Cultural stress: The undiagnosed epidemic of our time / 中西医结合学报

Global technologies that have made the world more interconnected have also, inadvertently, amplified the forces of stress that are now with us 24 hours a day, 7 days a week. The accumulated impact of this stress I call cultural stress anxiety syndrome and call on integrative medicine practitioners to recognize that it is exacerbating whatever acute stressors are also present in our patients' lives. In this Commentary, I outline seven major components of cultural stress (time pressure, digital intrusion, digital dependency, isolation, sedentary lifestyle, poor sleep and uncertainty), describe their health consequences, and finally, offer cultural stress-specific remedies I have utilized in my own practice, along with studies that affirm their efficacy. My hope is that we, as integrative medicine practitioners who are cognizant of the role that stress plays in disease development, will more fully appreciate the added impact of cultural stress, and advise our patients on the importance of proactive stress management. Please cite this article as: Murad H. Cultural stress: the undiagnosed epidemic of our time. J Integr Med. 2023; 21(3): 221-225.

Perspectives on mental health promotion alongside virtual teaching-learning engagements in the College of Pharmacy, University of the Philippines Manila

@#COVID 19 pandemic altered how people work and study. The unfamiliarity to the sudden shift to virtual/remote platforms particularly in the teaching-learning process brought poor mental health in the academe. Constituents of the College of Pharmacy in the University of the Philippines Manila is no exception. The College promoted mental health among its constituents-students, faculty, and staff, through facilitated/supervised self-care, where the usual manner is an individual kind. The approach to the management of stress was holistic to better support the current mode of teaching-learning which uses the virtual platform. Both the initiatives of faculty members and the activities offered by the administration of the college received positive responses and favorable outcomes from the participants. Further studies on the effects of the offered programs and initiatives may result in more regular events and inclusion to the Pharmacy curriculum, respectively.

Rethinking COVID-19 Outbreak Impact

The world is going through a tough time and struggling with a pandemic COVID-19. An illness started from Wuhan city, now spread over almost all countries of the globe.Vaccination process is still going on and people will have to wait a long for complete eradication. Till then the only prevention is following social distancing, wearing mask, being in quarantine and isolation. World leaders are imposing lockdown in the countries with different intensity. In totality this is a challenging time, not just for the leaders, doctors, and police but for the normal people including private employees, daily wage earners and self employed individuals. Economic activities got a long halt. Every part of the population is getting affected. Emotions of stress, anxiety, anger, fear and frustration are obvious among people in this lockdown time. During this time Indian spirituality has been rebooted by many aspects. There is no doubt that India is the richest in its knowledge of Ayurveda, Ethos and Universe. Keeping this in mind existing literature of COVID-19 outbreak with special context to call for mental health and role of spiritual practices in mitigating the stress was searched with the help of different database. Published articles were represented in systematic form and summarize based on their methodologies and themes. So, this paper is trying to give a picture how with the help of Indian spiritual practices people can regain their faith and self-confidence since Indian Government is doing a lot with Ayurvedic preventions and connecting people with knowledge and peace by re telecasting great Indian tales like Ramayana, Mahabharata and Upanishad. Objectives of the study: Following are the main objectives of this study- Ÿ To investigate COVID-19 outbreak in India and its general impact on business and human. Ÿ To study re conceptualization of business strategies during and after lockdown. Ÿ To investigate need of mental health call in pandemic. Ÿ To understand role of spirituality in stress management during COVID-19 outbreak

Perspectives on mental health promotion alongside virtual teaching-learning engagements in the College of Pharmacy, University of the Philippines Manila

@#COVID 19 pandemic altered how people work and study. The unfamiliarity to the sudden shift to virtual/remote platforms particularly in the teaching-learning process brought poor mental health in the academe. Constituents of the College of Pharmacy in the University of the Philippines Manila is no exception. The College promoted mental health among its constituents-students, faculty, and staff, through facilitated/supervised self-care, where the usual manner is an individual kind. The approach to the management of stress was holistic to better support the current mode of teaching-learning which uses the virtual platform. Both the initiatives of faculty members and the activities offered by the administration of the college received positive responses and favorable outcomes from the participants. Further studies on the effects of the offered programs and initiatives may result in more regular events and inclusion to the Pharmacy curriculum, respectively.

Effectiveness of Non-invasive Interventions in Managing Cardiovascular Disease Using Specific Biological Markers

Background: Lifestyle interventions consisting of diet, exercise, psychosocial support and stress management are a clinically effective alternative to the management of cardiovascular diseases that can be feasibly measured and monitored during treatment using various biological markers. Methodology: A thorough Pubmed search was conducted looking for the results of articles that treated cardiovascular disease patients of both sexes and all ages with lifestyle modification in which the effectiveness of lifestyle modification was measured by various biomarkers. Results: The final review was conducted on 11 journal articles that were found examining exercise, diet, psychosocial support and stress management in cardiovascular disease patients and showing a positive benefit of such an intervention and the effects on biomarkers as an alternative to traditional pharmacological treatment. The affected biomarkers found were percent diameter coronary artery stenosis, blood pressure, cholesterol, body weight and fat, heart rate, HbA1c, exercise capacity, C reactive protein, triglycerides and BMI. Conclusion: Lifestyle modification consisting of exercise, low fat, high complex carbohydrate diet, psychosocial support and stress management is clinically efficacious in the treatment of cardiovascular disease as seen by the various changes in biological measures.

Smart Stress Care: Usability, Feasibility and Preliminary Efficacy of Fully Automated Stress Management Application for Employees

OBJECTIVE: We developed a fully automated smartphone-based stress management application and explored its usability, potential feasibility, and preliminary efficacy for stress management in Korean employees. METHODS: Healthy employees working in large public enterprises were enrolled. Participants used our automated stress management application for four weeks. With the application, they monitored their stress level and life style factors. Personalized stress management techniques, including psychoeducation and cognitive behavioral technique, were also provided based on their stress level and lifestyle pattern. In 2014, additional relaxation techniques were incorporated. Participants’ mental health status and lifestyle pattern were self-assessed at baseline and at 4 weeks after using the application. RESULTS: A total of 68 subjects were recruited. The application generally received high satisfaction rating. After the intervention, perceived stress level was significantly decreased, both in 2013 and 2014 (BEPSI-K score pre. vs. post. 14.27 vs. 11.00, F=12.49, p=0.001 in 2013; 12.05 vs. 10.00, F=17.18, p < 0.001). In 2014, depression symptom severity was also significantly decreased (CES-D score pre- vs. Post-, 17.66 vs. 11.95, F=9.76, p=0.004). The effects were more significant in females and in those < 35 years. CONCLUSION: Our fully automated stress management application is acceptable and usable, showing preliminary efficacy for reducing employees’ stress levels.

The effects of stress management intervention for companions of patients with AIDS on psychological status and anti-viral treatment of patients with AIDS / 中华护理杂志

Objective To explore the effects of stress management intervention for companions of patients with AIDS on psychological status,quality of life and anti-viral treatment of patients with AIDS.Methods Totally 92 patients with AIDS and their companions were randomly divided into the experimental group and the control group,each with 46 cases.Both groups received routine nursing,the experimental group received stress management intervention for 4 months.Before and after intervention was complete,the GHQ-12 was used to assess the psychological status of companions in both groups.Morisky questionnaire,SF-12 and stigma scale were used to evaluate anti-viral treatment compliance,quality of life and stigma of patients in both groups.Results The differences in general health scores of two groups after 4 months were statistically significant.There were significant differences in scores of stigma,quality of life scores,anti-viral treatment adherence and anti-viral treatment between AIDS patients in two groups.Conclusion Stress management intervention for companions of patients with AIDS can significantly improve psychological status of companions,reduce the stigma of AIDS patients,improve the quality of life and anti-viral treatment adherence and the effects of anti-viral treatment for patients.

A relação entre a satisfação no trabalho com a saúde do trabalhador: um estudo em uma cooperativa de crédito / The relationship between satisfaction in the work with worker's health: a study in a credit cooperative

Pesquisas demonstram uma diminuição do envolvimento afetivo do colaborador em seus afazeres, assim como uma redução de sua capacidade em encontrar significado naquilo que faz. Esta situação determina geralmente uma queda na qualidade nos serviços realizados pelo trabalhador potencializado sua insatisfação com o trabalho. Este cenário negativo relacionado ao contexto do trabalho tem favorecido a diminuição da saúde emocional no trabalho e a ocorrência de um número significativo de doenças e síndromes como: hipertensão arterial, diabetes, depressão maior e síndrome do burnout. Outro fator significativo é a relação entre a satisfação no trabalho com a saúde do trabalhador, visto que com o aumento do nível de insatisfação no trabalho aumenta utilização de remédios, álcool e drogas por parte dos empregados. Essa insatisfação originada na imposição de realizar uma função sem significado e não envolvente para o funcionário, e principalmente pelo fato do colaborador não saber a utilidade do seu trabalho para toda a organização. Isto ocasiona no colaborador um sentimento de desvalorização, tanto com relação à remuneração quanto com relação à oportunidade de desenvolver suas habilidades, autonomia e responsabilidades na empresa. No presente trabalho, destacam-se aspectos pertinentes ao tema satisfação no ambiente de trabalho. Este estudo tem como objetivo a mensuração do nível de satisfação dos colaboradores de uma cooperativa de crédito, por meio da identificação de variáveis relacionadas à satisfação/insatisfação no ambiente de trabalho.

Research shows a decrease in the emotional involvement of employees in their business, as well as a reduction in their ability to find meaning in what they do. This usually causes a drop in the quality of services performed by the worker potentiated their dissatisfaction with the work. This negative scenario related to the work context has favored the decrease in emotional health at work and the occurrence of a significant number of diseases and syndromes such as hypertension, diabetes, major depression and burnout syndrome. Another significant factor is the relationship between job satisfaction with workers' health, as with increasing dissatisfaction level at work increased use of drugs, alcohol and drugs by employees. This dissatisfaction originated in imposing perform a meaningless function and not engaging for the employee, and mainly because the developer does not know the usefulness of its work for the entire organization. This causes the employee a feeling of worthlessness, both with respect to compensation and regarding the opportunity to develop their skills, autonomy and responsibilities in the company. In this paper, we highlight aspects relevant to the topic satisfaction in the workplace. This study aims to measure the level of satisfaction of employees of a credit union, through the identification of variables related to satisfaction / dissatisfaction in the workplace.

Avaliação de treino de controle do stress para mães de crianças com transtornos do espectro autista / Stress control training assessment for mothers of children with autism spectrum disorders

ResumoO diagnóstico de transtorno do espectro autista (TEA) em filhos tem sido descrito na literatura como razão de excessivo stress em suas mães. Como o Treino de Controle do Stress (TCS) de Lipp, já foi adaptado com êxito para o atendimento de diversas populações de diferentes faixas etárias, o objetivo deste trabalho foi investigar a eficácia de uma adaptação do TCS para mães de crianças com TEA (TCS-MTEA) na redução do stress desta população. Para isto comparou-se a presença e níveis de stress de vinte participantes, na faixa etária entre 20 e 50 anos, sendo dez submetidas a esta intervenção individual configurando uma amostra experimental (AE) e outras dez que tiveram apenas níveis de stress avaliados no mesmo intervalo de tempo, configurando uma amostra controle (AC). As vinte participantes foram avaliadas antes e após o treino com o Inventário de Sintomas de Stress para Adultos de Lipp. Ao final da intervenção das dez participantes estressadas inicialmente na AE, sete estavam sem stress (70%) e as outras três apresentaram redução do nível de stress (30%) enquanto as dez da AC (100%) continuavam estressadas. Conclui-se que o TCS-MTEA foi eficaz na redução do stress das participantes da AE. (AU)

AbstractThe diagnosis of autism spectrum disorder (ASD) in a child has been described in literature as associated to excessive stress in their mothers. As the Lipp Stress Control Training (referred to locally as TCS) has been successfully adapted for the care of diverse populations of different ages, the aim of this study was to investigate the effectiveness of an adaptation of TCS for mothers of children with ASD (referred to locally as TCS-MTEA) in reducing stress in this population. For this, the presence and levels of stress of twenty participants aged between 20 and 50 years was compared. Ten individuals were submitted to individual training, configuring an experimental sample (ES) and ten only had stress levels evaluated in the same time interval, configuring a control sample (CS). The twenty participants were assessed before and after training with the Lipp Stress Symptoms Inventory. After the intervention, among the ten ES participants initially stressed, seven were without stress (70%) and the other three had the level of stress reduced (30%) while the ten CS participants (100%) remained stressed. The study concluded that the TCS-MTEA was effective in reducing the stress of the ES participants. (AU)

Educational innovations/programmes for 1 Mbbs batch- 2012-13 under regional training centre, Smt.Nhl Municipal Medical College, Ahmedabad.

Context or Setting: The undergraduate MBBS curriculum needs revisions like active learning, exposure to newer teaching techniques, adding some new elements as suggested by MCI in its document Vision 2015. Need for innovation: Traditional teaching-learning process is perceived by students as boring and less relevant to their future goal. So we need to think of methods like integrated teaching and objective assessment methods like structured viva. Learners also need to have some hands on training for skills and active participation in important issues related to their careers. We tried to introduce some of these to First MBBS students. Description of innovation: Vertical And Horizontal Integration (Coordinated Program), Session On “Cardiopulmonary Resucitation”, Structured Viva, Session On “Time And Stress Management”, Programme Evaluation, Written Feedback Was Obtained From Students After Each Session. Lessons learnt : First MBBS students perceive innovative methods interesting and effective. They improve teaching-learning experience and hence should be encouraged.

Effects of A Brief Stress Reduction Intervention On Medical Students' Depression, Anxiety And Stress Level During Stressful Period

Objective: The objective of this study was to evaluate whether students exposed to a brief stress reduction intervention would have lesser stress, anxiety and depression levels compared to their non-exposed classmates during stressful events. Methods: The Ex Post Facto design was applied in this study. Students who were exposed and not exposed to a brief stress reduction intervention were surveyed during a continuous examination and during the final examination. The Depression Anxiety Stress Scales (DASS) was used to examine effects on anxiety, stress, and depression levels. Results: The exposed students statistically had lower anxiety and depression scores than the non-exposed students during the stressful period. Reduction of stress, anxiety and depression scores was sustained during the stressful period. Conclusion: The significant reduction of anxiety and depression scores suggested that brief intervention was effective in the enhancement of the psychological wellbeing of exposed medical students during stressful period.

Effects of a Stress-Management Program on Stress Coping Methods, Interpersonal Relations, and Quality of Life in Patients with Chronic Mental Illness / 정신간호학회지

PURPOSE: The purpose of this study was to examine the effects of a stress-management program on stress coping methods, interpersonal relations and quality of life in patients with chronic mental illness. METHODS: A nonequivalent control group pre-posttest design was used for this quasi-experimental study. The study was conducted from May 1 to December 30, 2010. The 41 participants in this study were selected from patients with chronic mental illness (20 for the experimental group and 21 for the control group). Datas were analyzed chi2-test, t-test, paired t-test, and one-way ANCOVA with the SPSS/WIN 15.0 program. RESULTS: There were significant changes in stress coping methods scores, interpersonal relations scores and quality of life scores in the experimental group before and after treatment, which were significantly different from those in the control group. CONCLUSION: The results of the study indicate that the stress-management program resulted in significant improvement in stress coping methods, interpersonal relations and quality of life for patients with chronic mental illness. Therefore, this study shows stress-management programs are useful in clinical practice as effective nursing interventions in patients with chronic mental illness.

Impact of medical student well-being workshop on the medical students' stress level: A preliminary study

Objective: Medical training has always been regarded as a highly stressful environment to students. This article described a preliminary data on impact of a stress-management programme on medical students’ stress level. Methods: This is a quasi-experimental before after comparison study design. The programme was run over half-day and convenient sampling method was applied. Sample size as calculated for this preliminary study was 38. The 12 items General Health Questionnaire (GHQ-12) was administered prior to the programme and four months later. Data was analysed using SPSS version 12. Results: 34 participants were involved in this study. This study found that there was a significant difference in participants’ GHQ-12 scores before and after the programme (p<0.001). It also found that the percentage of distressed participants to have significantly reduced after they went through the programme (p<0.05). Conclusion: This study showed that the programme is a promising stress-management programme with the evidence of positive impact on the medical students’ mental health by improving and reducing their stress level. Apart from that it is a well accepted programme by the medical students. Perhaps similar approach can be considered relevant to be incorporated in other set up.

Intervenções psicoeducativas para manejo de estresse ocupacional: um estudo comparativo / Psychoeducational interventions to occupational stress management: a comparative study

Este estudo implementou e avaliou um programa de manejo de estresse ocupacional em um grupo de 74 funcionários administrativos de uma universidade privada, dos quais 42 foram designados para uma Intervenção Multimodal de Manejo de Estresse (ME) e 32 foram designados para um Treino em Habilidades Sociais (HS). Foram conduzidas 12 sessões psicoeducativas, de 90 minutos, em grupo, durante o horário de trabalho. Medidas pré e pós-teste foram feitas em imunidade, pressão arterial e respostas verbais de estresse, habilidades sociais e coping a problemas no trabalho. Ao final do programa, os participantes de ambas as intervenções apresentaram níveis similares de sintomas de estresse, coping a problemas no trabalho, habilidades sociais e imunidade. Apenas diferiram em pressão arterial diastólica: os participantes da intervenção ME apresentaram médias mais baixas nesta variável. Os resultados obtidos não encontraram superioridade de um tipo de intervenção sobre outro.

This study implemented and evaluated an occupational stress management program for a group of 74 non-academics from a private university in the state of Goiás, Brazil. Forty-two employees attended a multimodal intervention for stress management while the other 32 attended social skills training. Both were conducted in 12 group sessions of 60 minutes each, during working hours. Pre and post-test measurements were taken for immunity, blood pressure, and verbal stress responses, social skills and coping with problems at work. Covariance analyses and analyses of variance with stratification has demonstrated that the participants in both interventions presented similar levels of stress symptoms, coping with problems at work, social skills and immunity. They only differed in terms of diastolic blood pressure: The participants from the stress management intervention showed lower mean results (F (3.73) = 15.69, p< .05) for this variable. The results did not indicate that one type of intervention was superior to the other.

The Effects of a Stress Management Program on Job Stress in a Hotel Culinary Staff

PURPOSE: This study was conducted to investigate the effects of a stress management program on Job Stress in culinary staff at a Hotel. METHOD: This was a quasi-experimental study using non-equivalent control group pretest-posttest design. The subjects of this study were 52 culinary staff members(head culinary, first culinary) working at a S hotel.(25 in the experimental group, 27 in the control group) The experimental group was provided with an individual counseling program for 12 weeks and 30 min/week. The control group was provided with booklets. Data were analyzed with SAS Program using repeated measures ANOVA. RESULTS: The stress management program was effective to improve job stressors and especially to relax interpersonal conflict among the sub-factors of job stress based on the results mentioned above. CONCLUSION: This program was effective in reducing job stress. However, further studies are required to measure persistent and long-term effects through the application of the program, which is specifically designed for reduce to job stress, for over 12 weeks.

A Meta-Analysis of Effects of Job Stress Management Interventions(SMIs) / 간호학회지

PURPOSE: This quantitative meta analysis sought to determine the effectiveness of SMIs. METHOD: Forty-six experimental studies with a randomized or nonequivalent control group pre-post test design were included in the analysis. The selected studies were classified according to the sample characteristics, the types and methods of the interventions, and the types of outcome variables. Six intervention types were distinguished: cognitive-behavioral intervention(CBT), relaxation techniques(RT), exercise(EX), multimodal programs 1 and 2(MT1, 2), and organizationfocused interventions(OTs). Effect sizes were calculated for the 4 outcome categories across intervention types: psycho-social outcome, behavioral-personal resources, physiologic, and organizational outcome. RESULTS: Individual worker-focused interventions(ITs) were more effective than OTs. A small but significant overall effect was found. A moderate effect was found for RT, and small effects were found for other ITs. The effect size for OTs was the smallest. The interventions involving CBT and RT appeared to be the preferred means of reducing worker's psycho-social and organizational outcomes. With regard to physiologic outcomes, RT appeared to be most effective. CBT appeared to be most effective in reducing psycho-social outcomes. The effects of OT were non-significant, except for the psycho-social outcomes. CONCLUSIONS: SMIs are effective. Interventions involving RT and CBT are more effective than other types.

The Effects of Psychosocial Interventions to Improve Stress and Coping in Patients with Breast Cancer / 간호학회지

PURPOSE: The purpose of this study was to examine stress, coping, and immune response effects of a psychosocial intervention program based on the PNI model and Stress-Appraisal-Coping for Korean patients with breast cancer. METHODS: A nonequivalent control group pretest-posttest design was used. The participants who had survived breast cancer and lived in Wonju city and the surrounding area were assigned to an intervention group (N=21) or a control group(N=18).We conducted a 12-week intervention, 2 hours a day weekly, and measured the variables at baseline, six and twelve weeks later. Dependent variables are: stress, anxiety-depression and anger, and immune response. RESULTS: Patients in the psychosocial intervention program reported significantly less stress perception (U=31.500, p=.023), more problem solving ability and less problem avoidance in coping (U=20.500, p= .013; U=29.500, p=.040), and less anxiety-depression (U=22.000, p=.023). No difference, however, was found in anger and immune responses between the two groups. Intervention effects were evident at week 6 and 12 for anxiety-depression, and at week 6 for problem avoidance in coping, the same time that NK cell counts and the T8 decreased. CONCLUSIONS: These results suggested positive effects of a psychosocial intervention program. However, the results are inconclusive due to the small sample.

Effectiveness of a Qigong-based Stress Management Program in Patients with Anxiety Disorder / 신경정신의학

OBJECTIVES: The object of this study was to examine the effectiveness of Qigong-based stress management program in patients with anxiety disorder. METHODS: An 8-week controlled clinical trial compared 24 patients with anxiety disorder assigned to a Qigong-based stress management program with 22 patients with anxiety disorder assigned to an education control program. Beck depression inventory (BDI), Spielberger trait state anxiety inventory (STAI), Hamilton depression rating scale (HAM-D), Hamilton anxiety scale (HAM-A), and Symptom checklist-90-revised (SCL-90-R) were used to assess the effectiveness of Qigong-based stress management program. RESULTS: Qigong-based stress management group showed significant improvement compared to the education control group on anxiety symptoms and hostility, but Qigong group showed inconsistent findings on depressive symptoms. Qigong-based stress management group did not show significant improvement on somatization, obsessive-compulsive symptoms, interpersonal sensitivity, or phobic anxiety subscale of SCL-90-R compared to the education control group. CONCLUSION: This study showed that Qigong-based stress management program can be an effective method for patients with anxiety disorder in relieving anxiety symptoms. However, well-designed randomized controlled trials are needed before these kind of interventions.

Medical Aromatherapy / 日本補完代替医療学会誌

Medical aromatherapy, a complementary and alternative medicine (CAM) to cure diseases or to diminish symptoms by using essential oils, is widely applied to the areas of nursing or medical care. Since the varied pharmacological effects of essential oils are anti-bacterial, anti-viral, anti-inflammatory, anxiolytic, sedative and analgesic, medical aromatherapy is used for the treatment of gynecological and obstetrical disorders, skin troubles, upper respiratory infections and psychosomatic diseases, and for pain control and stress management. The methods of aromatherapy include inhalation, oral administration, aromatic bathing and massage. Massage is most effective in inducing relaxation. Because aromatherapy is only complementary to mainstream medicine, the combination of aromatherapy with western medicine and other CAM therapies can realize an ideal integrative medicine.<br>

Effects of Psychosocial Stress Management on Stress and Coping in Student Nurses / 성인간호학회지

PURPOSE: The purpose was to examine the effectiveness of a psychosocial stress management program on stress and coping in student nurses. METHOD: A nonequivalent control group pre-posttest design was used. A convenience sample of 24 students from the Department of Nursing, Wonju College of Medicine, Yonsei University were assigned to experimental (n=12) and control groups (n=12). Stress was measured using the Visual Analog Scale (10 points) and blood cortisol. Coping was measured using a scale modified by So (1995) based on the Ways of Coping Checklist developed by Folkman and Lazarus (1985). Depression was measured using the CES-D by Radloff (1977) and state anxiety, using the State Anxiety Inventory by Spielberger (1976). The psychosocial stress management program included education, relaxation (Korean Dan Jeon-typed Breathing and music), and social support. RESULTS: Results showed for the two groups, 1) a significant difference in stress scores (U= 19.50, p=0.002), 2) no difference in cortisol levels (8am, 4pm), 3) a significant difference in problem-focused coping (U=25.50, p=0.007), 4) no difference in emotion-focused coping, and 5) no difference in state anxiety and depression. CONCLUSION: By utilizing the program, students were able to learn how to control their stress and improve their coping. Therefore with a partial modification, psychosocial stress management can be useful for continual management of stress in student nurses.