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

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

Randomized controlled trials assessing efficacy of brief web-based stress management interventions for college students during the COVID pandemic.

The purpose of this study was to evaluate the efficacy of brief, self-guided web-based interventions for decreasing distress among U.S. college students during the pandemic. Three randomized controlled trials were conducted during the spring (Study 1), summer (Study 2), and fall (Study 3) 2020 terms, and were combined into one sample to increase power (N = 775). We evaluated a web-based intervention that focused on increasing present control that had been shown to be effective in several studies prior to the pandemic (e.g., Nguyen-Feng et al., 2017). This intervention was compared to an active comparison condition (psychoeducation about and reminders to engage in Centers for Disease Control and Prevention (CDC)-recommended stress management techniques) in Study 1, to a waitlist comparison in Study 2, and to both comparison conditions in Study 3. Participants were undergraduate psychology students at two campuses of a midwestern state university system. Outcomes-perceived stress (primary); depression, anxiety, and stress symptoms (secondary); and boredom (tertiary)-were assessed at pretest and posttest (and 3-week follow-up in Study 3). Differences across conditions were significant for perceived stress, stress symptoms, and boredom (but not depression or anxiety). Contrary to hypotheses, the Present Control and CDC stress management interventions were equally effective. Both were more effective than no intervention (between-group ds = -0.27 and -0.42). Both interventions were more effective for students with higher baseline stress levels. Completion and adherence rates were high for both conditions. Results suggest that very brief, self-guided stress management interventions can be effective in reducing stress among college students. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effects of online brain training on self-reported mental health symptoms for generally healthy adults during the Covid-19 pandemic.

BACKGROUND: The cognitive training Strategic Memory Advanced Reasoning Training (SMART) has been shown to improve symptoms of depression, anxiety, and stress when completed using in-person delivery, but mental health outcomes have not yet been studied for online delivery of SMART. METHODS: Data was analyzed from 145 generally healthy adults participating in the BrainHealth Project pilot study who had access to 12 weeks of online self-paced SMART and self-reported mental health symptoms on the Depression Anxiety Stress Scale (DASS-21) pre- and post-training. We utilized linear models to examine the change in self-reported symptoms of depression, anxiety, and stress following the 12-week training period and to explore the influence of age, gender, and education on changes in symptomatology. Data from 44 participants who completed a follow-up DASS-21 6 months after completing SMART was used to explore the lasting impact of the training. RESULTS: Improvements in depression, anxiety, and stress symptoms were observed following online SMART, evidenced by a significant decrease in self-reported symptoms on the DASS-21. Improvement in self-reported mental health symptomatology was maintained or continued to improve 6-month post-training. No significant effect of gender was observed, but findings motivate additional exploration of the effects of education and age. CONCLUSION: Online SMART should be considered a low-cost, high-impact approach for supporting public mental health for generally healthy adults.

Multinational Study to Assess Stress Levels Among the Health Care Workers of Radiation Oncology Community at the Outset of the COVID-19 Pandemic.

PURPOSE: To evaluate stress levels among the health care workers (HCWs) of the radiation oncology community in Asian countries. METHODS: HCWs of the radiation oncology departments from 29 tertiary cancer care centers of Bangladesh, India, Indonesia and Nepal were studied from May 2020 to July 2020. A total of 758 eligible HCWs were identified. The 7-Item Generalized Anxiety Disorder, 9-Item Patient Health Questionnaire, and 22-Item Impact of Events Scale-Revised were used for assessing anxiety, depression, and post-traumatic stress disorder. Univariate and multivariate analysis was done to identify the causative factors affecting mental health. RESULTS: A total of 758 participants from 794 HCWs were analyzed. The median age was 31 years (IQR, 27-28). The incidence of moderate to severe levels of anxiety, depression, and stress was 34.8%, 31.2%, and 18.2%, respectively. Severe personal concerns were noticed by 60.9% of the staff. On multivariate analysis, the presence of commonly reported symptoms of COVID-19 during the previous 2 weeks, contact history (harzard ratio [HR], 2.04; CI, 1.15 to 3.63), and compliance with precautionary measures (HR, 1.69; CI, 1.19 to 2.45) for COVID-19 significantly predicted for increasing anxiety (HR, 2.67; CI, 1.93 to 3.70), depression (HR, 3.38; CI 2.36 to 4.84), and stress (HR, 2.89; CI, 1.88 to 4.43) (P < .001). A significant regional variation was also noticed for anxiety, stress, and personal concerns. CONCLUSION: This survey conducted during the COVID-19 pandemic revealed that a significant proportion of HCWs in the radiation oncology community experiences moderate to severe levels of anxiety, depression, and stress. This trend is alarming and it is important to identify and intervene at the right time to improve the mental health of HCWs to avoid any long-term impacts.

Interventions to Reduce Nurses' Moral Distress in the Intensive Care Unit: An Integrative Review.

BACKGROUND: Critical care nurses experience moral distress, the phenomenon of knowing the "right" thing to do but being unable to do so, at high rates; this contributes to attrition and has severe mental health impacts on nurses. OBJECTIVE: The purpose of this integrative review was to determine if interventions to reduce moral distress have an effect on intensive care unit (ICU) nurses' moral distress levels. METHODS: Three databases were searched, PubMed, APA PsycNet, and CINAHL, using the keywords "moral distress" AND nurs* AND reduc* AND ("intensive care" OR "critical care" OR ICU). Only experimental studies involving adult ICU nurses were included for a total of 6 studies. RESULTS: Interventions fell into 3 categories: (1) educational interventions, (2) interventions to enhance the ICU environment, and (3) interventions to help nurses cope. Two studies detailing educational interventions demonstrated some reduction in moral distress. One study aimed to improve the ICU environment and showed some statistically significant reduction in moral distress. All 6 studies included some focus on coping, and 2 showed statistically significant reductions in moral distress. DISCUSSION: Only a few studies have been conducted examining this issue. These studies had severe limitations, such as small sample sizes, attrition, and inadequate control groups. There were also few statistically significant results. These interventions should be reexamined using larger sample sizes, and other interventions should also be trialed. COVID-19 may have had a significant impact on this issue, and interventions may need to be refocused in the wake of the pandemic.

Protocol for a randomized controlled trial of mindfulness-based stress reduction to improve attentional control in older adults (HealthyAgers trial).

BACKGROUND: Mindfulness meditation is a form of mind-body intervention that has increasing scientific support for its ability to reduce age-related declines in cognitive functioning, improve affective health, and strengthen the neural circuitry supporting improved cognitive and affective health. However, the majority of existent studies have been pilot investigations with small sample sizes, limited follow-up data, and a lack of attention to expectancy effects. Here, we present the study design of a Phase I/II, efficacy trial-HealthyAgers trial-that examines the benefits of a manualized mindfulness-based stress reduction program in improving attentional control and reducing mind-wandering in older adults. METHODS: One hundred fifty older adults (ages 65-85 years) will be randomized into one of two groups: an eight-week mindfulness program or an eight-week, placebo-controlled, lifestyle education program. Behavioral and neuroimaging assessments are conducted before and after the training. Participants are then invited to booster sessions once every three months for a period of 12 months with post-intervention follow-up assessments conducted at 6-months and 12-months. The primary outcomes for the study are behavioral measures of attentional control and mind-wandering. Additional, secondary outcomes include network strength in an a priori defined neuromarker of attentional control, fluid and everyday cognition, emotion regulation strategy use, and markers of inflammation. DISCUSSION: This study will establish the efficacy of a group-based, low-cost mind-body intervention for the inter-related facets of attentional control and mind-wandering in older adults. Strengths of this study include a well-designed, placebo-controlled comparison group, use of web/mobile application to track study adherence, and longitudinal follow-up. TRIAL REGISTRATION: Clinicaltrials.gov (# NCT03626532 ). Registered August 4, 2018.

A qualitative exploration of university student perspectives on mindfulness-based stress reduction exercises via smartphone app in Bangladesh.

PURPOSE: Mental health problems are proliferating, and access to mental health care is difficult due to barriers imposed by the COVID-19 pandemic in low-income countries such as Bangladesh. University students are susceptible to mental health concerns, given their unique stressors (i.e., academic pressure, new social environment). Mindfulness techniques can promote mental health , yet their acceptability has not been examined among Bangladeshi university students. These techniques can be used on a digital app, to decrease barriers to use.Qualitative methods were used to examine the acceptability of mindfulness among university students in Bangladesh. In-depth interviews (n = 12) were conducted to examine student reactions to linguistically (Bangla) and culturally adapted mindfulness exercises. Thematic analysis generated three themes (1) previous experience with mindfulness (2) positive responses to and (3) improvements to mindfulness exercises. RESULTS: The results showed favourable attitudes towards the mindfulness content; students expressed positive psychological and physiological reactions. Students welcomed the concept of using these exercises on an app and felt it could overcomepast barriers to help-seeking. CONCLUSIONS: This evidence suggests the value of exploring the acceptability of an app with mindfulness exercises for mental health promotion through a larger-scale pilot study in university students in Bangladesh.

Meta-Analysis of Psychological Interventions for Reducing Stress, Anxiety, and Depression among University Students during the COVID-19 Pandemic.

(1) Background: The aim of this study is to investigate the effects of internet-based intervention programs for reducing stress, anxiety, and depression among university students during the COVID-19 pandemic by conducting a meta-analysis. (2) Methods: Searches were conducted in the following databases: MEDLINE, EbscoHost Academic Search Ultimate, and PsycArticles, using a combination of "Covid-19 AND 'Randomized Controlled Trial' AND students", as well as a combination of the following search terms: "internet", "online", "treat_", "psycholog_", "intervention", "program_", "stress_", "depress_", "anxiety", "university", "college", "freshm_", "sophomore_", and "undergraduat_". The population, intervention, control, outcomes, and study design (PICOS) framework was used (P (population): university students during the COVID-19 pandemic; I (intervention): internet-based intervention programs for reducing stress, anxiety, and depression; C (control): no intervention, usual care, or on a waiting list; O (outcomes): stress, anxiety, and depression indicators; S (study design): meta-analysis including only randomized controlled trials (RCTs)). A meta-analysis was performed on the 10 retrieved studies published between 2021 and 2022. Only RCTs were analyzed. (3) Results: All 10 analyzed papers revealed a trend in the effectiveness of internet-based intervention for reducing stress, anxiety, and depression in university students during COVID-19. Significant effects from the included RCTs with interventions for reducing stress and depression were established. (4) Conclusions: Psychological internet-based interventions may help to reduce depression and stress among university students; however, more research is needed to determine their effectiveness in reducing anxiety.

Remotely Administered Resilience- and Wisdom-Focused Intervention to Reduce Perceived Stress and Loneliness: Pilot Controlled Clinical Trial in Older Adults.

OBJECTIVE: Older adults are vulnerable to perceived stress and loneliness, exacerbated by the COVID-19 pandemic. We previously reported inverse relationships between loneliness/perceived stress and wisdom/resilience. There are few evidence-based tele-health interventions for older adults. We tested a new remotely-administered manualized resilience- and wisdom-focused behavioral intervention to reduce perceived stress and loneliness in older adults. METHODS: This pilot controlled clinical trial used a multiple-phase-change single-case experimental design, with three successive 6-week phases: control, intervention, and follow-up periods. The intervention included six once-a-week one-hour sessions. Participants were 20 adults >65 years, without dementia. RESULTS: All 20 participants completed every session. The study indicated feasibility and acceptability of the intervention. While the sample was too small for demonstrating efficacy, there was a reduction (small-to-medium effect size) in perceived stress and loneliness, and increase in resilience, happiness, and components of wisdom and positive perceptions of aging. CONCLUSION: These preliminary data support feasibility, acceptability, and possible efficacy of a remotely-administered resilience- and wisdom-focused intervention in older adults to reduce stress and loneliness.

The Effect of Creative Arts Therapy on Psychological Distress in Health Care Professionals.

BACKGROUND: Work-related psychological distress is common among health care professionals. We determined whether 4 creative arts therapy (CAT) programs were acceptable, feasible, and improved psychological distress and job turnover intention in health care professionals with burnout symptoms. METHODS: Health care professionals were enrolled during the coronavirus disease (COVID-19) pandemic from September 2020 until July 2021. Participants attended in-person weekly 90-minute group session for 12 consecutive weeks. Intervention and control subjects completed surveys before the beginning and after the end of their cohort. The study outcomes were session attendance (feasibility), program satisfaction (acceptability), and change in symptoms of anxiety, depression, burnout, posttraumatic stress disorder (PTSD), and job turnover intention. RESULTS: We randomized 165 participants into 4 CAT interventions and 1 common control group across 3 sequential cohorts. Thirty-five randomized participants dropped out before the start of the cohort, and 16 were replaced from a waiting list. Therefore, the cohort consisted of 146 participants. On average, participants were 35 years old, white (85%), and female (92%). Overall, 52% were nurses, 10% were doctors, and 16% were behavioral health specialists. Participants attended a median of 9.5 [8-11] sessions. Program satisfaction was high with a median Client Satisfaction Questionnaire (CSQ-8) score of 31 [17-32] out of a possible score of 32. Participants randomized to the intervention had improvements in anxiety (P < .0001) and depression scores (P = .0007), total posttraumatic stress disorder score (P =.0002), burnout scores (P = .001, .003, .008), and turnover intention (P = .001). CONCLUSIONS: A CAT program is feasible, acceptable, and may reduce psychological distress and turnover intention for health care professionals.

A synergistic mindsets intervention protects adolescents from stress.

Social-evaluative stressors-experiences in which people feel they could be judged negatively-pose a major threat to adolescent mental health1-3 and can cause young people to disengage from stressful pursuits, resulting in missed opportunities to acquire valuable skills. Here we show that replicable benefits for the stress responses of adolescents can be achieved with a short (around 30-min), scalable 'synergistic mindsets' intervention. This intervention, which is a self-administered online training module, synergistically targets both growth mindsets4 (the idea that intelligence can be developed) and stress-can-be-enhancing mindsets5 (the idea that one's physiological stress response can fuel optimal performance). In six double-blind, randomized, controlled experiments that were conducted with secondary and post-secondary students in the United States, the synergistic mindsets intervention improved stress-related cognitions (study 1, n = 2,717; study 2, n = 755), cardiovascular reactivity (study 3, n = 160; study 4, n = 200), daily cortisol levels (study 5, n = 118 students, n = 1,213 observations), psychological well-being (studies 4 and 5), academic success (study 5) and anxiety symptoms during the 2020 COVID-19 lockdowns (study 6, n = 341). Heterogeneity analyses (studies 3, 5 and 6) and a four-cell experiment (study 4) showed that the benefits of the intervention depended on addressing both mindsets-growth and stress-synergistically. Confidence in these conclusions comes from a conservative, Bayesian machine-learning statistical method for detecting heterogeneous effects6. Thus, our research has identified a treatment for adolescent stress that could, in principle, be scaled nationally at low cost.

Nursing Students' Covid-19 Induced Stress: Promoting Mindfulness and Resilience.

Nursing education to prepare students for practice traditionally includes teaching knowledge and developing clinical judgment in the physical classroom, laboratory, and clinical setting. The Covid-19 pandemic presented challenges previously unseen in academia. An abrupt shift to online learning was associated with higher levels of stress and anxiety. In response, the faculty at a mid-sized, rural, four-year private university in the Midwest incorporated mindfulness and resilience practices into courses to promote coping mechanisms for use throughout nursing school and in future practice, and surveyed students to determine the degree to which they used the mindfulness and resilience strategies provided. This article describes the implementation of the strategies, survey results, and lessons learned to inform use in the future.

Dealing with the COVID-19 pandemic in Europe: five lessons from the European Society for Traumatic Stress Studies.

The paper provides insights into the mental health consequences of the coronavirus disease 2019 (COVID-19) pandemic from the Central, Eastern, Nordic, Southern, and Western subregions of Europe, represented by five member countries of the European Society for Traumatic Stress Studies (ESTSS). On the basis of the existing national research and experiences in these countries, we propose five lessons learned. (1) There is no evidence of a mental health pandemic so far in the countries in focus. No increase in severe mental disorders but some increase in the symptoms of common mental health disorders are observable. More high-quality longitudinal studies are needed to understand the mental health burden of the pandemic. (2) The pandemic affects countries (including the mental health situation) differently, depending on the level of the exposure, management policies, pre-pandemic structural characteristics, and healthcare resources. (3) The pandemic affects people differently: the exposure severity to pandemic-related stressors differs between individuals, as well as individual resources to cope with these stressors. There are winners and losers as well as identifiable at-risk groups that need particular attention. (4) Besides the negative consequences, the pandemic has had a positive impact. The rapidly applied innovations within the system of healthcare responses provide a window of opportunity for positive changes in mental healthcare policies, strategies, and practices. The increased focus on mental health during the pandemic may contribute to the prioritization of mental health issues at policy-making and organizational levels and may reduce stigma. (5) A stress- and trauma-informed response to COVID-19 is required. The European community of psychotraumatologists under the leadership of ESTSS plays an important role in promoting stress- and trauma-informed healthcare and policies of pandemic management. Based on the lessons learned, we propose a stepped-care public mental health model for the prevention of adverse mental health outcomes during pandemics. HIGHLIGHTS: Population mental health is affected differently in the COVID-19 pandemic: there are winners and losers, as well as identifiable at-risk groups that need particular attention.A stress- and trauma-informed public mental health stepped-care model can address pandemic-related mental health burden in a systematic way.

Este articulo proporciona información sobre las consecuencias para la salud mental de la pandemia por la COVID-19 en las subregiones Central, Oriental, Nórdica, Meridional y Occidental de Europa, representadas por cinco países miembros de la Sociedad Europea de Estudios del Estrés Traumático (ESTSS). Sobre la base de las investigaciones y experiencias nacionales existentes en estos países, proponemos cinco lecciones aprendidas: 1. No hay evidencia de una pandemia de salud mental hasta el momento en los países en estudio. No se observa un aumento de los trastornos mentales severos, pero sí un aumento de los síntomas de los trastornos de salud mental comunes. Se necesitan más estudios longitudinales de alta calidad para entender la carga de salud mental de la pandemia; 2. La pandemia afecta a los países (incluida la situación de salud mental) en forma diferente según el nivel de exposición, las políticas de gestión, las características estructurales previas a la pandemia y los recursos de atención en salud; 3. La pandemia afecta a las personas de distintas maneras: la severidad de exposición a los estresores relacionados con la pandemia difiere entre las personas, así como los recursos individuales para hacer frente a estos factores estresantes. Hay ganadores y perdedores así como grupos de riesgo identificables que necesitan atención especial; 4. Además de las consecuencias negativas, la pandemia ha tenido un impacto positivo. Las innovaciones aplicadas rápidamente dentro del sistema de respuestas de atención de la salud son una ventana de oportunidad para cambios positivos en las políticas, estrategias y prácticas de atención de la salud mental. El aumento del enfoque en la salud mental durante la pandemia puede contribuir a la priorización de problemas de salud mental en los niveles organizacionales y de formulación de políticas y podría reducir el estigma; 5. Se requieren respuestas frente a la COVID-19 informadas en estrés y en trauma. La comunidad europea de psicotraumatólogos, bajo el liderazgo de la ESTSS, juega un papel importante en la promoción de la atención en salud informada en estrés y trauma y las políticas de gestión de pandemias. Basados en las lecciones aprendidas, proponemos un modelo de salud mental pública de atención escalonada para la prevención de las consecuencias adversas de salud mental durante las pandemias.

Perinatal Depression in Australian Women during the COVID-19 Pandemic: The Birth in the Time of COVID-19 (BITTOC) Study.

The COVID-19 pandemic has impacted perinatal mental health globally. We determined the maternal factors and pandemic-related experiences associated with clinically significant perinatal (pregnant and post-partum) depressive symptoms in Australian women. Participants (n = 2638; pregnant n = 1219, postnatal n = 1419) completed an online survey (August 2020 through February 2021) and self-reported on depression, social support, and COVID-19 related experiences. We found elevated depressive symptoms amongst 26.5% (pregnant) and 19% (postnatal) women. Multiple logistic regression analyses showed higher likelihood of elevated depression associated with residence in Victoria, lower education, past/current mental health problems, greater non-pandemic prenatal stress, age ≥ 35 years (pregnant women) and existing physical health issues or disability in self or others (postnatal women). Greater family stress/discord and lower social support (friends) was associated with higher odds of elevated perinatal depression, while lower social support (family) was significantly associated with elevated depressive symptoms in pregnant women. Greater depression was associated with social distancing, pandemic-related news exposure and changes to prenatal care (pregnant women). Single postnatal women showed lower odds of elevated depression than partnered women. Our findings underscore the importance of universal screening for depression and targeted support during a pandemic for perinatal women displaying vulnerability factors.

Potential benefits of Yoga in pregnancy-related complications during the COVID-19 pandemic and implications for working women.

BACKGROUND: Pregnancy is a vulnerable period of growth and enrichment along with many physiological and psychological challenges. These changes can lead to complications if compounded by external stress and anxiety. COVID-19 has emerged as a chief stressor among the general population and is a serious threat among vulnerable populations. Therefore, there is a need for stress management tools, such as Yoga and physical exercises, both at home and at work. These can be adopted during the pandemic with proper maintenance of social distancing. OBJECTIVE: To evaluate and compile literature that has reported the health outcomes of Yoga intervention on pregnancy at the workplace and analyzes both the restrictions as well as advantages of its beneficial effects in comparison to physical exercises. METHODOLOGY: A comprehensive literature review was conducted utilizing PubMed and Google Scholar. The keywords used for the search include "Yoga", "work", "complications", "physical exercise", "drugs" and "COVID" indifferent permutations and combinations with "pregnancy". We compiled the literature with respect to pregnancy complications and the effects of drugs, physical activity and Yoga for preventing these complications. RESULTS: We noted that pregnancy-related complications are becoming more prevalent because of a sedentary lifestyle, restricted physical activity and growing stress. In such situations, a home or workplace Yoga protocol can combine both exercise and mindfulness-based alleviation of anxiety for both working and non-working women. CONCLUSION: Yoga can be effective for combating stress and anxiety besides boosting immunity in pregnant working women confronted with the COVID-19 pandemic.

Practical strategies and the need for psychological support: recommendations from nurses working in hospitals during the COVID-19 pandemic.

PURPOSE: Nurses working during the coronavirus disease 2019 (COVID-19) pandemic have reported elevated levels of anxiety, burnout and sleep disruption. Hospital administrators are in a unique position to mitigate or exacerbate stressful working conditions. The goal of this study was to capture the recommendations of nurses providing frontline care during the pandemic. DESIGN/METHODOLOGY/APPROACH: Semi-structured interviews were conducted during the first wave of the COVID-19 pandemic, with 36 nurses living in Canada and working in Canada or the United States. FINDINGS: The following recommendations were identified from reflexive thematic analysis of interview transcripts: (1) The nurses emphasized the need for a leadership style that embodied visibility, availability and careful planning. (2) Information overload contributed to stress, and participants appealed for clear, consistent and transparent communication. (3) A more resilient healthcare supply chain was required to safeguard the distribution of equipment, supplies and medications. (4) Clear communication of policies related to sick leave, pay equity and workload was necessary. (5) Equity should be considered, particularly with regard to redeployment. (6) Nurses wanted psychological support offered by trusted providers, managers and peers. PRACTICAL IMPLICATIONS: Over-reliance on employee assistance programmes and other individualized approaches to virtual care were not well-received. An integrative systems-based approach is needed to address the multifaceted mental health outcomes and reduce the deleterious impact of the COVID-19 pandemic on the nursing workforce. ORIGINALITY/VALUE: Results of this study capture the recommendations made by nurses during in-depth interviews conducted early in the COVID-19 pandemic.

National Internet-Based Survey of the Use, Barriers, Reasons and Beliefs of Mind-Body Practices During the Early Months of the COVID-19 Pandemic.

The purpose of this study was to learn about the use, barriers, reasons and beliefs regarding mind-body practices among adults living in the United States during the beginning months of the 2019 novel coronavirus disease (COVID-19) pandemic. An on-line survey was developed following the Checklist for Reporting Results of Internet e-Surveys (CHERRIES) guidelines and using the online survey software program, Qualtrics®XM, platform. Pilot testing of the survey was conducted for usability and functionality. The final 24-item survey was distributed via email and social media. A total of 338 adults responded to the survey, with 68.8% indicating that they participated in mind-body activities since the start of the pandemic. Physical activity was the most frequently (61.5%, n = 227) used mind-body practice. Further, 2 of the common barriers to engaging in mind-body practices were lack of motivation and wandering mind. Frequently listed reasons for using mind-body practices were to promote health, reduce stress and relaxation. Respondents believed that mind-body practices resulted in less stress. These findings may be applicable for reducing psychological stress related to the pandemic, as the pandemic continues to impact many areas of the United States.