Nurses - Tab Down Your Stress Level: A Pilot Study on the Use of Aromatherapy to Decrease Stress Levels

The entire process of pregnancy, birth and postpartum falls within the perinatal period. The perinatal period is a process that must be closely monitored in order to protect and ensure the continuity of the health of the woman and her baby. Many physiological, anatomical and emotional changes occur in the woman during pregnancy and birth. These changes can negatively affect the woman's health and reduce her quality of life. In order to cope with these changes and increase her quality of life, women may prefer non-pharmacological applications instead of pharmacological applications due to the thought of harming their baby and themselves. One of the non-pharmacological methods that can be used in the perinatal process is aromatherapy. Aromatherapy reduces the woman's fatigue and stress levels, allows her to relax and have a more positive experience. The purpose of this review is to examine the use of aromatherapy in the perinatal period and present it in line with the literature.

Yoga is increasing in popularity in the United States and across the globe. However, most yoga programs are provided outside the worksite; although many companies offer worksite wellness programs, at present there is limited documentation regarding the potential benefits of participating in a worksite yoga program. Therefore, the purpose of this project was to examine the potential effect of a worksite yoga program on self-acceptance, quality of life, and perceived stress. A prospective cohort pilot study that examined a structured worksite yoga program was designed and tailored to individuals new to yoga. The 8-week Yoga Foundations program was conducted at an academic medical center's worksite wellness center with 86 subjects. Outcome measures were the 36-item Self-Acceptance Scale; a six-item quality-of-life measure that assesses overall, social, mental, physical, emotional, and spiritual well-being; and the ten-item Perceived Stress Scale. Participants demonstrated significant improvement in their overall self-acceptance ( p < 0.001), quality of life ( p < 0.001), and perceived stress ( p < 0.001) levels. They also highly rated the yoga instructors and the weekly format of the program. Participation in a Yoga Foundations program was associated with improvements in self-acceptance, quality of life and stress levels in worksite wellness center members. Future studies should use randomized designs and examine other wellness domains to learn more about the potential benefits of worksite yoga programs.

The objective of the study was to determine the stress levels of girls with central precocious puberty (CPP) before and during treatment with a long-acting gonadotropin-releasing hormone agonist (GnRHa). The Child Stress Scale (CSS) was used for 10 unrelated girls with CPP before and after the first year of GnRHa treatment. The CSS is divided into four subscales (physical, psychological, psychological with depressive component and psychophysiological reactions). Through a quantitative analysis, it is possible to classify stress into four stages: alarm, resistance, near-exhaustion and exhaustion. At diagnosis, 90% of the girls showed stress levels scores at the alarm or resistance stage on at least one subscale, mostly in terms of physical and psychological reactions. The mean total stress score was significantly higher before when compared to after GnRHa treatment (43.4±15.6 vs. 28.9±9.7; p<0.05). The mean stress scores obtained in all subscales, except the one on psychophysiological reactions, were significantly higher before GnRHa treatment. Higher stress levels were a common finding in girls with CPP before treatment. The significant stress level reduction after pubertal suppression reinforces the idea that sexual precocity is a stressful condition in children. The CSS might be a useful tool for psychological assessment of patients with CPP.

BackgroundPremenstrual syndrome (PMS) is characterized by a cluster of psychological and somatic symptoms during the late luteal phase of the menstrual cycle that disappear after the onset of menses. Behavioral differences in emotional and cognitive processing have been reported in women with PMS, and it is of particular interest whether PMS affects the parallel execution of emotional and cognitive processing. Related to this is the question of how the performance of women with PMS relates to stress levels compared to women without PMS. Cortisol has been shown to affect emotional processing in general and it has also been shown that women with severe PMS have a particular cortisol profile.MethodsWe measured performance in an emotional conflict task and stress levels in women with PMS (n = 15) and women without PMS (n = 15) throughout their menstrual cycle.ResultsWe found a significant increase (p = 0.001) in the mean reaction time for resolving emotional conflict from the follicular to the luteal cycle phase in all subjects. Only women with PMS demonstrated an increase in physiological and subjective stress measures during the luteal menstrual cycle phase.ConclusionsOur findings suggest that the menstrual cycle modulates the integration of emotional and cognitive processing in all women. Preliminary data are supportive of the secondary hypothesis that stress levels are mediated by the menstrual cycle phase only in women with PMS. The presented evidence for menstrual cycle-specific differences in integrating emotional and cognitive information highlights the importance of controlling for menstrual cycle phase in studies that aim to elucidate the interplay of emotion and cognition.

Introduction: Parental stress has various reasons like low income, broken family, and lesser family or social support. COVID-19 and the lockdown that has been imposed have created stress among the people. This may be due to increased financial instability within the family, illness or exposure to COVID-19 itself. This study is done to assess the stress on parents in managing their school-going children. Aim: To assess the stress on parents in managing school-going children with their online classes and the factors which are concerning for the parents during the lockdown period. Materials and Method: Parents of children between the age group of 5-12 years were included in the study. These parents’ stress level was analysed based on their response to the parental stress scale. Results: The stress level is found to be on the higher side in the case of a single parent working with the mean stress level being 42.6 when compared to both parents working which had a mean stress level of 32.6. Other factors which are found to increase the stress among parents were low socioeconomic status, having children of a younger age group, and parents living in nuclear families. Conclusion: During the COVID-19 lockdown, the mental health of the parents was found to be influenced by various causes. Good family support, better work timing of parents, and a routine help in reducing stress in the family.

The purpose of this study was to investigate the immediate and short-term effects of 3 different types of music therapy interven- tions on the levels of depression, anxiety, anger, and stress in clients with alcohol dependence. Thirty-six male clients participated in 30-minute music therapy sessions twice a week over a period of 6 weeks. The music therapy program was comprised of singing, music listening, and playing instruments. Each activity was conducted for 2 weeks and for 4 sessions. A repeated measures pretest–posttest design was used. An analysis of variance indicated no statistically significant differences in the effects of the 3 types of music therapy interventions on the levels of depression, anxiety, anger, and stress; however, participants’ scores in depression, anxiety, anger, and stress were significantly reduced after participating in the music therapy sessions. In the singing activity, significant differences in depression and stress levels were found between participant-selected songs and therapist-selected songs.

Background: Psychological stress can exacerbate many inflammatory diseases like psoriasis by dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis. One method of establishing this correlation is by measuring cortisol levels. Deposition of cortisol in the hair during its growth allows for retrospective quantification and to analyze the relationship between hair cortisol levels, stress, and psoriasis. Objective: The objective of this study is to evaluate hair cortisol levels as a biomarker of chronic stress in psoriasis patients. Materials and Methods: Detailed clinical and personal history and stress-related events before the onset of the disease or any exacerbations during the disease were taken. Clinical severity was assessed using psoriasis area and severity index (PASI) scoring. Stress levels in individuals, during the previous 6 months were assessed, using Holmes–Rahe Life Stress Inventory. Following this, hair samples were collected from the vertex of the scalp and sent to the laboratory in an envelope. After extraction of the cortisol, their levels were estimated using an enzyme-linked immunosorbent assay. Statistical analyses were done. Results: Mean hair cortisol level per mg of hair sample was 0.92 ± 0.84 ng/mg compared to 0.50 ± 0.60 ng/mg in controls (P = 0.002). There was a significant positive correlation of hair cortisol levels with the duration of disease, PASI score, and stress level. Conclusion: Measurement of cortisol in hair is a novel, noninvasive method that may assess systemic cortisol levels over several weeks to months. It may potentially be used as a biomarker in psychocutaneous disorders like psoriasis.

BackgroundTobacco smoking is still a worldwide health risk. Current pharmacotherapies have at best, a success rate of no more than 50%. Auricular (ear) acupressure has been purported to be beneficial in achieving smoking cessation in some studies, while in others has been deemed insignificant. We hereby describe the protocol for a three-arm randomised controlled trial to examine the possible benefits of self-administered acupressure for smoking cessation.MethodsSixty consenting participants with confirmed habit of tobacco smoking will be recruited and randomized into three arms to receive either auricular acupressure at five true acupoints (NADA protocol), auricular acupressure at five sham points, or no auricular acupressure at all. Participants having auricular acupressure will exert firm pressure to each acupoint bilaterally via the bead in the attached plasters whenever they feel the urge to smoke. The treatment phase will last for six weeks during which all participants will be assessed weekly to review their smoking log, state of abstinence, end-exhalation carbon monoxide levels and possible adverse effects including withdrawal reactions and stress levels. At any time, a successful quit date will be defined with continuous abstinence for the following consecutive 7 days. From then on, participants will be evaluated individually for continuous abstinence rate (CAR), end-exhalation carbon monoxide levels and adverse effects of stress and withdrawal at specified intervals up to 26 weeks. Expectancy of treatment will be assessed with a four-item Borkovec and Nau self-assessment credibility scale during and after intervention.DiscussionWe incorporate validated outcome measures of smoking cessation into our randomised controlled trial design with the objectives to evaluate the feasibility and possible benefits of self-administered auricular acupressure as a non-invasive alternative to pharmacotherapy for smoking cessation.Trial RegistrationClinicalTrials.gov: NCT01389622 (registered Jul 7 2011)

Introduction and Aim: It has been observed that recovery from COVID-19 is delayed due to continuation of myalgia, fatigue, headache and some respiratory problems even after the discharge from the hospital. Reports indicate the improvement of sensory, cardiorespiratory and psychological functions following practice of Prone asanas and Pal’s pranayama. Therefore, we conducted a pilot study to assess if practice of asanas in prone posture and slow breathing exercise of Pal’s pranayama schedule can facilitate recovery from the COVID-19 illness and alleviate post-recovery complications in these patients.&#x0D; Materials and Methods: This is an interventional pilot study conducted in COVID positive patients. A structured module of prone asanas and Pal’s pranayama schedule was given to the COVID positive patients in addition to the routine medical treatments and their stress levels were assessed prior to and after the practice. Also, the acute effects of asana-pranayama schedule on the improvement of cardiorespiratory functions and occurrence of other complications in the recovery phase was recorded.&#x0D; Results: Following practice of asana-pranayama schedule, the patients recovered faster from myalgia, fatigue, headache and respiratory problems and they had a feeling of well-being. Further, the complications in the recovery phase of COVID-19 were prevented and the intensity of stress was reduced with the practice of asana-pranayama schedule.&#x0D; Conclusion: This pilot study has shed some light on the early recovery and the prevention of complications in the recovery phase of COVID-19.

The sense of presence and cybersickness are key-factors to have into account when referring to Virtual Environments (VE). To achieve high levels of presence and minimize cybersickness, it is important to ensure that the user's stimulation is coherent with the contents that are being delivered. In this paper, it is presented a pilot study addressing the usage of both objective and subjective metrics to measure the sense of presence and cybersickness in VE in order to study possible correlations between these two evaluation approaches. On top of that, the pilot study includes two body positions to allow evaluating if the stimulation of the vestibular study has impact on the sense of presence and cybersickness. To evaluate presence and cybersickness, it was developed a VE that consists in a hill where participants ride a bicycle. To broaden the scope of the study, there were studied two body positions: standing and sitting on the bicycle. The equipment EMOTIV epoc+ was used to register the objective metrics. The subjective metrics were registered using the Igroup Presence Questionnaire (IPQ) and the Simulator Sickness Questionnaire (SSQ). To complement the collected data, the levels of fatigue and stress before and after the experience were also registered through self-evaluation. Results show that objective metrics Interest and Stress and the subjective metrics Realism, Fatigue and Stress have a positive interaction regarding the sense of presence. Results further suggest that there is a positive interaction between the objective metric Focus and the subjective metric Involvement.

A pilot study to evaluate mindfulness as a strategy to improve inpatient nurse and patient experiences

Scientific evidence has shown that healthcare clowning can decrease the level of stress and anxiety in pediatric patients. However, little attention has been devoted to the potentially beneficial impact of clown visits in the child and adolescent psychiatry setting. Therefore, this pilot study aims at investigating short-term effects of clown visits by RED NOSES Clowndoctors Austria on stress and mood levels of children and adolescents in psychiatric care. The sample will consist of approximately 50 children and adolescents in inpatient psychiatric wards who receive clown visits on a weekly basis over four consecutive weeks. The examined intervention, i.e., the clown visits, is an integral part within the selected psychiatric institutions. Using a non-controlled pre-/post-test design, the level of salivary cortisol and self-reported stress and mood will be measured as primary outcomes before and immediately after each clown visit. Additionally, self-reported effects on care staff at the health care facilities will be assessed based on a questionnaire after each clown visit within the same time period of four weeks. Secondary outcome measures (i.e., health-related quality of life, emotional and conduct problems, perceived chronic stress) will be assessed at baseline and at close-out assessment after the four intervention weeks. Further control variables and potential moderators are included at baseline. Due to the nested data structure, multilevel modeling will be used to analyze the data. To our knowledge, this is the first study to examine the stress-reducing and mood-improving effects of clown visits on inpatients in child and adolescent psychiatry. Results will be relevant for the design of future large-scale RCTs and might provide valuable implications for the use of healthcare clowning to reduce stress and improve mood in children and adolescents in psychiatric care. The study is registered at ClinicalTrials.gov (Identifier: NCT04844398).

Autism spectrum disorder is characterized by social impairments and behavioural inflexibility. In this pilot study, the feasibility and outcomes of a 6-week acceptance and commitment therapy-based skills training group were evaluated in a special school setting using a quasi-experimental design (acceptance and commitment therapy/school classes as usual). A total of 28 high-functioning students with autism spectrum disorder (aged 13-21 years) were assessed using self- and teacher-ratings at pre- and post-assessment and 2-month follow-up. All participants completed the skills training, and treatment satisfaction was high. Levels of stress, hyperactivity and emotional distress were reduced in the treatment group. The acceptance and commitment therapy group also reported increased prosocial behaviour. These changes were stable or further improved at the 2-month follow-up. Larger studies are needed to further evaluate the benefits of acceptance and commitment therapy for autism spectrum disorder.

In modern psychotherapy, digital health technology offers advanced and personalized therapy options, increasing availability as well as ecological validity. These aspects have proven to be highly relevant for children and adolescents with obsessive-compulsive disorder (OCD). Exposure and Response Prevention therapy, which is the state-of-the-art treatment for OCD, builds on the reconstruction of everyday life exposure to anxious situations. However, while compulsive behavior pre-dominantly occurs in home environments, exposure situations during therapy are limited to clinical settings. Telemedical treatment allows to shift from this limited exposure reconstruction to exposure situations in real life. In the SSTeP KiZ study (smart sensor technology in telepsychotherapy for children and adolescents with OCD), we combine video therapy with wearable sensors delivering physiological and behavioral measures to objectively determine the stress level of patients. The setup allows to gain information from exposure to stress in a realistic environment both during and outside of therapy sessions. In a first pilot study, we explored the sensitivity of individual sensor modalities to different levels of stress and anxiety. For this, we captured the obsessive-compulsive behavior of five adolescents with an ECG chest belt, inertial sensors capturing hand movements, and an eye tracker. Despite their prototypical nature, our results deliver strong evidence that the examined sensor modalities yield biomarkers allowing for personalized detection and quantification of stress and anxiety. This opens up future possibilities to evaluate the severity of individual compulsive behavior based on multi-variate state classification in real-life situations. Clinical Relevance- Our results demonstrate the potential for efficient personalized psychotherapy by monitoring physiological and behavioral changes with multiple sensor modalities in ecologically valid real-life scenarios.

Scientific evidence has shown that healthcare clowning can decrease the level of stress and anxiety in pediatric patients. However, little attention has been devoted to the potentially beneficial impact of clown visits in the child and adolescent psychiatry setting. Therefore, this pilot study aims at investigating short-term effects of clown visits by RED NOSES Clowndoctors Austria on stress and mood levels of children and adolescents in psychiatric care. The sample will consist of approximately 50 children and adolescents in inpatient psychiatric wards who receive clown visits on a weekly basis over four consecutive weeks. The examined intervention, i.e., the clown visits, is an integral part within the selected psychiatric institutions. Using a non-controlled pre-/post-test design, the level of salivary cortisol and self-reported stress and mood will be measured as primary outcomes before and immediately after each clown visit. Additionally, self-reported effects on care staff at the health care facilities will be assessed based on a questionnaire after each clown visit within the same time period of four weeks. Secondary outcome measures (i.e., health-related quality of life, emotional and conduct problems, perceived chronic stress) will be assessed at baseline and at close-out assessment after the four intervention weeks. Further control variables and potential moderators are included at baseline. Due to the nested data structure, multilevel modeling will be used to analyze the data. To our knowledge, this is the first study to examine the stress-reducing and mood-improving effects of clown visits on inpatients in child and adolescent psychiatry. Results will be relevant for the design of future large-scale RCTs and might provide valuable implications for the use of healthcare clowning to reduce stress and improve mood in children and adolescents in psychiatric care. The study is registered at ClinicalTrials.gov (Identifier: NCT04844398).