Stress Appraisal Research Articles

Perception of disease, dyadic coping, and the quality of life of oncology patients in the active treatment phase and their life partners: an approach based on the actor-partner interdependence model.

The aim of this study based on the Systemic Transactional Model was to examine the relationship between dyadic coping and (1) disease perception and (2) quality of life of a sample of cancer patients and their life partners. This cross-sectional study included 138 oncological dyads. The following questionnaires were used: Stress Appraisal Measure, Dyadic Coping Inventory, and European Organisation for Research and Treatment of Cancer QLQ-C30. Data collected was analysed by applying the actor-partner interdependence model. The perception of the disease as a threat as well as its centrality significantly negatively influences the positive forms of dyadic coping whilst the perception of the disease as a challenge has a significant positive influence on them. Dyadic coping does not influence symptoms but has significant influences on global health/quality of life. This study has highlighted new information regarding how couples cope with cancer. The results encourage the inclusion of the perception of the disease and dyadic coping in interventions that aim to improve the quality of life of cancer patients and their life partners.

Tournament incentives affect perceived stress and hormonal stress responses

We conduct a laboratory experiment among male participants to investigate whether rewarding schemes that depend on work performance—in particular, tournament incentives—induce more stress than schemes that are independent of performance—fixed payment scheme. Stress is measured over the entire course of the experiment at both the hormonal and psychological level. Hormonal stress responses are captured by measuring salivary cortisol levels. Psychological stress responses are measured by self-reported feelings of stress and primary appraisals. We find that tournament incentives induce a stress response whereas a fixed payment does not induce stress. This stress response does not differ significantly across situations in which winners and losers of the tournament are publically announced and situations in which this information remains private. Biological and psychological stress measures are positively correlated, i.e. increased levels of cortisol are associated with stronger feelings of stress. Nevertheless, neither perceived psychological stress nor elevated cortisol levels in a previous tournament predict a subsequent choice between tournaments and fixed payment schemes, indicating that stress induced by incentives schemes is not a relevant criterion for sorting decisions in our experiment. Finally, we find that cortisol levels are severely elevated at the beginning of the experiment, suggesting that participants experience stress in anticipation of the experiment per se, potentially due to uncertainties associated with the unknown lab situation. We call this the novelty effect.

P101 Understanding First Contact Physiotherapists experiences of remote consultations in primary care

Abstract Background/Aims First Contact Physiotherapists (FCPs) assess, diagnose and manage patients presenting with musculoskeletal disorders in primary care, without the need for prior GP consultation. Prior to COVID-19 almost every consultation was conducted in-person. Since the pandemic, many consultations are now undertaken remotely, a trend that is set to continue in line with the ‘Digital first’ strategy which seeks to enhance patient access to appointments. This aim of this study was to explore FCP views of remote consultations and how this impacted their role satisfaction and wellbeing. Methods This mixed methods two phase study consisted of an online survey investigating distributed via professional networks and through social media. The phase one survey explored consultation methods; levels of training; challenges and benefits; and a stress appraisal. Data were analysed descriptively. Respondents were invited to take part in phase two which included a semi-structured interview to gain an in-depth understanding of FCPs lived experience of remote consultation ways of working. Transcripts were thematically analysed. Results The online survey received n = 109 responses from UK-based FCPs. Data revealed that despite the ‘Digital First’ push for continued remote consultations, the majority of FCPs (62%) used them for less than a quarter of their appointment slots. Whilst recognising that many patients found this format convenient, FCPs highlighted their own stress levels, citing poor efficacy, anxiety of misdiagnosis, feelings of isolation and increased administrative workload. Nearly two thirds (66%) of respondents had not received any training in how to conduct effective remote consultations. Follow-up interviews with n = 16 FCPs highlighted coping strategies including following up with an in-person consultation and directing patients to other community health and wellbeing resources. In areas of high socioeconomic deprivation and poor health literacy additional problems associated with communication difficulties, poor IT access and capability, and digital poverty were all cited. Conclusion Remote consultations may offer a convenient alternative for some patients. FCP responses suggest that the continued offer of remote consultation is decreasing now pandemic restrictions have been lifted, despite the push for continued digital working practices. The perceived lack of efficacy, and fear of missing important diagnostic information means that many FCPs are either returning to in-person consultation or following up with a second face-to-face assessment resulting in potential service inefficiencies. Additional challenges were identified in areas of high deprivation and low health literacy, and the value of this consultation format needs to be considered in this context. Future work should focus on the training and support needs of FCP staff who are engaging with remote working to ensure clinical effectiveness and staff wellbeing. Disclosure N. Walsh: Grants/research support; Walsh is funded by NIHR. B.E. Jones: None. R. Thomas: None. Z. Anchors: None.

Adult age differences in the psychophysiological response to acute stress

Age-related differences in the psychophysiology of the acute stress response are poorly understood given the limited number of studies and the high heterogeneity of findings. The present study contributes by investigating age differences in both the psychological and physiological responses to acute stress in a sample of healthy younger (N = 50; 18–30; Mage = 23.06; SD = 2.90) and older adults (N = 50; 65–84; Mage = 71.12; SD = 5.02). Specifically, the effects of psychosocial stress (i.e., age-adapted Trier Social Stress Test) were investigated at numerous timepoints throughout the stress response phases (i.e., baseline, anticipation, reactivity, recovery) on cortisol, heart rate, subjective stress, and anticipatory appraisal of the stressful situation. The study was conducted in a between-subject (younger vs. older) cross-over (stress vs. control) design. Results revealed age-related differences in both physiological and psychological variables: older adults had overall lower salivary cortisol levels in the stress and control conditions and lower stress-induced cortisol increase (i.e., AUCi). In addition, older adults’ cortisol reactivity was delayed compared to younger adults. Older adults showed a lower heart rate response in the stress condition while no age differences were observed in the control condition. Finally, older adults reported less subjective stress and a less negative stress appraisal during the anticipation phase than younger adults, which could potentially explain lower physiological reactivity in this age group. Results are discussed in relation to the existing literature, potential underlying mechanisms, and future directions for the field.

The impact of ICT characteristics on students’ learning outcomes during COVID-19 lockdown period: The crucial role of techno eustress perception

BACKGROUND: The COVID-19 crisis led to an unprecedented acceleration of digital learning. It pushed many institutions to abruptly switch to fully online learning modes from face-to-face learning. Prior studies show that higher IT demands can cause challenge or hindrance stressors, depending on how the digital technology characteristics are perceived by the end-user. However, there is a gap in our knowledge regarding how ICT characteristics can lead to positive stress appraisals in a remote learning environment. OBJECTIVE: This paper leverages the person-environment fit and technostress literature to examine how usefulness and reliability as demand-ability stressors of ICT tools can positively impact learning outcomes among remote learning students. Techno eustress perceptions are evaluated as a crucial mechanism for theorizing the positive impact. METHODS: We used the survey method, sampling students (N = 82) during the lockdown period to test this model. RESULTS: Our findings highlight the ICT characteristic of usefulness as salient in contributing to student learning outcomes as it promotes techno eustress. CONCLUSIONS: This is the first study to demonstrate a positive impact of ICT characteristics on student learning outcomes via techno eustress perceptions.

The mediating role of spirituality in the relationships between posttraumatic stress and posttraumatic growth among patients with cancer: A cross-sectional study

ObjectiveThis study explores the impact of posttraumatic stress (PTS) on posttraumatic growth (PTG) and verifies the mediating effect of spirituality among patients with cancer. MethodsThis study used a cross-sectional correlational design. This study surveyed 141 hospitalized patients over 20 years of age diagnosed with cancer. Participants were recruited by convenience sampling from a regional hospital in Taiwan. Data were collected from January to April 2021. Measurements included sociodemographic and disease-related information and data from the following self-report questionnaires: Posttraumatic Stress Reaction Index-Short Form, Posttraumatic Growth Inventory, and Spiritual Health Scale-Short Form. Structural equation modeling and bootstrapping were used to analyze the mediating effect of spiritual health on PTS and PTG. ResultsPTS and spirituality were negatively correlated, spirituality, and PTG were positively correlated, and PTS had no correlation with PTG. Spirituality fully presented a mediating role between PTS and PTG. ConclusionsPatients' spirituality should be regarded as an important variable that can impact stress appraisal and improve the patient's PTG when a diagnosis of cancer is received. Assessing spiritual health at regular intervals and integrating spiritual care with clinical care could decrease PTS and improve PTG for patients with cancer.

Clinical phenotypes and prognostic factors in persons with hip osteoarthritis undergoing total hip arthroplasty: protocol for a longitudinal prospective cohort study (HIPPROCLIPS)

BackgroundLarge heterogeneity exists in the clinical manifestation of hip osteoarthritis (OA). It is therefore not surprising that pain and disability in individuals with hip OA and after total hip arthroplasty (THA) cannot be explained by biomedical variables alone. Indeed, also maladaptive pain-related cognitions and emotions can contribute to pain and disability, and can lead to poor treatment outcomes. Traumatic experiences, mental disorders, self-efficacy and social support can influence stress appraisal and strategies to cope with pain, but their influence on pain and disability has not yet been established in individuals with hip OA undergoing THA. This study aims (1) to determine the influence of traumatic experiences and mental disorders on pain processing before and shortly after THA (2) to identify preoperative clinical phenotypes in individuals with hip OA eligible for THA, (3) to identify pre- and early postoperative prognostic factors for outcomes in pain and disability after THA, and (4) to identify postoperative clinical phenotypes in individuals after THA.MethodsThis prospective longitudinal cohort study will investigate 200 individuals undergoing THA for hip OA. Phenotyping variables and candidate prognostic factors include pain-related fear-avoidance behaviour, perceived injustice, mental disorders, traumatic experiences, self-efficacy, and social support. Peripheral and central pain mechanisms will be assessed with thermal quantitative sensory testing. The primary outcome measure is the hip disability and osteoarthritis outcome score. Other outcome measures include performance-based measures, hip muscle strength, the patient-specific functional scale, pain intensity, global perceived effect, and outcome satisfaction. All these measurements will be performed before surgery, as well as 6 weeks, 3 months, and 12 months after surgery. Pain-related cognitions and emotions will additionally be assessed in the early postoperative phase, on the first, third, fifth, and seventh day after THA. Main statistical methods that will be used to answer the respective research questions include: LASSO regression, decision tree learning, gradient boosting algorithms, and recurrent neural networks.DiscussionThe identification of clinical phenotypes and prognostic factors for outcomes in pain and disability will be a first step towards pre- and postoperative precision medicine for individuals with hip OA undergoing THA.Trial registrationClinicalTrials.gov: NCT05265858. Registered on 04/03/2022.

Meaning Salience and Meaning in Life Prospectively Predict Lower Distress During the COVID-19 Pandemic.

The COVID-19 pandemic is a widespread source of stress with adverse mental health impacts. Meaning in life, both as a trait and as momentary awareness of what is personally meaningful (meaning salience), is associated with positive health outcomes and may buffer against the deleterious effects of stress. This project examines prospective associations between baseline meaning salience (daily, post-laboratory stressor) and meaning in life with perceived stress during COVID-19. A community sample of healthy adults (n = 147) completed a laboratory stress protocol in 2018-2019, where perceived stress, meaning in life, and meaning salience (daily, post-stressor) were assessed. During April and July 2020 (n = 95, and 97, respectively), participants were re-contacted and reported perceived stress. General linear mixed-effects models accounting for repeated measures of stress during COVID-19 were conducted. Partial correlations holding constant baseline perceived stress showed that COVID-19 perceived stress was correlated with daily meaning salience (r = -.28), post-stressor meaning salience (r = -.20), and meaning in life (r = -.22). In mixed-effects models, daily and post-stressor meaning salience and higher meaning in life, respectively, predicted lower perceived stress during COVID-19, controlling for age, gender, and baseline perceived stress. Individuals more capable of accessing meaning when exposed to laboratory stress reported lower perceived stress during a global health crisis. Despite study limitations concerning generalizability, results support meaning in life and meaning salience as important aspects of psychological functioning that may promote well-being by affecting stress appraisals and available resources for coping.

(Re)Framing Resilience: A Trajectory-Based Study Involving Emerging Religious/Spiritual Leaders

The COVID-19 pandemic has provided a unique circumstance for the study of resilience, and clergy resilience has garnered increased research attention due to greater recognition that religious/spiritual leaders are at risk for elevated levels of anxiety and burnout. We examined longitudinal patterns of change during the pandemic in a sample of emerging leaders (N = 751; Mage = 32.82; SD 11.37; 49.9% female; 59.8% White). In doing so, we offered a conceptual and methodological approach based on historical and critical evaluations of the study of resilience. Results revealed a subgroup that exhibited resilience over three waves of data. The labeling of this trajectory was based on established criteria for determining resilience: (a) significant adversity in the form of COVID-19 stress at time 1, which included the highest levels of the subjective appraisal of stress; (b) risk in the form of low religiousness/spirituality and greater likelihood of reporting marginalized identifications, relative to those who were flourishing; (c) a protective influence for transformative experiences to promote positive adaptation; and (d) interruption to the trajectory in the form of improvement in levels of symptoms and well-being. Practical implications center on the potential for transformative experiences to clarify emotional experience and construct new meaning.

The Interactive Effect of Stressor Appraisals and Personal Traits on Employees' Procrastination Behavior: The Conservation of Resources Perspective.

Procrastination has become a pervasive phenomenon in the workplace, yet knowledge of its antecedents remains limited. Therefore, this study explains when and why employees procrastinate. As procrastination is an individual intentional behavior to escape potential resource loss by taking actions to relax; this study regards procrastination as resource-protection behavior. Building on the conservation of resources (COR) theory, the purpose of the current study is to explore the direct impact of external situational factors (ie, stressor appraisals) and individual traits (ie, personality) and their interactive effect on workplace procrastination behavior. The study adopts a quantitative approach and uses two-wave data. Data was collected through the randomized cluster sampling technique and a structured questionnaire survey. The sample consisted of civil servants in an organization located in the Shandong province of China. Received 347 valid questionnaires representing an overall response rate of 87%. The theoretical model was tested through confirmatory factor analysis and regression analyses using Mplus 7.2. The results show that hindrance stressor appraisal is positively related to procrastination, whereas challenge stressor appraisal is negatively related to procrastination. Neuroticism had a positive relationship with procrastination, while conscientiousness had a negative relationship with procrastination. Conscientiousness moderates the relationship between challenge stressor appraisal and procrastination such that the relationship is salient under high conscientiousness. Overall, our study suggests that procrastination is affected by personal traits and workplace stressor appraisals. This study makes potential contributions to employees' procrastination literature by and its understanding within the job procrastination knowledge base. Also, this study confirms the comprehensive reach and applicability of the COR theory developed by scholars such as Hobfoll (1989). In practically, the research benefits organizations by providing suggestions for managing employees' procrastination behavior.

Effects of Cultural Intelligence on Perceived Stress Among the Japanese Overseas Workers

AbstractWe evaluated the effects of cultural intelligence (CQ) on perceived stress and explored the factors associated with CQ. We constructed a model that included the antecedents that may affect the CQ based on hypotheses derived from a preliminary feasibility study. The main study comprised an Internet survey of Japanese workers who were currently working or had previously worked overseas (n = 296). The Expanded Cultural Intelligence Scale (E‐CQS) was used to assess the CQ and the Perceived Stress Scale was used to assess the cognitive appraisal of stressors. The path analysis results showed that “Self‐efficacy to adjust” in CQ was influenced by all explored antecedents and negatively related to perceived stress. This suggests that facilitating the antecedents of CQ and developing “Self‐efficacy to adjust” may ameliorate perceived stress in overseas Japanese workers.

Everybody Copes: An Interprofessional Workshop on Stress, Coping, and Helping Primary Care Patients Manage Medical Stressors.

The value of psychological principles has become apparent in medical settings, especially with the rise of patient-centered care. We aimed to provide a curriculum informing medical providers about the theoretical basis and clinical utility of the social-cognitive model of stress and coping. This workshop was delivered to an interprofessional team of faculty and trainees. Our initial pedagogical approach was to relate the concepts of cognitive appraisals and coping strategies to participants' own stress responses. We then used didactic presentation and small-group activities to explore ways to promote adaptive coping with patients to improve health outcomes. Learners participated in a mindfulness exercise, conceptualized coping strategies given a hypothetical case scenario, and, in small groups, role-played a patient encounter to construct an effective coping repertoire for the patient. Participants completed a prework self-assessment and workshop evaluation form. The 2.5-hour workshop had 48 participants from five professions (medicine, education, physician assistant, pharmacology, psychology). We received 35 evaluations (73% response rate). Learners reported increased real-world skills (M = 8.0 out of 10) and feeling better prepared for working in interprofessional settings (M = 7.6 out of 10). Qualitative feedback suggested that participants recognized the importance of individual differences in coping with stress and felt they could categorize strategies into emotion- or problem-focused coping. This workshop provided participants with basic knowledge about the social-cognitive model of stress and coping and allowed them to practice newly learned skills in a role-play as an interprofessional medical care team.

How and when can job-insecure employees prevent psychological distress against the COVID-19 pandemic? The role of cognitive appraisal and reappraisal.

The COVID-19 pandemic has greatly affected economies around the world, causing record unemployment rates that have exacerbated the already prevalent job insecurity, thereby leading to psychological distress among many individuals. The present study aims to reveal the underlying mechanisms of psychological distress induced by the COVID-19 pandemic among job-insecure employees and to identify one of the emotion regulation strategies (i.e., cognitive reappraisal) as a protective factor that mitigates psychological distress. Drawing upon transactional theory, we proposed and tested a moderated mediation model, wherein cognitive reappraisal serves as a moderator of the direct and indirect relationship between job insecurity and psychological distress via stress appraisals (i.e., threat appraisal and challenge appraisal) based on data from 922 employees. Results show that threat appraisal and challenge appraisal positively and negatively mediate the relationship between job insecurity and psychological distress, respectively. Furthermore, as an emotion regulation strategy, cognitive reappraisal mitigates psychological distress among job-insecure employees, weakens the positive indirect effect of threat appraisal, but intensifies the negative indirect effect of challenge appraisal. Our findings suggest that cognition plays an important role in individuals' emotional reactions to COVID-19-related stress, and cognition reappraisal is an effective emotion regulation strategy in mitigating psychological distress. Therefore, cognition reappraisal skills should be improved to reduce psychological distress induced by COVID-19 pandemic.

Trauma's effects on shopper choice confusion: The role of psychological hardiness and retailer strategies as mitigating factors

Retailers must understand how trauma influences the consumer shopping journey and identify ways to mitigate any potential adverse effects. Two studies were conducted to explore trauma in the retail environment. First, a conceptual model was tested using structural equation modeling (SEM) based on survey data collected from 324 participants. Findings indicate that consumers who report previously experiencing traumatic events feel anxiety while shopping in retail environments, negatively influencing their ability to make purchase decisions. This outcome is due to challenges in adequately assessing stressful environmental stimuli and developing positive coping mechanisms. Consumer propensity for psychological hardiness was found to moderate this relationship. Next, a follow-up qualitative study from 110 consumers who reported experiencing instances of trauma identified potential ways for retailers to help consumers who have experienced trauma feel more comfortable in shopping environments. These findings extend research on trauma and consumer shopping behavior by identifying its impacts on choice confusion and stress appraisal and suggesting how retailers can support shoppers through a trauma-informed approach.

“Am I Next?”: A qualitative study of Black college students’ experiences of stress, trauma, and grief from exposures to police killings

ABSTRACT There is little research that explores the experiences of Black people exposed to police killings of other unarmed Blacks, despite the fact these incidents repeatedly and disproportionately affect this population. While some quantitative studies have examined the impacts of police violence exposure on mental health in recent years, there remains a dearth of in-depth qualitative research exploring the processes through which chronic exposures to police killings contribute to traumatic and complex life experiences for Black people, particularly. Informed by theories of critical race, stress and cognitive appraisal, historical trauma, and loss and grief, this qualitative study used in-depth semi-structured interviews to explore the experiences of stress, trauma, and grief among Black undergraduate college students exposed to police killings of other unarmed Black people, and to examine the perceived impacts of these experiences in the lives of students and their close personal networks.

Stressor appraisals among adults in late middle age and late adulthood in the United States: Applying the intersectionality framework.

Stressor appraisals among adults in late middle age and late adulthood in the United States: Applying the intersectionality framework.

Relationships between cognitive appraisal and roles/personality traits in basic life support.

To examine the relationship between the cognitive assessment of stress (cognitive appraisal) caused in a scenario requiring basic life support (BLS) and the roles during BLS/personality traits in nursing students. We conducted an anonymous self-administered questionnaire survey for 264 freshman and senior nursing students. The study period was one month from June 2019. The questionnaire included characteristics, roles (active involvement group/passive involvement group/no involvement group), Cognitive Appraisal Rating Scale (CARS), and Maudsley Personality Inventory (MPI). We only included data for female students (107 people) in the analysis because very little data is available for male students. The Mann-Whitney test was used for the comparison between two groups and the Kruskal-Wallis test was used for the comparison between three groups. The significance level was set at p<0.05. The total number of responses was 133 (50.4%), and the number of valid responses was 107 (40.5%). As a result of analyzing the relationship between the role and the CARS subscale, the controllability of the active and passive involvement groups was significantly lower than that of the no involvement group (p=0.046). Also, the analysis of the relationship between the grade and the CARS subscale showed that the controllability was significantly lower in freshmen than seniors (p=0.020). This study showed the relationship between controllability and cognitive appraisal of stress in the simulation scenario of BLS. Therefore, it was suggested that support for improving controllability is necessary as a preventive measure to reduce the stress associated with BLS.

Pilot Study Using Cognitive Rehearsal, Simulation, and Biomarker Data to Address Workplace Incivility.

Workplace incivility poses a threat to patient safety. This intervention pilot study used simulation and biomarker data with newly graduated nurses to explore the impact of incivility on patient care and tested whether cognitive rehearsal could mitigate the effects of workplace incivility. A clinical scenario and script were used by actors to deliver either an uncivil or a hurried but not uncivil handoff report to participants before they conducted a focused patient assessment and administered medications to a standardized patient. Participants identified gaps in understanding of both handoff reports that resulted in compromised patient care. Quantitative trends showed lower resilience scores and higher stress appraisal scores for participants who received the uncivil handoff report. Although participants expressed confidence using cognitive rehearsal as an intervention before the simulation, responses indicated that a 60-minute session was insufficient to adequately prepare them to effectively address an uncivil nurse encounter. [J Contin Educ Nurs. 2023;54(2):79-88.].

Toward a Positive Life beyond COVID-19: Problem-Solving Appraisal as a Resistance Resource in the Relationship between Stress and Well-Being in Students.

The COVID-19 pandemic is a major global stressor that has been associated with elevated risk of negative mental health symptoms. As a helping profession, our main task should be identifying factors that may shield individuals from the negative consequences of stress, rather than only focusing on the causes and symptoms of stress. One such factor, identified in the literature, is an individual's perception of their problem-solving skills. In this study we investigate the role of problem-solving appraisal in the association between perceived stress and psychological well-being. Participants were students (n = 322) who completed the Problem Solving Inventory, the Perceived Stress Scale, the short forms of the trait scale of the State-Trait Anxiety Inventory, and the Beck Hopelessness Scale. The results demonstrate the health-sustaining benefits of problem-solving appraisal, as all dimensions of problem-solving appraisal (problem-solving confidence, approach-avoidance style, and problem-solving control) were directly associated with hopelessness and anxiety. The stress-buffering role of problem-solving appraisal with respect to hopelessness was demonstrated through the interaction between perceived stress and problem-solving appraisal. However, problem-solving appraisal did not buffer the effects of stress on anxiety. The findings indicate that problem-solving appraisal may be an important protective resource that could be beneficial for coping with other negative events and experiences beyond COVID-19. The implications of these findings for interventions are discussed.

Customer engagement in idea contests: Emotional and behavioral consequences of idea rejection

AbstractIdea contests are well‐accepted and cost‐efficient approaches to tap the creativity of customers. At the same time, idea contests enable customer engagement, defined as voluntary resource provision beyond financial patronage. However, although much research has been devoted to the factors that motivate consumers to participate in such contests, research that investigates how idea rejection as a stressor affects future engagement behavior is comparatively rare. This research draws on cognitive dissonance literature combined with stress appraisal theory to explain rejection‐induced emotional and behavioral consequences. Study 1 assesses the different effects of company appreciation of customer engagement (i.e., idea acceptance vs. rejection) in an experimental setting and tests emotional reactions to rejection as a stressor, as well as the moderating effects of firm acknowledgment. Study 2, which was organized as a randomized field experiment, is devoted to assessing differences in firm acknowledgment versus individualized firm feedback in a real‐world setting. Taken together, the studies show that the way rejection is communicated is important. The findings have important theoretical and managerial implications for service management and for stimulating customer engagement through idea contest initiatives.