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      Biofeedback Intervention for Stress and Anxiety among Nursing Students: A Randomized Controlled Trial

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          Abstract

          Purpose. It has been well documented that nursing students across the world experience stress and anxiety throughout their education and training. The purpose of this randomized controlled study is to investigate the impact of biofeedback intervention program on nursing students' levels of stress and anxiety during their first clinical training. Methods. Participants consisted of 60 second-year baccalaureate nursing students. The 30 participants in the biofeedback group received training on how to use the biofeedback device to assist in stress and anxiety management for 5 weeks while the 30 in the control group did not receive any training. Findings. Results indicated that the biofeedback group was able to maintain the stress level while the control group had a significant increase in the stress level over the 5-week period of clinical training. Additionally, the biofeedback group had a significant reduction in anxiety, while the control group had a moderate increase in anxiety. Conclusions. The better the nursing students can manage their stress and anxiety, the more successful they can be in their clinical training. Ultimately, the more psychologically healthy the nursing students are, the more likely they will flourish and graduate to become productive and contributing members of the nursing profession.

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          Most cited references36

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          The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea.

          This study examined the effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. A nonequivalent, control group, pre-posttest design was used. A convenience sample of 41 nursing students were randomly assigned to experimental (n=21) and control groups (n=20). Stress was measured with the PWI-SF (5-point) developed by Chang. Anxiety was measured with Spieberger's state anxiety inventory. Depression was measured with the Beck depression inventory. The experimental group attended 90-min sessions for eight weeks. No intervention was administered to the control group. Nine participants were excluded from the analysis because they did not complete the study due to personal circumstances, resulting in 16 participants in each group for the final analysis. Results for the two groups showed (1) a significant difference in stress scores (F=6.145, p=0.020), (2) a significant difference in anxiety scores (F=6.985, p=0.013), and (3) no significant difference in depression scores (t=1.986, p=0.056). A stress coping program based on mindfulness meditation was an effective intervention for nursing students to decrease their stress and anxiety, and could be used to manage stress in student nurses. In the future, long-term studies should be pursued to standardize and detail the program, with particular emphasis on studies to confirm the effects of the program in patients with diseases, such as cancer.
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            Does mindfulness decrease stress and foster empathy among nursing students?

            This pilot study of baccalaureate nursing students explored the effects of an 8-week mindfulness-based stress reduction (MBSR) course on stress and empathy. The course was intended to provide students with tools to cope with personal and professional stress and to foster empathy through intrapersonal knowing. A convenience sample of 16 students participated in the course, used guided meditation audiotapes at home, and completed journal assignments. Stress and empathy were measured using paired sample t tests. Participation in the intervention significantly reduced students' anxiety (p > .05). Favorable trends were observed in a number of stress dimensions including attitude, time pressure, and total stress. Two dimensions of empathy--personal distress and fantasy--also demonstrated favorable downward trends. Regular home meditation was correlated with additional benefit. Participants reported using meditation in daily life and experiencing greater well-being and improved coping skills as a result of the program. Findings suggest that being mindful may also decrease tendencies to take on others' negative emotions. Coping with stress and fostering the affective domain are important facets of nursing education that may be facilitated by mindfulness training.
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              Stress and health in novice and experienced nursing students.

              This paper is a report of a study conducted to identify the differences in novice and experienced nursing students' reports of stress and health. Stress from clinical practice and its impact are international yet culturally mediated phenomena. Nursing students are under considerable stress during clinical practice periods, putting their education and health at risk. However, there is little or no empirical evidence about the stress suffered by nursing students and its impact on their health throughout clinical practice. We performed cross-sectional research using standard information gathering tools. This study was carried out with 357 students from all 3 years of a nursing diploma programme at a Spanish nursing college (71% response rate). The data were collected over an 8-month period in 2004-2005. We identified three types of stressors (clinical, academic and external) and two categories of symptoms (physiological and psychological) linked to clinical practice. Factor analysis identified six major sources of stress and six important symptoms. Students perceived clinical stressors more intensely than academic and external stressors, and showed psychological symptoms more frequently than physiological symptoms. Nursing students from all 3 years perceived moderate stress at similar levels. Experienced students perceived more academic stressors than novices. Although the students were healthy, second year students were the most vulnerable to somatic and psychic anxiety, and common symptoms. We suggest informing students about possible stressors associated with their profession, and introducing interventions to support development of professionalism, social skills and coping capacity for clinical practice.
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                Author and article information

                Journal
                ISRN Nurs
                ISRN Nurs
                ISRN.NURSING
                ISRN Nursing
                International Scholarly Research Network
                2090-5483
                2090-5491
                2012
                28 June 2012
                : 2012
                : 827972
                Affiliations
                1Department of Advanced Studies in Education and Counseling, California State University, Long Beach, CA 90840, USA
                2Student Health Services, California State University, Long Beach, CA 90840, USA
                3Department of Nursing, Boromarajonani College of Nursing, Nakhornratchasima 30000, Thailand
                Author notes

                Academic Editors: F.-H. Chou and N. E. Ervin

                Article
                10.5402/2012/827972
                3395228
                22811932
                995a21be-bf39-4323-872a-3e5a682dea07
                Copyright © 2012 Paul Ratanasiripong et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 March 2012
                : 7 May 2012
                Categories
                Research Article

                Nursing
                Nursing

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