Stress Reduction Practices Research Articles

Unobtrusive Health Hazard

Oxidative stress is a biological mechanism triggered by an imbalance between the biosynthesis and accumulation of reactive oxygen species (ROS) in a biological system. Normally, ROS are produced as byproducts of oxygen metabolism and fulfill various physiological roles such as cell signaling. However, environmental stressors like UV radiation, ionizing radiation, pollutants, heavy metals, and xenobiotics can also lead to increased ROS production. Common types of ROS include superoxide radicals (O2−), hydrogen peroxide (H2O2), hydroxyl radicals (•OH), and singlet oxygen (1O2), which are generated during various metabolic pathways. Key cellular processes such as protein phosphorylation, activation of transcriptional factors, apoptosis, immunity, and differentiation depend on maintaining appropriate levels of ROS within cells. Under conditions of excessive ROS production, which can occur during both normal physiological processes and pathological conditions like inflammation, ischemia, and aging, ROS can damage important cellular components such as proteins, lipids, and nucleic acids. This production is primarily mitochondrial but can also result from enzymatic activities involved in the respiratory chain, prostaglandin synthesis, phagocytosis, and the cytochrome P450 system. Both immune system activation and environmental factors contribute to endogenous and exogenous free radical production. The signs of oxidative stress include fatigue, memory loss, muscle or joint pain, the appearance of wrinkles and grey hair, decreased eyesight, headaches, increased sensitivity to noise, and a heightened susceptibility to infections. To reduce oxidative stress, it is advised to avoid sugar and processed foods while balancing blood sugar levels, prevent infections, incorporate daily stress reduction practices, avoid toxins, and promote the production of antioxidants through diet and herbal supplements that are rich in antioxidants.

The Interaction between Stress and Inflammatory Bowel Disease in Pediatric and Adult Patients.

Background: Inflammatory bowel diseases (IBDs) have seen an exponential increase in incidence, particularly among pediatric patients. Psychological stress is a significant risk factor influencing the disease course. This review assesses the interaction between stress and disease progression, focusing on articles that quantified inflammatory markers in IBD patients exposed to varying degrees of psychological stress. Methods: A systematic narrative literature review was conducted, focusing on the interaction between IBD and stress among adult and pediatric patients, as well as animal subjects. The research involved searching PubMed, Scopus, Medline, and Cochrane Library databases from 2000 to December 2023. Results: The interplay between the intestinal immunity response, the nervous system, and psychological disorders, known as the gut-brain axis, plays a major role in IBD pathophysiology. Various types of stressors alter gut mucosal integrity through different pathways, increasing gut mucosa permeability and promoting bacterial translocation. A denser microbial load in the gut wall emphasizes cytokine production, worsening the disease course. The risk of developing depression and anxiety is higher in IBD patients compared with the general population, and stress is a significant trigger for inducing acute flares of the disease. Conclusions: Further large studies should be conducted to assess the relationship between stressors, psychological disorders, and their impact on the course of IBD. Clinicians involved in the medical care of IBD patients should aim to implement stress reduction practices in addition to pharmacological therapies.

Impact of COVID-19 on student perceived stress, life satisfaction, and psychological flexibility: examination of gender differences

Objective: To identify stress management practices and examine the impact of the COVID-19 pandemic on well-being among male and female physician assistant (PA) students. Participants: Participants included 1,239 students from nine PA programs who matriculated pre-pandemic, acute pandemic, or post-acute pandemic. Methods: Measures included questions about stress management practices and validated instruments assessing perceived stress, life satisfaction, and psychological flexibility. Data were analyzed for differences based on year and gender. Results: Exercise (91.6%), yoga (54.6%), meditation (34.3%), and journaling (32.5%) were commonly reported stress reduction practices. Newly matriculated PA students adjusted to the COVID-19 pandemic differently based on gender. Pre-pandemic, men and women reported similar levels of perceived stress and psychological flexibility, but female students reported higher life satisfaction. Post-acute pandemic, however, female students reported higher perceived stress and lower psychological flexibility. Conclusions: Wellness resources may be strengthened by approaches that account for differences based on gender.

Perceptions of mindfulness practices as a support for individuals managing caregiving responsibilities and chronic disease: A qualitative study.

Explore the lived experience of individuals managing and/or caregiving for someone with a chronic disease and their perceptions of developing a mindfulness program for stress reduction. Sixteen participants with chronic disease and/or caregivers participated. Participants completed eligibility screening, demographic questionnaires, and semi-structured interviews (30-60 min each) online or by phone. Interviews (n = 16) were audio recorded, transcribed, and analyzed using thematic analysis and NVivo® 12. Survey data were analyzed using SPSS® 28. Four themes emerged: (a) Chronic disease management and stress-perspectives on life's stressors; (b) Stress reduction techniques/perceptions of mindfulness-knowledge and implementation of stress reduction practices and familiarity with mindfulness; (c) Mindfulness program acceptability, barriers, and facilitators-interest, barriers, and facilitators to attending; (d) Mindfulness program structure-logistics to increase access and appeal to diverse audiences. Mindfulness has the potential for addressing the complexities of stress associated with disease management. Targeting mindfulness programs for populations with chronic disease management and caregiving responsibilities should include: Consideration of group formats with participation limited to this population, structuring programs to overcome barriers (i.e., culturally appropriate location), and equipping members of the community being served as instructors to ensure culturally relevant instruction.

Aromatherapy through the lens of trauma-informed care: Stress-reduction practices for healthcare professionals

In this post-pandemic era of short-staffing, limited resources, and an ever-growing rate of healthcare professionals reporting exhaustion, stress, anxiety, and burn-out, it is imperative to arm workers with easy to use self-care practices. Aromatherapy is a personal, easy to use, low-cost, effective complementary therapy to promote relaxation, stress reduction, grounding, and calm. Aromatherapy is the use of aromatic plant essences, such as essential oils, to support physiological and psychological wellness. When essential oils are inhaled, they impact the limbic system and sequentially the nervous system. Using a trauma-informed approach, aromatherapy is paired with polyvagal theory and somatic experiencing and presented with breathing practices and recommendations for use in the healthcare workplace.

The Selah study protocol of three interventions to manage stress among clergy: a preference-based randomized waitlist control trial

IntroductionLike many helping professionals in emotional labor occupations, clergy experience high rates of mental and physical comorbidities. Regular stress management practices may reduce stress-related symptoms and morbidity, but more research is needed into what practices can be reliably included in busy lifestyles and practiced at a high enough level to meaningfully reduce stress symptoms.Methods and analysisThe overall design is a preference-based randomized waitlist control trial. United Methodist clergy in North Carolina will be eligible to participate. The intervention and waitlist control groups will be recruited by email. The interventions offered are specifically targeted to clergy preference and include mindfulness-based stress reduction, Daily Examen, and stress inoculation training. Surveys will be conducted at 0, 12, and 24 weeks with heart rate data collected at 0 and 12 weeks. The primary outcomes for this study are self-reported symptoms of stress and heart rate at week 12 for each intervention compared to waitlist control; the secondary outcome is symptoms of anxiety comparing each intervention vs waitlist control.Ethics and disseminationEthical approval was obtained from the Duke University Campus IRB (2019-0238). The results will be made available to researchers, funders, and members of the clergy community.Strengths and limitations of this studyWhile evidence-based stress reduction practices such as mindfulness-based stress reduction (MBSR) exist, a wider variety of practices should be tested to appeal to different individuals.Clergy in particular may prefer, and consequently enact, spiritual practices like the Daily Examen, and individuals such as clergy who spend most of their time thinking and feeling may prefer experiential-based practices like stress inoculation training.If efficacious, the Daily Examen and stress inoculation training practices have high feasibility in that they require few minutes per day.This study is limited by the inclusion of Christian clergy of only one denomination.Trial registrationClinicalTrials.gov NCT04625777. November 12, 2020.

Lifestyle Modification Improves Physical and Mental Health in Elderly Participants: Observational Study in a Controlled Environment

A 60-day observational study was conducted to evaluate how lifestyle modification principles relying upon a customized regimen of aerobic and muscle strength exercise, a plant-based diet and meditative stress reduction techniques may improve physical endurance and strength, mental health, and reverse normal aging associated with the average American lifestyle. All enrolled participants were generally in good health respective to their age. Several subjects had overlapping mild medical conditions. The results demonstrate that the intervention of a customized lifestyle modification regimen of regular daily exercise, a plant-based diet, and daily stress reduction practices, such as meditation and yoga, may provide a viable and beneficial preventative strategy as an anti-aging and wellness model to increase the physical and mental health of elderly men and women.

Synergistic Action of Membrane-Bound and Water-Soluble Antioxidants in Neuroprotection.

Prevention of neurodegeneration during aging, and support of optimal brain function throughout the lifespan, requires protection of membrane structure and function. We review the synergistic action of different classes of dietary micronutrients, as well as further synergistic contributions from exercise and stress reduction, in supporting membrane structure and function. We address membrane-associated inflammation involving reactive oxygen species (ROS) that produce immune regulators from polyunsaturated fatty acids (PUFAs) of membrane phospholipids. The potential of dietary micronutrients to maintain membrane fluidity and prevent chronic inflammation is examined with a focus on synergistically acting membrane-soluble components (zeaxanthin, lutein, vitamin E, and omega-3 PUFAs) and water-soluble components (vitamin C and various phenolics). These different classes of micronutrients apparently operate in a series of intertwined oxidation-reduction cycles to protect membrane function and prevent chronic inflammation. At this time, it appears that combinations of a balanced diet with regular moderate exercise and stress-reduction practices are particularly beneficial. Effective whole-food-based diets include the Mediterranean and the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay diet, where DASH stands for Dietary Approaches to Stop Hypertension).

Psychedelics and health behaviour change.

Healthful behaviours such as maintaining a balanced diet, being physically active and refraining from smoking have major impacts on the risk of developing cancer, diabetes, cardiovascular diseases and other serious conditions. The burden of the so-called ‘lifestyle diseases’—in personal suffering, premature mortality and public health costs—is considerable. Consequently, interventions designed to promote healthy behaviours are increasingly being studied, e.g., using psychobiological models of behavioural regulation and change. In this article, we explore the notion that psychedelic substances such as psilocybin could be used to assist in promoting positive lifestyle change conducive to good overall health. Psilocybin has a low toxicity, is non-addictive and has been shown to predict favourable changes in patients with depression, anxiety and other conditions marked by rigid behavioural patterns, including substance (mis)use. While it is still early days for modern psychedelic science, research is advancing fast and results are promising. Here we describe psychedelics’ proposed mechanisms of action and research findings pertinent to health behaviour change science, hoping to generate discussion and new research hypotheses linking the two areas. Therapeutic models including psychedelic experiences and common behaviour change methods (e.g., Cognitive Behaviour Therapy, Motivational Interviewing) are already being tested for addiction and eating disorders. We believe this research may soon be extended to help promote improved diet, exercise, nature exposure and also mindfulness or stress reduction practices, all of which can contribute to physical and psychological health and well-being.

Supporting the mental well-being of healthcare professionals during a pandemic.

11037 Background: Burnout amongst healthcare professionals has been well-documented as a phenomenon that compromises the quality and viability of patient-centered care, particularly in oncology. Due to the extraordinary demands of the pandemic, burnout has emerged as a public health crisis that warrants immediate attention to preserve the wellbeing of healthcare staff. At the onset of the pandemic, The Sidney Kimmel Cancer Center (SKCC) at Jefferson, an urban NCI-designated cancer center, translated its support offerings to virtual events. Initially, healthcare providers (HP) sought support by attending patient programs. In response, SKCC initiated virtual programming to support the well-being and needs of the HP team. Methods: Within weeks of the state shutdown due to the pandemic, programs were initiated to address HP self-reported distress: Coping Effectively and Mindfulness Moments Each 30-minute session was facilitated by a licensed psychologist and social worker. Coping Effectively offers strategies from evidence based treatment including Dialectical Behavior Therapy, Acceptance and Commitment Therapy, and Cognitive Behavioral Therapy, to cope with distress and burnout. Mindful Moments draws from Mindfulness Based Stress Reduction practices including observing breath and guided meditations. These programs have been offered consistently throughout the pandemic. Schwartz Rounds, geared towards supporting the human side of healthcare, provided “hot” topic moderated discussions, four of which focused on the pandemic These discussions allow for HP to come together to discuss difficult topics and emotions impacting a variety of professionals. All programming was evaluated with a single question to measure the impact of the session on reducing distress. Each program began and ended with a poll asking, “How distressed do you currently feel?” Attendees respond on a Likert scale from 0 to 10, in which10 indicated the highest level of distress. Results: Since March 31st, 340 staff have attended Mindful Moments and 236 staff have attended Coping Effectively. From March 2020-February 2021, 382 attendees measured their distress before and after attending a staff program. Schwartz Rounds hosted 471 HP from a variety of disciplines. Participants were asked to complete an evaluation following rounds. 31% of program participants’ completed an evaluation form and 89% rated the program exceptional/very good. Conclusions: Despite the challenges of COVID-19, the pivot to virtually create programs to support staff during the pandemic was swift and thoughtful. The increased attendance and the feedback from evaluations are promising indicators of decreasing burnout amongst HP. How Distressed do you Currently Feel? (Average Score scale 1-10)[Table: see text]

Strategies for Designing Clergy and Spouse Obesity-Related Programs.

Clergy have influence on the health of congregations and communities yet struggle with health behaviors. Interventions tailored to their occupation-specific demands and unique needs may provide a solution. Qualitative methods were used to identify opportunities and resources for the development of an effective obesity-related program for clergy. Ninety-minute focus groups were held with clergy (3 groups) and spouses (3 separate groups). Discussion explored: Program target(s); Opportunities and barriers that influence diet, physical activity, and stress-reduction practices; Empowering and culturally relevant health promotion strategies. All study activities took place in Memphis, TN. Eighteen clergy and fourteen spouses participated. All clergy were male, all spouses were female. Previous research with clergy informed the interview guide and the PEN-3 framework aided in organizing the coding of clergy and spouse focus groups. Focus groups were audio recorded and transcripts analyzed using NVivo® 12. Themes included: 1) Intervention targets-clergy, spouses, congregations; 2) Opportunities and barriers-making time, establishing boundaries, church traditions, individuals who support and hinder behavior change; 3) Intervention strategies-tools for healthy eating, goal setting, camaraderie, combining face-to-face with eHealth modalities. The relationship between clergy, spouse, and congregation make it important for obesity-related programs to target the unique needs of both clergy and spouses. Strategies should focus on healthy eating and personal connections no matter the modality used.

CPR to the Rescue!: An Interprofessional Pilot Program: Cultivating Practices for Resilience (CPR) Camp.

The hCATS (health Colleges Advancing Team Skills) to CPR (Cultivating Practices for Resilience) Camp was an interprofessional pilot program to promote resilience, introduce strategies for coping with stress, cultivate compassion, and promote work-life balance to prevent burnout among health profession students, faculty, and healthcare professionals who team to provide patient care. The University of Kentucky (UK) College of Nursing received funding to partner with the UK Center for Interprofessional Health Education for immersive weekend activities utilizing KORU and Mindfulness Based Stress Reduction models, conducted by certified UK faculty experts in self-stewardship techniques such as mindfulness practices. Thirty-nine participants from 7 UK colleges and UK HealthCare participated in 4 distinct CPR Camps, completed program assessments, and created team projects. Mean scores from each cohort significantly increased in a retrospective pre/post analysis of student perception of knowledge in all of the following categories: (1) habits and practices for resilient people, (2) strategies for building resilience and preventing/coping with stress/burnout in self and others, and (3) work-life balance (with the exception of cohort 4, for work-life balance). Students indicated on open-response items specific strategies they were willing to adopt going forward. These outcomes met our objectives for developing participants' understanding of resilience practices and adopting useful stress reduction practices. Planning and implementation of team projects successfully brought different professions together to advance learning in resilience. The CPR Camp initiative is an effective model for promoting and sustaining resilience-building strategies among health profession students. Similar programming conducted and/or attended by academic and/or health system leaders, such as clinical nurse specialists, can help cultivate practices for resilience among the members of the interprofessional workforce, enabling teams to better cope with stress, prevent burnout, and ultimately improve team-based care delivery for patients and their families.

Abstract P1-17-15: OWL: Own your wellness and living platform -An artificial intelligence virtual well - being supporting coach for breast cancer survivors

Abstract BACKGROUND: Cancer survivors experience unmet educational, psychosocial, and physical needs related to their cancer experiences (1). Nearly 60% of survivors are obese (2) and 80% prefer their oncologist to provide nutrition, exercise, and psychosocial guidance. The 30% increased risk of disease recurrence and death from breast cancer (3) related to obesity, requires interventions to be part of the treatment and after-care plan. Given the increasing numbers of cancer survivors, there is an opportunity for artificial intelligence (AI) to be incorporated in their physical and psychosocial needs. OWL is a mobile digital platform that integrates proven scientific results to assist breast cancer survivors improve their well-being. OWL provides personalized support using an AI experience coach for nutrition and activity guidance, in addition to education and psychosocial wellbeing. METHOD: OWL uses chatbot technology to 1. Reinforce breast cancer education and the importance of being compliant with treatment and follow-up, 2. Educate and provide guidance about conscious eating and exercise plans aimed at maintaining normal BMI/BFI (body fact index), 3. Provide psychosocial and mindfulness techniques for stress and anxiety, 4. Include support for care-taker activities. OWL provides the user with a personalized 30-day plan each month generated from users’ responses to survey questions about their current diet, exercise, and stress reduction practices, and allows the users to choose their own monthly goals. This increases personal accountability and gives each user control over the process. Objective data including cancer stages and BMI/BFI, fitness level, BP, cholesterol, etc will be collected. With their personalized monthly plan in place, the users will receive daily reminders and encouragements via push notifications and frequent chatbot interaction to encourage them to stay compliant with the plan. Their nutrition, exercise, and stress reduction activity will be tracked via their personal smart devices equipped with augmented reality (AR) to provide the user with real time, 3D visual interaction and allow them to actively participate in their own learnings and progress. At the end of a 30-day plan, the users’ progress report will be summarized for personal use as well as the option to report to their physicians. With each new goal and plan developed every 30 days, OWL attempts to provide long lasting habits that will help users achieves optimal wellness for a long, healthy lifestyle of which the first building brick is good eating, exercise, and less stress. Using a combine multimodality approach and tailoring to each individual user, OWL creates goals specific to their current needs, and build upon these each month by increasing the exercise intensity, improving lean mass to fat mass ratio, increase the amount of fruit and vegetable intake and stress reduction practices via being mindfulness to achieve the evidence-based recommendation for optimal well-being. CONCLUSION: Studies show that increasing vegetables and fruits to 80% of food intake and 300 minutes per week of moderate activity increases cancer survival and 20 minutes of meditation per day contributes to long-term well being. Most survivors have difficulty sustaining these recommendations. OWL is the ideal coaching tool that will help cancer survivors achieve and maintain long term health and ultimately reduce cancer recurrence and increase overall survival. Updated results will be presented. We provide a brief visual presentation of the app at https://vimeo.com/346003400/6ccdfc06b5 Citation Format: Colin Kenneth Hill, Thehang Luu, Laura Bourdeanu. OWL: Own your wellness and living platform -An artificial intelligence virtual well - being supporting coach for breast cancer survivors [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-17-15.

The effect of dbt-informed mindfulness skills (what and how skills) and mindfulness-based stress reduction practices on test anxiety in college students: A mixed design study

Many studies have shown the anxiety reducing effects of extended mindfulness interventions; however, few have examined mindfulness interventions on test anxiety in a college student population. This study assesses the effects of Dialectical Behavior Therapy’s (DBT’s) mindfulness skills and Mindfulness-based Stress Reduction practices over an 8-week period on college students. Participants (N = 43), included randomly assigned college students that were either included in a mindfulness group (an 8-week mindfulness training course), an online mindfulness group, or acted as a waitlist control group (no intervention received). Participants were assessed on text anxiety, general anxiety, and mindfulness at the beginning, mid-way point, and end of the study. Participants in the mindfulness conditions showed significant within-group reductions in test anxiety, general anxiety, and all sub-scales of mindfulness, except Observe, while participants in the Wait-List Control group primarily did not show changes. This specific mindfulness intervention that taught the “What” and “How” skills of DBT’s mindfulness module can help students reduce test anxiety and general anxiety as well as increase individual levels of mindfulness.

Mindfulness-Based Stress Reduction on breast cancer symptoms: systematic review and meta-analysis.

ABSTRACTMindfulness-Based Stress Reduction practices increase the capacity for concentration and attention, and these practices are particularly effective for people with breast cancer. To analyze the effects of the application of Mindfulness-Based Stress Reduction on breast cancer symptoms. Systematic review and meta-analysis were carried out. To find suitable studies, the PubMed/ MEDLINE database was searched using the keywords “breast cancer” and “Mindfulness-Based Stress Reduction”. Studies included were published between 2013 and 2017, written in English and showed methodological quality through the PEDro scale (score greater than 3). They also presented empirical evidence, had an experimental study design (randomized or non-randomized), and had full text available. For the meta-analysis, we used a random-effects model, with standardized mean differences and 95% confidence intervals. Seven studies were included, one non-randomized and containing only an intervention group of Mindfulness-Based Stress Reduction, and six randomized including samples of two or three groups. The non-randomized study showed 6 points on the PEDro scale, the randomized studies of two groups 6 to 7 points and studies with three groups showed 7 points. In the meta-analysis of the two randomized studies, the results, although not significant, revealed a moderate effect for Mindfulness-Based Stress Reduction on the outcome of fatigue, with a mean difference of −0.42 (95%CI −0.92- −0.07; p=0.09). Mindfulness-Based Stress Reduction seems to be a promising alternative for treatment of this disease's symptoms.

Mindfulness Meditation to Promote Wellness and Manage Chronic Disease

Lifestyle medicine is a patient-engaged field that has grown in tandem with our increasing knowledge of the importance of lifestyle factors and modifiable health behaviors for disease prevention, health promotion, and the management of chronic illness. Stress is at the epicenter of many negative behaviors that contribute to unhealthy lives, such as smoking, overeating, and unhealthy diets, and lack of activity. Mindfulness meditation is a stress reduction practice that teaches awareness, appreciation, and nonjudgmental acceptance of one’s present experience, thereby short-circuiting reactive, automatic stress reactions. Our systematic review and meta-analysis focuses on the application of randomized controlled mindfulness intervention studies across a broad range of populations and conditions that are relevant to lifestyle medicine. In addition to organizing and highlighting mindfulness research studies that are relevant to the field of lifestyle medicine, we also empirically examine the impact of study design issues (eg, use of different controls, intervention length and duration, sample size, primary outcomes) on the magnitude of effect of mindfulness interventions in lifestyle medicine. Overall, this systematic review and meta-analysis found partial evidence for mindfulness-based interventions to provide short-term benefits across a wide range of lifestyle medicine–relevant populations and study outcomes, particularly focusing on the areas of diet and weight management and symptom burden. Numerous outcome measures were used; however, the most common were the Perceived Stress Scale and the State Trait Anxiety Inventory. This analysis also provides evidence for mindfulness-based interventions that have fewer than 20 individuals per group, as well as partial support for interventions that are less than the standard 8 weeks in duration.