Perceived Stress Scale Scores Research Articles

Intraocular Pressure Response to Perceived Stress in Juvenile-Onset Open Angle Glaucoma.

High perceived stress from academic pressure is associated with intraocular pressure (IOP) elevation and reduced fluctuation in juvenile-onset open angle glaucoma patients. Personalized stress assessment and relief strategies may serve as an adjunct therapy in glaucoma. To evaluate the effect of higher perceived stress, resulting from academic pressure, on IOP in juvenile-onset open angle glaucoma (JOAG) patients compared with healthy individuals. The study included 48 university students aged 18-27 years, comprising 24 JOAG patients on antiglaucoma eyedrops and 24 healthy controls. In an examiner-blind pretest-posttest design, participants' IOP was measured weekly using Goldmann tonometry during three follow-up visits at the beginning and end of the academic semester. Perceived Stress Scale (PSS) scores were also evaluated at these 2-time points to capture the contrast in perceived stress between periods of low and high academic pressure. The baseline PSS score at the semester's start was lower in both groups (14.1±1.9 in glaucoma vs. 13.5±2.4 in control) and significantly increased by the end of the semester (29.2±2.1 vs. 28.5±1.3; P <0.001), indicating increased perceived stress. Concurrently, IOP rose from 22.01±5.87 to 25.08±5.84mmHg in the glaucoma group and from 11.36±2.03 to 13.65±2.11mmHg in the control group. Factorial analysis revealed a significant interaction between stress and JOAG ( F(1,94) =15.94, P =0.001), partial η 2 =0.08, with stress having a greater increase on IOP in the glaucoma group (+3.10mmHg) compared with the control group (+2.23mmHg) ( t(94) =4.457, P <0.001). Higher perceived stress significantly increases IOP, especially in JOAG patients, suggesting personalized stress management as a potential adjunct therapy for patients.

The effect of physical activity on stress levels of medical students: A cross-sectional analysis

Objectives To determine association between physical activity and hours of physical activity and stress levels in medical students Methods A cross sectional study was conducted at a private medical college in Karachi, during April and May 2015. Convenience sampling was used to identify the study participants. The subjects were medical students from year one through five. We interviewed 235 students. A pre-tested, self-administered three-part questionnaire was used to collect the data. The first part of the questionnaire inquired about the subjects’ demographics and exercise habits, the second part of the questionnaire was adapted from the Perceived Stress Scale (PSS) to determine stress scores within participants, and the third part of the questionnaire asked about other stress relieving factors. Results According to the PSS, 30.3% of the participants were moderately stressed. The mean PSS was found to be 16.95 ± 5.72. 2A significant correlation was found between physical activity and stress levels; those involved in physical activity were 52 percent less likely to be moderately stressed (OR 0.48, p-value = 0.015) as compared to those who had not partaken in physical activity. Furthermore, studentswho performed physical activity for &gt;4 hours per week had a lower mean PSS score (16.2) when compared to those who exercised for &lt;2 hours per week. (18.2). Post-hoc statistical testing revealed the difference to be significant (p=0.028). Conclusion Based on the findings of our study, we conclude that physical activity of any form is associated with significantly decreased stress levels in medical students.

The Relationship Between Stress and Burnout: A Sample of Automotive Factory Workers

The purpose of this research is to determine the relationship between stress and burnout in employees of an automotive factory. This research was conducted descriptively with 306 participants at Sango Automotive Products Industry and Trade Joint Stock Company in Kocaeli/Türkiye between April and July 2021. Data were collected using the Personal Information Form, Perceived Stress Scale and Burnout Scale-Short Version. The mean Perceived Stress Scale score of participants was 25.11±7.39; The average score of the Burnout Scale were 29.69±12.61. A statistically significant positive relationship was determined between the mean Perceived Stress Scale scores and Burnout Scale scores of participants (r=0.67; p

The effects of mindfulness-based psycoeducation program on the perceived stress levels and emotion regulation strategies of patients diagnosed with bipolar disorder

ObjectivesIn recent years, mindfulness-based practices in psychiatric patients have become a new trend. It is applied to many mental disorders and is stated to have various benefits. There is not enough research yet on how mindfulness-based practices effect patients with diagnosed bipolar disorder. This study aimed to evaluate the effects of mindfulness-based psychoeducation program on emotion regulation strategies and perceived stress levels of patients diagnosed with bipolar disorder. MethodsThe study, which was carried out as a pre-test and post-test quasi-experimental research design with a control group, was carried out with a total of 71 patients diagnosed with bipolar disorder, 35 of whom were assigned to the experimental group, and 36 of them were assigned to the control group. Data of the study was collected with the Personal Information Form, Mindful Attention Awareness Scale (MAAS), Emotion Regulation Questionnaire (ERQ), and Perceived Stress Scale (PSS). The mindfulness-based psychoeducation program was implemented in the form of group training, 2 sessions per week, for a total of 6 sessions. ResultsCompared to the control group, it was determined that the MAAS and ERQ-Reappraisal total mean scores of the experimental group increased significantly, and the PSS and ERQ-Suppression total mean scores decreased significantly (p < 0.01). ConclusionsMindfulness-Based psycoeducation program improved mindfulness, emotion regulation and level of perceived stress of patients diagnosed with bipolar disorder.

Quantitative EEG correlates of 'Kriya yoga' benefits for mental health among health care providers.

Health care workers (HCWs) experience abounding physical and mental exhaustion mandating a deliverable solution for their mental health care. Kriya yoga (KY) includes several relaxation techniques and offers a stress-alleviating experience. The objective signature of KY benefits needs to be investigated. To study the effects of KY practice on brain oscillations and perceived stress in health care providers. This prospective interventional study was conducted during coronavirus disease 2019 pandemic. HCWs were enrolled to the intervention group (IG) and control group (CG) after obtaining an informed consent. IG visited the yoga center for learning the KY technique. Electroencephalogram (EEG) was recorded in both the groups, at baseline, and at the end of 6 weeks in the EEG Laboratory. Perceived stress scale (PSS) scores and participants' subjective response to KY practice were also collected. Paired t-test and independent t-test were used for statistical comparison wherever applicable. Age and baseline EEG powers among the IG and CG (N = 25) were statistically comparable. Absolute power analysis revealed a statistically significant increase in alpha and delta powers after 6 weeks of KY practice. The PSS scores revealed a statistically significant decrease in perceived stress after KY practice. Furthermore, 83% of the participants reported the subjective calming effects of KY practice. KY practice ensues relaxing effects on the brain, as evident from the EEG absolute power analysis, PSS scores, and participants' subjective response. As KY is a brief technique, it may be encouraged during short break session among the HCWs for promotive health.

Evaluating the Therapeutic Effectiveness of Music Therapy in Post-Laparoscopic Ovarian Cystectomy Patients: A Single-Center Retrospective Study.

The therapeutic effects of music therapy on improving negative emotions and reducing pain are increasingly acknowledged. However, limited clinical research exists on its use in patients post-laparoscopic ovarian cystectomy (LOC). A total of 147 patients undergoing LOC at our hospital were evaluated. Patients were divided based on the implementation time of music therapy: group A (72 patients, October 2020 to October 2021) received standard clinical treatment, while group B (75 patients, November 2021 to November 2022) received music therapy alongside routine care. The baseline data of patients and the scores of the Short-Form McGill Pain Questionnaire (SF-MPQ), Perceived Stress Scale (PSS), Beck Anxiety Inventory (BAI), and Patient Satisfaction Questionnaire were collected. Pain and psychological stress levels were compared on the first postoperative day and at discharge to assess the clinical value of each treatment approach. Group B exhibited significantly lower PSS, SF-MPQ, and BAI scores (P < 0.001 for all) and higher overall satisfaction at discharge (P < 0.001). These findings suggest that music therapy can reduce psychological stress, decrease pain levels, and improve mood in patients undergoing LOC. This study demonstrates that music therapy positively rehabilitates patients after LOC, offering new insights for future clinical treatment strategies.

A randomized, double-blind, parallel and placebo-controlled clinical study to evaluate the efficacy and safety of KaraCalm™: a dietary supplement to support sleep and manage stress

Background: KaraCalm™ is a novel polyherbal formulation obtained from the combination of Valeriana officinalis extract, Passiflora incarnata extract, Ocimum sanctum extract, Ziziphus jujuba extract, Rosmarinus officinalis extract, and Nigella sativa extract. The objective of the present investigation was to assess the efficacy and safety of KaraCalm™ to manage stress and improve sleep in healthy subjects in a randomized, double-blind, placebo-controlled clinical study. Methods: A total of 60 healthy volunteers were randomized into two groups, with 30 subjects in the KaraCalm™ group and 30 in the placebo group. Participants were asked to take KaraCalm™ 500 mg or placebo once daily for 56 days. As primary outcomes, sleep analysis was performed by using Actiwatch, while stress level was evaluated with the Perceived Stress Scale (PSS) scores from baseline to the end of the study period. Serum cortisol, and hs-CRP from baseline to the end of the study period were assessed as secondary endpoints. Results: An increase in overall sleep quality was observed in the KaraCalm™ group compared to the placebo as measured by total sleep time, onset latency, wake after sleep onset minutes, and number of awakenings. There was also a reduction in PSS scores in the KaraCalm™ group from baseline to the end of the study, indicating reduced stress levels. A significant reduction in Serum cortisol and hs-C-reactive protein (CRP) levels in the KaraCalm™ group from baseline to the end of the study further supported the effectiveness of KaraCalm™ in reducing stress. There was no significant change in the safety analyses of the patients in the intervention group when assessed from the start of the study to the end. Conclusions: KaraCalm™ can be considered a safe and effective dietary herbal Supplement to reduce stress and improve sleep quality.

Determinants of Perceived Stress among Indian Adults during Second Wave of COVID-19

The present study was conducted from June–July, 2021 in online mode and a questionnaire was designed at the Department of Food Science and Nutrition, College of Community Science, G. B. Pant University of Agriculture and Technology, Pantnagar. The study aims to find an association of perceived stress with socio-demographic factors, health profile and physical activity among Indian adults during the second wave of COVID-19. Data on perceived stress was collected through an online cross-sectional survey of 1933 Indian adults based on the Perceived Stress Scale (PSS). Multivariate ordinal regression was conducted to identify the predictors of perceived stress. Indian adults were moderately stressed, with a mean PSS score of 19.7±5.5 during the crisis time of COVID-19. The study population remained moderately active (59.3%) during the lockdown period. Perceived stress was negatively associated with age, education, income, and physical activity and positively associated with random blood sugar levels and sitting time. Odds of perceived stress increased with female gender, separated marital status, having one child or adolescent in the family, graduate or postgraduate as the educational status of the family’s head, and increased sitting time. High educational status, retirement, regular employment, middle or lower-class social class, and high physical activity level were negative predictors of perceived stress. The current investigation highlights the role of multiple factors in the perception of stress and the need for tailored interventions for vulnerable groups focusing on education and physical activity.

Correlation of stress, depression, sleep, and pain with race and body mass index (BMI): Secondary analysis from Alliance A011502.

e23171 Background: A011502 is a phase 3 trial that randomized high-risk nonmetastatic breast cancer (BC) patients (pts) to aspirin 300 mg daily vs. placebo. Obesity and Black race have been shown to be associated with worse clinical outcomes. We studied the association of stress, depression, sleep and pain with each other, and with BMI and race. Methods: At baseline, 2735, 2610, 2720, and 2422 pts completed Perceived Stress Scale (PSS), Center for Epidemiologic Studies Depression Scale Revised (CESD-R), Brief Pain Inventory (BPI), and Pittsburgh Sleep Quality Index (PSQI) respectively. Stress was categorized with PSS scores: low (0-13), moderate (14-26) or high (27-40). Depression was categorized with CESD-R scores: no depression (0-15) or depression (≥16). Pain was categorized with BPI scores: none/mild (0-3) or moderate/severe (≥4). Sleep quality was categorized with PSQI scores: good (0-5) or poor ( &gt; 5). Associations of measures by race and BMI were analyzed using chi-square test. Results: There was a statistically significant association among stress, depression, pain, and sleep quality (p &lt; 0.01 for all). Compared to pts with BMI &lt; 25, overweight and obese women reported higher stress (2.9%, 2.3% vs. 1.7%, p = 0.04), depression (13.4%, 18% vs. 9.6%, p &lt; 0.01), moderate/severe pain (16.5%, 20.3% vs. 12%, p &lt; 0.01), and poor sleep (64.9%, 71.5% vs. 60.4%, p &lt; 0.01). Black women reported more moderate/severe pain compared to White women or other races (32.9% vs. 14.2% vs. 27.8%, p &lt; 0.01). There was no association of other symptoms with race (Table 1). Conclusions: Obesity was associated with higher stress, depression, poor sleep and pain among BC pts from A011502. Black women reported higher pain compared to other races. Future studies are warranted that determine causal associations, how symptoms may relate to outcome disparities, and develop approaches to address them. U10CA180821, U10CA180882, UG1CA233196; https://acknowledgments.alliancefound.org . Clinical trial information: NCT02927249 . [Table: see text]

Association of higher baseline stress and pain with clinical outcomes: Secondary analysis from Alliance A011502.

11016 Background: A011502 is a phase 3 randomized double-blind clinical trial that enrolled high-risk nonmetastatic breast cancer (BC) patients (pts) and randomized pts to aspirin 300 mg daily vs. placebo. There was no significant difference in invasive disease-free survival (iDFS) between the two arms. A secondary objective was to determine the association of inflammation-affiliated factors (stress, depression, poor sleep quality and pain) with iDFS and overall survival (OS). We hypothesized that these baseline factors are associated with worse clinical outcomes. Methods: At baseline, 2735, 2720, 2422 and 2610 pts completed Perceived Stress Scale (PSS), Brief Pain Inventory (BPI), Pittsburgh Sleep Quality Index (PSQI) and Center for Epidemiologic Studies Depression Scale Revised (CESD-R) respectively. Stress was categorized with PSS scores: low (0-13), moderate (14-26) or high stress (27-40). Pain was categorized with BPI scores: none/mild (0-3) or moderate/severe (≥4). Sleep quality was categorized with PSQI scores: good (0-5) or poor ( &gt; 5).Depression was categorized with CESD-R scores: no depression (0-15) or depression (≥16). Associations between the measures of interest and outcomes were performed with multivariable Cox models controlling for age, body mass index, time since diagnosis, race, ethnicity, hormone receptor status and treatment arm. Results: Median follow up was 35 months. The associations from multivariable Cox model are shown in Table 1. Pts who reported high PSS had significantly worse iDFS and (non-significant) worse OS. Moderate/severe average (avg) pain was significantly associated with worse iDFS and OS. Poor sleep quality and depression were associated with worse iDFS and OS but not statistically significant. Conclusions: Pts reporting higher stress and pain at baseline had worse outcomes. We acknowledge that both pain and stress may be related to other non-cancer issues (chronic comorbidities). Our study highlights the need for clinical trials to consider including questionnaires to assess pt-reported outcomes. Future studies are warranted to determine if measures to decrease pain and stress would improve BC outcomes. U10CA180821, U10CA180882, UG1CA233196; https://acknowledgments.alliancefound.org . NCT02927249: Clinical trial information: NCT02927249 . [Table: see text]

Association of dysmenorrhea with stress among female students at Universal College of Medical Sciences, Bhairahawa

Background: Dysmenorrhea, the cramping pain experienced by women during menstruation, can significantly impact their daily lives and academic performance. Mental stress is a potential trigger for dysmenorrhea, but their association remains to be precisely determined. This study aims to explore the prevalence of dysmenorrhea among undergraduate female students at Universal College of Medical Sciences and investigate its association with perceived stress.Methods: A descriptive cross-sectional study was conducted among undergraduate female students at Universal College of Medical Sciences, Bhairahawa. Participants were selected using a simple random sampling method. A structured questionnaire, including anthropometric data, menstrual history, and the Perceived Stress Scale (PSS), were used for data collection. PSS scores were used to categorize stress levels as low, moderate, or high.Results: Total 196 female students participated in the study. Dysmenorrhea was present in 80.1% of the participants, with 34.7% seeking treatment for the condition. Additionally, 29.6% of the students reported moderate to severe premenstrual symptoms. Most students (81.6%) had a moderate level of perceived stress. Statistical analysis revealed a significant association between dysmenorrhea and level of perceived stress (p &lt; 0.001).Conclusion: The study findings highlight a considerable prevalence of dysmenorrhea among female students at Universal College. The association between dysmenorrhea and perceived stress underscores the importance of addressing the psychosocial well-being of these students. Implementing supportive measures, such as mental health support and stress management programs, can create a more conducive environment for students to manage dysmenorrhea and its impact on their academic performance.

Changes in sleep patterns in primary care workers during the first wave of the COVID-19 pandemic in 2022 in Shanghai: a cross-sectional study

The coronavirus disease (COVID-19) pandemic has significantly affected the sleep health of healthcare workers (HCWs); however, no studies have assessed this effect in primary HCWs. This cross-sectional, web-based study explored the prevalence and factors associated with sleep disorders among primary HCWs during the first COVID-19 outbreak in Shanghai from 12 July to 15 August 2022. Sociodemographic and work-related characteristics, various sleep dimensions, and exposure to patients with COVID-19 were assessed. They were screened for common mental disorders (depression, burnout, and stress). Overall, 313 primary HCWs were recruited. At least one sleep dimension in 84% of respondents deteriorated compared with that observed pre-pandemic; sleep quality (decline of 66%) and daytime sleepiness (increase of 56%) were the most affected domains. After excluding 145 primary HCWs with pre-pandemic ‘poor sleep’, depression (odds ratio [OR] 3.08; 95% confidence interval [CI] 1.59–5.98), weekly burnout symptoms (OR 2.57; 95% CI 1.32–5.03), and high psychological stress (OR 4.51; 95% CI 2.09–9.72) were associated with poor sleep patterns during the pandemic. After adjusting for significant differences between groups, for every 1-point increase in the Perceived Stress Scale score, an associated 12% increased risk of poor sleep (adjusted OR 1.12; 95% CI 1.05–1.21; p = 0.002) was observed. Most primary HCWs showed significant worsening of sleep quality, with increases in daytime sleepiness during the first wave of the COVID-19 pandemic in Shanghai. HCWs with high stress levels were at greater risks of sleep disorders.

Safety and Efficacy of AlphaWave® L-Theanine Supplementation for 28Days in Healthy Adults with Moderate Stress: A Randomized, Double-Blind, Placebo-Controlled Trial.

Prolonged periods of stress may lead to negative health consequences. AlphaWave® L-Theanine was safe and efficacious during an acute stress challenge. However, double-blind, placebo-controlled clinical trials investigating the longer term effects of L-theanine supplementation on stress are warranted. Thirty healthy adults (18-65years) with moderate stress were randomized to AlphaWave® L-Theanine (400mg L-theanine/day) or placebo (n = 15/group) for 28days. Stress was assessed by salivary cortisol, Perceived Stress Scale (PSS) and Depression, Anxiety and Stress Scale-21; sleep was assessed by the Healthy People Sleep Quality Index and actigraphy device; cognition was assessed by Computerized Mental Performance Assessment System; mood was assessed by Profile of Mood States. All outcomes were measured at baseline, Days 14 and 28. Safety included vital signs, clinical chemistry, haematology and adverse events (AEs). All AEs were resolved by the end of the study period or upon subsequent follow up, and out of range laboratory values and changes in vital signs were deemed not clinically relevant following AlphaWave® L-Theanine supplementation. Participants supplemented with AlphaWave® L-Theanine had decreases of 12.92% (p = 0.051) and 17.98% (p = 0.04) in PSS scores after 14 and 28days, respectively, while those on placebo had respective decreases of 9.74% (p = 0.061) and 17.88% (p = 0.009). There were no significant differences between groups for change in salivary cortisol. The AlphaWave® L-Theanine group demonstrated decreased time asleep after 28days and significantly reduced light sleep after 14 and 28days compared to placebo (p ≤ 0.040). The AlphaWave® L-Theanine group significantly improved by 21.79% and 21.33% in Stroop test correct reaction time after 14 and 28days, respectively, while those on placebo improved after 28days only (p = 0.005). AlphaWave® L-Theanine supplementation for 28days was safe and significantly decreased perceived stress significantly decreased perceived stress and light sleep, improved sleep quality and enhanced cognitive attention in the studied population. Larger, randomized controlled trials with longer duration of AlphaWave® L-Theanine supplementation are warranted to reduce inter-individual variability and the potential placebo effect. ClinicalTrials.gov identifier, NCT05808595.

The influence of perceived stress and motivation on telomere length among NCAA swimmers.

Telomere length (TL) shortening is associated with increased cellular senescence and functional decline with age. Regular physical activity is posited to safeguard against TL shortening, but there is disagreement on how concurrent psychosocial stress may influence this relationship. The current analysis explored whether psychosocial stress is associated with TL differences in highly physically active individuals. TL was measured from capillary dried blood spots collected from Division-I (D-1) and Division-III (D-3) National Collegiate Athletics Association (NCAA) swimmers (N = 28) and non-athlete students from the same schools (N = 15). All participants completed Cohen's Perceived Stress Scale (PSS) and student-athletes completed an additional questionnaire to assess psychosocial factors associated with their lifestyle; The Student Athletes' Motivation towards Sports and Academics Questionnaire (SAMSAQ). Semi-structured interviews further contextualized how student-athletes internalize their stress. There was no significant difference in TL or PSS scores between swimmers and controls. D-1 swimmers reported significantly higher career and student-athlete motivation scores compared to D-3, but non-significantly higher PSS and similar academic motivation scores. Themes from interviews with collegiate swimmers included COVID-19 stress, fear of injury, pressure from academics, expectations to perform, and financial pressures. These themes may have contributed to higher PSS scores in D-1 swimmers compared to D-3 but did not appear to impact their TL. Given differences in perceived stress, sources of stress, and SAMSAQ scores, further analyses with larger sample sizes are needed to better understand how these factors influence human biology and health while engaged in intense physical activity.

Salivary and serum estrogen level assessment in oral lichen planus patients and its correlative analysis with OLP and stress.

Lichen planus is a chronic inflammatory disease of the skin and mucous membrane with higher predilection seen in the female population. Oral lichen planus (OLP) has been associated with various etiological factors, such as stress, hormonal imbalance, and immunological variation. The purpose of this study was to assess serum and salivary estrogen (E2) levels in OLP patients and correlate them with stress levels. This study aimed to evaluate serum and salivary estrogen levels in female patients with OLP, along with the assessment of stress and its correlation with estrogen levels. A total of 78 females, 39 clinically diagnosed with OLP and 39 healthy females, were included in the study as the case and control groups, respectively. 2 ml each of salivary and serum samples was obtained from each participant to measure the estrogen levels. Stress levels in the study group patients were assessed using the Depression Anxiety Stress Scale (DASS-21) and the Perceived Stress Scale (PSS). The nonparametric Mann-Whitney test was used for intergroup comparisons. Significantly higher serum estrogen levels with higher DASS-21 and PSS scores were noted in patients with OLP. Overall, significant positive correlations were observed between salivary E2 and serum E2 (r = 0.361, P = 0.001). There was a positive correlation between salivary and serum E2 and DASS score (r = 0.410, P < 0.001, and r = 0.768, P < 0.001, respectively), serum/salivary E2 and PSS score (r = 0.745, P < 0.001, and r = 0.410, P < 0.001, respectively), and DASS score and PSS score (r = 0.878, P < 0.001). Estrogen can be used as a useful biomarker for OLP in the future. Salivary samples can prove to be an accurate and feasible alternative to serum estrogen level determination. We also suggest that OLP patients must be given supportive psychological treatment for improved life quality and disease management.

A Multimodal Ayurveda and Mind-Body Therapeutic Intervention for Chronic Symptoms Attributed to a Postinfectious Syndrome: A Pilot Study.

Objective: Evaluate feasibility and impact of a multimodal integrative therapeutic intervention in patients presenting with chronic symptoms attributed to a postinfectious syndrome. Design: This was a prospective longitudinal single-center pilot study conducted from January 2019 to December 2020. Setting/Location: University of Maryland Lyme Program, Baltimore Maryland. Subjects: Persons presenting for Lyme evaluation for symptoms attributed to Lyme disease. Interventions: Participants attended two 1-h individual instructional sessions consisting of Ayurveda-based dietary intervention and breath-coordinated mind-body practice to be used for home practice. Outcome measures: Standard measures of impact were obtained at baseline, 1, 3, 6, and 12 months using the following validated survey instruments: Perceived Stress Scale (PSS), PROMIS Global Health v1.2 (GH), and PROMIS 29 v2.0 survey. Results: From 216 patients presenting for Lyme evaluation, 19 participants enrolled with 84% completing the study (N = 16). Baseline PROMIS GH scores consisting of general Physical Health (GPH) and general Mental Health (GMH) scores were lower in the study population than in the general U.S. population. PROMIS 29 scores were higher for fatigue, anxiety, and pain than those in the general U.S. population. Over 12-month period, improvement in both the GPH and GMH was 6.09 (confidence interval [95% CI] = 2.71-9.46; p < 0.001) and 4.65 (95% CI = 1.50-7.80; p = 0.004), respectively. PROMIS 29 scores showed the greatest improvement in fatigue at -7.91 (95% CI = -12.34 to -3.48; p < 0.001), pain interference -5.08 (95% CI = -9.20 to -0.96; p = 0.016), and ability to participate in social roles and activities 7.48 (95% CI = 3.21-11.75; p = 0.001) and least with depression -1.82 (95% CI = -4.74 to 1.10; p = 0.223). Employment status had significant effects on almost all outcome scores. Postinfectious state was associated with improvement in anxiety and PSS scores. Conclusions: A multimodal Ayurvedic and breath-coordinated mind-body therapeutic intervention is feasible and a potential nonpharmacologic therapeutic option for persons presenting with pain, stress, fatigue, physical dysfunction, and sleep disturbance attributed to a postinfectious syndrome. Further research is needed to determine efficacy in this population and in other groups with similar symptom complexes due to postinfectious syndromes.

Quality of Life and Perceived Stress in Chronic Spontaneous Urticaria: Counting the Burden

Abstract Background: Chronic spontaneous urticaria (CSU) is a dermatosis with a significant psychological component. Only a few studies have assessed the quality of life (QoL) and perceived stress in CSU patients. Objectives: To evaluate the QoL and perceived stress in patients with CSU. Materials and Methods: A cross-sectional study was done on 54 patients of CSU attending the Urticaria clinic of the Dermatology department in a tertiary care postgraduate teaching hospital in North Kerala. QoL in chronic urticaria was assessed using the Chronic Urticaria-Quality of Life (CU-QoL) questionnaire and perceived stress was assessed using the Perceived Stress Scale (PSS). Results: The mean scores of CU-QoL and PSS were 55.78 and 16.31, respectively. Out of 54 patients, 26 (48.1%) had mild impairment, 26 (48.1%) had moderate impairment, and 2 (3.7%) had severe impairment of QoL. Low stress was seen in 20 (37%) patients, moderate stress in 28 (51.9%), and six (11.1%) patients had high stress. Conclusion: This study shows that more than half of the patients with CSU had moderate to severe impairment of QoL and had moderate to severe stress.

Relationships among Cortisol, Perceived Stress, and Dental Caries Experience in Adolescents and Young Adults

Introduction: Stress can impact mental and physical health, especially during adolescence and young adulthood, but the extent of its contribution to dental caries is poorly understood. The present study assessed the association between perceived stress, cortisol levels (in hair and saliva), and overall caries experience of adolescents and young adults aged 15–25 years. Methods: Hair and saliva samples were obtained from 93 participants free of periodontal disease. Cortisol in hair and saliva was determined using a competitive enzyme-linked immunosorbent assay. Participants completed a perceived stress questionnaire and underwent full-mouth oral examination by a calibrated examiner. Dental caries experience was based on the decayed, missing, and filled teeth (DMFT) index. Sociodemographic variables were also recorded. Results: There were significantly higher hair cortisol levels and perceived stress scale (PSS) scores in individuals with dental caries experience (DMFT≥1) than in those without (DMFT = 0). However, there was no significant difference in salivary cortisol concentration. A binary logistic regression revealed that higher hair cortisol levels and greater scores on the perceived stress scale were associated with increased odds of having experienced dental caries. In contrast, no significant association was found between salivary cortisol concentration and dental caries. Using multivariable regression models, caries experience was found to be significantly associated with both hair cortisol levels and PSS scores. These associations remained statistically significant even after adjusting for sociodemographic variables. Conclusion: Hair cortisol levels and perceived stress have a significant association with dental caries experience, whereas salivary cortisol concentrations do not.

Perception of Good Death and Level of Perceived Stress in Relatives of Palliative Care Patients.

This study aimed to examine the perception of a good death and the level of perceived stress in relatives of palliative care patients. Relatives of 110 patients hospitalized in a palliative care center constituted the research sample. A personal information form, the "Good Death Scale," and the "Perceived Stress Scale" were used for data collection. The patients' relatives defined good death as being with family members and living this process without suffering. The mean total Good Death Scale score of the relatives of palliative care patients was 54.86 ± 7.78, and their mean total Perceived Stress Scale score was 31.11 ± 10.10. These findings showed that patients' relatives had high perceptions of good death and that their stress levels were above average. To expand the scope of nursing care, it is important to know how patients' relatives are affected by this process. It is recommended that more studies be conducted on this subject.

Stress and Anxiety Levels of International Nursing Students: Case of Northern Cyprus

Introduction: Stress is a multifaceted concept that focuses on changes in the interaction between people and their environment. Stress, which is increasing in developing and rich countries, is one of the biggest problems affcting the health sector, especially universities, and especially nursing practices. Aim: This study aimed to determine the stress and anxiety levels of undergraduate nursing students. Method: This descriptive study was conducted on 223 international nursing students studying at Near East University to determine the stress and anxiety levels of nursing students. Data were collected through online Google Forms using the Generalized Anxiety Disorder - 7 Scale, Perceived Stress Scale and Sociodemographic questionnaire in December 2022 and January 2023. Results: Of the students participating in this study, 182 (81.6%) were female and 41 (18.4%) were male. Students' average Perceived Stress Scale score was 22.00 ± 8.52; Generalized Anxiety Disorder -7 Scale mean score were found to be 7.43 ± 6.43. Perceived Stress Scale average scores vary depending on students' grade point averages and alcohol/substance use while under stress. Generalized Anxiety Disorder - 7 Scale mean scores vary depending on alcohol/ substance use while under stress (p &amp;lt; 0.05). Conclusion: Educational programs should be organized to enable students to cope more effctively with the stressors they encounter. On the other hand, it is recommended to create learning environments that will help alleviate the stress and anxiety that students encounter during the education process.