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Background In an effort to combat burnout, a study investigates Mindfulness-Based Stress Reduction (MBSR) training for nurses. The goal is to reduce stress and improve job satisfaction, ultimately enhancing patient care. These findings may inspire the development of mindfulness-based support systems for healthcare professionals to promote overall well-being in the workplace. Materials and methods A single-blinded, randomized controlled trial with 60 emergency medical center nurses was conducted to assess the effectiveness of an eight-session MBSR program in reducing stress and burnout. The randomization process, utilizing sealed envelopes, ensured unbiased allocation to intervention or control groups. The training program included group sessions focused on meditation, yoga, and discussions, with participants receiving educational materials and CDs for home practice. Collected data included demographics, Maslach Burnout Inventory, and Occupational Stress Questionnaire results. Statistical analysis, utilizing SPSS version 21, featured Kolmogorov-Smirnov, Mann–Whitney U, and Wilcoxon tests to evaluate outcomes. Results Following MBSR Training, the intervention group displayed statistically significant differences in all occupational stress subscales compared to the control group (P < 0.05). Post-intervention, the intervention group also exhibited significant differences in burnout subscale scores (P < 0.001) compared to the control group. Conclusion MBSR can boost resilience and job satisfaction, enhancing patient care. Healthcare organizations should integrate MBSR programs for nursing staff well-being and combat stress and burnout. Research should probe long-term impacts and effective delivery methods for sustained stress relief in nursing. Trial registration This study has registered in Iranian Registry of Clinical Trials by the number of IRCT20131112015390N5 on Jun 2022.

ObjectivesCommon mental disorders (CMDs) are among the main causes of sickness absence and can lead to suffering and high costs for individuals, employers and the society. The occupational health service (OHS) can offer work-directed interventions to support employers and employees. The aim of this study was to evaluate the effect on sickness absence and health of a work-directed intervention given by the OHS to employees with CMDs or stress-related symptoms.MethodsRandomisation was conducted at the OHS consultant level and each consultant was allocated into either giving a brief problem-solving intervention (PSI) or care as usual (CAU). The study group consisted of 100 employees with stress symptoms or CMDs. PSI was highly structured and used a participatory approach, involving both the employee and the employee’s manager. CAU was also work-directed but not based on the same theoretical concepts as PSI. Outcomes were assessed at baseline, at 6 and at 12 months. Primary outcome was registered sickness absence during the 1-year follow-up period. Among the secondary outcomes were self-registered sickness absence, return to work (RTW) and mental health.ResultsA statistical interaction for group × time was found on the primary outcome (p=0.033) and PSI had almost 15 days less sickness absence during follow-up compared with CAU. Concerning the secondary outcomes, PSI showed an earlier partial RTW and the mental health improved in both groups without significant group differences.ConclusionPSI was effective in reducing sickness absence which was the primary outcome in this study.

Improving mental healthcare using mobile apps might be an effective way to increase interest in mental health and respond to the demand for better psychological health. However, few studies have investigated the effectiveness of app-based stress-management programs. This study aimed to assess the efficacy of an app-based stress-management program. A non-equivalent comparison group pretest-posttest design was used. Participants were randomized into the experimental (n = 26) and control (n = 30) groups. The experimental group used an application developed for workers for four weeks. The results indicated that stress, emotional labor, self-efficacy, and well-being were significantly different in the experimental group, but the control group’s average scores did not change significantly. On average, the Perceived Stress Scale scores decreased by 1.5 points (p = 0.035) and the Korean Occupational Stress Scale scores decreased by 0.87 points (p = 0.4). However, depression and anxiety were not significantly different. Emotional labor decreased by 0.16 points (p = 0.027), and well-being and self-efficacy mean scores increased by 0.492 (p = 0.005) and 0.162 (p = 0.025), respectively. These findings support the developed application’s value for promoting mental health and healthy lifestyles. Further research and supplementation are needed for the application’s sustainability.

Health care workers (HCWs) frequently face multiple stressors at work, particularly those working night shifts. HCWs who have experienced distress may find it difficult to adopt stress management approaches, even if they are aware of the effects of stress and coping processes. Therefore, an individualized intervention may be required to assist distressed HCWs in bridging the \"knowledge-practice\" gap in stress management and effectively alleviating stress symptoms. The main objective of this research was to compare the effects of a complex interactive multimodal intervention (CIMI) to self-guided stress management interventions on stress symptoms of distressed HCWs, as measured by physiological (heart rate variability), psychological (perceived stress, mental distress, and subjective happiness), and sleep disorder (fatigue and sleepiness) indicators. We conducted a nonrandomized, controlled study in 2 Chinese general hospitals. The participants in this study were 245 HCWs who fulfilled at least 1 of the 3 dimensions on the Depression, Anxiety, and Stress Scale. All eligible individuals were required to complete a questionnaire and wear a 24-hour Holter device to determine the physiological signs of stress as indexed by heart rate variability at both baseline and after the intervention. The CIMI group received a 12-week online intervention with 4 components-mobile stress management instruction, a web-based WeChat social network, personalized feedback, and a nurse coach, whereas the control group simply received a self-guided intervention. After a 12-week intervention, the Perceived Stress Scale (PSS) scores reduced significantly in the CIMI group (mean difference [MD] -5.31, 95% CI -6.26 to -4.37; P<.001) compared to the baseline levels. The changes in PSS scores before and after the intervention exhibited a significant difference between the CIMI and control groups (d=-0.64; MD -4.03, 95% CI -5.91 to -2.14; P<.001), and the effect was medium. In terms of physiological measures, both the control group (MD -9.56, 95% CI -16.9 to -2.2; P=.01) and the CIMI group (MD -8.45, 95% CI -12.68 to -4.22; P<.001) demonstrated a significant decrease in the standard deviation of normal-to-normal intervals (SDNN) within the normal clinical range; however, there were no significant differences between the 2 groups (d=0.03; MD 1.11, 95% CI -7.38 to 9.59; P=.80). The CIMI was an effective intervention for improving sleep disorders, as well as parts of the psychological stress measures in distressed HCWs. The findings provide objective evidence for developing a mobile stress management intervention that is adaptable and accessible to distressed HCWs, but its long-term effects should be investigated in future research. ClinicalTrials.gov NCT05239065; https://clinicaltrials.gov/ct2/show/NCT05239065.

Abstract Objective: to analyze the effectiveness of auriculotherapy for decreasing anxiety and stress of perioperative nursing professionals. Method: mixed methods research, embedded experimental model. In the quantitative stage, a randomized, triple-blind clinical trial was conducted with perioperative nursing professionals, who answered a characterization questionnaire, the List of Signs and Symptoms of Stress, and the General Anxiety Disorder-GAD 7. The participants attended eight auriculotherapy sessions with semi-permanent needles. The qualitative stage was exploratory and descriptive, in which data were collected through semi-structured interviews. Data were mixed with the incorporation of qualitative findings to examine the intervention in the experimental study. Results: 13 professionals participated in the intervention group and 14 in the control group. Anxiety and stress levels decreased significantly within groups, though no statistical difference was found between groups (p>0.05). The central category, “Auriculotherapy as an intervention to treat anxiety and stress,” emerged from the qualitative data, which was subdivided into a base unit and three categories concerning the therapy’s benefits. Conclusion: applying real and sham auriculotherapy had the same effect on the participants’ anxiety and stress levels; the reports reinforced such evidence. Non-pharmacological interventions, such as auriculotherapy, are essential for recovering and promoting the health of perioperative nursing professionals. Brazilian Clinical Trials Registry: RBR-3jvmdn. Resumo Objetivo: analisar a eficácia da auriculoterapia na ansiedade e estresse de profissionais de enfermagem perioperatória. Método: pesquisa de métodos mistos, experimental incorporada. Na etapa quantitativa realizou-se um ensaio clínico randomizado, triplo cego, com profissionais de enfermagem perioperatória, que responderam a um questionário de caracterização, a Lista de Sinais e Sintomas de Estresse, o Transtorno de Ansiedade Geral-GAD 7, sendo submetidos a oito sessões de auriculoterapia com semiagulhas. A etapa qualitativa foi exploratória e descritiva, com dados obtidos por entrevistas semiestruturadas. Dados mixados com incorporação dos achados qualitativos para examinar a intervenção no estudo experimental. Resultados: participaram 13 profissionais no grupo intervenção e 14 no controle, constatando-se redução significativa de ansiedade e estresse intragrupos, porém, sem diferença estatística intergrupos (p>0,05). Dados qualitativos possibilitaram a construção da categoria central “Auriculoterapia como intervenção para ansiedade e estresse”, subdividida em uma unidade de base e três categorias, que versaram sobre os benefícios da prática. Conclusão: aplicar auriculoterapia com pontos verdadeiros e falsos (sham) apresentou igual efeito para ansiedade e estresse dos participantes investigados; evidências reforçadas pelos depoimentos. Intervenções não farmacológicas, como a auriculoterapia, são importantes para recuperação e promoção da saúde de profissionais de enfermagem perioperatória. Registro Brasileiro de Ensaios Clínicos: RBR-3jvmdn. Resumen Objetivo: analizar la eficacia de la auriculoterapia en la ansiedad y estrés de profesionales de enfermería perioperatoria. Método: investigación de métodos mixtos, experimental e incorporada. En la etapa cuantitativa se realizó un ensayo clínico aleatorio, triple ciego, con profesionales de enfermería perioperatoria - que respondieron a un cuestionario de caracterización, a la Lista de Señales y Síntomas de Estrés, y al Trastorno de Ansiedad General GAD 7 - sometidos a ocho sesiones de auriculoterapia con agujas finas. La etapa cualitativa fue exploratoria y descriptiva, con datos obtenidos a través de entrevistas semiestructuradas. Datos mixtos con incorporación de los hallazgos cualitativos para examinar la intervención en el estudio experimental. Resultados: participaron 13 profesionales en el grupo intervención y 14 en el grupo control, habiéndose constatado reducción significativa de ansiedad y estrés intragrupos; sin embargo, sin diferencia estadística intergrupos (p>0,05). Datos cualitativos posibilitaron la construcción de la categoría central “Auriculoterapia como intervención para ansiedad y estrés”, que fue subdividida en una unidad de base y tres categorías, que versaron sobre los beneficios de la práctica. Conclusión: aplicar auriculoterapia con puntos verdaderos y falsos (sham) presentó igual efecto para ansiedad y estrés en los participantes investigados, evidencias que fueron reforzadas por las declaraciones. Intervenciones no farmacológicas, como la auriculoterapia, son importantes para recuperación y promoción de la salud de profesionales de enfermería perioperatoria. Registro Brasileño de Ensayos Clínicos: RBR-3jvmdn.

Teaching is often characterized as a stressful profession, with a substantial proportion of teachers experiencing chronic stress and burnout. Research indicates that teachers often experience stress upon entering the workforce, leading to detrimental effects on their health, occupational well-being, and work performance and adversely impacting student outcomes. While meta-analyses have demonstrated the efficacy of internet-based stress management interventions (iSMIs) for both experienced professionals and university students, there remains a gap in research on the efficacy of iSMIs tailored to teachers and career starters. We tailored an iSMI to beginning teachers and added a newly developed web-based classroom management skill training. This study examined the effectiveness of the tailored iSMI in reducing perceived stress and improving further secondary outcomes. In addition, this study was the first to explore problem-solving ability and emotion regulation skills as potential mechanisms of change within an iSMI grounded in transactional stress theory. Participants were 200 highly stressed beginning teachers (Perceived Stress Scale score of >21) undergoing German teacher induction randomized to either an intervention group (IG) with guidance or a waitlist control group. Outcomes were assessed online at baseline, 8 weeks after randomization (postintervention time point; T2), and at both the 3-month (T3) and extended 6-month follow-up. At T2, data were collected from 84% (84/100) of the participants in the IG and 90% (90/100) of the participants in the waitlist control group. The IG reported significant, practically meaningful, and sustained improvements in both perceived stress (T2: d=0.52, 95% CI 0.24-0.80, and P<.001; T3: d=0.49, 95% CI 0.21-0.77, and P<.001) and most secondary outcomes in the intention-to-treat analysis using analyses of covariance. Postintervention (T2) effects on mental health indicators, including depression, work-related rumination, anxiety, and insomnia, were substantial (d≥0.60), whereas no significant effects were observed for absenteeism (P=.22) and presenteeism (P=.80). The investigated mediators, problem-solving ability (d=0.57) and emotion regulation skills (d=0.69), improved. Moreover, parallel mediation analysis revealed that the iSMI exerted its effect on perceived stress through improved problem-solving ability (indirect path a b =-0.77, 95% CI -1.50 to -0.04) and emotion regulation skills (indirect path a b =-0.97, 95% CI -1.73 to -0.22). This study contributes to the growing body of evidence on iSMIs for beginning teachers during a highly demanding transition phase and supports the integration of these interventions into teacher training programs. Findings from the mediation analysis suggest that both problem-focused and emotion-focused coping strategies should be equally considered in stress management interventions. This strengthens the program theory based on the transactional stress model. Finally, these findings encourage further research on iSMIs for other groups of career starters to support their transition into the workforce. German Clinical Trials Register (DRKS) DRKS00013880; https://tinyurl.com/3mpsyvw5.

Background Depression associated with occupational stress is highly prevalent, causing high rates of sick leave and thus posing significant societal and economic burden. Meta-analyses of the few studies on psychological and work-focused interventions for common mental disorders including depression report small effects on depressive symptomatology and occupational outcomes. There is an urgent need for more controlled studies on work-directed interventions assessing work outcomes. Methods This is an interventional, multicentre, active-controlled, cluster-randomised, observer-blinded clinical trial with two parallel groups conducted in 6 clinical centres throughout Germany over the course of 3 years. A sample of 144 outpatients with work stress related depression will be cluster-randomised to either a specific interpersonal group intervention for depression and work stress (IPT-Work) or a nonspecific supportive group psychotherapy (SP). Each group consists of 10 sessions over 8 weeks of 90 min duration with 4–6 participants. Patients will be assessed at baseline, post-treatment and at 3 months follow-up. The primary endpoint is the relative change in HRSD-24 score from baseline to follow-up 3 months after end of treatment. Secondary outcome measures include the Occupational Depression Inventory (ODI), the Work Ability Index (WAI), the Return to Work Attitude (RTW-SE), the Effort-Reward-Imbalance (ERI), the Job Content Questionnaire 2 (JCQ2), and the Connor-Davidson Resilience Scale (CD-RISC). In addition, Quality of Life (WHOQOL-BREF) and days of sick leave throughout the study period will be assessed. Effects of treatment will be analysed with a linear mixed model for repeated measures including randomised arm, time point and their interaction as well as HRSD-24 baseline scores and their interaction with time point as fixed effects. Discussion Results will provide a comparison of a nonwork-directed psychological intervention and a specific, work-directed approach with respect to symptom improvement and increase in work ability. The aim is to improve quality of mental health care for depressed employees to facilitate recovery, improve work ability, and reduce the risk of long-term occupational incapacity. Ultimately, findings will inform the practice of the efficiency of using psychological group treatment in depressed individuals with work stress. Trial registration German Clinical Trials Register (DRKS00035259); prospectively registered on 15th January 2025.

Medical professionals are exposed to multiple and often excessive demands in their work environment. Low-intensity internet interventions allow them to benefit from psychological support even when institutional help is not available. Focusing on enhancing psychological resources-self-efficacy and perceived social support-makes an intervention relevant for various occupations within the medical profession. Previously, these resources were found to operate both individually or sequentially with self-efficacy either preceding social support (cultivation process) or following it (enabling process). The objective of this randomized controlled trial is to compare the efficacy of 4 variants of Med-Stress, a self-guided internet intervention that aims to improve the multifaceted well-being of medical professionals. This study was conducted before the COVID-19 pandemic. Participants (N=1240) were recruited mainly via media campaigns and social media targeted ads. They were assigned to 1 of the following 4 groups: experimental condition reflecting the cultivation process, experimental condition reflecting the enabling process, active comparator enhancing only self-efficacy, and active comparator enhancing only perceived social support. Outcomes included 5 facets of well-being: job stress, job burnout, work engagement, depression, and job-related traumatic stress. Measurements were taken on the web at baseline (time 1), immediately after intervention (time 2), and at a 6-month follow-up (time 3). To analyze the data, linear mixed effects models were used on the intention-to-treat sample. The trial was partially blinded as the information about the duration of the trial, which was different for experimental and control conditions, was public. At time 2, job stress was lower in the condition reflecting the cultivation process than in the one enhancing social support only (d=-0.21), and at time 3, participants in that experimental condition reported the lowest job stress when compared with all 3 remaining study groups (ds between -0.24 and -0.41). For job-related traumatic stress, we found a significant difference between study groups only at time 3: stress was lower in the experimental condition in which self-efficacy was enhanced first than in the active comparator enhancing solely social support (d=-0.24). The same result was found for work engagement (d=-0.20), which means that it was lower in exactly the same condition that was found beneficial for stress relief. There were no differences between study conditions for burnout and depression neither at time 2 nor at time 3. There was a high dropout in the study (1023/1240, 82.50% at posttest), reflecting the pragmatic nature of this trial. The Med-Stress internet intervention improves some components of well-being-most notably job stress-when activities are completed in a specific sequence. The decrease in work engagement could support the notion of dark side of this phenomenon, but further research is needed. ClinicalTrials.gov NCT03475290; https://clinicaltrials.gov/ct2/show/NCT03475290. RR2-10.1186/s13063-019-3401-9.

Background Caring for patients with coronavirus disease 2019 (COVID-19) challenges nurses and causes them to experience stress and anxiety. From this perspective, it is of utmost importance to develop quick and effective intervention strategies to prevent numerous complications. This study aimed to investigate the effect of the progressive muscle relaxation technique, using the demonstration method on the stress and anxiety of nurses who care for COVID-19 patients. Methods This randomized clinical trial was conducted in 2021. Forty-six nurses working in two referral hospitals with wards for COVID-19 patients in Tehran, Iran recruited by convenience sampling method and then randomly assigned to experimental or control groups. The nurses in the experimental group educated the progressive muscle relaxation by the demonstration method, and they were encouraged to practice it. The Depression Anxiety Stress Scale-21 was utilized to measure the stress and anxiety levels in the nurses. Results Before the intervention, the levels of stress in the experimental and control groups were 13.91 ± 2.41 vs. 14.34 ± 2.74 ( p  = 0.571), and their anxiety was 13.34 ± 3.41 vs. 12.78 ± 2.21 ( p  = 0.510), respectively. After the intervention, the levels of stress in the experimental and control groups were 10.95 ± 2.01 vs. 14.17 ± 2.34 ( p  < 0.001), and their anxiety was 9.47 ± 2.37 vs. 12.91 ± 1.85 ( p  < 0.001), respectively. Moreover, the levels of stress and anxiety in the experimental group significantly diminished after intervention ( p  < 0.001), but no significant changes were observed in the control group ( p  > 0.05). Conclusion Concerning the effectiveness of the progressive muscle relaxation technique in relieving the stress and anxiety of the nurses caring for COVID-19 patients, it is suggested to include this relaxation technique in nursing courses.

Work-related stress is a major health issue in most industrialized countries. Heart rate variability biofeedback (HRV-BfB) can promote resilience and stress coping capacity. Mobile HRV-BfB could contribute to stress prevention in the workplace. Little is known about whether the type of training, with digital or live instruction, has an impact on the training outcome. This study analyzes the psychophysiological effects of four-week workplace resilience training with mobile HRV-BfB and the influence of instruction format (digital or live) on training success. This was a prospective, three-arm, non-randomized controlled trial with parallel group design. 73 employees of a bearing and seal manufacturer (58.9% male, 86.3% full-time employment, 67.1% office workers) attended resilience training with HRV-BfB, live ( n  = 24) or digital ( n  = 19) format, or served as waitlist controls ( n  = 30). HRV-BfB training spanned four weeks. Participants applied resilience techniques to increase HRV using visual biofeedback. Data were collected at baseline (T0), post-intervention (T1), and another four weeks later (T2). Primary outcome measure was the Burnout scale of the Copenhagen Psychosocial Questionnaire (COPSOQ) at T1. Secondary outcome measures included further COPSOQ scales, self-reported sleep quality (Pittsburgh Sleep Quality Index, PSQI), and HRV parameters. Burnout parameters decreased significantly in HRV-BfB and waitlist. The decrease (T0-T1 and T0-T2) showed higher effect sizes in HRV-BfB (Cohen’s d : 0.63; 0.69) than in waitlist ( d : 0.27; 0.36). Sleep quality improved in HRV-BfB with small effect sizes (no change for waitlist). SDNN (standard deviation of beat-to-beat intervals) increased in HRV-BfB between T0 and T1 ( d : 0.23;). In subgroup analysis, digital reached higher effect sizes for improvement in burnout ( d : 0.87; 0.92) and sleep quality ( d : 0.59; 0.64) than live learning (burnout: d : 0.43; 0.51; sleep quality: d : 0.28; 0.22). HRV-analysis revealed no differences between subgroups. Four-week mobile HRV-BfB resilience training reduced stress and burnout symptoms in employees. No significant differences were found between HRV-BfB digital or live. Hence, companies should choose the approach that fits their company profile or, if possible, offer both formats to accommodate the different needs of employees. However, findings were nonhomogeneous and should be verified by further studies. Trial Registration : ClinicalTrials.gov , NCT04897165, 05/18/2021, retrospectively registered.