Improvements In Stress Management Research Articles

Acceptability of a digital health application to empower persons with multiple sclerosis with moderate to severe disability: single-arm prospective pilot study

BackgroundMany persons with multiple sclerosis (pwMS) desire to learn how health behaviour changes (e.g., dietary adjustments, physical activity, improvements in stress management) might help them manage their disease. Previous research has shown that certain health behaviour changes can improve quality of life (QoL), fatigue and other MS outcomes. Digital health applications may be well suited to deliver relevant health behavioural interventions because of their accessibility and flexibility. The digital health application “levidex” was designed to facilitate health behaviour change by offering evidence-based patient information and cognitive-behavioural therapy techniques to pwMS. By doing so, levidex aims to improve QoL and MS symptoms such as fatigue and mental health.ObjectivesA previous study reported on the development of levidex; this non-randomised pilot study examined the feasibility (practicability and acceptability) of levidex in pwMS with moderate to severe disability. Furthermore, the intervention’s impact on empowerment, stress management, and relevant health behaviours (e.g., dietary behaviour, physical activity) was explored.Methodslevidex was originally developed for newly diagnosed pwMS in the first year after diagnosis and eventually modified to offer access to pwMS with moderate to severe disability. Participants (n = 43) with an Expanded Disability Status Scale between 3.5 and 7.5 and a disease duration of more than one year were eligible to participate. The intervention was used over a period of six months with measurement time points at baseline, month 3 and month 6.ResultsOut of 38 participants who completed the six-month intervention period, 18 (47.4%) completed all 16 modules and 9 (23.7%) reached modules 13–16, the long-term maintenance part of levidex. Participants rated levidex positively in terms of practicability and acceptability and had only few points of criticism such as to include more physical exercise routine suggestions suitable for participants with severe impairment. Data on secondary endpoints showed no significant changes.ConclusionThis pilot study provided evidence for the practicability and acceptability of levidex, a digital health application designed to facilitate health behaviour change in pwMS with moderate to severe disability. Adequately powered randomised controlled studies with longer follow-up periods are needed to clarify the benefit of levidex in pwMS with moderate to severe disability.Trial registrationGerman Clinical Trials Register (DRKS) DRKS00032667 (14/09/2023); Retrospectively registered.

Genetic Behavioral Trait Assessment Paired With Personalized Recommendations and Coaching to Support Mental Health and Wellness

AbstractBackgroundGenetics, environment, and lifestyle each contribute to human behaviors. We have developed a direct-to-consumer genetic assay (Mental Health Map) that allows users to explore their genetic behavioral predispositions and potential interventions that may positively influence mental health and wellness. Based on preliminary consumer feedback suggesting increased desire to take action on their mental health and wellness, we initiated a pilot study to assess several measures of mental health and self-care in individuals both before and after reviewing their Mental Health Map.MethodsThis was a virtual case series in adults who purchased a Mental Health Map. Subjects served as their own control based on survey responses leading up to genetic testing and up to 7 weeks after an introductory coaching session. Coaching included a demonstration of how to navigate the interactive online report, discussion of key results, and provision of additional external resources as appropriate. The co-primary measures were changes in quality of life as measured by WHO-5, report of initiating a discussion or seeking mental health care with a health care provider, report of initiating and sustaining positive lifestyle changes, and subjective improvements in stress management, sleep quality, mood, focus, and social interactions. Secondary measures were changes in GAD-7 and PHQ-9.ResultsTwenty-seven individuals completed the study. Average WHO-5 at baseline was 41.2 which numerically increased to 48.3 at week 7, suggesting improved quality of life, but this effect was not statistically significant. 42.3% of individuals were in treatment with a mental health provider at the time of survey. Of those not in treatment, 33.3% were actively seeking professional mental healthcare prompted by the coaching session. At week 6, 87% of survey respondents (n=15) asserted that they continued to make lifestyle changes that improved stress; 74% made changes to improve mood and 80% made changes that improved their habits. Percentage of respondents who reported lifestyle changes to improve sleep, focus, and social interactions were all less than 70%. In secondary outcomes, average GAD-7 at baseline was 8.9 and decreased to 6.7 at week 7, while PHQ-9 averaged 10.3 at baseline and decreased to 7.5 at week 7. Neither of the secondary outcome measures achieved a statistically significant difference.ConclusionDespite the small patient population, this pilot study provides proof-of-concept that Mental Health Map and the accompanying coaching session encourages participants to make positive lifestyle changes and prompts pursuit of a healthcare professional. We also saw numerical trends toward modest improvements in quality of life, anxiety, and depression symptoms, although these differences were not statistically significant, and may require larger sample sizes.FundingGenomind

Robotics and cbt and entertainment in the enhancement of children with asd, mental disorders, dysfunctional emotions and irrational beliefs

Children and adolescents with autism spectrum disorder (ASD) frequently present symptoms of various mental disorders along with the features that define ASD. Problems with anxiety, depression, emotion regulation, cognitive problems, such as deficits in theory of mind, and associated behavioral problems, occur in children with autism of all ages [5]. In recent years, the application of robots in therapeutic interventions for children with neurodevelopment disorders and more specifically in children with ASD, has aroused the interest of the robotic community and experts in the field of autism [3]. Socially Assistive Robots are promising in their potential to promote and support mental health in children with ASD. There is a growing number of studies investigating the feasibility and effectiveness of robot interventions in supporting children’s mental wellbeing, such as helping in anxiety, depression and socio-emotional problems [3, 4]. Several authors have also suggested Cognitive and Behavior Therapy (CBT) as a very useful intervention therapy, which can apply in combination with a social assistive robot [5, 6, 8]. CBT has specific strategies that can be very supportive and particularly useful for individual’s problems. Many applications of this combination have shown substantial improvements in stress management, contextualized emotion recognition and theory of mind. With a coordinated effort, robot, cbt techniques and collaboration with mental health consultants, children with ASD can improve their social, emotional and behavioral competence [5].

An Exploratory Case Study of Mindfulness Techniques in a High School Band Program During the COVID-19 Pandemic

The purpose of this study was to explore the effects of mindfulness practices on high school band students. This action research project took place in spring 2020, during the COVID-19 pandemic stay-at-home orders. Four students enrolled in the high school band participated in five weeks of mindfulness practice interventions over the virtual format alongside their instrumental music director. Mindfulness practices included diaphragmatic breathing, relaxation imagery, cued relaxation, and stretching. Throughout the five weeks, student participants discussed improved focus, improvement of stress management, and increased frequency of mindfulness practice. However, four months after data collection was complete, three of the four student participants continued to practice mindfulness techniques on their own time to assist with nervousness, anxiety, and stress.

Effects of Three Genres of Focus Music on Heart Rate Variability and Sustained Attention

Previous research has demonstrated restorative effects of music, showing that exposure to music yields mental health benefits that include improvement in stress management. However, it remains unclear whether the benefits of “on the spot” music interventions extend to cognitive performance. The present study explored whether music can be applied as a low-cost, non-invasive “on the spot” intervention to improve cognitive performance and physiological effects. Specifically, studies has yet to examine whether the effects of different genres of focus music extend beyond stress management to include cognitive performance and physiological effects. To address this gap in the literature, the current study recruited 120 healthy adults in a fully randomized procedure involving three experimental groups of participants and a control group. Each experimental group was exposed to one specific genre of focus music compared to a no-music control group. In a between-group design, the study exposed three separate groups to jazz music, piano music, and lo-fi music respectively. The fourth group was a no-music control group. The study employed a 3-day experimental procedure and a follow-up procedure in which participants completed two attention monitoring tasks. Participants completed focus music interventions with a duration of 15 and 45 min. The follow-up procedure aimed to experimentally induce music familiarity and probe its effect on cognitive performance. To assess cardiovascular effects, heart rate variability (HRV) data was collected during the music intervention period and during a baseline period. Results showed performance differences across the three active music groups on the sustained attention to response task (SART) compared to the no-music control group. Furthermore, the study showed a physiological effect in the direction of increased parasympathetic activity indexed as an increased HRV response in the three active music groups compared to the no-music control group, adding to convergent lines of evidence suggesting that music can enhance parasympathetic activity and cognitive performance. In addition, the study found that music familiarity (relative to music unfamiliarity) influenced cognitive performance in the direction of faster reaction times (RTs) during the music intervention period in which participants were exposed to the attentional network task (ANT) and an increase in the physiological response in the familiar relative to the unfamiliar music condition. In summary, the study found evidence of a pronounced effect of three types of focus music on both cognitive performance and the underlying physiological response. Thus, focus music holds promise as an evidence-based intervention offering mental health benefits through physiological improvements and enhancement of cognitive processing.

Effects of Zentangle art workplace health promotion activities on rural healthcare workers

ObjectivesWorkplace health promotion activities have a positive effect on emotions. Zentangle art relaxes the body and mind through the process of concentrating while painting, achieving a healing effect. This study aimed to promote the physical and mental health of rural healthcare workers through Zentangle art–based intervention. Study designThis was a quasi-experimental pilot study. MethodsA Zentangle art workshop was held from November 2019 to July 2020. A total of 40 healthcare workers were recruited. The participants were asked to provide baseline data, and the Brief Symptom Rating Scale (BSRS-5), work stress management effectiveness self-rating scale, General Self–Efficacy Scale (GSES), and Workplace Spirituality Scale (WSS) were administered before and after the workshop. SPSS 22.0 statistical package software was used to conduct the data analysis. ResultsThe median age (interquartile range [IQR]) was 32.00 years (23.00–41.75 years). The Wilcoxon signed-rank test revealed that the median (IQR) BSRS-5 postintervention score was 4.0 (1.25–5.0), which was lower than the preintervention score (P = 0.004). The postintervention score for the work stress management effectiveness self-rating scale was 36.5 (31.0–40.0), which was also lower than the preintervention score (P = 0.009). A higher score for the GSES or WSS indicated improvements in stress management and self-efficacy. The GSES postintervention score 25.00 (21.0–30.75) was significantly higher than the preintervention score (P = 0.010), and the WSS postintervention score 104.0 (88.0–111.75) was significantly higher than the preintervention score (P = 0.005). ConclusionsThe study provides evidence that painting therapy can effectively relieve stress, reduce workplace stress and frustration, enhance self-efficacy, and increase commitment to work among healthcare workers, thus improving their physical, mental, and spiritual well-being. Zentangle art provides employees with multiple channels for expressing their emotions and can improve the physical and mental health of healthcare workers in the workplace. It is beneficial and cost-effective and can serve as a benchmark for peer learning.

Effectiveness of music therapy with relaxation technique on stress management as measured by perceived stress scale.

Background:Living in Nigerian environment is enough stress. In our time, many students could not cope with the stress of school environment like ours and others are still suffering from different health problems attributed to stress. Based on this, we investigated the effect of music therapy with relaxation technique on stress management among university students in southeastern Nigeria.Methods:Participants for the study were 142 university students in the Southeastern Nigeria. Perceived stress scale (PSS) was used to measure the symptoms of stress. Statistical tool used was repeated measures with analysis of variance (ANOVA) to ascertain the effectiveness of music therapy with relaxation. Among other tools used was Partial η2 to examine the effect sizes and level of changes inthemanagement of stress across groups.Results:The finding indicated that there were no baseline differences in levels of stress management between participants in the treatment and waitlist control conditions. Results revealed significant improvement in stress management for participants in the music therapy with relaxation group, whereas the waitlist control group showed no significant change in their score over the same period. Furthermore, the positive effect of music therapy with relaxation was maintained at follow-up.Conclusion:The findings of this study suggest that the efficacy of music therapy with relaxation technique for improving the students’ stress management can be consistent at follow-up. Hence, music therapists, counsellors and psychotherapists should continue to investigate the beneficial effects of music therapy with relaxation on stress management among university students in every part of the world.

Positive Maternal Attitudes during Infancy and a Positive Lifestyle May Be Associated with Beneficial Epigenetic Alterations and Improved Oral Health

Periodontitis causes various diseases, including arterial sclerosis, cardiac infarction, diabetes, aspiration pneumonia, and tooth loss, all of which lower the quality of life of individuals. Risk factors of periodontitis include a lack of oral care and low secretion of saliva due to stress, accompanied by excessive activity of the sympathetic nervous system and low secretion of serotonin and melatonin. Serotonin may improve the ability of individuals to manage stressful events, while melatonin may enhance the regeneration of tooth tissues. Saliva contains melatonin, epidermal growth factor, and nerve growth factor. The production and secretion of serotonin and melanin involve epigenetic mechanisms, i.e., gene expression resulting from chemical responses with genome sequences. Warm-hearted maternal attitudes to babies during infancy and a positive lifestyle, including a well-balanced diet, moderate aerobic exercise, and a purpose in life, as well as warm-hearted human relations, may also improve the ability of individuals to manage stressful events. This improvement in stress management may be linked to beneficial epigenetic alterations that promote the secretion of sufficient amounts of serotonin and melatonin, which may in turn contribute to the prevention and treatment of periodontitis and the regeneration of tooth tissues.

Individual and regional factors affecting stress and problem alcohol use: A representative nationwide study of China

ObjectivesThe objective of this study was to examine the association between individual and environmental stressors and problem alcohol use among Chinese university students. MethodsParticipants were 11,942 students, who were identified through a multistage survey sampling process that included 50 universities. Individual information, including feelings of stress and perceptions of problem alcohol use, was obtained by self report. Urban and regional variables were retrieved from the National Bureau of Statistics database. Both unadjusted and adjusted methods were considered in the analyses. ResultsAlmost one third (32.6%) of the students suffered from some form of severe stress while problem alcohol use prevalence was 7.3%, (95% CI: 4.1–10.4%). The multilevel logistic regression model found that uncertainty stress, gender, father's occupation and monthly expenses were associated with problem alcohol use. Of the contextual factors home region and the university city GDP and unemployment rate were important. When interactions were considered, the relationship between monthly expenses and financial uncertainty and problem drinking was most evident in high level universities. By contrast, the effects of uncertainty stress on problem drinking were most evident in middle and low level universities. ConclusionsThe findings underscore that efforts to control problem alcohol use among students in China should pay greater attention to environmental determinants of stress and particularly to improvements in stress management in university settings.

Identifying potential molecular factors involved in Bacillus amyloliquefaciens 5113 mediated abiotic stress tolerance in wheat.

Abiotic stressors are main limiting factors for agricultural production around the world. Plant growth-promoting bacteria have been successfully used to improve abiotic stress tolerance in several crops including wheat. However, the molecular changes involved in the improvement of stress management are poorly understood. The present investigation addressed some molecular factors involved in bacterially induced plant abiotic stress responses by identifying differentially expressed genes in wheat (Triticum aestivum) seedlings treated with the beneficial bacterium Bacillus amyloliquefaciens subsp. plantarum UCMB5113 prior to challenge with abiotic stress conditions such as heat, cold or drought. cDNA-AFLP analysis revealed differential expression of more than 200 transcript-derived fragments (TDFs) in wheat leaves. Expression of selected TDFs was confirmed using RT-PCR. DNA sequencing of 31 differentially expressed TDFs revealed significant homology with both known and unknown genes in database searches. Virus-induced gene silencing of two abscisic acid-related TDFs showed different effects upon heat and drought stress. We conclude that treatment with B.amyloliquefaciens 5113 caused molecular modifications in wheat in order to induce tolerance against heat, cold and drought stress. Bacillus treatment provides systemic effects that involve metabolic and regulatory functions supporting both growth and stress management.

Care for the Caregiver

Stress affects the well-being of both nursing students and the individuals with whom they work. With the theory of cognitive appraisal as a framework for this study, it is proposed that mind-body self-care strategies promote stress management by stabilization of emotions. Outcomes will be a perception of less stress and more mindful engagement with the environment. Objective of the study was to describe an evaluation of student perceived stress and mindfulness to 1-hour per week of class time dedicated to mind-body self-care (yoga, mindful breathing, Reiki, and essential oil therapy). It was a quasi-experimental study; data collection took place at 4 time points. Participants were entry-level accelerated nursing students from 3 US universities: 50 in the treatment group, 64 in the comparison group. Data included health-promoting practices using Health-Promoting Promotion Lifestyle Profile II as a control variable, stress and mindfulness (Perceived Stress Scale [PSS] and Mindful Attention Awareness Scale [MAAS]), and demographic information; analysis using mixed-design repeated-measures analysis of variances. There was a statistically significant interaction between intervention and time on PSS scores, F(3, 264) = 3.95, P = .009, partial η(2) = 0.043, with PSS scores of the intervention group decreasing from baseline to T3 when intervention ended whereas PSS scores of the comparison group increased from baseline. The average scores on the MAAS did not differ significantly. Evaluation of an embedded mind-body self-care module in the first nursing course demonstrated promising improvements in stress management. The findings support the appropriateness of integrating mind-body self-care content into nursing curricula to enhance students' ability to regulate stress.

Investigating short- and long-term transfer effects of a Taiji beginner course in participants' daily life

In recent years research investigating various health benefits of Taiji practice has markedly increased. Despite this growing scientific interest, essential questions such as to what extent a Taiji course may exert noticeable effects in participants' everyday life, what these effects are, and how and where potential transfer effects occur, have hardly been considered. The aim of our study was to explore transfer effects from a Taiji course into participants' daily lives. We conducted a longitudinal observational study in 45 healthy participants at the end of their three-month Taiji beginner course (tp1) and at two months (tp2) as well as one year after course completion (tp3). Participants were asked to report their Taiji practice behavior at all time points, as well as to rate and describe perceived transfer effects of Taiji course contents on their daily life at tp1 and tp3. Transfer effects were reported by 91.1% of all respondents after course completion (tp1) and persisted in 73.3% at the one-year follow-up assessment (tp3), counting "increase of self-efficacy", "improvement of stress management", and "increase of body awareness" as the most frequently mentioned effects. Transfer effects predominantly occurred in participants' work and social environments, as well as during everyday activities in public areas. While self-reliant Taiji practice frequency significantly decreased from 82.2% at tp1 to 55.6% at tp3 (P < 0.001), the magnitude of self-reported transfer effects did not (P = 0.35). As explorative analyses revealed, regular Taiji course attendance was highly correlated with stronger transfer effects at tp1 (r = 0.51; P < 0.001) and tp3 (r = 0.35; P = 0.020). Participants reporting high self-reliant Taiji practice frequency at tp2 were likely to maintain a regular practice routine at tp3 (r = 0.42; P < 0.004), whereas self-reliant practice frequency and transfer effects at tp1 were positively correlated with self-reliant practice frequency at tp3 on a trend level (r < 0.27; P > 0.08). Our data underline the importance of regular course participation for pronounced and long lasting transfer effects into participants' everyday life. We discuss that several context and process-related aspects of a Taiji intervention are potentially relevant factors for enhancement of transfer effect.

Dance movement therapy group intervention in stress treatment: A randomized controlled trial (RCT)

This randomized controlled trial compares the effect of a dance movement therapy (DMT) group intervention on stress management improvement and stress reduction with a wait-listed control group (WG). 162 self-selected clients suffering from stress were randomly assigned to a WG or a DMT intervention that received 10 group therapy sessions. Stress management [Stressverarbeitungsfragebogen/SVF 120], psychopathology and overall distress (Brief Symptom Inventory/BSI) were evaluated at baseline (t1: pre-test), immediately after completion of the ten sessions DMT group intervention (t2: post-test), and 6 months after the DMT treatment (t3: follow-up test). Analysis of variance was calculated to evaluate the between-group (time×condition) and within-group (time) effect of the DMT intervention. Negative stress management strategies decreased significantly in the short-term at t2 (p<.005) and long-term at t3 (p<.05), Positive Strategy Distraction improved significantly in the short-term (p<.10), as well as Relaxation (p<.10). Significant short-term improvements were observed in the BSI psychological distress scales Obsessive-Compulsive (p<.05), Interpersonal Sensitivity (p<.10), Depression (p<.05), Anxiety (p<.005), Phobic Anxiety (p<.01), Psychoticism (p<.05), and in Positive Symptom Distress (p<.02). Significant long-term improvement in psychological distress through DMT existed in Interpersonal Sensitivity (p<.05), Depression (p<.000), Phobic Anxiety (p<.05), Paranoid Thinking (p<.005), Psychoticism (p<.05), and Global Severity Index (p<.01). Results indicate that DMT group treatment is more effective to improve stress management and reduce psychological distress than non-treatment. DMT effects last over time.

Getting started with taiji: investigating students expectations and teachers appraisals of taiji beginners courses.

In recent years, Taiji has been frequently investigated and considered as a stress management intervention. Although health care providers' appraisals and consumers' expectations are regarded as essential for treatment outcome, little attention has been drawn to this issue in Taiji research. In our study we have conducted two surveys to explore beginners' (n = 74) expectations and teachers' (n = 136) appraisals of their Taiji courses in general as well as more particularly related to stress management. Qualitative data analysis revealed that beginners mainly expected to learn a new method that is applicable in their daily life to foster peace of mind and to enhance their stress management. Congruently moderate-to-high improvements in stress management have also been found in quantitative analysis, whereby a lower educational level predicted higher expectations (P = 0.016). Taiji-teachers stated body- and mind-related benefits most frequently and appraised moderate-to-high improvements in stress management. Higher appraisals were predicted by a shorter teaching experience (P = 0.024). Our results inform about beginners' expectations and teachers' appraisals related to a Taiji-beginners course and highlight the role of educational background and teaching experience in shaping stress-management-related beginners' expectations and teachers' appraisals.

Evaluation of a Biofeedback-Assisted Meditation Program as a Stress Management Tool for Hospital Nurses: A Pilot Study

To assess whether a self-directed, computer-guided meditation training program is useful for stress reduction in hospital nurses. We prospectively evaluated participants before and after a month-long meditation program. The meditation program consisted of 15 computer sessions that used biofeedback to reinforce training. Participants were instructed to practice the intervention for 30 minutes per session, four times a week, for four weeks. Visual analogue scales were used to measure stress, anxiety, and quality of life (assessments were performed using Linear Analogue Self-Assessment [LASA], State Trait Anxiety Inventory [STAI], and Short-Form 36 [SF-36] questionnaires). Differences in scores from baseline to the study's end were compared using the paired t test. Eleven registered nurses not previously engaged in meditation were enrolled; eight completed the study. Intent-to-treat analysis showed significant improvement in stress management, as measured by SF-36 vitality subscale (P = .04), STAI (P = .03), LASA stress (P = .01), and LASA anxiety (P = .01). Nurses were highly satisfied with the meditation program, rating it 8.6 out of 10. The results of this pilot study suggest the feasibility and efficacy of a biofeedback-assisted, self-directed, meditation training program to help hospital nurses reduce their stress and anxiety. Optimal frequency of use of the program, as well as the duration of effects, should be addressed in future studies.

Outcomes of an educational intervention for the family of a person with bipolar disorder: a 2-year follow-up study

This study aimed to analyse the outcomes of an educational intervention for family members living with a person with bipolar disorder. A longitudinal study was conducted comprising a 10-session educational intervention designed for families with members in outpatient mental health care. Thirty-four family members agreed to participate. Data were collected on five occasions, at baseline and during a 2-year follow-up through self-assessment instruments: the Carers of Older People in Europe Index, the Jalowiec Coping Scale-40, the Sense of Coherence questionnaire and the Social Adaptation Self-evaluation Scale. The results showed that the condition had a considerable negative impact on the family members as carers, but the educational intervention increased their understanding, which facilitated the management of their lives. A significant improvement in stress management was seen over time and social functioning was retained. The study showed that families living with one member with bipolar disorder benefited from the educational intervention in terms of increasing understanding of the condition and reducing stress. Mental health care needs to develop educational interventions further and offer the families support to strengthen their ability to manage with the situation.

Long-term effects of lifestyle changes on well-being and cardiac variables among coronary heart disease patients.

To focus on psychological well-being in the Lifestyle Heart Trial (LHT), an intensive lifestyle intervention including diet, exercise, stress management, and group support that previously demonstrated maintenance of comprehensive lifestyle changes and reversal of coronary artery stenosis at 1 and 5 years. The LHT was a randomized controlled trial using an invitational design. The authors compared psychological distress, anger, hostility, and perceived social support by group (intervention group, n = 28; control group, n = 20) and time (baseline, 1 year, 5 years) and examined the relationships of lifestyle changes to cardiac variables. Reductions in psychological distress and hostility in the experimental group (compared with controls) were observed after 1 year (p < .05). By 5 years, improvements in hostility tended to be maintained relative to the control group, but reductions in psychological distress were reported only by experimental patients with very high 5-year program adherence. Improvements in diet were related to weight reduction and decreases in percent diameter stenosis, and improvements in stress management were related to decreases in percent diameter stenosis at both follow-ups (all p < .05). These findings illustrate the importance of targeting multiple health behaviors in secondary prevention of coronary heart disease.