Effects of relaxation training, combining imagery, and meditation on the stress level of Chinese nurses working in modern hospitals in Taiwan. Teaching health-care providers coping: results of a two-year study. The efficacy and effectiveness of process consultation in improving staff morale and absenteeism. Effect of assertiveness training on levels of stress and assertiveness experienced by nurses in Taiwan, Republic of China. Effectiveness of stress management training for nurses working in a burn treatment unit. Effects of web-based career identity training for stress management among Japanese nurses: a randomized control trial. A brief mindfulness-based stress reduction intervention for nurses and nurse aides.
The purpose of this study was to test the effectiveness of relaxation training, which was based on the cognitive-behavioral model and specifically focused on helping Chinese registered nurses employed in large teaching hospitals to reduce their work stress in Taiwan, Republic of China. The study design was a pretest-posttest control design with two posttest points. The 137 subjects were selected randomly from three first-ranked teaching hospitals. Twenty-three subjects in the experimental group and 23 in the control group from each hospital participated in the study. The treatment of the experimental group consisted of two sessions of relaxation training based on Smith's (1988) cognitive behavioral model of relaxation at weeks 1 and 2, with a follow-up session in the fifth week. The control group had the same sequence of sessions with a presentation by the researcher on theory analysis in nursing. The mean scores on the Nurse Stress Checklist (NSC) and the Chinese General Health Questionnaire (CGHQ) differed significantly between the experimental and control group in posttest 2 at week 5. These results supported the hypotheses that the relaxation training decreased the Chinese nurses' self-reported work stress as measured by NSC and increased the Chinese nurses' self-reported psychophysiologic health as measured by CGHQ. The significant difference on means of the CGHQ in posttest 1 at week 2 showed that the self-reported psychophysiologic health level responded to the relaxation training earlier than to the self-reported work stress level. In the relaxation treatment, duration of practice was an important factor of the effectiveness of the treatment on the dependent variable of NSC. It is suggested that even brief teaching of relaxation techniques may reduce work stress levels and promote a sense of psychophysiologic health in Chinese nurses who are employed in large teaching hospitals in Taiwan. This study examined coping strategies and occupational burnout in a sample of 118 health-care providers. Subjects who participated in a 6-week program designed to improve coping reported significant short-term decreases in emotional exhaustion and lack of personal accomplishment, two dimensions of burnout. Subjects who received 1-hr coping "refresher" sessions at 5, 11, and 17 months showed consistent decreases in burnout throughout the 2-year period. However, those who did not receive the refresher sessions following the 6-week course showed only temporary improvement. Results indicate that health-care providers can be taught to employ adaptive coping strategies that improve levels of burnout, but long-term changes are achieved only through long-term coping training. The purpose of this randomized controlled trial was to test the efficacy and effectiveness of process consultation consisting of a series of nurse manager-consultant problem-solving meetings for leadership development that would lead to their staff's improved morale, quality of care, and reduced absenteeism.
                Thirteen consenting clinical inpatient units were stratified for four variables known to affect outcome and were then randomly assigned to treatment and control conditions. The nurse managers from the seven experimental units were paired with outside nurse consultants from the McMaster University School of Nursing (Hamilton, Ontario, Canada) in a cooperative form of retraining in problem-solving through process consultation. Morale was determined through measures of perceptions of the work environment, an attitude scale concerning work (alienation), a personality measure (hardiness), and one of each scale for work satisfaction and for sources of satisfaction and dissatisfaction. Demographic data and information regarding family life responsibilities were collected as well. Assessment of quality of care was determined by the frequency and type of incident reports and by patients' perception of their satisfaction. A ratio of absence hours to total paid hours of work was used to compare experimental and control units' absenteeism rates.
                Experimental subjects reported a statistically significant improvement in the characteristics of their work setting and in the quality of working relationships. The consultation process facilitated a perceived change in the organizational context of the experimental hospital units with less centralization of authority and more clarity about expectation. These organizational changes were accompanied by improved working relationships and less alienation from work. There was no statistically significant difference in absenteeism. However, a subanalysis of the units by "dose" of the intervention identified those who benefited from the effects of the consultation. Subjects whose nurse managers participated more actively in the consultation process accounted for the changes in working relationships and perceived organizational changes. The "low-dose" experimental subjects were more like the control subjects, with the exception of absenteeism, for which they had higher rates.
                The findings of this study suggest that process consultation can alter the staff's perceptions of the characteristics of the work setting, can reverse negative attitudes (alienation), and can create a more positive and supportive working environment (improved working relationship). However, the results suggest the need to target this type of intervention to managers who have the personal resources to engage in self-evaluation and personal development and thus to participate in the consultative process. The purpose of the study was to examine the effectiveness of assertiveness training in improving self-perceived levels of stress and assertiveness among nurses in Taiwan, Republic of China. The two-group experimental design was conducted in a 2,000-bed veteran general hospital. A sample of 60 volunteer Chinese-speaking nurses participated in the study. Subjects were randomly assigned to one of two treatments: assertiveness training (AT) or alternate treatment control (ATC), which served as a control and contained updated knowledge of new computer technology for in patient settings. Subjects in each group participated in six 2-hour workshops in the same two-week period. All subjects were pre-, post-, and follow-up posttested for stress and assertiveness with the Perceived Stress Scale (PSS) and Rathus Assertiveness Schedule (RAS), respectively. Results revealed the following: (1) subjects in both groups of pretest were clearly subassertive and under considerable stress; (2) by the end of training, the AT group scored significantly higher on the rating of assertiveness than those in the ATC group, and had successfully maintained their improvement by the 4-week follow-up; and (3) by the end of training, the AT group reported significantly lower levels of stress than the ATC group as indicated on the PSS, and successfully maintained their improvements at the 4-week follow-up. Overall, the results indicate clear support for the effectiveness of assertiveness training for treating subassertive behaviors and stress in a population of professional nurses in Taiwan. All fourteen nurses working in a burn unit were given three hours of individual training in cognitive behavioral stress management skills. Anxiety measures were obtained before, during, and after training by weekly administration of the State-Trait Anxiety Inventory, and by daily administration of a nurses' stress scale constructed for this study. Nurses were randomly assigned to two groups which were treated using a successive-groups time-series design. Results suggested that stress management training was effective in reducing work-related anxiety among inexperienced nurses but not among experienced nurses. The gains made by the inexperienced nurses may have been more associated with increases in their understanding of stress and their feelings of control over stress than with changes in their actual stress management behavior. nan Whereas the causes and negative consequences of stress among nurses are well known, less is known about effective ways to reduce or prevent this growing problem. Mindfulness-based stress reduction programs are proving to be effective in reducing stress and improving health in a variety of clinical populations. A smaller body of evidence suggests that these programs are also effective for nonclinical populations at risk for stress-related health problems. This study involved the development and evaluation of a brief 4-week mindfulness intervention for one such group-nurses and nurse aides. In comparison with 14 wait-list control participants, 16 participants in the mindfulness intervention experienced significant improvements in burnout symptoms, relaxation, and life satisfaction. The results of this pilot study, together with a natural fit between mindfulness philosophy and nursing practice theory, suggest that mindfulness training is a promising method for helping those in the nursing profession manage stress, even when provided in a brief format.