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OBJECTIVES: This study assessed yoga as an adjuvant strategy for symptoms of combat-related posttraumatic stress disorder (PTSD). METHODS: Subjects had significant, combat-related PTSD. Control data were collected during an eight-week waiting period. Trauma-sensitive yoga sessions of 90 minutes duration were provided every seven days for eight weeks. Assessments included the PTSD checklist (PCL); the Depression, Anxiety and Stress Scale (DASS); the Pittsburgh Sleep Quality Index (PSQI); the Adult/Adolescent Sensory Profile (AASP); the SF36 Quality of Life instrument; and a brief, structured pre-enrolment assessment of attitudes towards yoga. Biomarkers were also assessed. RESULTS: Thirty participants were recruited, with 28 completing the protocol ( Mage=63.5 years). For most variables, there was no significant change in results after the waiting period. Comparing measurements obtained immediately prior to the commencement of the intervention to those taken after completion of eight yoga sessions, significant changes included an increase in the serum dehydroepiandrosterone concentration, decreased total PCL score (and all PCL sub-scales), decreases in all DASS sub-scale scores and significant improvements in PSQI and SF36 scores. No adverse events were reported. CONCLUSIONS: A range of benefits were observed after yoga, consistent with the theoretical construct for the long history of yoga as a strategy to reduce stress and promote well-being.
OBJECTIVES: This study assessed yoga as an adjuvant strategy for symptoms of combat-related posttraumatic stress disorder (PTSD). METHODS: Subjects had significant, combat-related PTSD. Control data were collected during an eight-week waiting period. Trauma-sensitive yoga sessions of 90 minutes duration were provided every seven days for eight weeks. Assessments included the PTSD checklist (PCL); the Depression, Anxiety and Stress Scale (DASS); the Pittsburgh Sleep Quality Index (PSQI); the Adult/Adolescent Sensory Profile (AASP); the SF36 Quality of Life instrument; and a brief, structured pre-enrolment assessment of attitudes towards yoga. Biomarkers were also assessed. RESULTS: Thirty participants were recruited, with 28 completing the protocol ( Mage=63.5 years). For most variables, there was no significant change in results after the waiting period. Comparing measurements obtained immediately prior to the commencement of the intervention to those taken after completion of eight yoga sessions, significant changes included an increase in the serum dehydroepiandrosterone concentration, decreased total PCL score (and all PCL sub-scales), decreases in all DASS sub-scale scores and significant improvements in PSQI and SF36 scores. No adverse events were reported. CONCLUSIONS: A range of benefits were observed after yoga, consistent with the theoretical construct for the long history of yoga as a strategy to reduce stress and promote well-being.
BackgroundKnowledge of coping mechanisms is important for nursing and midwifery students to cope with stressful events during undergraduate education.
Objectives
To evaluate the impact of a psycho-educational intervention “Coping with Stressful Events” with first year undergraduate nursing and midwifery students.
Design
A quasi-experimental, one-group pre-post-test.
Settings
One school of nursing/midwifery in one university in Ireland.
Participants
A convenience sample of all first year undergraduate nursing and midwifery students (n=197). Of these 166 completed the pretest and 138 students completed the post test.
Methods
Using the COPE Inventory questionnaire (Carver et al., 1989) data was collected pre and post-delivery of the psycho-educational intervention “Coping with Stressful Events” by two research assistants. Data were analysed using the IBM SPSS Statistics version 22 (NY, USA).
Results
Results demonstrated improved coping skills by students. There were statistically significant differences between pre and post intervention for some coping subscales. For example, the mean subscale scores were lower post-intervention for restraint and mental disengagement, and higher for use of emotional and instrumental social support indicating improved coping strategies.
Conclusions
This intervention has the potential to influence undergraduate nursing and midwifery students coping skills during their first year of an undergraduate programme.
Nicholls’ achievement goal theory suggests that a task-oriented individual sets goals based on a desire to master particular skills or tasks (Nicholls, 1984, 1989), thus promoting intrinsic motivation (Duda, Chi, Newton, & Walling, 1995). An ego-oriented individual evaluates one’s own performance against the performance of others with comparable skill sets, basing success on outperforming the opponent (Nicholls, 1984, 1989), resulting in low intrinsic motivation. Cognitive evaluation theory, embraced within self-determination theory (Deci & Ryan, 1985, 1991), suggests that an event that satisfies an inherent need for competence and autonomy leads to increased intrinsic motivation (Standage, Duda, & Pensgaard, 2005). Similarly, Brown and Ryan (2003) found that trait-mindfulness predicted more autonomous activity in day-to-day life and lower intensity and frequency of negative affect. It was therefore hypothesized that in a population of collegiate athletes, a relationship between mindfulness and goal orientation would exist; athletes higher in task-orientation would be more mindful than athletes higher in ego-orientation. Results indicate that a relationship does in fact exist between the Acting with Awareness subscale of the Kentucky Inventory of Mindfulness Skills (KIMS; Baer, Smith, & Allen, 2004) and task-orientation, in that as level of awareness increases, the level of task-orientation also increases. Level of awareness also predicted level of task orientation in athletes. Implications for practice and future research are discussed.
BackgroundGroup Mindfulness Therapy (GMT) is a program tailored for adolescents that targets anxiety with mindfulness skills including present moment awareness, mindfulness in everyday life (breathing, eating, walking), body scan, loving‐kindness, and self‐acceptance. Youth with anxiety may benefit from mindfulness exercises precisely because they learn to redirect their mind, and presumably their attention, away from wandering in the direction of worry and negative self‐appraisals and toward greater acceptance of internal states. This open trial assessed the feasibility and initial effectiveness of GMT in a school setting.
Method
Twelve 6th and 7th grade adolescents with elevated anxiety [Screen for Child Anxiety Disorders (SCARED) ≥ 30] participated in GMT after school. Youth completed measures of anxiety and perceived stress and their parents completed measures of internalizing and externalizing behavior problems at pretreatment and posttreatment. We hypothesized that GMT would significantly reduce youth anxiety and stress.
Results
Significant improvements were observed in anxiety, internalizing, stress, and attention, with effect sizes ranging from .88 to 1.34.
Conclusions
We demonstrate that GMT is feasible and acceptable to adolescents presenting with anxiety as a primary concern. We provide further support for the use of a mindfulness‐based intervention for anxiety reduction. The group format suggests a cost‐effective way to deliver services in a school setting.
Although exercise is often recommended for managing osteoarthritis (OA), limited evidence-based exercise options are available for older adults with OA. This study compared the effects of Hatha yoga (HY) and aerobic/strengthening exercises (ASE) on knee OA. Randomized controlled trial with three arms design was used: HY, ASE, and education control. Both HY and ASE groups involved 8 weekly 45-min group classes with 2-4 days/week home practice sessions. Control group received OA education brochures and weekly phone calls from study staff. Standardized instruments were used to measure OA symptoms, physical function, mood, spiritual health, fear of falling, and quality of life at baseline, 4 and 8 weeks. HY/ASE adherences were assessed weekly using class attendance records and home practice video recordings. Primary analysis of the difference in the change from baseline was based on intent-to-treat and adjusted for baseline values. Eight-three adults with symptomatic knee OA completed the study (84% female; mean age 71.6 +/- 8.0 years; mean BMI 29.0 +/- 7.0 kg/m(2)). Retention rate was 82%. Compared to the ASE group at 8 weeks, participants in the HY group had a significant improvement from baseline in perception of OA symptoms (-9.6 [95% CI -15.3, -4]; p = .001), anxiety (-1.4 [95% CI -2.7, -0]; p = .04), and fear of falling (-4.6 [-7.5, -1.7]; p = .002). There were no differences in class/home practice adherence between HY and ASE. Three non-serious adverse events were reported from the ASE group. Both HY and ASE improved symptoms and function but HY may have superior benefits for older adults with knee OA. Trial registration The full trial protocol is available at clinicaltrials.gov (NCT02525341).
Although exercise is often recommended for managing osteoarthritis (OA), limited evidence-based exercise options are available for older adults with OA. This study compared the effects of Hatha yoga (HY) and aerobic/strengthening exercises (ASE) on knee OA. Randomized controlled trial with three arms design was used: HY, ASE, and education control. Both HY and ASE groups involved 8 weekly 45-min group classes with 2-4 days/week home practice sessions. Control group received OA education brochures and weekly phone calls from study staff. Standardized instruments were used to measure OA symptoms, physical function, mood, spiritual health, fear of falling, and quality of life at baseline, 4 and 8 weeks. HY/ASE adherences were assessed weekly using class attendance records and home practice video recordings. Primary analysis of the difference in the change from baseline was based on intent-to-treat and adjusted for baseline values. Eight-three adults with symptomatic knee OA completed the study (84% female; mean age 71.6 +/- 8.0 years; mean BMI 29.0 +/- 7.0 kg/m(2)). Retention rate was 82%. Compared to the ASE group at 8 weeks, participants in the HY group had a significant improvement from baseline in perception of OA symptoms (-9.6 [95% CI -15.3, -4]; p = .001), anxiety (-1.4 [95% CI -2.7, -0]; p = .04), and fear of falling (-4.6 [-7.5, -1.7]; p = .002). There were no differences in class/home practice adherence between HY and ASE. Three non-serious adverse events were reported from the ASE group. Both HY and ASE improved symptoms and function but HY may have superior benefits for older adults with knee OA. Trial registration The full trial protocol is available at clinicaltrials.gov (NCT02525341).
Although exercise is often recommended for managing osteoarthritis (OA), limited evidence-based exercise options are available for older adults with OA. This study compared the effects of Hatha yoga (HY) and aerobic/strengthening exercises (ASE) on knee OA. Randomized controlled trial with three arms design was used: HY, ASE, and education control. Both HY and ASE groups involved 8 weekly 45-min group classes with 2-4 days/week home practice sessions. Control group received OA education brochures and weekly phone calls from study staff. Standardized instruments were used to measure OA symptoms, physical function, mood, spiritual health, fear of falling, and quality of life at baseline, 4 and 8 weeks. HY/ASE adherences were assessed weekly using class attendance records and home practice video recordings. Primary analysis of the difference in the change from baseline was based on intent-to-treat and adjusted for baseline values. Eight-three adults with symptomatic knee OA completed the study (84% female; mean age 71.6 +/- 8.0 years; mean BMI 29.0 +/- 7.0 kg/m(2)). Retention rate was 82%. Compared to the ASE group at 8 weeks, participants in the HY group had a significant improvement from baseline in perception of OA symptoms (-9.6 [95% CI -15.3, -4]; p = .001), anxiety (-1.4 [95% CI -2.7, -0]; p = .04), and fear of falling (-4.6 [-7.5, -1.7]; p = .002). There were no differences in class/home practice adherence between HY and ASE. Three non-serious adverse events were reported from the ASE group. Both HY and ASE improved symptoms and function but HY may have superior benefits for older adults with knee OA. Trial registration The full trial protocol is available at clinicaltrials.gov (NCT02525341).
ObjectivesThe aim of this review is to examine the literature related to the sources of stress, coping mechanisms and interventions to support undergraduate nursing and midwifery students to cope with stress during their undergraduate education.
Design
Integrative literature review.
Data Sources
The databases CINAHL, PubMed and PsycINFO were searched for articles published between 2010 and 2016. Search terms in various combinations were used for example; student nurse, student midwife, undergraduate, stress, coping and interventions.
Review Methods
An integrative review based on Whittemore and Knafl's approach was used to conduct the review.
Results
The search generated 25 articles that met the inclusion criteria. The key sources of stress emanated from clinical, academic and financial issues but predominantly from the clinical environment. Students used a variety of coping strategies, both adaptive and maladaptive. These appear to be influenced by their past and present circumstances such as, their needs, what was at stake and their options for coping. Interventions for student nurses/midwives to cope with stress were varied and in the early stages of development. Mindfulness showed some promising positive results. Interventions focussed on the individual level excluding the wider social context or organisation level.
Conclusions
Stress is pervasive in all aspects of undergraduate nursing and midwifery education. Nursing and midwifery educators need to be aware of this impact and provide appropriate support to students in both the clinical and academic environments. Further research is needed to capture the experience of stress from the students' perspective as well as the barriers and facilitators to supporting students from the preceptors'/mentors' perspectives. Finally, more intervention studies are needed to identify and compare what interventions are effective in supporting students to cope with stress during their undergraduate education.
This exploratory study evaluated a short-term (6–8 weeks) psychoeducation and support group for teachers focused on stress prevention and mindfulness (labeled SPAM group). A total of 4 groups were implemented in different schools, and evaluation was conducted with quantitative (pre- and post-measures of teacher vulnerability to stress, job satisfaction, and mindfulness) and qualitative (post-intervention interviews) elements using a quasi-experimental mixed methods design. Members reported higher mindfulness scores than participants in the comparison condition, which consisted of teachers in the same school who did not complete the group, and qualitative analyses were supportive of teachers’ satisfaction.
This exploratory study evaluated a short-term (6–8 weeks) psychoeducation and support group for teachers focused on stress prevention and mindfulness (labeled SPAM group). A total of 4 groups were implemented in different schools, and evaluation was conducted with quantitative (pre- and post-measures of teacher vulnerability to stress, job satisfaction, and mindfulness) and qualitative (post-intervention interviews) elements using a quasi-experimental mixed methods design. Members reported higher mindfulness scores than participants in the comparison condition, which consisted of teachers in the same school who did not complete the group, and qualitative analyses were supportive of teachers’ satisfaction.
This exploratory study evaluated a short-term (6–8 weeks) psychoeducation and support group for teachers focused on stress prevention and mindfulness (labeled SPAM group). A total of 4 groups were implemented in different schools, and evaluation was conducted with quantitative (pre- and post-measures of teacher vulnerability to stress, job satisfaction, and mindfulness) and qualitative (post-intervention interviews) elements using a quasi-experimental mixed methods design. Members reported higher mindfulness scores than participants in the comparison condition, which consisted of teachers in the same school who did not complete the group, and qualitative analyses were supportive of teachers’ satisfaction.
Working memory (WM) comprises operations whose coordinated action contributes to our ability to maintain focus on goal-relevant information in the presence of distraction. The present study investigated the nature of distraction upon the neural correlates of WM maintenance operations by presenting task-irrelevant distracters during the interval between the memoranda and probes of a delayed-response WM task. The study used a region of interest (ROIs) approach to investigate the role of anterior (e.g., lateral and medial prefrontal cortex--PFC) and posterior (e.g., parietal and fusiform cortices) brain regions that have been previously associated with WM operations. Behavioral results showed that distracters that were confusable with the memorandum impaired WM performance, compared to either the presence of non-confusable distracters or to the absence of distracters. These different levels of distraction led to differences in the regional patterns of delay interval activity measured with event-related functional magnetic resonance imaging (fMRI). In the anterior ROIs, dorsolateral PFC activation was associated with WM encoding and maintenance, and in maintaining a preparatory state, and ventrolateral PFC activation was associated with the inhibition of distraction. In the posterior ROIs, activation of the posterior parietal and fusiform cortices was associated with WM and perceptual processing, respectively. These findings provide novel evidence concerning the neural systems mediating the cognitive and behavioral responses during distraction, and places frontal cortex at the top of the hierarchy of the neural systems responsible for cognitive control.
International research examining teacher stress and contextual factors, such as culture, government policies, professional autonomy, and school level factors, are reviewed in this chapter, as well as their impact on teachers’ occupational health. Research reviewed identifies important contextual and cultural factors impacting teacher stress and the occupational health factors of job satisfaction and workforce instability. While research examining teacher stress in different countries nation is robust, there is a dearth of research examining the role of culture within or between national borders. Further, while models of stress and occupational health are prevalent in existing research, theoretical models explaining the role of culture and other contextual factors in teacher stress are needed.
International research examining teacher stress and contextual factors, such as culture, government policies, professional autonomy, and school level factors, are reviewed in this chapter, as well as their impact on teachers’ occupational health. Research reviewed identifies important contextual and cultural factors impacting teacher stress and the occupational health factors of job satisfaction and workforce instability. While research examining teacher stress in different countries nation is robust, there is a dearth of research examining the role of culture within or between national borders. Further, while models of stress and occupational health are prevalent in existing research, theoretical models explaining the role of culture and other contextual factors in teacher stress are needed.
Undergraduate nursing students experience significant stress and anxiety, inhibiting learning and increasing attrition. Twenty-six intervention studies were identified and evaluated, updating a previous systematic review which categorized interventions targeting: (1) stressors, (2) coping, or (3) appraisal. The majority of interventions in this review aimed to reduce numbers or intensity of stressors through curriculum development (12) or to improve students' coping skills (8). Two studies reported interventions using only cognitive reappraisal while three interventions combined reappraisal with other approaches. Strength of evidence was limited by choice of study design, sample size, and lack of methodological rigor. Some statistically significant support was found for interventions focused on reducing stressors through curriculum development or improving students' coping skills. No statistically significant studies using reappraisal, either alone or in combination with other approaches, were identified, although qualitative findings suggested the potential benefits of this approach do merit further study. Progress was noted since 2008 in the increased number of studies and greater use of validated outcome measures but the review concluded further methodologically sound, adequately powered studies, especially randomized controlled trials, are needed to determine which interventions are effective to address the issue of excessive stress and anxiety among undergraduate nursing students.
A stress prevention and mindfulness (SPAM) group is described, which is a 6-week psychoeducational and support group for teachers. The group incorporated psychoeducation about stress and utilized elements of Mindfulness-Based Stress Reduction (MBSR). The group was implemented in a public charter school in the Southwest. Preliminary evaluation conducted with two elements (session ratings and pre- and post-measures of mindfulness, teacher perceptions of demands and resources in their classroom, and job satisfaction) was supportive of teachers' satisfaction with the group. Implications and future research directions are discussed.