Stress Management And Resiliency Training Research Articles

Virtual Delivery of Stress Management and Resiliency Training (SMART) During the COVID-19 Pandemic to Hematology/Oncology Fellows: A Pilot Study

Virtual Delivery of Stress Management and Resiliency Training (SMART) During the COVID-19 Pandemic to Hematology/Oncology Fellows: A Pilot Study

Outcomes of a Stress Management and Resiliency Training (SMART) Program for Family Caregivers of Individuals With Advanced Head and Neck Cancer.

To conduct a single-arm prospective pilot study examining the feasibility, acceptability, and preliminary effectiveness of a Stress Management and Resiliency Training (SMART) intervention among family caregivers (FCGs) of individuals with head and neck cancer (HNC). This study was conducted with 26 FCGs of individuals with HNC receiving chemotherapy in the medical oncology clinic at the Mayo Clinic Comprehensive Cancer Center. The SMART intervention consisted of in-person and online components. Measurements included feasibility, acceptability, self-compassion, resilience, perceived stress, anxiety, and mindfulness. Results support acceptability of the SMART program and provide recommendations to improve feasibility. Data indicate significant improvements in self-compassion (p = 0.03) and anxiety (p = 0.02), with positive trends for resilience, stress, and mindfulness. This study warrants further research with larger, more diverse samples testing the efficacy of the program, its mechanism of action, and potential synergistic effects among individuals receiving oncology care, FCGs, and nurses.

Feasibility of virtual stress management and resiliency training (SMART) for oncology fellows during the COVID-19 pandemic.

11016 Background: Stress Management and Resiliency Training (SMART) is a validated resilience training program designed to reduce stress, improve emotional resilience, and decrease burnout. The prevalence of burnout among practicing oncologists is as high as 40%, but unknown among oncology trainees. We implemented a virtual format of the SMART program to the Hematology/Oncology fellowship at Mayo Clinic to assess the feasibility of such a delivery, measure baseline rates of burnout in this group, and to investigate if a virtual method of delivery is as effective as in-person delivery as described in the literature. Methods: The SMART project was a mixed-methods, prospective, single arm clinical trial. Hematology/Oncology Fellows at Mayo Clinic were invited to participate. Four one-hour training sessions were conducted virtually. Fellows were given access to SMART online video modules and a book which supported the content covered during virtual training, a companion resilience mobile app, and a paperback mindfulness journal. Stress, burnout, and emotional resilience were measured at baseline and three months post-intervention using the Perceived Stress Scale (PSS), Maslach Burnout Inventory (MBI), and Connor-Davidson Resilience Scale (CD-RISC2). Changes in mean scores on the PSS, MBI, and CD-RISC2 were assessed using the Wilcoxon signed-rank test. Program feedback and feasibility data were obtained during a virtual focus group. Audio transcripts from the focus group were codified for thematic analysis and verified by intercoder triangulation. A 6-month assessment will be due in March 2022. Results: 26 of 50 fellows invited participated in our study. At baseline, 24% of participants had measurable burnout and 92% had moderate to high stress. At 3-months, the number of participants with moderate to high stress decreased to 71%, while rates of burnout remained unchanged. The PSS demonstrated a decrease in mean stress (-10.9%, p = 0.005), while the MBI demonstrated decreased emotional exhaustion (MBI-EE -6.01%, p = 0.04), an improved sense of personal achievement (MBI-PA 28.1%, p < 0.001), but slightly worse feelings of depersonalization (MBI-DP 16.46%, p = 0.05). The CD-RISC2 suggested no change in global emotional resilience (-0.71%, p = 0.82). Thematic analysis of the focus group data revealed that participants overwhelmingly found the program beneficial (83% of all responses), 20% indicated improved stress, and 15% indicated improved work performance. Conclusions: Oncology fellows in this study had lower rates of burnout compared to practicing oncologists. Virtual implementation of the SMART program is feasible and resulted in improvements in stress and prevented worsened burnout. Outcomes were comparable to previously published studies conducted in-person. Focus group participants found the training beneficial, reported lower stress, and improved work performance.

SMART-ly Managing Type 1 Diabetes - Modifying Glucose Metabolism With an Online Mind-Body Intervention: A Feasibility and Pilot Study.

Managing type 1 diabetes is stressful. Stress physiology influences glucose metabolism. Continuous glucose monitors allow us to track glucose variability in the real-world environment. Managing stress and cultivating resiliency should improve diabetes management and reduce glucose variability. The study was designed as a randomized prospective cohort pre-post study with wait time control. Participants were adult type 1 diabetes patients who used a continuous glucose monitor and recruited from an academic endocrinology practice. The intervention was the Stress Management and Resiliency Training (SMART) program conducted over 8 sessions over web-based video conference software. The main outcome measures were Glucose variability, the Diabetes Self-Management questionnaire (DSMQ),Short-Form Six-Dimension (SF-6D), and the Connor-Davidson Resiliency (CD-RSIC) instrument. There was statistically significant improvement in participants DSMQ and CD RISC scores though the SF-6D did not change. Participants under age 50 years-old showed a statistically significant reduction in average glucose (p = .03) and Glucose Management Index (GMI) (p = .02). Participants also had reduced percentage of time high and increased time in range though this did not reach statistical significance. The participants found doing the intervention online acceptable if not always ideal. An 8-session stress management and resiliency training program reduced diabetes related stress and improved resiliency and reduced average blood glucose and GMI in those under 50 years-old. ClinicalTrials.gov, identifier NCT04944264.

Feasibility and efficacy of integrating resiliency training into a pilot nurse residency program

The high stress associated with the nursing profession can negatively affect the health of nurses and the quality of patient care that they provide. This quasi-experimental study aimed to 1) assess the feasibility of integrating a Stress Management and Resiliency Training (SMART) program within a nine-month pilot nurse residency program and 2) assess the effects of the program on participants’ stress, anxiety, mindfulness, and resilience relative to a comparison group. A pre- and post-intervention survey design was used, with measurements taken at baseline and at 1, 3, 9, and 12 months after baseline. We enrolled 51 registered nurses (intervention group, n = 23; comparison group, n = 28) at a Midwestern US academic medical center. Nurses in the intervention group had a participation rate of 93%–100% with SMART program events. Despite the relatively limited adherence to the protocol by intervention group participants, significant improvements were noted for stress (P < .001), mindfulness (P < .001), and resilience (P < .001) in the intervention group compared with the comparison group. The SMART program can potentially be successfully integrated into a nurse residency program and positively impact nurse stress, mindfulness, and resilience. Further research is needed to determine the proper dose of the intervention and methods to enhance adherence.

Stress Management and Resiliency Training for Healthcare Professionals: A Mixed-Methods, Quality-Improvement, Cohort Study.

To assess the effects of a multi-modal resilience program, the Stress Management and Resiliency Training (SMART) Program, on healthcare professional well-being and job satisfaction. This pilot, mixed-methods, quality improvement, cohort study assessed perceived stress, physical and mental health, job satisfaction, burnout, and value of the curriculum to attendees. Participants experienced a significant reduction in perceived stress (P < 0.001) and significant improvements in global mental health (P = 0.001), physical health (P = 0.045), and job satisfaction (P = 0.047). There was no significant improvement in burnout. Qualitative analysis of free text responses revealed appreciation for the skills taught, increased resiliency, and a positive impact on relationships. Delivering the SMART Program to healthcare professionals is feasible and may serve as a useful tool for reducing stress and increasing resilience.

Application of a mind-body tool in a rural population to improve post-operative outcomes in women with breast cancer: A pilot study

BackgroundBreast cancer is the most commonly diagnosed cancer in women in the United States. While improvements in treatment have improved mortality, they can negatively impact quality of life (QOL). Mindfulness-based programs are low-cost interventions shown to improve QOL. The study aim was to evaluate a well-validated mind-body program – determining its feasibility, acceptability, and improvement in symptomatology in post-operative breast cancer patients in a rural setting. MethodsWe recruited patients during post-operative appointments following mastectomy or lumpectomy for breast cancer. Each participant completed 3 surveys before and after the intervention: (8 PROMIS-29, PROMIS –Global QOL, and MAAS (Mindfulness Attention Awareness Scale). The intervention was an 8-week course: “The Stress Management and Resiliency Training (SMART) - Relaxation Response and Resiliency Program (3RP)”, which has been well-validated for the treatment of various clinical problems. Feasibility, acceptability, quantitative survey data, and demographics were analyzed. ResultsSMART-3RP was highly acceptable with greater than >80% completion rate. 23% of the invited participants enrolled, although over 70% of patients approached (34/48) expressed interest. The principal recruitment deterrent was scheduling. Sleep and anxiety/depression were improved in participants although not significantly due to small sample size. We also demonstrated improving trends in other QOL measures. ConclusionsThis small pilot study proved feasibility, showed excellent acceptability, and demonstrated a benefit in post-operative breast cancer patients. Even with our small sample size, we found trends in improvement in certain QOL measures which emphasizes SMART-3RP's potential effectiveness. A large-scale randomized controlled trial is warranted.

Stress Management and Resiliency Training for public school teachers and staff: A novel intervention to enhance resilience and positively impact student interactions

BackgroundBurnout in teachers has been linked to decreased effectiveness as educators, and suboptimal interactions with students. The purpose of this pilot study was to assess the outcomes of a brief Stress Management and Resiliency Training (SMART) program for public school staff. Materials and methodsThis single-arm, prospective trial involved an investigation of the effects of a brief SMART program on participant stress, anxiety, resilience, gratitude, happiness, life satisfaction, and quality of life (QOL). ResultsSignificant improvements were noted in participant anxiety (P < 0.001), stress (P = 0.003), gratitude (P = 0.001), happiness (P < 0.001), life satisfaction (P < 0.001), and QOL (P < 0.001). Most participants reported that the skills learned positively affected interactions with students (77.2%) and coworkers (72.2%). ConclusionsThe SMART program showed promising effectiveness for improving anxiety, stress, gratitude, happiness, life satisfaction and QOL. Given the prevalence and impact of teacher burnout, larger, controlled trials and broader dissemination of the intervention are warranted.

Stress Management and Resiliency Training (SMART) for Family Medicine Residents at Eglin AFB

Stress Management and Resiliency Training (SMART) for Family Medicine Residents at Eglin AFB

Stress Management and Resilience Intervention in a Women's Heart Clinic: A Pilot Study.

Background: In general, women report higher stress levels than men. High baseline anxiety, depression, and stress levels are associated with greater risk of cardiovascular diseases. Current evidence for efficacy of stress management interventions for women is limited. This study aimed at assessing the effect of a stress management and resiliency training (SMART) program for decreasing stress, anxiety, and depressive symptoms. Methods: Fifty moderately or severely stressed Women's Heart/Preventive Cardiology Clinic patients consented to the SMART intervention delivered online (n = 36) or in-person (n = 9). Primary outcome measures were the observed changes between baseline and at 12 weeks for the following psychometric tools: General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaires (PHQ-9), Perceived Stress Scale (PSS), and Brief Resiliency Scale (BRS). Results: Forty-five patients completed the study. We observed significant improvements in PSS and GAD-7, but not in PHQ-9 or BRS, after the SMART intervention. When assessing outcomes among those with depressive symptoms at baseline (PHQ-9 > 15), we observed significant changes in PSS, GAD-7, and PHQ-9. No differences between online and in-person program delivery methods were found (all p-values >0.05). Conclusions: Training exposure using the SMART program to decrease stress and anxiety in women seeking preventive cardiology services was feasible and similarly effective, whether delivered online or in a single in-person session. Impacts on depression and resilience likely require a more intensive approach. In the future, larger randomized clinical trials with additional training and longer follow-up are warranted.

Decreasing Stress and Burnout in Nurses: Efficacy of Blended Learning With Stress Management and Resilience Training Program.

The study's purpose was to assess efficacy of blended learning to decrease stress and burnout among nurses through use of the Stress Management and Resiliency Training (SMART) program. Job-related stress in nurses leads to high rates of burnout, compromises patient care, and costs US healthcare organizations billions of dollars annually. Many mindfulness and resiliency programs are taught in a format that limits nurses' attendance. Consistent with blended learning, participants chose the format that met their learning styles and goals; Web-based, independent reading, facilitated discussions. The end points of mindfulness, resilience, anxiety, stress, happiness, and burnout were measured at baseline, postintervention, and 3-month follow-up to examine within-group differences. Findings showed statistically significant, clinically meaningful decreases in anxiety, stress, and burnout and increases in resilience, happiness, and mindfulness. Results support blended learning using SMART as a strategy to increase access to resiliency training for nursing staff.

Stress Management and Resiliency Training (SMART) Program among Department of Radiology Faculty: A Pilot Randomized Clinical Trial

To test the efficacy of a Stress Management and Resiliency Training (SMART) program for decreasing stress and anxiety and improving resilience and quality of life among Department of Radiology physicians. The study was approved by the institutional review board. A total of 26 Department of Radiology physicians were randomized in a single-blind trial to either the SMART program or a wait-list control arm for 12 weeks. The program involved a single 90-min group session in the SMART training with two follow-up phone calls. Primary outcomes measured at baseline and week 12 included the Perceived Stress Scale, Linear Analog Self-Assessment Scale, Mindful Attention Awareness Scale, and Connor-Davidson Resilience Scale. A total of 22 physicians completed the study. A statistically significant improvement in perceived stress, anxiety, quality of life, and mindfulness at 12 weeks was observed in the study arm compared to the wait-list control arm; resilience also improved in the active arm, but the changes were not statistically significant when compared to the control arm. A single session to decrease stress among radiologists using the SMART program is feasible. Furthermore, the intervention afforded statistically significant and clinically meaningful improvement in anxiety, stress, quality of life, and mindful attention. Further studies including larger sample size and longer follow-up are warranted.

Integration of A Stress Management and Resiliency Training (SMART) Program in a Nurse Residency Program: A Feasibility Study

The Journal of Alternative and Complementary MedicineVol. 20, No. 5 Education ResearchIntegration of A Stress Management and Resiliency Training (SMART) Program in a Nurse Residency Program: A Feasibility StudySherry Chesak, Amit Sood, Karen Morin, Susan Cutshall, Kristin Vickers Douglas, and Jennifer RidgewaySherry ChesakSearch for more papers by this author, Amit SoodSearch for more papers by this author, Karen MorinSearch for more papers by this author, Susan CutshallSearch for more papers by this author, Kristin Vickers DouglasSearch for more papers by this author, and Jennifer RidgewaySearch for more papers by this authorPublished Online:7 May 2014https://doi.org/10.1089/acm.2014.5267.abstractAboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Integration of A Stress Management and Resiliency Training (SMART) Program in a Nurse Residency Program: A Feasibility Study." The Journal of Alternative and Complementary Medicine, 20(5), p. A101FiguresReferencesRelatedDetailsCited byCurricular Development and Implementation of a Longitudinal Integrative Medicine Education Experience for Trainees and Health-Care Professionals at an Academic Medical Center1 April 2019 | Global Advances in Health and Medicine, Vol. 8The Effects of the Relaxation Response on Nurses’ Level of Anxiety, Depression, Well-Being, Work-Related Stress, and Confidence to Teach Patients18 July 2017 | Journal of Holistic Nursing, Vol. 35, No. 4 Volume 20Issue 5May 2014 InformationCopyright 2014, Mary Ann Liebert, Inc.To cite this article:Sherry Chesak, Amit Sood, Karen Morin, Susan Cutshall, Kristin Vickers Douglas, and Jennifer Ridgeway.Integration of A Stress Management and Resiliency Training (SMART) Program in a Nurse Residency Program: A Feasibility Study.The Journal of Alternative and Complementary Medicine.May 2014.A101-A101.http://doi.org/10.1089/acm.2014.5267.abstractPublished in Volume: 20 Issue 5: May 7, 2014PDF download

P02.197. Self help intervention to decrease stress and increase mindfulness: a pilot trial

Purpose The Stress Management and Resiliency Training (SMART) program has shown efficacy for reducing anxiety and perceived stress and increasing resilience and quality of life. SMART has traditionally consisted of an in-person training session with an instructor and follow up teleconferences over 12-24 weeks. The purpose of this study was to assess whether self-directed SMART training using only written material would have efficacy.

Stress Management and Resilience Training Among Department of Medicine Faculty: A Pilot Randomized Clinical Trial

Physician distress is common and related to numerous factors involving physicians' personal and professional lives. The present study was designed to assess the effect of a Stress Management and Resiliency Training (SMART) program for increasing resiliency and quality of life, and decreasing stress and anxiety among Department of Medicine (DOM) physicians at a tertiary care medical center. Forty DOM physicians were randomized in a wait-list controlled clinical trial to either the SMART intervention or a wait-list control group for 8 weeks. The intervention involved a single 90 min one-on-one training in the SMART program. Primary outcome measures assessed at baseline and week 8 included the Connor Davidson Resilience Scale (CDRS), Perceived Stress Scale (PSS), Smith Anxiety Scale (SAS) and Linear Analog Self Assessment Scale (LASA). Thirty-two physicians completed the study. A statistically significant improvement in resiliency, perceived stress, anxiety, and overall quality of life at 8 weeks was observed in the study arm compared to the wait-list control arm: CDRS: mean ± SD change from baseline +9.8 ± 9.6 vs. -0.8 ± 8.2, t(30) = 3.18, p = 0.003; PSS: -5.4 ± 8.1 vs. +2.2 ± 6.1, t(30) = -2.76, p = 0.010; SAS: -11.8 ± 12.3 vs.+ 2.9 ± 8.9, t(30) = -3.62, p = 0.001; and LASA: +0.4 ± 1.4 vs. -0.6 ± 1.0, t(30) = 2.29, p = 0.029. A brief training to enhance resilience and decrease stress among physicians using the SMART program was feasible. Further, the intervention provided statistically significant improvement in resilience, stress, anxiety, and overall quality of life. In the future, larger clinical trials with longer follow-up and possibly wider dissemination of this intervention are warranted.