBSM group presented lower Hospital Anxiety and Depression Scale (HADS)-anxiety score and anxiety rate at month (M) 4 and M6 versus UC group (all P < 0.05), but not at M0, M1, and M2. Meanwhile, CBSM group exhibited a lower HADS-depression score versus UC group at M6 (P = 0.036) but no other timepoints; however, CBSM group showed no difference in depression rate versus UC group at any timepoints. Regarding the Quality-of-Life Questionnaire-Core30 (QLQ-C30) evaluation, CBSM group exhibited higher global health status scores at M1 (P = 0.010), M2 (P = 0.001), M4 (P = 0.029), and M6 (P = 0.015), higher functions score at M4 (P = 0.040) and M6 (P = 0.044), but a lower symptom score at M4 (P = 0.034) versus UC group; meanwhile, the above QoL indexes were not different at other timepoints between CBSM and UC groups. CONCLUSION: CBSM serves as an effective caring program in relieving anxiety and depression as well as improving the QoL in postoperative PC patients.

Randomized Controlled Trial on the Effect of the Neonatal Nurse Navigator Program on Maternal Stress and Neonatal Cortisol Levels.

OBJECTIVE: To assess the effect of the Neonatal Nurse Navigator Program (NNNP) compared to usual care on maternal stress and neonatal salivary cortisol level (SCL) in the NICU. DESIGN: Randomized control trial. SETTING: NICU in a tertiary health care hospital in Manipal, Udupi District, Karnataka, India. PARTICIPANTS: Neonates between 34 and 36 weeks gestation and their mothers (N = 120 dyads). METHODS: We used block randomization to assign dyads to the intervention or control group. We measured maternal stress using the Parental Stress Scale: Neonatal Intensive Care Unit, and we estimated neonatal stress by measuring SCLs within 24 hours of NICU admission and before discharge from the unit. We conducted a descriptive analysis on participant characteristics and reported maternal stress levels using means and standard deviations. We used the analysis of covariance change score test to determine the difference in maternal and neonatal stress levels between the intervention and control groups. RESULTS: The NNNP group exhibited significantly lower maternal stress scores before discharge than the control group, and we observed reductions across all three subscales of the Parental Stress Scale: Neonatal Intensive Care Unit. Mean neonatal salivary cortisol levels were significantly lower in the interventional group than in the control group, F(1.117) = 24.03, 95% confidence interval [7.9, 18.6], p < .001. CONCLUSION: Use of the NNNP reduced maternal stress SCLs in high-risk neonates by actively engaging mothers in the care of their neonates in the NICU. We recommend adoption of the NNNP model as a standard care policy in NICUs throughout India.