A Mixed Methods Evaluation of a Pilot Resilience Training Course on Stress Management
DOI:
https://doi.org/10.17140/PHOJ-4-127Keywords:
Resilience; Stress; Wellbeing.Abstract
Background: Chronic stress adversely affects biologic, cognitive and emotional functioning, is associated with worsened morbidity and mortality outcomes, and is predictive of performance and productivity. Interventions for resilience to stress can be effective but are typically time intensive. With contemporary life demands, effective, brief interventions may be advantageous.Methods: This single arm, mixed methods study evaluated the effectiveness of a 1-day resilience to stress training course. Thirty community participants were surveyed at baseline and 1-month. Qualitative interviews were conducted between 30-68 days post-intervention according to a grounded theory approach. Quantitative measures included Perceived Stress Scale (PSS), Public Health Surveillance Wellbeing (PHS-WB), Rand Medical Outcome Survey (MOS) SF-36, Health, and Productivity Questionnaire (HPQ), Work Productivity and Activity Impairment (WPAI) and Brief Cope Scale (BCS). Participants had a mean age of 53-years (SD=9) and were largely female (57%), caucasian (79%), married (83%), and employed (80%). Generalized estimating equations and paired sample t-tests were used to analyze quantitative data.Results: Participants self-reported improvement at 1-month on the PSS (moderate or high 100% vs. 50%, p<0.001), PHS-WB (29.8 vs. 31.5, p=.04), SF-36 subscales role limitation due to physical health (44.1 vs. 69.0, p=.002), vitality (55.2 vs. 63.6, p=.008), emotional wellbeing (70.9 vs. 78.0, p=0.001), and social functioning (76.0 vs. 87.9, p=0.003). Qualitative analysis suggested participants used the course as an opportunity to build a framework for action. Critical ideas triggered a recalibration of perspectives and reference points (i.e., mindsets) opening the way to updating routinized decisions and harnessing new ways of behaving in service of resilience. Embedding changes in behavior were swift for some or a gradual process of pragmatic adaption for others. Conclusions: Our pilot findings suggest that brief one-day interventions may facilitate personal reform and may enhance resilience and psychological wellbeing. Longer follows-ups to determine sustainability are also required.
References
Schneiderman N, Ironson G, Siegel SD. Stress and health: Psychological, behavioral, and biological determinants. Annual Review of Clinical Psychology. 2005; 1: 607-628. doi: 10.1146/annurev. clinpsy.1.102803.144141
Workplace Stress. The American Institute of Stress Website: https://www.stress.org/workplace-stress/. Accessed July 19, 2018.
Five Things You Should Know About Stress. National Institute of Mental Health. Website: https://www.nimh.nih.gov/health/ publications/stress/index.shtml. Accessed July 19, 2018.
Waterman AD, Garbutt J, Hazel E, et al. The emotional impact of medical errors on practicing physicians in the United States and Canada. Jt Comm J Qual Patient Saf. 2007; 33(8): 1-10.
Mosadeghrad AM. Occupational stress and turnover intention: Implications for nursing management. Int J Health Policy Manag. 2013; 1(2): 169-176. doi: 10.15171%2Fijhpm.2013.30
Stress in America: The State of our Nation. Stress in AmericaTM Survey. American Psychological Association. 2017.
Stress in America: The Impact of Discrimination. American Psychological Association. 2016.
Lamontagne AD, Keegel T, Louie AM, Ostry A, Landsbergis PA. A systematic review of the job-stress intervention evaluation literature, 1990-2005. Int J Occup Environ Health. 2007; 13(3): 268- 80. doi: 10.1179/oeh.2007.13.3.268
Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and wellbeing: A systematic review and meta-Original Research | Volume 4 | Issue 1| analysis. JAMA Intern Med. 2014; 174(3): 357-368. doi: 10.1001/ jamainternmed.2013.13018
Fjorback LO, Arendt M, Ørnbøl E, Fink P, Walach H. Mindfulness-based stress reduction and mindfulness-based cognitive therapy: A systematic review of randomized controlled trials. Acta Psychiatr Scand. 2011; 124(2): 102-119. doi: 10.1111/j.1600-0447.2011.01704.x
Elder JP, Ayala GX, Harris S. Theories and intervention approaches to health-behavior change in primary care. Am J Prev Med. 1999; 17(4): 275-284.
Holzel BK, Carmody J, Vangel M, et al. Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Res. 2011; 191(1): 36-43. doi: 10.1016%2Fj.pscychresns.2010.08.006
Mrazek MD, Franklin MS, Phillips DT, Baird B, Schooler JW. Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering. Psychol Sci. 2013; 24(5): 776-781. doi: 10.1177/0956797612459659
Keller A, Litzelman K, Wisk LE, et al. Does the perception that stress affects health matter? The association with health and mortality. Health Psychol. 2012; 31(5): 677-684. doi: 10.1037/ a0026743
Kupriyanov R, Zhdanov R. The eustress concept: problems and outlooks. World Journal of Medical Sciences. 2014; 11(2): 179-185.
Loprinzi C, Prasad K, Schroeder D, Sood A. Stress management and resilience training (SMART) program to decrease stress and enhance resilience among breast cancer survivors: A pilot randomized clinical trial. Clinical Breast Cancer. 2011; 11(6): 364-368. doi: 10.1016/j.clbc.2011.06.008
Lake Nona Life Project Community Health Study. Website: http://www.liveworkparticipate.com/. Accessed July 19, 2018.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983; 24(4): 385-396.
Bann CM, Kobau R, Lewis MA, Zack MM, Thompson WW. Development and psychometric evaluation of the public health surveillance wellbeing scale. Qual Life Res. 2012; 21(6): 1031-1043. doi: 10.1007/s11136-011-0002-9
Ware Jr JE, Sherbourne CD. The MOS 36-item short-form Submit your article to this journal | https://openventio.org/submit-manuscript/ Original Research | Volume 4 | Issue 1| Mason ST, et al health survey (SF-36): I. Conceptual framework and item selection. Med Care.1992; 473-483.
Kessler RC, Barber C, Beck AL, et al. The world health organization health and work performance questionnaire (HPQ). J Occup Environ Med. 2003; 45(2): 156-174.
Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a Work Productivity and Activity Impairment instrument. Pharmacoeconomics. 1993; 4(5): 353-365. doi: 10.2165/00019053-199304050-00006
Carver CS. You want to measure coping but your protocol’s too long: Consider the brief COPE. Int J Behav Med. 1997; 4(1): 92-100. doi: 10.1207/s15327558ijbm0401_6
Glaser B. Theoretical Sensitivity. Mill Valley, CA, USA: Sociology Press. 1978.
Glaser B. Doing Grounded Theory: Issues and Discussions. Mill Valley, CA, USA: Sociology Press. 1998.
Glaser B, Strauss A. The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago, USA: Aldine Publishing. 1967
Loehr J. Toughness Training for Life. New York, USA: Plume by Penguin Group.1993.
Bergouignan A, Legget KT, De Jong N, et al. Effect of frequent interruptions of prolonged sitting on self-perceived levels of energy, mood, food cravings and cognitive function. Int J Behav Nutr Phys Act. 2016; 13(1): 113. doi: 10.1186/s12966-016-0437-z
Schaefer SM, Morozink Boylan J, Van Reekum CM, et al. Purpose in life predicts better emotional recovery from negative stimuli. PLoS One. 2013; 8(11): e80329. doi: 10.1371/journal. pone.0080329. eCollection 2013
Kim ES, Strecher VJ, Ryff CD. Purpose in life and use of preventive health care services. Proc Natl Acad Sci U S A. 2014; 111(46): 16331-16336. doi: 10.1073/pnas.1414826111
Hill PL, Turiano NA. Purpose in life as a predictor of mortality across adulthood. Psychol Sci. 2014; 25(7): 1482-1486. doi: 10.1177/0956797614531799
Crum A, Salovey P, Achor S. Rethinking stress: The role of mindsets in determining the stress response. J Pers Soc Psychol. 2013; 104(4): 716-733. doi: 10.1037/a0031201
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