Stress Management Group Research Articles

Exploring gender as a sociocultural construct among cancer caregivers enrolling in a dyadic resiliency trial.

186 Background: Caregiving relations are essential for navigating cancer care among cancer curvivors (i.e., completed curative-intent treatment) and metavivors (i.e., living with incurable illness). Caregiving is associated with poor health outcomes, but little work explicates gender differences in specific sociocultural constructs that drive caregivers’ health outcomes. This study explores gender differences in caregiving relationship type (e.g., partner, friend) and psychosocial variables theorized to be impacted by caregiving stress, such as preventative health behaviors, self-compassion, depression/anxiety, informational/emotional social support and perceived caregiving relationship quality among caregivers of cancer curvivors and metavivors. Methods: 47 survivor-caregiver dyads (64% metavivors) enrolled in a pilot clinical trial of simultaneous remotely-delivered dyadic stress management groups at a tertiary care academic center. Eligible caregivers were those supporting survivors who had completed initial treatment for cancer with curative intent 3 months- 5 years ago OR were diagnosed with metastatic illness at least 3 months before enrollment. Data were collected via brief self-report baseline surveys measuring depression (PHQ-2), anxiety (GAD-2), self-compassion (SCS-12), informational/emotional support (PROMIS short forms-4a), including assessments of sex-specific cancer screening behavior (i.e., recommended breast, cervical, prostate, and colorectal screening) and relationship quality created for this study. Bivariate statistics compared caregivers based on self-reported gender identity (two-tailed p < .05) with Cohen’s D used to characterize strength of between-group differences (0.2 = small, 0.5 = medium, 0.8 = large). Results: Most caregivers ( M age = 56.9) were White (87%) women (64%) caring for men (53%). Women (79% partners, 17% family, 4% friends) and men (64% partners, 36% family) caregivers did not significantly differ in caregiving relationship type ( p = .33). Most caregivers were up-to-date with sex-specific screening recommendations for breast (83%), cervical (80%), and prostate (85%) cancer, though women vs. men were significantly less adherent to colon cancer screening (60% vs. 100%, p = .003). Significant gender differences emerged in (anxiety D = -0.69, p =.03) but not depression (D = -0.47, p = .14 or self-compassion (D = .58, p = .07), such that women experienced great distress. Finally, women reported not significantly greater informational/emotional support (Ds = -0.30 and -0.25, p s > .40) and relationship quality (D = -0.63, p = .05). Conclusions: When comparing the experiences of women and men currently in caregiving roles, gendered traits such as anxious emotional expression, as well as gender norms around self-focused preventative health behaviors may place women at increased risk for poor health outcomes. Clinical trial information: NCT05702723 .

Assessment of stress level and depression among orthopaedic surgeons in Saudi Arabia

PurposeThe aim of this study was to assess the stress level and depression among orthopaedic surgeons in Saudi Arabia. In addition, to evaluate orthopedic training programs related factors that might have a critical role in the development of depression among orthopaedic surgeons.MethodsThe study adopted a cross-sectional study design. Two validated questionnaires were utilized, the Patient Health Questionnaire 9 (PHQ-9) and the Perceived Stress Scale (PSS-10) for assessing depressive symptoms and stress levels. Data was collected by sending the survey to the Saudi Commission for Health Specialties so they could be distributed throughout all registered orthopaedic surgeons.ResultsThe study sample consisted of 325 participants. The results revealed that the severity of depression varied across the different groups. As per the PHQ-9 criteria, 74 (22.8%) were initially diagnosed with major depression. Among assistant consultants, 39.5% reported severe depression, while 34.9% reported mild depression. Consultants predominantly reported moderate perceived stress (82.9%) with a notable proportion experiencing high perceived stress (12.4%). Assistant consultants showed a balanced distribution, with 93.0% reporting moderate perceived stress and 4.7% reporting high perceived stress. Demographic variables gender, relationship status and having children revealed statistically significant relationship with PHQ-9 scores (p-value < 0.05) but not with PSS-10 scores.ConclusionThe study highlights pressing need to address mental health concerns within orthopaedic surgeons. To address these challenges, healthcare institutions should implement comprehensive mental health support programs offering resources for stress management, counseling services, and peer support groups.

SPECIAL ISSUE: Differentiating Successful from Less Successful Males and Females in a Group Relaxation/Biofeedback Stress Management Program

Managing stress in the post-COVID world requires a program that can efficaciously and cost-effectively address a large number of people who have differing experiences and needs and can also be adapted for internet presentation. The purpose of this paper is to share observations, collected over more than forty years, of group stress management training in university and community settings. The specific data reported are from a subgroup that is representative of the other groups. An in-person group stress-management program of 141 adults in community clinics with approximately 15 to 20 per group attended 10 training sessions across 5 weeks with pre-post personality measures. The group also documented 5 weeks of home practice, symptoms, and medication use. The average group improvement in well-being was 80%, following training in breathing, progressive muscle relaxation, autogenic training, visualization, quieting response, and alphagenics, with individual temperature biofeedback having been provided during the last 5 classes. A pre- to post-two-way analysis of variance (ANOVA) revealed that the Spielberger State-Trait Anxiety Inventory (STAI) trait anxiety and Eysenck Personality Inventory (EPI) neuroticism significantly decreased. EPI extraversion increased only in females. Males and females equally preferred autogenic training (55%). The most successful males and females were older, practiced more, reported greater increases in self-confidence, and attributed more of their success to the group and/or instructor. The success of a program may also be associated with excellent home practice compliance, being a part of a group, and increases in self-confidence/efficacy.

Важливі навички в період стресу. досвід проведення навчання груповому курсу управління стресом для дорослих самодопомога+ (self-help+)

Relevance. The full-scale war on the territory of Ukraine resulted in severe and long-lasting distress among its population. The distress caused by the hostilities may cause a psychological trauma among Ukrainians. [1] According to experts of the World Health Organization, one of the consequences of the military actions taking place in Ukraine is the emergence of mental health problems. [2] This may affect a quarter of the country's population, namely, according to Yarno Gabiht, a representative of the above mentioned organization, the number will approach 10 million. Moreover, mental disorders can be displayed in different ways: starting from manifestations of anxiety and ending with more severe conditions. [2] Talking about "more severe conditions", the concept of post-traumatic stress disorder is meant. The above-mentioned representative of the WHO also pointed to the fact that the number of those applying for the help concerning the described problem after the end of the 10-month period from the beginning of the invasion of Russian troops has increased. [2] WHO experts have developed a number of short-term scalable psychological interventions, one of which is a group stress management course for adults, Self-Help Plus (SH+). SH+ consists of pre-recorded audios and an illustrated “Essential Stress Skills” manual that could be used by participants for individual skill development. [3; 4] This group stress management course for adults offers a range of psychological exercises aimed at mastering stress management skills. The exercises, presented in the form of illustrations and short comments, show equal effectiveness both in conditions of active hostilities and in peaceful communities, among persons who have been diagnosed with or not diagnosed with a mental disorder. Working according to the instructions of the manual, the facilitator (assistant) together with the co-facilitator teach stress management skills to people who have been affected by adverse circumstances. [3; 4] It should be noted that Self-Help Plus is not psychotherapy or psychological counseling, or a substitute for more specialized services. This guideline is evidence-based, requires fewer resources to implement, is short-term and reduces time to provide help, and provides skills that can be useful when access to psychosocial service providers is absent or limited, and those are the essential advantages of this course. Also, one of the key tasks of short-term interventions is the redistribution of the burden between informal organizations, medical workers and experts in the field of mental health. [5] The goal of the work was to help people learn how to cope with stress in adverse life circumstances. Methods. 20 people agreed to participate in the Self-Help Plus course: 16 women and 4 men, aged 24-67. For the experimental study, the questionnaire "Coping strategies of R. Lazarus", the reactive and personal anxiety scale of C. D. Spielberger - Y. L. Khanin (STAI), the Hospital Anxiety and Depression Scale (HADS) and the method of mathematical processing of the criterion by T.Student were used for the experimental study. The results. With the help of R. Lazarus's "Coping strategies" questionnaire, it was found that a significant part of the participants, which is 60%-80%, shows maladaptive behavior, which is expressed through coping strategies: confrontation, distancing and escape. According to the results of the Ch.D. Spielberger-Y.L. Khanin scale of reactive and personal anxiety (STAI), the level of reactive anxiety decreased in the studied group. A repeat survey on the Hospital Anxiety and Depression Scale (HADS) showed signs of reduction in mood disorder to moderate/mild state or no disorder at all. In the course of the study, it was found out that most participants of the Self-Help Plus (SH+) course developed stress management skills. According to the Student's formula, the Student's t-criterion of 2.09 was obtained, which makes the probability of an error-free forecast about 95%.

Facilitating the transition to posttreatment survivorship for adolescent and young adults: A randomized waitlist control trial of a virtual mind-body intervention.

12132 Background: Adolescent and young adults (AYAs) with cancer experience chronic stress and poor quality of life, particularly in early posttreatment as AYAs grapple with a “new normal.” Mind-body programs introduced early posttreatment hold promise for providing AYAs with skills to mitigate the adverse psychosocial and physiological effects of stress. Methods: We adapted and piloted an 8-session virtual, mind-body stress management and resilience group program for AYAs (3RP-AYA) to support the posttreatment transition. AYAs were randomized to receive the 3RP-AYA immediately (intervention group; IG) or after 3 months (waitlist control; WC). Data were collected at baseline (T0), 3 (T1) and 6 months (T2). We assessed feasibility by examining 3RP-AYA participation and survey completion rates. Paired-samples t-tests evaluated within-group effects of the 3RP-AYA on coping, distress (worry, depression, uncertainty intolerance), and resilience from T0-T1 (intervention period for IG, waitlist period for WC). Independent-samples t-tests of T0-T1 change scores for each group tested between-group differences in strength of change. Cohen’s d characterized strength of within- and between- group differences. Acceptability (i.e., content satisfaction and perceived helpfulness) was assessed at progam end (T1 for IG, T2 for WC). Results: From 05/19-09/20, 72 AYAs (77% participation rate; Mage = 23.8; 73.6% female; mean 18-months posttreatment; 59.7% non-Hispanic white; 20.8% Hispanic; 25% international) were randomized to IG (n = 35) or WC (n = 37); 85.9% completed 6/8 sessions (median = 7), and 87.5% completed the T1 survey. At enrollment, AYAs presented with elevated worry (M = 52.5, SD = 12.2) and uncertainty intolerance (M = 33.8, SD = 8.7), resembling patients with generalized anxiety. From T0-T1, the IG demonstrated moderate-to-large improvements in coping (d= 0.78, P &lt; .001), worry ( d =0.45, p = .04), depression ( d= .31, p = .11), tolerance of uncertainty ( d = .37, p = .06 ) and resilience ( d =.34, p = .09). When examining between-group differences, the IG showed significantly greater improvement in coping (d = 0.72, p = .01), with non-significantly greater change in worry, depression, tolerance of uncertainty, and resilience (ds = 0.27-0.49, ps &gt; .09) relative to WC. Notably, 96.6% of participants reported overall content satisfaction, and 91.7% reported the 3RP-AYA was helpful. Conclusions: A virtual mind-body program is feasible, acceptable and shows promising efficacy in improving coping and distress among posttreatment AYAs. Findings offer a paradigm shift in the way survivorship care is delivered, suggesting that integrating a mind-body program into early posttreatment survivorship care can facilitate adjustment to life after treatment. This can have downstream effects on the long-term emotional and physical health of AYAs. Clinical trial information: NCT03768336 .

Healthy lifestyle behaviors among a diverse population of early posttreatment adolescent and young adult (AYA) survivors participating in a virtual stress management program.

e24048 Background: Adolescent and young adults (AYA) cancer survivors have worse long-term physical health than survivors of adult cancers. Healthy lifestyle behaviors can maximize physical health and enhance quality of life. The National Comprehensive Cancer Network (NCCN) publishes survivorship guidelines for healthy behaviors; however, it is unclear if AYA survivors follow these recommendations. Methods: This is a secondary analysis of a waitlist-controlled trial of an adapted mind body stress management group program for AYA survivors recruited between 03/2019-09/2020. Participants completed self-report questionnaires assessing tobacco use, e-cigarette use, alcohol use, physical activity, and sleep quality both before and after completing the 8-week group program. Descriptive statistics were used to characterize the proportions of survivors meeting NCCN guidelines at time of enrollment. Results: Seventy-two AYA survivors participated in this study (mean age 24, 74% female, 60% Non-Hispanic White, 21% Hispanic, 4% Black, 53% hematologic malignancy, mean 1.6 years post-treatment).Table 1 summarizes NCCN guidelines and concordant behavior at enrollment. Most participants met guidelines for tobacco and e-cigarette use at study entry, with the majority reporting they abstained from using tobacco (85%) and e-cigarettes (90%). Only 28% reported abstaining from any alcohol use. Of those who consumed alcohol, most reported consuming &lt; 3 drinks per day (83%), but 65% endorsed at least occasional binge drinking behavior ( &gt; 5 drinks). Only 52% met guidelines for vigorous- or moderate- intensity activity (i.e. 75 and 150 minutes weekly, respectively). Specifically, participants reported a median of 47.5 minutes/week (IQR 0-120 min/week) of vigorous-intensity activity and 60 minutes/week (IQR 30-140) of moderate-intensity activity. Many experienced sleep concerns, with only 30% reporting good or very good sleep (i.e. &gt; 4 on a 1 (very poor)-5 (very good) Likert scale). Conclusions: In a racially/ethnically diverse sample of AYA survivors, NCCN survivorship guideline concordance for healthy lifestyle was mixed. Of concern was that AYA survivors’ use of tobacco and e-cigs was similar to the general population. Furthermore, alcohol and physical activity recommendations were mostly not followed, and reported sleep quality was poor. These results highlight the need to better understand barriers and promote healthy lifestyles to optimize post-treatment outcomes. [Table: see text]

Factors Affecting the General Health of Hospital Nurses in the Decade (2007-2017 in Iran): A Meta-Analysis Study

Background: Nurses constitute a large population of organizational workforce in the field of health. They experience a high level of job stress and workplace pressure. Therefore, paying attention to nurses’ health and reducing burnout, increase productivity, job satisfaction, and organizational commitment. Relying on meta-analysis method, this study seeks to investigate the factors related to the general health of nurses and measure the effect of each factor.&#x0D; Methods: The method of this research is quantitative meta-analysis, which was carried out in the period of 2007-2017 with a sample size of 14 research documents. The statistical population of the study included all the studies conducted in Iran regarding the general health of nurses which have been published in scientific and research journals as IRANDOC, NORMAGS, and SID. The purposive sampling method was based on the inclusion and exclusion criteria, as well as considering the validity and reliability of the research. Compliance with validity, reliability and quality of research; the existence of correlation coefficient, sample size and significant level of research has been the criteria for entering the research into the Comprehensive Meta-Analysis Software version 2.&#x0D; Results: In this study, the lack of diffusion bias and homogeneity of the effect size were first confirmed. In terms of bias, most of the studies under review were sub-funnel, indicating no propagation error. Based on the results of the N-error-free test, 253 studies should be performed to question the results of the present study. The results of I2 also indicated that the research in this field was homogeneous. Based on the results of effect size, strengthening communication skills, followed by stress management group therapy, had the greatest role in improving the general health of nurses. Finally, it was found that the average effect size of various factors on the general health of nurses was 0.164.&#x0D; Conclusion: It can be concluded that strengthening communication skills among nurses has an important role in improving their general health followed by group therapy. Stress management has the next highest effect size and is one of the most important factors related to improving the health of nurses.

Cognitive behavioral stress management for parents: Prevention and reduction of parental burnout

ContextParental burnout increases the risk of deleterious consequences on parents’, couples’, and children's physical and mental health. MethodsThe current study (N = 134) aimed to assess the effectiveness of a Cognitive Behavioural Stress Management (CBSM) group programme in terms of parental burnout reduction. In total 67 parents attended the 8-week CBSM intervention groups, and another 67 parents were assigned to the waiting-list control group. We compared the effectiveness of the CBSM intervention with a waiting-list control group directly after the end of the programme and at three-months follow-up. ResultsThe results showed that compared to the control group the CBSM programme contributed to the reduction of parental burnout symptoms with statistically significant and small effect size. Moreover, the contrast analyses showed that the reduction in parental burnout severity was maintained at 3 month-follow-up. The reduction in parental burnout scores was mediated by the decrease in stress and the increase in unconditional self-kindness. ConclusionsThese results highlight the potential benefits of the CBSM programme for parental burnout prevention and reduction.

Results of a controlled study in lifestyle medicine in a cohort of preclinical medical students

Background: Lifestyle Medicine (LM) is an emerging field that can enable providers to educate patients on the impact of their health behaviors. Therefore, LM is emerging as an important component of medical education. But studies investigating the effects of LM education in medical students are sparse. Aims: This paper reports on a controlled study to test the effects of a lifestyle medicine education elective within the medical school curriculum. Methods: The study was IRB approved. Fifty-eight preclinical students gave informed consent. Students completed screening instruments which assessed physical activity, consumption of fats and fruits/vegetables, anxiety, perceived distress, and mood. First-year students were assigned to the control group and were reassessed after three months. Second-year students chose one of three focus groups (nutrition, stress management or physical activity) and set a personal goal for change. Each focus group met a minimum of three times. At the end of the intervention, they were reassessed. The controls had the opportunity to participate in the same focus groups for the same amount of time. Statistical analysis comprised analysis of covariance and paired t-tests. Results: Intervention students performed better than the controls in reducing perceived stress, anxiety, and dietary fat. Paired t-tests comparing baseline and post intervention in all subjects who had the intervention revealed significant improvements in perceived stress, anxiety, mood, dietary fat, fruits and vegetables consumption and number of minutes of physical activity. Analysis of the focus groups pre and post measures showed significant improvements in anxiety and perceived stress in the stress management groups, improvements in both measures of nutrition, but no significant changes in physical activity. Conclusion: It is feasible to add LM concepts and techniques to the medical school curriculum. Medical students significantly improved multiple lifestyle medicine behaviors after being part of the elective. They also experienced the process of setting SMART goals and implementing a plan for change, which can be useful in their future practice.

Beneficial effects of a cognitive-behavioral occupational stress management group training: the mediating role of changing cognitions.

While the effectiveness of cognitive-behavioral stress management trainings (SMTs) is well-documented, the underlying mechanisms, especially in an occupational context, are not fully understood. We tested whether SMT-induced improvements in stress management skills, particularly in the mastery of changing cognitions, may explain beneficial SMT effects. Our non-randomized controlled trial comprised 108 employees of a German health insurance company, with 65 of them participating in a cognitive-behavioral SMT and 43 participating in an alternative control training (AT). As outcome variables, we repeatedly assessed stress-related (functional stress management skills, relaxation, stress reactivity, exhaustion), work-related (job dissatisfaction), and specific-context-related (social support, trait anger) measures at baseline, 2 weeks, and 3 months after the trainings. Functional stress management skills and, in particular, a subscale assessing perceived mastery of changing cognitions ("cognitive-strategies-and-problem-solving") were tested as mediators of change. Repeated measures (M)AN(C)OVAs and complementary multigroup latent difference models confirmed improvements in all outcomes in the SMT-group compared to the AT-group (p's ≤ 0.015). Multivariate mediation path analyses revealed that, regarding mechanisms of change, the subscale cognitive-strategies-and-problem-solving was identified as the most important mediator for all outcomes (95% CIs for expected increases in SMT- vs. AT-group = [lower limits (LLs) ≥ 0.004]; 95% CIs for expected decreases in the SMT- vs. AT-group = [upper limits(ULs) ≤ -0.078]) except for job dissatisfaction. Our findings confirm that employees can effectively learn to master stress reduction techniques and consequently lower the resulting burden. Moreover, beneficial SMT effects seem to result from improvements in functional stress management skills, particularly in the ability to change cognitions. This points to the importance of training cognitive techniques.

Thriving under pressure: The effects of stress-related wise interventions on affect, sleep, and exam performance for college students from disadvantaged backgrounds.

Nearly all students experience stress as they pursue important academic goals. Because stress can be magnified for students from disadvantaged backgrounds, it becomes important to identify interventions that can help mitigate this stress, particularly for these populations as they enter academic environments. We examine the effects of stress mindset and stress management interventions administered to students from disadvantaged backgrounds (N = 140) before freshman year. We compare effects on affect, sleep, and performance during end-of-year exams seen in a subset of these students who could be tracked via experience sampling (N = 57) to those of a comparison group at the same elite university (N = 74) receiving no such stress interventions. As predicted, we find significant differences in exam-week positive affect between the stress mindset and comparison groups. However, there was no difference in positive affect between the stress mindset and management groups or the stress management and comparison groups. For negative affect, stress, sleep, and exam performance, we find no significant differences between any of the three groups. However, both stress interventions decoupled the significant negative association between exam-week stress and exam performance exhibited by the comparison group, rendering the relationship nonsignificant. The reduction in this association was somewhat more pronounced for the mindset relative to the management group. These findings suggest that mindset and management approaches both confer benefits in certain circumstances and highlight the potential value of targeting mindsets about stress using a "wise intervention" approach for students from disadvantaged backgrounds during stressful times. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Brief Virtual Reality Exposure Therapy and Its Effects on Negative and Positive Emotions Among Healthy Working Adults: A Feasibility Study.

The primary purpose of this study is to examine the feasibility of a short-term virtual reality exposure therapy among healthy working adults sample. The secondary aim is to measure the effect of virtual reality exposure therapy on negative and positive emotions by comparing it to the standard stress management program and the wait-list groups. We enrolled 67 participants allocated into 3 groups to receive virtual reality exposure therapy, standard stress management, or wait-list group. The virtual reality exposure therapy group received a total of a 30-minute exposure to a virtual reality environment over 2 weeks. The standard stress management group received a stress management program once during the study period. The results showed a heterogeneous sample, whereby a significantly younger, less-working years, and higher anxiety baseline score were found in the virtual reality exposure therapy group compared to standard stress management and wait-list groups. Nonetheless, the virtual reality exposure therapy group showed a reduction in depression, anxiety, and stress score (P < .001). The standard stress management group showed a reduction in anxiety score only (P = .002), whereas no significant changes were observed in the wait-list group. For positive emotion, all 3 groups showed significant improvement. Short-term virtual reality exposure therapy is a feasible intervention for the negative and positive emotions; however, cautious interpretation is needed due to significant heterogeneous sample. Replication of study with comparable groups is recommended.

N12 Systematic Review: The role of psychological stress in Inflammatory Bowel Disease

Abstract Background Psychological stress is a possible factor in the disease course and poor psychosocial outcomes in Inflammatory Bowel Disease (IBD). Understanding the exact relationship between stress and health has been hampered by methodological issues and how stress has been defined and measured. This study aims to explore the association between stress and disease outcomes, investigate the impact of stress on psychosocial outcomes, and evaluate the efficacy of interventions in reducing stress for people with IBD. Methods A systematic review was performed. Medline, CINAHL, Embase, and PsycInfo databases were searched. Prospective studies recruiting people with IBD 16 years old or over and measuring psychological stress or distress were included. Results Thirty-eight studies, from 41 reports, with 4757 people with IBD were included in the review. Studies used thirty-six different instruments to measure stress. Perceived stress was the most frequently studied concept and was found to precede IBD disease exacerbation. Depression and helplessness were positively associated with perceived stress, while social support, resilience, and quality of life were negatively associated. Cognitive-behavioural group programmes may reduce stress and education, stress management, and exercise and other group programmes may reduce disease-specific stress, but more studies are needed where groups have comparable baseline characteristics and potential harms are considered alongside benefits. Conclusion Psychological stress appears to precede IBD disease exacerbation, though what role it plays in psychosocial outcomes and how it is best managed is unclear. Further research is needed to examine the differential effects of stress on disease subtypes and IBD in flare and remission.

Stress management intervention to enhance adolescent resilience: a randomized controlled trial.

The purpose of this study was to examine the effects of an 8-week stress management intervention to enhance resilience and coping techniques and decrease stress in adolescent students. Teenagers, 11 to 17 years old, recruited from two tertiary Adolescent Medicine Centers of the National and Kapodistrian University of Athens, Greece, were randomly assigned into two groups: the stress management group (n=24) and the control group (n=25). Resilience, stress, anxiety, everyday use of social media, school performance and cognitive skills were measured in adolescents of both groups, pre- and post-intervention. Post-intervention, the stress management group had significantly higher resilience scores and school performance self-evaluation scores, lower scores of stress, anxiety and everyday use of social media and better cognitive skills than the control group. Regarding cognitive skills, the stress management group significantly improved the speed of information processing and memory. Adolescents following stress management experienced significantly reduced stress from interacting with teachers/parents, from peer pressure, from school/leisure conflict as well as compulsive behaviours. With respect to resilience, the intervention improved adolescents' individual skills and resources, relationships with primary caregivers, and environmental factors that facilitated the sense of belonging. Future studies of large adolescent samples are required to evaluate the long-term benefits of stress management techniques on adolescents' health and resilience, as well as the need of continued support to preserve these benefits throughout transition to adulthood.

Effect of Psycho-Socio-Spiritual Strategies on Hope Level of Patients with Cancer: A Narrative Review

Context: Cancer diagnosis and its therapeutic methods can lead to considerable psychological problems and decrease the levels of hope in patients. Due to the considerably important multidimensional effects of hope on the life of patients with cancer, this study aimed to assess the effect of psycho-socio-spiritual strategies on the hope level of patients with cancer. Evidence Acquisition: In this narrative review, electronic databases were searched including Google Scholar, Scientific Information Database, Magiran, PubMed, ScienceDirect, Web of Science (ISI), Ovid, and Scopus. Those articles published between 1978 and 2020 were retrieved and assessed through the abstract and full-text appraisal. Finally, 74 articles were included in this study. Results: Psycho-socio-spiritual strategies for affecting the hope level of patients with cancer were classified as follows: (1) psychological interventions (psychotherapy, counseling, coping skills training, stress management training, crisis management, individual or group supporting therapy, hope therapy, and psychoeducational interventions); (2) social interventions (social and family support intervention); and (3) spiritual interventions (logotherapy, religion therapy, and praying). Conclusions: Due to the chronic nature of cancer disease, in addition to the important role of pharmacological treatment such as chemotherapy and radiotherapy, considering non-pharmacological approaches such as hope-fostering interventions for these patients is essential and can lead to a better quality of life.

Effectiveness of Stress Management and Acceptance and Commitment Therapy in Psychological Capital among Patients with Type 2 Diabetes

Background and Aim: Type 2 diabetes is a chronic and complex disease. This study aims to compare the effectiveness of stress management and acceptance and commitment therapy on psychological capital in patients with type 2 diabetes.Methods: The present study was a quasi-experimental study with pre-test, post-test, and follow-up design with a control group. The statistical population of the study consisted of all patients with type 2 diabetes referred to Milad Hospital in Tehran in 2019. In order to form three groups using the purposive sampling method, 90 patients were selected first by convenience sampling method, and then 30 patients were randomly grouped in the first experimental group and 30 in the second experimental group, and 30 in the control group. Follow-up phase was performed on all three groups three months after the post-test. The research instrument was The Lotans Psychological Capital Questionnaire (2007). Data were analyzed using a mixed analysis of variance by Spss.22. Results: The results showed that stress management and acceptance and commitment therapy had a significant effect on psychological capital components in patients with type 2 diabetes compared to the control group (p <0.00). Also, the mean scores of post-test and follow-up of hope component in the acceptance and commitment group increased more than the stress management group (p <0.00).Conclusion: It can be concluded that stress management and acceptance and commitment therapy were effective in psychological capital in patients with type 2 diabetes. Acceptance and commitment therapy was more effective than stress management on the hope component.

The Effects of a Stress Management Group Education Program on Symptoms of Depression, Anxiety, and Stress in People With Comorbid Diabetes and Chronic and/or Recurrent Foot and Ankle Complications

Individuals with diabetic foot and ankle complications are at heightened risk for depression, anxiety, and stress. This study evaluated the effect of a stress management group education (SMGE) program in this population. The 21-question Depression Anxiety Stress Scales and the Problem Areas in Diabetes scale were administered prior to, upon completion of, and at approximately 6 weeks after the program. Twenty-five patients from an urban diabetic foot and ankle center completed the study. The SMGE program demonstrated decreased levels of anxiety, depression, and diabetes problem areas for our study population.

Maternal mental health and partner delivered massage: a pilot study

Abstract Background Mental health problems place a significant burden on the health system and are an important public health issue. Many pregnant women experience anxiety and depression, which can negatively impact health outcomes for both mother and baby. Partner-delivered massage may provide a cost effective and accessible approach to support the mental wellbeing of pregnant women. Methods A feasibility randomised controlled trial was conducted to compare partner-delivered relaxation massage (intervention) with a self-directed stress management program (control), for pregnant women with mild anxiety. Women attended an initial workshop at 28-32 weeks gestation, followed by the completion of either the self-directed massage or stress management program. Qualitative feasibility and acceptability data (primary outcomes) were collected via online participant diaries and post-birth interviews. Anxiety, depression and stress symptoms (secondary outcomes) were assessed using the Depression and Anxiety Stress Scale (DASS-21). Results 14 women/partner dyads attended the partner- delivered massage group and 13 women attended the self-directed stress management group. Participants from both groups reported the programs were feasible and acceptable. Mean scores on all DASS-21 subscales significantly decreased over time in both the intervention and the control group. Conclusions The partner-delivered massage program was feasible and acceptable. Both programs decreased women's symptoms of anxiety, depression and stress, with no significant between-group differences identified. An adequately powered, experimental study is needed to determine the effectiveness of partner-delivered relaxation massage. Key messages Many women experience anxiety and depression during pregnancy and this can have a negative impact on both mother and baby. Partner-delivered relaxation massage, at least once a week in the third trimester, may help reduce women’s symptoms of anxiety, depression and stress.

Maternal mental health and partner-delivered massage: A pilot study

BackgroundAnxiety and depression affects many pregnant women. Massage may be beneficial for supporting mental wellbeing during this time. The aim of this study was to assess the feasibility and acceptability of a partner-delivered relaxation massage program for pregnant women, and its impact on symptoms of antenatal anxiety, stress and depression. MethodsA feasibility randomised controlled trial was conducted to compare partner-delivered relaxation massage (intervention) with self-directed stress management (control). Women attended an initial workshop at 28–32 weeks gestation followed by completion of a self-directed massage or stress management program. Qualitative data about the feasibility and acceptability (primary outcomes) were collected via online participant diaries and post-birth interviews. Anxiety, depression and stress symptoms (secondary outcomes) were assessed using the Depression and Anxiety Stress Scale (DASS-21). Birth outcomes were collected at the post- birth interview. ResultsA total of 14 women/partner dyads in the massage group and 13 women in the self-directed stress management group, attended the initial workshops. When interviewed, participants from both groups reported that the programs were feasible and acceptable. Women’s mean scores on all subscales of the DASS-21significantly decreased over time in both the intervention and the control group. ConclusionPregnant women found the partner-delivered massage program to be feasible and acceptable. Both programs decreased women’s symptoms of anxiety, depression and stress with no significant differences identified between the two groups. An adequately powered experimental study with a large representative sample is needed to determine whether partner-delivered relaxation massage reduces pregnant women’s symptoms of anxiety, depression and stress.

The Effect of Cognitive-Behavioral Stress Management Group Training on Anxiety, Depression, Stress and Readmission in Asthma Patients

The Effect of Cognitive-Behavioral Stress Management Group Training on Anxiety, Depression, Stress and Readmission in Asthma Patients