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Mobile Stress Management for Cancer Nurses

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Mobile Stress Management Protocol for Nurses working with Cancer Patients : A Controlled Study …

Mobile Stress Management Protocol for Nurses working with Cancer Patients : A Controlled Study
MMVR 2012 Presentation by Daniela VIllani and Giuseppe Riva

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  • 1. Mobile Stress Management Protocolfor Nurses working with Cancer PatientsA Controlled StudyGiuseppe Riva, ATN-P Lab., Istituto Auxologico ItalianoMilan, Italy - http://www.giusepperiva.com
  • 2. 1. Stress in oncology Outline nursing of the2. The current solutions3. Our approach: a presentation Stress Inoculation Training self-help protocol with mobile phones4. A controlled trial involving 30 female oncology nurses
  • 3. Although all professionsStress in are susceptible to work-nursing related stress, the nursing profession has been identified as particularly stressful. Indeed, oncology nursing is often described as being among the most stressful specialty areas.
  • 4. Helping Nurses Based on existent literature, healthcare professionals coping with clearly need support in addressing stress the numerous stressors inherent in their work. The most used strategies are: a) to increase workers’ awareness; b) to reduce the high level of negative arousal. Strategies used to reduce negative arousal include relaxation techniques, promotion of a healthy lifestyle (e.g., physical training), and cognitive–behavioral techniques.
  • 5. In this study we investigatedOur the use of the mobile phone inapproach the stress management of nurses.Mobile Using this approach nursesSelf-help autonomously self-administerStress clinical content, becoming able to improve their knowledgeManagement according to their needs.Training More, the multimedia capability of the mobile phone allow the provision of self-help content based on the Stress Inoculation Training.
  • 6. In this study we used theOur mobile phone most common inapproach the selected sample: Nokia N70, an entry level multimediaMobile phone.Self-helpStressManagementTraining Participants used the N70 mobile phone with a display resolution of 176 x 208 pixels (2.1 inches) and headphones.
  • 7. Several studies have shown thatskills training, such as in the form Ourof Stress Inoculation Training (SIT; approachMeichenbaum 1977, 1985), maylead to a reduction in burnout Stresslevels by: Inoculationa) altering the way in which an individual processes Training information about stressful situations and;b) identifying cognitive, emotional, and behavioral coping skills to change unproductive ways of reacting.
  • 8. SIT is a short and structured program that includes three phases:SIT 1. The conceptual phase aims to make clients aware of theThe three transactional nature of stress;phases 2. The skill acquisition and rehearsal phase aims to teach clients to manage emotions and maladaptive behaviors as well as learn new coping skills; 3. The application and follow-through phase aims increase self-efficacy (Bandura, 2005) through imaginative exercises and simulations.
  • 9. • The self-help protocol lasted four weeks. During this time, nurses received a book about stress and watched eight multimedia videos (10 SIT min each) on the mobile phone, twice a week. Our clinical• The first six videos presented different relaxation techniques that the nurse protocol had to practice at least once a day.• The final two videos - created by combining three different public social advertising campaigns -presented oncology patients suffering from cancer.
  • 10. The controlled trialSample• 30 female oncology nurses (Mean age = 43; SD = 8.80) enrolled in the study, with an average of 22 years of experience as a nurse and 9 years of experience in the oncology ward.• Control group (15 nurses) received the same book and experienced 8 video clip representing natural environments.• Inclusion criteria included: 1. being a current oncology nurse with a minimum of five years of experience in the oncology ward; 2. having a permanent status to avoid sources of stress related to temporary employment; 3. with a cut-off level of stress corresponding to the higher quartile (Italian normative data), measured using the Measure du Stress Psychologique (MSP) Questionnaire
  • 11. The controlled trialMeasures 1. The State Trait Anxiety Inventory (STAI; Spielberger, Gorush, & Lushene, 1970) is a 40-item self- reported broken down into two sections: state (or current) and trait (or characteristic or chronic) anxiety. 2. The Brief Coping Orientation to Problems Experienced (COPE) questionnaire (Carver, 1997) is a short version of the original self-reported item that includes 28 items to measure the coping styles used in events management— namely, active coping, positive attitude, external strategies, social support, hedging strategies, and denial. 3. The Job Content Questionnaire (JCQ) proposed by Karasek and Theorell (1990) comprises 35 items evaluating job content in terms of psychological job demands, job decision latitude, and social support.
  • 12. The controlled trialResults 1Hypothesis 1: The emotional state (state anxiety reduction)of oncology nurses included in the experimental group will improve by the end of each session of the protocol. We found a significant and continuous decrease of anxiety state (STAI State) at the end of each session for the experimental group, but not for the control group.
  • 13. The controlled trialResults 2Hypothesis 2: The affective state (trait anxiety reduction andacquisition of styles of coping) of oncology nurses included in the experimental group will improve by the end of the entire protocol. Significant results were found only for the experimental group: active coping (taking action to change the situation) increased while denial (denying the existence of the critical situation) decreased.
  • 14. Results showed a significantdecrease in anxiety among those Conclusionswho performed the SIT protocolcompared to the control group. We reducedIn addition to the significant decrease anxiety andat the end of each session, the improvedresults demonstrated a significantimprovement in anxiety trait reduction copingand coping skills acquisition.In particular, nurses learned twoimportant coping strategies: thedecrease of denial and the increaseof active coping,
  • 15. These results suggest the Conclusions possibility of developing Self-help controllable self-help stress management mobilemobile stress experiences for severalmanagement professions. is possible Self-management training offers a potential solution to the demand for efficient, low- cost, and stigma-reducing interventions for stress, especially in high-demand professions.
  • 16. Giuseppe Riva, Ph.D.• Professor of General Psychology at the Catholic University of Milan, Italy;• Director, Applied Technology for Neuro-Psychology Laboratory - ATN-P Lab., Istituto Auxologico Italiano, Milan, Italy. • President of the International Association of CyberPsychology, Training, and Rehabilitation (http://iactor.ning.com)