Stress Response Inventory Research Articles

The impact of forest therapy on functional recovery after acute ischemic stroke

Stroke is a leading cause of disability worldwide, with a growing need for effective rehabilitation strategies. Forest therapy, involving structured activities in natural environments, has shown significant beneficial effects in various health-related outcomes but no studies have assessed its direct effect on functional recovery after acute ischemic stroke. We assessed whether forest therapy is effective in recovering functional outcome of acute ischemic stroke compared to conventional rehabilitation therapy. This prospective cohort study included patients with acute ischemic stroke admitted within 24 hours of symptom onset. Participants were randomized into forest therapy (n=15) and control (n=27) groups. The forest therapy group underwent five sessions of guided activities in a national forest center, while the control group received standard outpatient rehabilitation. Primary outcome was changes in the modified Rankin Scale (mRS) scores, with secondary outcomes including grip strength, body composition, and psychological well-being assessed using the Worker's Stress Response Inventory and the Positive and Negative Affect Schedule from the time of hospital discharge to 3 months after stroke onset. Change of mRS were analyzed using the generalized estimating equation to compare changes over time between the two groups. At three-month follow-up, the forest therapy group demonstrated a significant improvement in mRS scores compared to the control group (p=0.034). Although no significant differences were found in grip strength or body composition, reductions in somatization and job-related stress were observed in the forest therapy group. No significant changes in positive or negative affect were detected. Forest therapy can contribute to functional recovery and reduce stress-related indicators in acute ischemic stroke patients. These findings support that the integration of forest therapy into stroke rehabilitation protocols to address both physical and psychological aspects of recovery, highlighting the potential for multidisciplinary approaches in post-stroke care.

A comparative analysis of older patients with chewing difficulties due to temporomandibular disorders and tooth loss

Background/purposeChewing difficulty can contribute to psychological stress, which reduces the quality of life for older adults. The purpose of this study was to investigate and analyze the severity of masticatory discomfort, stress response, and sleep disturbance in older patients experiencing masticatory discomfort due to tooth loss or temporomandibular disorders (TMD), to find the further treatment direction for these patients. Materials and methodsA total of 392 patients aged 50 years and older with mastication difficulties were analyzed. Two group of patients, those seeking prosthetic treatment due to tooth loss (n = 193) and those who were referred due to TMD-related pain discomfort (n = 199), were identified. Numeric rating scale (NRS), stress response inventory (SRI), and insomnia severity index (ISI) were used as tools to measure patients’ subjective chewing discomfort, stress response, and sleep status. ResultsChewing discomfort and age were found to be much higher in the prosthetic group than in the TMD group. The TMD group had significantly higher scores in five SRI parameters (tension, anger, depression, fatigue, and frustration) as well as total score and a higher percentage of clinical insomnia compared to prosthetic patients. ConclusionSince the number of remaining teeth has a significant impact on the masticatory discomfort severity, restoring the occlusion through prosthodontic treatment is important to improve masticatory function. In patients with TMD, it is necessary to assess stress response and sleep quality, and a multidisciplinary treatment approach may be necessary to effectively address masticatory discomfort.

Eight-week stress management exercise program improves mental health and autonomic nervous system of adults exposed to chronic stress.

This study investigated a stress management exercise program's effect on mental health, muscle pain, and autonomic nervous system activity in adults exposed to chronic stress. Thirty mothers between 40 to 59 years old raising children with disabilities were equally allocated into the yoga (YG) or control group (CG). The YG participated in 16 prop-assisted yoga sessions twice weekly for eight weeks, focusing on relaxing and strengthening neck, shoulder, back, and waist stress-related muscles. The Beck Depression Inventory, State-Trait Anxiety Inventory, Parenting Stress Scale, Stress Response Inventory, and Brief Resilience Scale assessed mental health variable changes. Visual Analog Scales (VAS) were used to self-report neck, shoulders, back, and waist pain and assess stress, anxiety, relaxation, and confidence. We also measured pain, psychological VAS, and Heart Rate Variability (HRV) immediately before and after each yoga session. The YG exhibited significant reductions in muscle pain, depression, stress response, fatigue, and frustration, whereas the CG expressed no change. Prop-assisted yoga immediately improved pain and psychological VAS. HRV analyses revealed instantly reduced heart rates and an R-R interval and standard deviation normal to normal (SDNN) increase. Prop-assisted yoga may serve as a viable, safe, and efficient alternative therapeutic modality for managing chronic stress-related conditions.

The Effects of Nature Exposure Therapies on Stress, Depression, and Anxiety Levels: A Systematic Review.

Mental well-being plays a pivotal role within the broader spectrum of health and illness, encompassing factors such as stress, depression, and anxiety. Nature-based therapeutic interventions have emerged as a promising approach to addressing these mental health challenges. This study seeks to assess the impact of these interventions on stress, depression, and anxiety levels. We conducted an extensive search for randomized clinical trials that examined stress, anxiety, and depression levels. The selected studies underwent a rigorous risk-of-bias assessment following the guidelines outlined in the Cochrane Handbook for Systematic Reviews. Our review encompassed findings from eight publications. Among them, two studies measuring cortisol levels revealed significant differences between the pre-test and post-test measurements within the intervention groups. In two studies that employed the Stress Response Inventory, a significant decrease in stress levels was observed within the intervention groups in contrast to the control groups. However, no significant differences were noted in studies that utilized the Restorative Outcome Scale. In the assessment of anxiety and depression levels, three studies employed the Positive and Negative Affect Schedule, while four studies utilized The Profile of Mood States scale; none of these studies demonstrated significant differences. The current body of evidence offers limited support for advocating nature-based therapeutic interventions as a primary approach to reducing stress, depression, and anxiety.

Investigation of the relationship between university students' attentional impulsivity levels and psychological and physiological stress responses.

The purpose of this study is to investigate the relationship between attentional impulsivity levels and physiological and psychological stress responses of university students. 300 university students participated in the study. Four different data collection tools were used in the study: a personal information form, the Physiological Stress Response Inventory, and the Attentional Impulsivity Part of Barratt Impulsiveness Scale. We showed that attentional impulsivity of the participants is significantly related to both physiological stress responses (R2 = 0.04, F[1;267] = 11.45, p < 0.05) and psychological stress responses (R2 = 0.04, F[1;270] = 10.40, p < 0.05). At the same time, there is a significant negative association between physiological stress responses and psychological stress responses (r = -0.68). The attentional impulsivity is an important variable for explaining changes in both physiological and psychological stress responses. Physiological and psychological stress responses should be considered as separate kinds of stress responses in stress response measurements.

A Quasi-Experimental Study Investigating the Impact of a Lifestyle Redesign Program on the Well-Being of Korean University Students.

Korean university students (KUS) face numerous challenges that can jeopardize their well-being, including academic stress, peer pressure, irregular sleep patterns, unhealthy eating habits, lack of physical exercise, and difficulties in time management, resulting in unhealthy habits and fluctuations in lifestyle. Consequently, there is a growing need for interventions tailored to this population. This study explored the effects of a Lifestyle Redesign (LR) intervention on Korean university students' well-being including occupational participation, satisfaction, perceived stress levels, and quality of life. A quasi-experimental study with 33 KUS (17 intervention, 16 control) assessed the effects of a 10-week LR intervention on well-being of the students. Pre- and postintervention changes were measured using Canadian Occupational Performance Measure (COPM), Stress Response Inventory (SRI), and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). The intervention, delivered by trained OTs, comprised of individual and group sessions. Statistically significant improvement was observed in occupational performance. While statistical significance was not consistently achieved in the rest of other areas, the LR group displayed positive trends. The LR group exhibited higher COPM satisfaction scores, lower SRI scores (indicating reduced stress), and elevated WHOQOL-BREF scores compared to the control group. This study contributes to the understanding of the importance of addressing lifestyle changes and habits in the well-being of university students, especially in the context of academic stress and peer pressure. Future research with larger, more diverse samples and extended intervention periods may offer further insights into the benefits of LR programs in university settings.

Effects of a music-based exercise program on the postural balance and emotions of instrumentalists.

This study aimed to verify the effects of a music-based exercise program on postural balance and emotional factors among instrumentalists. We recruited 11 instrumentalists aged 25-45 years who were asked to perform a music-based exercise program for 60 min per session, three sessions weekly, for 8 weeks. The anterior balance and lateral alignment of the participants were determined using a body posture analyzer. To assess the emotional factors, the World Health Organization Quality of Life, stress response inventory, and Rosenberg self-esteem scale were used. This study did not reveal a statistically significant difference in anterior postural imbalance and lateral misalignment. In contrast, emotional factors, including quality of life, stress response, and the self-esteem subcategories, exhibited significant differences. The music-based exercise program in this study significantly improved the emotional factors. Nevertheless, a more structured and long-term program should be developed to ensure the improvement of postural imbalance among instrumentalists.

Development of an Artificial Intelligence-Based Tailored Mobile Intervention for Nurse Burnout: Single-Arm Trial.

Nurse burnout leads to an increase in turnover, which is a serious problem in the health care system. Although there is ample evidence of nurse burnout, interventions developed in previous studies were general and did not consider specific burnout dimensions and individual characteristics. The objectives of this study were to develop and optimize the first tailored mobile intervention for nurse burnout, which recommends programs based on artificial intelligence (AI) algorithms, and to test its usability, effectiveness, and satisfaction. In this study, an AI-based mobile intervention, Nurse Healing Space, was developed to provide tailored programs for nurse burnout. The 4-week program included mindfulness meditation, laughter therapy, storytelling, reflective writing, and acceptance and commitment therapy. The AI algorithm recommended one of these programs to participants by calculating similarity through a pretest consisting of participants' demographics, research variables, and burnout dimension scores measured with the Copenhagen Burnout Inventory. After completing a 4-week program, burnout, job stress, stress response using the Stress Response Inventory Modified Form, the usability of the app, coping strategy by the coping strategy indicator, and program satisfaction (1: very dissatisfied; 5: very satisfied) were measured. The AI recognized the recommended program as effective if the user's burnout score reduced after the 2-week program and updated the algorithm accordingly. After a pilot test (n=10), AI optimization was performed (n=300). A paired 2-tailed t test, ANOVA, and the Spearman correlation were used to test the effect of the intervention and algorithm optimization. Nurse Healing Space was implemented as a mobile app equipped with a system that recommended 1 program out of 4 based on similarity between users through AI. The AI algorithm worked well in matching the program recommended to participants who were most similar using valid data. Users were satisfied with the convenience and visual quality but were dissatisfied with the absence of notifications and inability to customize the program. The overall usability score of the app was 3.4 out of 5 points. Nurses' burnout scores decreased significantly after the completion of the first 2-week program (t=7.012; P<.001) and reduced further after the second 2-week program (t=2.811; P=.01). After completing the Nurse Healing Space program, job stress (t=6.765; P<.001) and stress responses (t=5.864; P<.001) decreased significantly. During the second 2-week program, the burnout level reduced in the order of participation (r=-0.138; P=.04). User satisfaction increased for both the first (F=3.493; P=.03) and second programs (F=3.911; P=.02). This program effectively reduced burnout, job stress, and stress responses. Nurse managers were able to prevent nurses from resigning and maintain the quality of medical services using this AI-based program to provide tailored interventions for nurse burnout. Thus, this app could improve qualitative health care, increase employee satisfaction, reduce costs, and ultimately improve the efficiency of the health care system.

The effects of Korean Red Ginseng on stress-related neurotransmitters and gene expression: A randomized, double-blind, placebo-controlled trial

BackgroundKorean Red Ginseng (KRG) is an effective anti-stress treatment. In this study, we investigated the therapeutic potential effects of KRG on relieving stress in a general population using transcriptome analysis. MethodsWe conducted an 8-week clinical pilot study on 90 healthy men who reported stress. The study was completed by 43 participants in the KRG group and 44 participants in the placebo group. Participants were randomized 1:1 to the KRG and placebo groups. We evaluated the stress by stress response inventory (SRI) at baseline and 8 weeks. The main outcomes were changes in the levels of neurotransmitters (NTs) and NT-related gene expression. NTs were analyzed using automated (GC) content, and levels of gene expression were measured by reads per kilobase of transcript per million mapped reads (RPKM). ResultsThe KRG group showed significantly preserved epinephrine decrease compared with placebo group at 8 weeks (changes in epinephrine, KRG vs. placebo; −1623.2 ± 46101.5 vs. −35116.3 ± 86288.2, p = 0012). Among subjects who higher SRI score, meaning stress increased compared to baseline, the KRG group showed a smaller decrease in serotonin than the placebo group (changes in serotonin, KRG vs. placebo; −2627.5 ± 5859.1 vs, −8087.4 ± 7162.4, p = 0.005) and a smaller increase in cortisol than the placebo group (changes in cortisol, KRG vs. placebo; 1912.7 ± 10097.75 vs. 8046.2 ± 8050.6 , p = 0.019) in subgroup analysis. Transcriptome findings indicated that KRG intake affects gene expression related with metabolism of choline, adrenalin, and monoamine. ConclusionThese findings suggest that KRG has beneficial effects on the amelioration of stress response in NTs, and this effect is more prominent in stressful situations. Further clinical studies are required to confirm the anti-stress effect of KRG.

Effect of Childhood Adversity and Positive Psychological Resources on Stress Response-Comparison Between Depressed and Nondepressed Young Adults.

The purpose of this study was to explore the relationship between stress response, childhood adversity, and positive psychological resources in young adults, to investigate the mediation effect of positive psychological resources, and to compare the moderated mediation effects between depressed and non-depressed groups. A total of 360 young adults (165 outpatients diagnosed with depression and 195 non-depressed participants) were recruited. Data were collected using the Adverse Childhood Events questionnaire, Positive Resources Test, and Stress Response Inventory. Models 4 and 14 of the PROCESS macro were used to test the mediating and moderated mediating effects. In both groups, the stress response was negatively correlated with positive psychological resources and positively correlated with childhood adversity. Positive psychological resources mediated childhood adversity and depression. In the depression group, positive resources had a moderated mediation effect on the relationship between childhood adversity, positive psychological resources, and stress response. The findings suggest the importance of enhancing positive psychological resources, especially in patient groups, to help overcome childhood adversity and cope with stress more effectively.

Factors Affecting Nurse Retention Intention: With a Focus on Shift Nurses in South Korea.

This study aims to investigate the factors affecting shift nurses' retention to solve the nurse shortage problem. The independent variables were general characteristics, stress response, work-life balance, and grit. The subjects for the study were 214 nurses working in three shifts at three general hospitals in Korea. Data were collected from 1 to 31 August 2022. We used structured tools such as the Nurses' Retention Index, Stress Response Inventory, Work-Life Balance Scale, and Clinical Nurse's Grit Scale. Data analysis was conducted using descriptive statistics, independent sample t-test, one-way variance analysis, Pearson correlation analysis, and hierarchical multiple regression analysis. Age, job satisfaction, and grit were factors that had a significant impact on retention intention. Grit had the greatest impact on retention intention. Additionally, retention intention increased in those aged from 30 to 40 years as compared with those under the age of 30. It is necessary to develop and implement a program that can improve grit to enhance the retention intention of shift nurses. Additionally, it is necessary to actively seek measures to reduce dissatisfaction with nursing jobs, increase satisfaction, and manage human resources considering the characteristics of age groups.

Psychological Impact of the COVID-19 Outbreak on Mental Health Among Iranians

Background: The coronavirus disease 2019 (COVID-19) pandemic and its consequences may impact individuals’ mental health. Objectives: The present study aimed to investigate the psychological status of individuals during the COVID-19 outbreak in Iran following the government’s social distancing plan. Methods: Data from 1,524 people were collected using a cross-sectional web-based survey via social media. Demographic variables and psychological status were evaluated using the General Health Questionnaire, Stress Response Inventory, and Brunel Mood Scale. Results: Individuals reported that their mental health functioning decreased during the pandemic. Four factors were associated with increased stress: (1) fear of getting sick; (2) indefinite quarantine duration; (3) impaired daily activities; and (4) reduced social communication. One-third of the participants reported physical symptoms (32.7%), 47% anxiety, 72% social dysfunction, and 28.3% depression. Approximately half of the participants (52.2%) reported mental health disorder symptoms. Detrimental mental health characteristics were higher among females, younger people, and single people. Conclusions: Health policies should be implemented to help reduce the psychological burden during and after the Iranian government’s Social Distancing Plan, especially among females, single people, and younger people.

The Relationship Between Posttraumatic Embitterment Disorder and Stress, Depression, Self-Esteem, Impulsiveness, and Suicidal Ideation in Korea Soldiers in the Local Area.

The purpose of this study was to identify the prevalence of posttraumatic embitterment disorder (PTED) among soldiers, and examine its relation to stress, depression, self-esteem, impulsiveness, and suicidal ideation. The subjects of this study were 200 soldiers and 197 control subjects, a total of 397 persons. Measurement tools used included the PTED self-rating scale, Stress Response Inventory, Beck Depression Inventory, Rosenberg Self-Esteem Inventory, Barratt Impulsiveness Scale, and Beck Scale of Suicide Ideation. The major findings of the analysis are as follows: first, 11.5% of the soldiers were in the risk group for PTED, and 4% of them had PTED. Second, PTED in the soldiers was significantly associated with a number of variables such as their educational background, stress, depression, self-esteem, impulsiveness, and suicidal ideation, while it was not significantly associated with age. Third, through the hierarchical multiple regression analysis, it was found that academic background, stress, and depression had a statistically significant positive effect on the incidence of PTED in the soldiers. In order to prevent and effectively intervene in PTED in soldiers, there is a need for interventional efforts focused on depression and stress related to negative life events.

Reducing Maternal Stress in Pediatric Hospitalization during the COVID-19 Pandemic by Improving Family-Centered Care with Bedside Telehealth: A Pilot Randomized Clinical Trial.

Objective: Stress and anxiety in the mother as one of the most important members of the child's health can delay recovery and prolong hospitalization of the child. However, families feel very anxious or stressed because of the limitations imposed by COVID-19; therefore, it is important for physicians and nurses who work with children and families to recognize and reduce family stress. This study aimed to investigate the effect of implementing an educational-supportive program on improving family-centered care with bedside telehealth. Method : In this clinical trial, 40 parents with hospitalized children were selected and randomly assigned to control and intervention groups. The intervention group received a supportive training program, including teaching parental roles and supportive methods for the child and mother during the illness, while nurse counseling and support role was performed virtually as part of the intervention. After the virtual and visual implementation of the training, the father established online video communication with the child and the mother as the primary caregiver. Data collection tools were a demographic questionnaire and Stress Response Inventory (SRI) completed by the mother before and after seven days of intervention. The control group received routine care. Results: After the intervention, mothers in the intervention group showed significantly lower levels of stress than before the intervention (P < 0.05). Stress level of mothers in the control group did not demonstrate significant difference before and after the intervention (P > 0.05). Also, a comparison of mothers' stress scores post-intervention showed significant difference between the two groups (P < 0.05). Conclusion: Planning and maintaining family integrity during the COVID-19 pandemic along with educating and supporting fathers through the supportive role of spouses can reduce stress of mothers with hospitalized children.

대학생의 경부기능장애에 대한 경부통증과 스트레스의 관련성 연구

The purpose of this study was to investigate the correlation of neck pain and disability and stress in university students. 136 participants with volunteered for this study. General characteristics of the participants, neck disability index, and stress response inventory was collected by using the survey, and its data were included in the final analysis. The neck disability index score showed positive correlation with neck pain (r=.415, p=0.00) and stess level (r=.419, p=0.00). Finally, neck disability index score of university students was a factor affecting on neck pain (ß=.654, p<.001) and stress level (ß=.094, p<.001). These findings suggest that neck pain and disability and stress level might have correlation with each other, and neck pain can be considered as the main variable. Further studies need to warrant these findings.

A Randomized Double-Blind, Placebo-Controlled Study on Anti-Stress Effects of Nelumbinis Semen.

Introduction: Depression is a serious and common mental disease that causes low mood and loss of interest in activities. Nelumbinis semen (NS) has been widely used as a treatment for depression for hundreds of years in many Asian countries. Water extract of nelumbinis semen (WNS) is a standardized herbal medicine made from NS. Methods: The objective of the present research was to perform a randomized, double-blind, placebo-controlled trial to estimate the efficacy of WNS for improving depressive and stress symptoms using Beck depression inventory (BDI) and the stress response inventory (SRI) in 45 adults diagnosed with major depression or other forms of depressive disorders. They were randomized to either a placebo-treated group, a 2.4 g per day WNS-treated group, or a 4.8 g per day WNS-treated group. BDI and SRI were determined in order to evaluate changes in depression before and after two weeks of WNS treatment. Results: The average BDI and SRI of the 2.4 g WNS-treated group were significantly (p < 0.05) improved compared to those of the placebo-treated group. Their BDI subscale A (negative attitudes towards self) and subscale C (somatic disturbances), SRI E, and depression subscale of SRI were substantially shorter (p < 0.05). In addition, an analysis of collected EEG data of participants showed a significant increase in alpha/beta activity in the 4.8 g WNS-treated group, which might be explained as an advancement of their depression symptoms (p < 0.05). Conclusions: These results suggest that WNS treatment can decrease depression. Our study provides preliminary evidence for the safety of WNS and its potential to decrease depression.

Comparison of Peripheral Biomarkers and Reduction of Stress Response in Patients With Major Depressive Disorders vs. Panic Disorder.

Alteration in stress response seems to affect the development of psychiatric disorders. In this study, we aimed to investigate whether baseline peripheral biomarkers could predict the reduction of stress response among patients with major depressive disorder (MDD) and panic disorder (PD). Patients with MDD (n = 41) and PD (n = 52) and healthy controls (HC, n = 59) were selected and regularly followed up with five visits for 12 weeks. The severity of stress at every visit was assessed using the Stress Response Inventory (SRI), and peripheral biomarkers were measured by blood tests at baseline and 2, 4, 8, and 12 weeks. Interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, C-reactive protein (CRP), adiponectin, and leptin levels were analyzed using enzyme-linked immunosorbent assays. Reduction of stress response was defined as the difference in SRI score between baseline and 12 weeks divided by the baseline score. SRI scores were significantly (p < 0.0001) higher in patients with MDD and PD than in HC at every visit after adjusting for variables. In multivariable linear regression, adiponectin levels at baseline were significantly associated with reduction of stress response in patients with PD. When adiponectin increased 1 mg/l, stress response decreased 0.781 points (β = −0.781, S.E. = 0.220, p = 0.001). Among the subscales of SRI, somatization had a moderate negative correlation with adiponectin levels (r = −0.469). There was no significant association between baseline peripheral biomarkers and reduction of stress response in patients with MDD. Our study showed an inverse association between baseline adiponectin levels and stress response changes in patients with PD, but not in patients with MDD. Thus, differentiated approaches for assessing and treating stress responses of patients with PD and MDD might be helpful. Larger and longitudinal studies are necessary to establish the role and mechanism of action of adiponectin in regulating stress responses in PD.

Associations of clinical, psychological, and socioeconomic characteristics with nicotine dependence in smokers

Cigarette smoking is a risk factor of mortality and morbidity from various cancerous, respiratory, and myocardial diseases. Nicotine dependence is assessed based on the degree of physical dependence. We aimed to determine the clinical, socioeconomic and psychological factors associated with the smoking status and degree of nicotine dependence of smokers. From April 2009 to September 2010, we retrospectively collected data from 17,577 subjects aged ≥ 18 years who had undergone a general health examination at a health promotion center. The instruments used included the Fagerström Tolerance Questionnaire (FTQ), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Stress Response Inventory (SRI), and Alcohol Use Disorder Identification Test (AUDIT). Of the current smokers (N = 3946), 2345 (59%), 1154 (29%), and 447 (12%) had low, moderate, and high nicotine dependence, respectively. In multiple logistic analysis, predictors of high nicotine dependence were male sex (odds ratio [OR] 3.705, 95% confidence interval [CI] 1.997–6.945), older age (≥ 65 years) (OR 1.016, 95% CI 1.004–1.029), higher body mass index (BMI) (OR 1.048, 95% CI 1.018–1.078), diabetes (OR 1.870, 95% CI 1.251–2.794), single marital status (OR 1.575, 95% CI 1.186–2.092), lower education level (OR 1.887, 95% CI 1.463–2.433), and a higher stress level (OR 1.018, 95% CI 1.997–6.945). Thus, clinical, psychological, socioeconomic status including male, older age, higher BMI, diabetes, single marital status, lower education, and higher stress should be taken into consideration by promoting smoking cessation.

Follow-up Plan as a Necessity for Nursing Care: A Decrease of Stress in Mothers with their Children in Pediatric Surgical Units.

Introduction: Children are vulnerable to damage. Health problems in children, especially if necessitate hospitalization, can cause stress in their parents that may persist even long after discharge. This study aimed to investigate the effect of implementing follow-up care plans on stress in mothers of children discharged from pediatric surgical units. Methods: A quasi-experimental study was conducted on 64 mothers whose children were hospitalized in the surgical wards of two educational hospitals affiliated to Isfahan University of Medical Sciences, Iran. The participants were randomly assigned into two groups of control and experimental. The data collection tools included a demographic data questionnaire and stress response inventory (SRI). The interventions were performed using a four-stage follow-up care plan. The data were analyzed using SPSS software version 13 and descriptive statistics, independent t-test, repeated measures analysis of variance (ANOVA), and least significant difference (LSD) test. Results: The mean (SD) stress scores of the experimental group were 64.1 (28.8), 20.4 (12.4), and 11.6 (7.5) before, one week, and one month after the intervention, respectively. In the control group, these scores were 61.2 (29.2), 59.9 (25.5), and 46.7 (19.1), respectively. The results showed the mean score was significantly lower than that of the control group at one week and one month after the intervention in the experimental group. Conclusion: Our results demonstrated that a follow-up care plan can decrease the stress levels of mothers as a continuity of patient care even after discharge.

Effects of Probiotic NVP-1704 on Mental Health and Sleep in Healthy Adults: An 8-Week Randomized, Double-Blind, Placebo-Controlled Trial.

The human gut microbiome is closely linked to mental health and sleep. We aimed to verify the efficacy and safety of probiotic NVP-1704, a mixture of Lactobacillus reuteri NK33 and Bifidobacterium adolescentis NK98, in improving stress, depression, anxiety, and sleep disturbances, along with the measurement of some blood biomarkers. A total of 156 healthy adults with subclinical symptoms of depression, anxiety, and insomnia were retrospectively registered and randomly assigned to receive either NVP-1704 (n = 78) or a placebo (n = 78) for eight weeks. Participants completed the Stress Response Inventory, Beck’s Depression and Anxiety Inventory, Pittsburg Sleep Quality Index, and Insomnia Severity Index at baseline, at four and eight weeks of treatment. Pre- and post-treatment blood tests for biomarkers were conducted. After intervention, gut microbiota composition was quantified by pyrosequencing the bacterial 16S rRNA gene. The NVP-1704 group had a more significant reduction in depressive symptoms at four and eight weeks of treatment, and anxiety symptoms at four weeks compared to the placebo group. Those receiving NVP-1704 also experienced an improvement in sleep quality. NVP-1704 treatment led to a decrease in serum interleukin-6 levels. Furthermore, NVP-1704 increased Bifidobacteriaceae and Lactobacillacea, whereas it decreased Enterobacteriaceae in the gut microbiota composition. Our findings suggest that probiotic NVP-1704 could be beneficial for mental health and sleep.