Yoga for Stress Management Among Intensive Care Unit Staff: A Pilot Study

Well-being interventions for rural health professionals: A scoping review

INTRODUCTION

The objective of this scoping review is to identify interventions to promote well-being that have been tried or proven effective to prevent or address burnout in rural health care professionals and trainees (HCPTs). Secondarily, we aimed to identify potentially applicable and feasible well-being interventions that could help rural HCPTs.

METHODS AND ANALYSIS

We used PRISMA guidelines to conduct a scoping review of peer-reviewed English language studies, from all countries, published in core health sciences databases. We focused on intervention studies for burnout and well-being in rural HCPTs published from July 2013 to January 2024. Searches identified 571 studies; 18 additional studies were identified from hand searches of websites, reviews, and bibliographies identified in the original search strategy. Two authors screened and extracted all data using Covidence.

FINDINGS

After deduplication, 507 studies were screened for inclusion, and 50 full-text studies were assessed for eligibility. After discussion and consensus, 30 studies were selected for inclusion. We included selected "applicable" studies, for example, online interventions. We excluded potentially applicable studies that would not be feasible in rural settings, that is, health system interventions requiring substantial personnel and infrastructure. Interventions included individual interventions (eg, mindfulness), increased support for professionals (eg, remote pharmacist assistance), and interventions to improve quality or teamwork.

CONCLUSIONS

Few interventional studies have been done to support well-being and prevent burnout in vulnerable rural HCPTs. While individual interventions, such as mindfulness, are most effective to date, studies replicating or extending these interventions, and to identify supports that address workload and systems issues are needed.

The Impact of COVID-19: Nurses Occupational Stress and Strategies to Manage It

OBJECTIVE

The aim of this study was to explore the occupational stress perception of nurses and how they manage it during the COVID-19 pandemic.

BACKGROUND

The management of occupational stress is a key factor in promoting nurses' well-being.

METHODS

A descriptive cross-sectional study was conducted.

RESULTS

The top occupational stressors from the nurses' perspectives (N = 236) as measured by using an updated version of the Nursing Stress Scale (NSS) included wearing a face mask at all times in the hospital, unpredictable staffing and scheduling, not enough staff to adequately cover the unit, feeling helpless in the case a patient fails to improve, and being assigned to a COVID-19 patient. The mean stress score was 31.87. The updated NSS Cronbach's α was 0.92, and the interclass interclass correlation coefficient was 0.914.

CONCLUSION

Nurse administrators are in a strategic position to develop interventions (eg, open door policy, meetings, and employee assistance programs) to assist nurses in effectively managing stress.

Physical relaxation for occupational stress in healthcare workers: A systematic review and network meta-analysis of randomized controlled trials

OBJECTIVES

Work related stress is a major occupational health problem that is associated with adverse effects on physical and mental health. Healthcare workers are particularly vulnerable in the era of COVID-19. Physical methods of stress relief such as yoga and massage therapy may reduce occupational stress. The objective of this systematic review and network meta-analysis is to determine the effects of yoga, massage therapy, progressive muscle relaxation, and stretching on alleviating stress and improving physical and mental health in healthcare workers.

METHODS

Databases were searched for randomized controlled trials on the use of physical relaxation methods for occupational stress in healthcare workers with any duration of follow-up. Meta-analysis was performed for standard mean differences in stress measures from baseline between subjects undergoing relaxation vs non-intervention controls. Network meta-analysis was conducted to determine the best relaxation method.

RESULTS

Fifteen trials representing 688 healthcare workers were identified. Random-effects meta-analysis shows that physical relaxation methods overall reduced measures of occupational stress at the longest duration of follow-up vs baseline compared to non-intervention controls (SMD -0.53; 95% CI [-0.74 to -0.33]; p < .00001). On network meta-analysis, only yoga alone (SMD -0.71; 95% CI [-1.01 to -0.41]) and massage therapy alone (SMD -0.43; 95% CI [-0.72 to -0.14]) were more effective than control, with yoga identified as the best method (p-score = .89).

CONCLUSION

Physical relaxation may help reduce occupational stress in healthcare workers. Yoga is particularly effective and offers the convenience of online delivery. Employers should consider implementing these methods into workplace wellness programs.

Stress management interventions for intensive and critical care nurses: A systematic review

BACKGROUND

The level of occupational stress of nurses working in intensive and critical care units is high. Although many studies have assessed the effectiveness of stress management interventions among intensive and critical care nurses, the methodological quality of these studies remains unclear.

PURPOSE

The purpose of this review was to summarize and appraise the methodological quality of primary studies on interventions for management of occupational stress among intensive and critical care nurses.

METHODS

This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted to identify primary studies that assessed the effectiveness of interventions in managing occupational stress among intensive and critical care nurses using multiple databases from January 2009 to June 2019.

RESULTS

Twelve studies published between 2011 and 2019 were eligible for inclusion. These included studies were classified as being of good or fair quality. The consensus across the included studies was that, compared with control condition, cognitive-behavioural skills training and mindfulness-based intervention were more effective in reducing occupational stress among intensive and critical care unit nurses.

CONCLUSION

Further research should focus on methodologically strong studies by blinding the outcome assessors, using Randomized Controlled Trial (RCT) design with an active control group, using standardized assessment tools, and reporting enough details about the stress management intervention-related adverse events.

RELEVANCE TO CLINICAL PRACTICE

This review demonstrates the need for high methodological quality studies to rigorously evaluate the effectiveness of stress management interventions before it can be recommended for use in clinical practice to reduce stress in intensive and critical care unit nurses. In addition, attention should be given to developing research protocols that place more emphasis on interventions aimed at the organization level to address the growing problem of occupational stress among intensive and critical care nurses.

Evaluation of a Web-Based Holistic Stress Reduction Pilot Program Among Nurse-Midwives

Purpose: Work-related stress among midwives results in secondary traumatic stress, posttraumatic stress disorder, and job attrition. The purpose of this pilot project was to evaluate the effectiveness of a holistic, web-based program using holistic modalities for stress reduction and improved coping among certified nurse-midwives. Design and Method: A convenience sample of 10 midwives participated in a web-based holistic stress reduction intervention using yoga, mindfulness-based stress reduction, and meditation for four days each week over 4 weeks. Participants completed pre- and postintervention questionnaires (Perceived Stress Scale [PSS] and the Coping Self-Efficacy Scale [CSES]) for evaluation of effectiveness. Findings: The PSS means showed improvement in midwives’ stress (16.4-12.3). The CSES means showed improvement in coping (174.8-214.5). Improvement was shown in each subscale of the CSES (“uses problem-focused coping”: 19.2%; “stops unpleasant thoughts and emotions”: 20.3%; and “gets support from family and friends”: 16.6%). Conclusion: Findings suggest the potential for stress reduction and improved coping skills after using holistic techniques in a web-based format within a cohort of nurse-midwives. Further research of web-based, holistic intervention for stress reduction among midwives is warranted.