Mean Perceived Stress Scale Score Research Articles

Anxiety, perceived stress and coping strategies in nursing students: a cross-sectional, correlational, descriptive study

BackgroundFor many nursing students, clinical training represents a stressful experience. The levels of stress and anxiety may vary during students’ educational training, depending on their ability to adopt behavioral strategies for coping with stress, and other factors. This study aimed to investigate the relationship between anxiety, perceived stress, and the coping strategies used by nursing students during their clinical training.MethodsA cross-sectional correlational descriptive study. The sample consisted of 190 nursing students enrolled in the Nursing Faculty of Ciudad Real University in Spain. Participants provided data on background characteristics and completed the following instruments: the Perceived Stress Scale; the State-Trait Anxiety Inventory and the Coping Behavior Inventory. Relationships between scores were examined using Spearman’s rho.ResultsThe mean age of participants was 20.71 ± 3.89 years (range 18–46 years). Approximately half of the students (47.92%) indicated a moderate level of stress with a mean Perceived Stress Scale score of 22.78 (±8.54). Senior nursing students perceived higher levels of stress than novice students. The results showed a significant correlation for perceived stress and state anxiety (r = 0.463, p < .000) and also for trait anxiety (r = 0.718, p < .000). There was also a significant relationship between the total amount of perceived stress and the following domains of the coping behavior inventory: problem solving (r = −.452, p < .01), self-criticism (r = .408 p < .01), wishful thinking (r = .459, p < .01), social support(r = −.220, p < .01), cognitive restructuring (r = −.375, p < .01), and social withdrawal (r = .388, p < .01). In the current study, the coping strategy most frequently used by students was problem-solving, followed by social support and cognitive restructuring.ConclusionsNursing students in our study presented a moderate level of stress, in addition there was a significant correlation with anxiety. Nursing teachers and clinical preceptors/mentors should be encouraged to develop programs to help prepare nursing students to cope with the challenges they are about to face during their clinical placements.

Mental health of medical personnel during the COVID-19 pandemic.

IntroductionThe coronavirus disease 2019 (COVID‐19) pandemic caused significant changes in the everyday functioning of the general population, as well as medical workers. Medical personnel, especially those in direct contact with COVID‐19 patients, could have increased levels of stress, anxiety, and depression. The objective of this study was to explore the mental health status of medical personnel in Serbia during the pandemic by assessing stress levels, symptoms of anxiety, and depression.MethodsThis cross‐sectional study was conducted as an online‐based survey, in the period from 8 April to 14 April 2020, during the COVID‐19 pandemic. The study included 1678 participants, and the snowball sampling technique was used to reach healthcare professionals. The level of stress and symptoms of depression and anxiety were assessed among medical personnel in Serbia by the 10‐item Perceived Stress Scale (PSS), the Beck Depression Inventory IA (BDI‐IA), and the 7‐item Generalized Anxiety Disorder Scale (GAD‐7), respectively.ResultsA total of 1678 participants completed the survey, with a mean age of 40.38 ± 10.32 years, of which 1,315 (78.4%) were women, and 363 (21.6%) were men. Out of these, 684 (40.8%) participants were medical personnel, and 994 (59.2%) were people of other professions. Frontline medical personnel reported higher scores on all measurement tools than second‐line medical personnel (e.g., mean PSS scores: 19.12 ± 5.66 versus 17.53 ± 5.71; p = .006; mean GAD‐7 scores: 8.57 ± 6.26 versus 6.73 ± 5.76; p = .001; mean BDI‐IA scores: 9.25 ± 8.26 versus 7.36 ± 7.28; p = .006). Binary logistic regression showed that the probability of developing more severe anxiety symptoms doubles in frontline medical personnel.ConclusionOur findings suggest that frontline medical personnel is under an increased psychological burden during the COVID‐19 pandemic, having higher levels of stress, anxiety, and depression than second‐line medical personnel. Adequate measures should be taken to relieve this burden and preserve the mental health of frontline medical personnel.

CORONAVİRÜS HASTALIĞI 2019 (COVİD 19) DÖNEMİNDE ÜNİVERSİTE ÖĞRENCİLERİNDE UYKU KALİTESİ VE İNSOMNİ ŞİDDETİ

Objective: To determine the sleep quality and insomnia severity of university students and the factors affecting them during the coronavirus pandemic (COVID-19) process. Materials and Methods: Our study was conducted by e-mail using Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Perceived Stress Scale (PSS) between 15 March and 31 May 2020 at our university's Health Services Vocational School. Results: 446 (414 F, 32 M) students participated in the study. Participants' mean time to fall asleep is 26.19 ± 22 minutes, and their average sleep time is 7.98 ± 2.10 hours. PSQI total score average is 15.69 ± 2.96. The mean PSS score was determined as 30.94 ± 8.46. The mean ISI score is 10.87 ± 5.35 and its level is above the lower threshold. It is observed that the group with the curfew has a lower severity of insomnia than the group without it. Sleep quality and perceived stress differ according to alcohol use, but insomnia severity does not differ. It has been found that those who consume more than 2 cups of coffee a day have the worst sleep quality and the highest severity of insomnia. It was found that the participants who did not exercise at all and those who spent 3 hours or more a day on social media had the highest perceived stress level. Conclusion: It is seen that measures applied as staying at home during the COVID-19 pandemic have a negative effect on sleep health.

Relationship Between Chronic Stress and Heart Rate Over Time Modulated by Gender in a Cohort of Office Workers: Cross-Sectional Study Using Wearable Technologies.

BackgroundChronic stress is increasing in prevalence and is associated with several physical and mental disorders. Although it is proven that acute stress changes physiology, much less is known about the relationship between physiology and long-term stress. Continuous measurement of vital signs in daily life and chronic stress detection algorithms could serve this purpose. For this, it is paramount to model the effects of chronic stress on human physiology and include other cofounders, such as demographics, enabling the enrichment of a population-wide approach with individual variations.ObjectiveThe main objectives of this study were to investigate the effect of chronic stress on heart rate (HR) over time while correcting for weekdays versus weekends and to test a possible modulation effect by gender and age in a healthy cohort.MethodsThroughout 2016 and 2017, healthy employees of technology companies were asked to participate in a 5-day observation stress study. They were required to wear two wearables, of which one included an electrocardiogram sensor. The derived HR was averaged per hour and served as an output for a mixed design model including a trigonometric fit over time with four harmonics (periods of 24, 12, 8, and 6 hours), gender, age, whether it was a workday or weekend day, and a chronic stress score derived from the Perceived Stress Scale (PSS) as predictors.ResultsThe study included 328 subjects, of which 142 were female and 186 were male participants, with a mean age of 38.9 (SD 10.2) years and a mean PSS score of 13.7 (SD 6.0). As main effects, gender (χ21=24.02, P<.001); the hour of the day (χ21=73.22, P<.001); the circadian harmonic (χ22=284.4, P<.001); and the harmonic over 12 hours (χ22=242.1, P<.001), over 8 hours (χ22=23.78, P<.001), and over 6 hours (χ22=82.96, P<.001) had a significant effect on HR. Two three-way interaction effects were found. The interaction of age, whether it was a workday or weekend day, and the circadian harmonic over time were significantly correlated with HR (χ22=7.13, P=.03), as well as the interaction of gender, PSS score, and the circadian harmonic over time (χ22=7.59, P=.02).ConclusionsThe results show a relationship between HR and the three-way interaction of chronic stress, gender, and the circadian harmonic. The modulation by gender might be related to evolution-based energy utilization strategies, as suggested in related literature studies. More research, including daily cortisol assessment, longer recordings, and a wider population, should be performed to confirm this interpretation. This would enable the development of more complete and personalized models of chronic stress.

Perceived stress and burden of caregiving among nurses in the United Arab Emirates during the COVID-19 pandemic

Objective: To examine the perceived stress and burden of caregiving during the COVID-19 pandemic among nurses in the United Arab Emirates. Method: A descriptive survey was conducted in two selected hospitals in the UAE. A non-probability voluntary sample (n=64) of nurses working in the Intensive Care Unit (n=41) and isolation wards (n=24) was taken. Each respondent completed an online validated Perceived Stress Scale (PSS) Cronbach’s alpha=0.754; and Professional Care Team Burden Scale (Short version) Cronbach’s alpha =0.785. Range of scores on PSS was 0-40, categorized as, Low: 0-13, Moderate: 14-26 and High: 27-40, while the PCTB score was categorized into Low: 0-13, Moderate: 14-26 and High: 27-40. Pearson (r) correlation was used to determine the relationship between perceived stress and burden of care at 5% level of significance. Results: Respondents’ mean age was 38.81 ± 7.23. In all, 61 nurses (95.3%) engaged in 12-hours duty, 59.4% were confident of fighting the virus and 57 (89.1%) signed up to work in these units, despite the fear of infecting their families (78.1%). Perceived stress scale showed that 50 (78.1%) experienced moderate level of stress with only 3.1% reporting high level of stress (x̄=18.3.47 ± 5.3), while 40 (62.5%) reported low burden of care (11.98 ± 3.78). There was positive correlation between mean PSS score and the PCTB (r=0.451, p=0.000). Conclusion: Reported moderate perceived stress may suggest vulnerability to stress-related illness. Routine screening and more support from their employers to mitigate the adverse effects on their health is recommended.

Do the undergraduate medical students perceive stress and what are the stressors?

Background: Medical students have been reported to suffer from higher perceived stress compared to general population and students in the other academic fields. The objective of the study was to estimate the prevalence of stress and to identify the potential stressors among undergraduate medical students using perceived stress scale (PSS).Methods: A cross sectional study was conducted among 301 undergraduate medical students at a private medical college in Dakshina Kannada district, Karnataka. The extent of the stress was assessed using PSS-10 and a questionnaire was used to identify the potential academic, psychosocial and environmental stressors.Results: The mean PSS score was found to be 26.34±3 in this study. Moderate stress was observed in 68% of the study participants. The PSS score was higher among the 2nd year MBBS students. Stress was observed more among female medical students (74%). Inadequate study leave (92.4%), vastness of academic curriculum (84.1%), poor quality of food in mess or home (70.4%), accommodation away from home (60.1%) and high parental expectations (48.5%) were found to be the potential stressors in this study.Conclusions: The study results thereby highlight the need to plan tailored interventions to address the various stressors and prevent stress among the medical students.

Predictors of high achievers in Indian medical undergraduates: Association with emotional intelligence and perceived stress.

BACKGROUND:Today's Bachelor in Medicine, Bachelor in Surgery (MBBS) students will become Indian Medical Graduates in future. Emotional intelligence (EI) is an essential component in the making of an Indian Medical Graduate. There is increasing stress during medical training. The study was conducted to compare the association of EI score and perceived stress scale (PSS) among average and excellent undergraduate medical students. The secondary objective was to find the predictors of excellent academic performance.MATERIALS AND METHODS:This descriptive cross-sectional study was conducted after institutional ethics committee approval. All 522 consented students studying in 2nd, 4th, 7th, and 9th semesters filled up established pre-validated questionnaires ; Schutteself report EI test and Cohen's perceived stress scale. Sociodemographic details of the respondents were collected. Average attendance and marks of previous semester examinations of all included students were collected from academic cell of the institution. All students were grouped into three groups: average, good, and excellent performers from the marks collected. Comparison of EI scores and PSS scores was done between students in excellent and average groups using unpaired t-test.RESULTS:Of the 94.9% of respondents, 78.2% of the students were included in the study. The mean EI and PSS scores were 123 ± 14.5 and 22.8 ± 13.9, respectively. There was no statistically significant difference in EI scores between average and excellent performers ([123.8 ± 18.7] vs. [127.7 ± 16]; P – 0.089). Perceived stress was lower in excellent performers ([20.9 ± 11.1] vs. [24.8 ± 15.0]; P – 0.01). EI was associated with better performance in clinical year students. EI was negatively correlated to perceived stress.CONCLUSION:Our study provides predictors of excellent academic performances among Indian medical undergraduates. This study suggests introduction of extracurricular activities in ongoing undergraduate curricular syllabus. It imparts awareness among students about the importance of attending classes. This study bestows higher EI and lower perceived stress to better academic performance.

Perceived stress and coping behavior among future nurses: A cross-sectional study in West Bengal, India

Background:Demanding clinical and academic environments have been potential sources of stress among nursing students. Inability to cope effectively often potentiates this stress. If not intervened early, this may have a detrimental effect on health and may eventually affect the future workforce in rendering care.Objectives:The objective of this study was to explore the levels and sources of perceived stress and coping behavior among undergraduate nursing students in West Bengal.Materials and Methods:This descriptive cross-sectional study was conducted in two nursing training institutions in West Bengal, from July to September 2018, using a validated pretested self-administered questionnaire comprising demographics, Perceived Stress Scale (PSS), and coping behavior inventory (CBI). Students having at least 6 months of clinical exposure were invited to participate. Of 256 eligible students, 182 returned completed questionnaires, giving an overall response rate of 71%. Descriptive statistics, Pearson's correlation, and multiple regression analysis were performed using SPSS 16.0 software.Results:“Stress from assignments and workload” and “problem-solving” was the most prominent stressor and coping behavior (Factor rank 1) respectively among students. Statistically significant correlation was observed between overall mean PSS and CBI score (r = 0.306, P < 0.01). Years of education, self-decision to join, increased screen time, staying at hostel significantly predicted stress (R2 = 0.248, F = 9.640, P < 0.01), and coping behavior (R2 = 0.223, F = 10.077, P < 0.01) among students.Conclusions:Stress from academics and clinics were high among nursing students. As they are the future carers, it is apt to intervene early to mitigate their stress and enhance their coping skills during professional training and practice.

Perceived Stress Among Resident Doctors in Jordanian Teaching Hospitals: Cross-Sectional Study.

BackgroundMedical residents in Jordanian hospitals are involved in many clinical and nonclinical tasks that expose them to various stress factors. High stress and burnout have the potential to negatively impact work performance and patient care, including medication errors, suboptimal care, clinical errors, and patient dissatisfaction.ObjectiveThis study aimed to determine the perceived stress among medical residents in Jordanian hospitals and its associated risk factors.MethodsA cross-sectional study was conducted among residents in Jordanian hospitals. A cluster sample of 5 hospitals with residency programs was selected from different health sectors. All residents who were working in the selected hospitals were invited to participate in this study, during the period from April to July 2017. A total of 555 residents agreed to participate in this study, giving a response rate of 84%. The perceived stress scale (PSS) was used for assessment.ResultsA total of 398 male and 157 female residents were included in this study. The mean PSS score in this study was 21.6; 73% (405/555) of the residents had moderate level of stress, and 18% (100/555) had high level of stress. About 6.7% (37/555) of the residents had hypertension, 2.7% (15/555) had diabetes, 3.2% (18/555) had heart disease, and 8.5% (47/555) were anemic. 233 (42%) respondents complained of back pain, and 161 (29%) of the respondents complained of insomnia. Stress was associated with higher workload, sleep deprivation, and dissatisfaction in the relationship with colleagues, with income, and with the program. In multivariate analysis, the following factors were significantly associated with stress: female gender, dissatisfaction with working environment, and facing work-related, academic, and family stressors.ConclusionsThe majority of medical residents in Jordanian hospitals felt nervous and stressed. Conducting stress management programs during residency and improving the work environment are strongly recommended.

A cross-sectional study of maternal-fetal attachment and perceived stress at the first antenatal visit.

ABSTRACT Background Maternal-fetal attachment (MFA) psychologically is well described. Suboptimal attachment may have negative consequences particularly if it is associated with unhealthy maternal behaviour that may potentially increase the risk of adverse pregnancy outcomes. The perception of stress or anxiety is also associated with potential adverse outcomes including preterm birth. Objective This cross-sectional study examined MFA and perceived stress at the time of the first ultrasound examination in early pregnancy. Methods Convenience sampling was used to recruit women after they presented to the Ultrasound Department for a routine dating ultrasound at their first antenatal visit. Informed consent was obtained and clinical and sociodemographic details were recorded. Women were invited to complete validated Cranley MFA and Perceived Stress Scale (PSS) questionnaires. Results Of the 90 women recruited, 80 completed the questionnaires successfully. No association was found between the MFA score and maternal age, parity, education, marital status, previous pregnancy loss or smoking behaviour. An unplanned pregnancy was associated with a lower mean MFA score (p < 0.01) and a higher mean PSS score (p < 0.005). These relationships persisted in a multiple regression analysis controlling for maternal age and parity. Conclusion In early pregnancy, an unplanned pregnancy is associated with a lower MFA and higher PSS score. Additional research is required to assess if this persists as pregnancy advances. Abbreviations Maternal-Fetal Attachment (MFA), Maternal-Fetal Attachment Scale (MFAS), Perceived stress scale (PSS), Maternal Antenatal Attachment Scale (MAAS), Standard Deviation (SD), Central Statistics Office (CSO), Body Mass Index (BMI), Relative Risk (RR)

Associations of perceived prenatal stress and adverse pregnancy outcomes with perceived stress years after delivery.

Maternal stress is a risk factor for adverse pregnancy outcomes (APOs). This study evaluates the associations of prenatal stress and APOs with maternal stress years after pregnancy. The 10-item Perceived Stress Scale (PSS) (0-40 range) was completed in the first and third trimesters, and 2-7years after delivery among a subsample (n = 4161) of nulliparous women enrolled at eight US medical centers between 2010 and 2013 in a prospective, observational cohort study. Demographics, medical history, and presence of APOs (gestational diabetes (GDM), hypertensive disorders of pregnancy (HDP), preeclampsia (PE), and medically indicated or spontaneous preterm birth (miPTB, sPTB)) were obtained. The associations of prenatal PSS and the presence of APOs with PSS scores years after delivery were estimated using multivariable linear regression. Mean PSS scores were 12.5 (95% CI 12.3, 12.7) and 11.3 (95% CI 11.1, 11.5) in the first and third trimesters respectively and 14.9 (95% CI 14.7, 15.1) 2-7years later, an average increase of 2.4 points (95% CI 2.2, 2.6) from the start of pregnancy. Regressing PSS scores after delivery on first-trimester PSS and PSS increase through pregnancy showed positive associations, with coefficients (95% CI) of 2.8 (2.7, 3.0) and 1.5 (1.3, 1.7) per 5-point change, respectively. Adding APO indicator variables separately showed higher PSS scores for women with HDP (0.7 [0.1, 1.3]), PE (1.3 [0.6, 2.1]), and miPTB (1.3 [0.2, 2.4]), but not those with GDM or sPTB. In this geographically and demographically diverse sample, prenatal stress and some APOs were positively associated with stress levels 2-7years after pregnancy.ClinicalTrials.gov Registration number NCT02231398.

Work addiction is associated with increased stress and reduced quality of life: Validation of the Bergen Work Addiction Scale in Danish.

Addiction to work is defined as a compulsion or an uncontrollable need to work incessantly. Only few measures exist to identify work addiction and the health consequences are sparsely explored. The Bergen Workaholic Scale (BWAS) measures seven core elements of work addiction and has been used in Norway, Hungary, Brazil, Italy, USA and Poland. The aim of this study was to validate the BWAS in a Danish sample and to investigate if high risk of work addiction was associated with stress and reduced quality of life. We conducted an online screening survey with 671 participants aged 16-68 years with the Danish translation of the BWAS. We added the perceived stress scale (PSS) and the quality of life scale EQ-5D-5L. Those with high risk of work addiction reported significantly higher mean PSS scores (20.0 points) compared to those with low risk of addiction (12.5 points) and poorer quality of life (61.9) compared to the low risk group (81.3). Furthermore, work addiction was associated with more weekly working hours (44.0 vs. 35.6 hours/week) and having more leadership responsibility. A preliminary estimate of work addiction prevalence was 6.6%. The BWAS demonstrated good reliability (α = 0.83), and factor analyses pointed at a single factor structure. Work addiction seems to be associated with health problems in terms of stress and poorer quality of life. The BWAS is recommended as a reliable and valid tool to identify work addiction in Danish.

Correlation of periodontal status with perceived stress scale score and cortisol levels among transgenders in Puducherry and Cuddalore

Background: The stigmatization of transgender community can lead to various physical/psychological problems compared to the general population. The social discrimination in the transgender community causes undue stress which disrupts homeostasis and alters the immune system, which is one of the contributing factors to the severity of periodontal problems. To the best of our knowledge, there are no studies reported in the transgender community correlating periodontal status with stress in terms of perceived stress scale (PSS) and salivary cortisol levels. Materials and Methods: Periodontal status was assessed in 75 transgender participants in terms of probing pocket depth (PPD) and clinical attachment level (CAL). Stress scores were assessed by means of a PSS questionnaire and salivary cortisol levels were estimated by ELISA in 40 participants. Results: The mean PPD and CAL of participants were 4.06 ± 0.70 and 3.97 ± 0.68, respectively. The mean cortisol level of the transgender population was 6.02 ng/mL. The mean PSS score was estimated as 28. Positive correlation of PPD and CAL values with PSS scores (r = 0.592 and r = 0.618, respectively) was observed. Conclusion: There is high perceived stress as per the PSS scale scores and a positive correlation of PSS scale scores with salivary cortisol levels (r = 0.774, P = 0.000) in our study population.

Relationship between diet, atopy, family history, and premature hair graying.

Premature hair graying (PHG) is commonly observed in society, but there are a few studies evaluating risk factors associated with PHG. We aimed to evaluate the socio-clinical risk factors associated with PHG in this study. A total of 1192 volunteers between 18 and 20years old were included in this cross-sectional study. Volunteers were asked to fill in a questionnaire on socio-clinical risk factors associated with PHG such as smoking, alcohol consumption, diet preference, atopy history, and family history of PHG and Perceived Stress Scale (PSS). Three hundred and seventy-seven (31.6%) of the 1192 volunteers had PHG. Vegetarian diet preference, atopy history, and family history of PHG were significantly higher in subjects with PHG. Mean body mass index (BMI) and PSS scores were higher in subjects with PHG, but was not statistically significant. In the ordinal logistic regression analysis according to severity of PHG, male gender, BMI, alcohol consumption, and history of paternal PHG were significantly higher and onset age of PHG was significantly lower in PHG group. Our study is the first study reporting a relationship between PHG and diet. It may be possible to prevent PHG or reduce its severity with some lifestyle changes such as diet preference, having normal weight, and decreasing alcohol consumption.

Prevalence and Pattern of Phantom Ringing and Phantom Vibration among Medical Interns and their Relationship with Smartphone Use and Perceived Stress.

Background:Phantom sensations like phantom vibration (PV) and phantom ringing (PR)— the sensations of vibration and ringing of the phone when they are not, respectively—are among the latest in the category of “techno-pathology” to receive global attention. This study was conducted with the aim to estimate the prevalence of such sensations among medical interns and their association with perceived stress levels and smartphone usage pattern.Materials and Methods:Ninety-three medical interns using smartphone were recruited for the study. Data were collected anonymously using semi-structured questionnaire, perceived stress scale (PSS), and smartphone addiction scale-short version (SAS-SV). Data were analyzed using descriptive statistics, Chi-square test, independent t-test, ANOVA, and Pearson's correlation coefficient.Results:Fifty-nine percent students had a high level of stress, whereas 40% had problematic smartphone use. Sixty percent students experienced PV, whereas 42% experienced PR and both were significantly associated with higher frequency of phone use and the use of vibration mode. Mean SAS-SV score was significantly lower in students who did not perceive PR/PV, whereas mean PSS score was significantly lower in students who did not perceive PV.Conclusion:This study confirms findings from other national and international researches about the experience of cell phone phantom sensations and their relationship with the pattern of phone use and stress level. It also brings to light high levels of stress and problematic smartphone use among medical students during the internship.

Mindfulness: Assessing the Feasibility of a Pilot Intervention to Reduce Stress and Burnout.

To examine the feasibility of a brief mindfulness intervention and to reduce nurse stress and burnout in an inpatient medical unit. Single-arm, pre/post test study design. Perceived Stress Scale (PSS), Maslach Burnout Inventory (MBI), and pre/post demographic questionnaires given at pre-intervention (baseline) and 6 weeks post-intervention. Intervention effectiveness was compared between the pre-survey ( N = 52) and post-survey ( N = 33). Five choices were offered to inpatient staff: a guided mindfulness CD, soothing sounds machine with a breathing technique instructional, mindfulness prompts, a journal, and water/snacks during six consecutive weekends. The mean PSS score did not improve and demonstrated a slight increase during the six-weekend intervention. However, mean MBI scores for the subscales of emotional exhaustion and depersonalization did demonstrate improvement as evident by decreased scores. Additionally, the mean MBI score for the subscale of personal accomplishment also improved with increased scores. Qualitative themes were positive and included relaxation, nourishment, and refocus. Majority of participants (75%) perceived the intervention as being effective or very effective in reducing stress at work. Respondents were "interested" or "very interested" in continuing a similar intervention in the future (84.9%). The improvement in scores for the MBI measures were a positive finding. The intervention was low cost, individualized, and accessible. The feasibility and perceptions of the intervention's effectiveness has positive implications for the well-being of nurses.

A Questionnaire Study to Investigate Stress among Future Pharmacists by Gender and Year Group.

Background: This work aimed to ascertain future pharmacists’ stressors and stress-coping practices. Methods: Queens’ University Belfast Year 2 and 4 pharmacy students were invited to participate in an ethically approved, pre-piloted questionnaire study. Section A was the 10-item Perceived Stress Scale, Sections B and C related to stressors and stress-coping mechanisms, and Section D gathered non-identifiable demographic information. Data analysis largely took the form of descriptive statistics. Results: A response rate of 94.2% (213/226) was obtained. The mean Perceived Stress Scale score was 19.94 [standard deviation (SD) 6.37], with females having a higher mean score than males (20.55 SD 5.67 versus 18.16 SD 7.42). Common general stressors were career choice, employment opportunities, and finance. Common degree-specific stressors were particular assessments (objective structured clinical examinations and one-off written examinations) and the amount of course material. Popular stress-coping practices included getting emotional support from friends and family and using self-distractions. Conclusion: Stress appears to be an issue among these future pharmacists, and potentially more so for females. While the main stressors are unsurprising, this UK data enables comparisons to be made and helps inform support mechanisms within the university.

Grit, anxiety, and stress in emergency physicians

IntroductionThe personality traits of emergency physicians are infrequently studied, though interest in physician wellness is increasing. The objective of this study is to acquire pilot data about the amount of grit, anxiety, and stress in emergency physicians using established psychological survey instruments, and to examine their associations of each of these traits with each other. MethodsThirty-six emergency medicine resident and attending physicians from an urban academic medical center consented for enrollment. Participants were administered the Duckworth 12-point Grit Scale, the State-Trait Anxiety Inventory (STAI), and the Perceived Stress Scale (PSS), which measure grit, anxiousness, and perceived stress, respectively. These are the gold standard psychological instruments for each of their areas. We analyzed the results with descriptive statistics, Spearman correlations, and linear regression. ResultsNineteen residents and 17 attending physicians completed the surveys during the first quarter of a new academic year. The mean grit score was 3.7 (95% CI 3.5–3.8, SD: 0.56), the mean trait-anxiety score was 32.61 (95% CI 30.15–35.07, SD: 7.26), and the mean PSS score was 12.28 (95% CI 10.58–13.97, SD: 4.99). Only trait-anxiety and perceived stress were significantly correlated (Spearman's rho: 0.70, p<0.01). ConclusionsIn this pilot study at a single institution, emergency physicians demonstrated a range of grit, trait-anxiety, and perceived stress. Trait-anxiety and stress were strongly associated, and individuals who were more anxious reported more stress. Levels of grit were not associated with trait-anxiety. These psychological concepts should be studied further as they relate to the function and health of emergency medicine providers.

The relationship between self-reported exposure to greenspace and human stress in Baltimore, MD

Cross-sectional methods were utilized to investigate if greenspace (GS) exposure predicts stress, a known factor affecting health outcomes. Data included publicly accessible Community Statistical Area (CSA) level information and survey (mailed and online) results of residents in Baltimore, Maryland. The convenience sample was recruited in spring 2013 using random (by CSA) and snowball techniques. The survey included demographic information, GS exposure, recent stressful life events, and the validated Perceived Stress Scale (PSS). Individuals reported (hours per week, type) where they see (visual exposure) or spend time in (physical exposure) GS around their home, work and/or school, and during recreation. Duration of GS exposure was defined as hours of visual exposure, hours of physical exposure, and total hours of exposure (both visual and physical). Multivariable linear regression assessed the effect of GS on perceived stress. Respondents (N=323) reported a mean 25.5 total hours/week exposed to GS. Mean PSS scores were 15.75 for females and 13.45 for males. Controlling for all covariates, there was a statistically significant reduction in PSS score (0.049, p=0.007) for every hour/week exposed to GS. This means that an individual who spent 25.5h/week exposed to GS would have a PSS score 3.1% lower than those who were not exposed to GS. Total hours/week exposed to GS, and the individual effects of visual and physical exposure were all statistically significant. These findings indicate the stress reducing effects of GS exposure may be part of complex set of factors behind the relationship between GS and health outcomes.

Psychometric properties of the Perceived Stress Scale in a sample of German dementia patients and their caregivers.

The aim of the present study was to investigate the psychometric characteristics of the Perceived Stress Scale (PSS) in a sample of dementia patients and their spousal caregivers. We investigated the reliability and validity of the 14-item PSS in a sample of 80 couples, each including one spouse who had been diagnosed with mild to moderate dementia (mean age 75.55, SD = 5.85, 38.7% female) and one spousal caregiver (mean age 73.06, SD = 6.75, 61.3% female). We also examined the factor structure and sensitivity of the scale with regard to gender differences. Exploratory factor analysis of the PSS revealed a two-factor solution for the scale; the first factor reflected general stress while the second factor consisted of items reflecting the perceived ability to cope with stressors. A confirmatory factor analysis verified that the data were a better fit for the two-factor model than a one-factor model. The two factors of the PSS showed good reliability for patients as well as for caregivers ranging between α = 0.73 and α = 0.82. Perceived stress was significantly positively correlated with depressive symptomatology in both caregivers and patients. Mean PSS scores did not significantly differ between male and female patients nor did they differ between male and female caregivers. The present data indicate that the PSS provides a reliable and valid measure of perceived stress in dementia patients and their caregivers.