Worldwide stress: different problems, similar solutions? Cultural adaptation and evaluation of a standardized stress management program in Hungary.

ABSTRACT

BACKGROUND: Chronic stress is an important risk factor for morbidity and premature mortality at the individual and societal level. PURPOSE: Our aim was to describe the process of adapting and testing the effectiveness of a structured stress management skills training program in a culture different from the one in which it was first developed. METHOD: We translated an internationally used standardized behavioral intervention program into Hungarian and adapted it for use in a Hungarian cultural setting. We evaluated the changes in stress level and stress-related symptom scores among distressed voluntary participants on the basis of self-reported questionnaires completed before, immediately after, and 4 to 6 months after the 12-h intervention. The following measures were included PSS-10, STAI-T, BDI-S, PHQ-15, and WBI-5. For statistical analyses, paired sample t test and Cohen's d value for effect size were used. RESULTS: In a sample of 107 distressed individuals, after the training, stress level, psychological and somatic symptoms decreased and well-being increased (p < 0.0001). These positive changes were maintained at follow-up in a subsample of 42 persons tested 4-6 months later. CONCLUSION: These results confirm the long-term positive effects of this standardized behavioral intervention in a different cultural context and in real-world settings, which encourages further dissemination of the program in various community settings.