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Int J Nurs Pract. 2019 Nov 13:e12788. doi: 10.1111/ijn.12788. [Epub ahead of print]

Distraction-focused interventions on examination stress in nursing students: Effects on psychological stress and biomarker levels. A randomized controlled trial.

Author information

1
FHG - Zentrum für Gesundheitsberufe Tirol GmbH, Innsbruck, Austria.
2
Ausbildungszentrum West für Gesundheitsberufe der Tirol Kliniken GmbH, Innsbruck, Austria.
3
Medizinische Universität Innsbruck, Innsbruck, Austria.
4
IMC Fachhochschule Krems, Krems, Austria.

Abstract

BACKGROUND:

Nursing students all over the world experience high levels of stress with negative impacts on their health, emotional state and performance.

AIM:

This study aimed to investigate the effects of distraction-focused interventions on examination stress and anxiety in nursing students.

METHODS:

A randomized controlled, parallel trial design was conducted from January to June 2016. After baseline measurement, 72 participants were randomized to one of the following groups (n = 18 each): (i) animal-assisted therapy; (ii) music therapy; (iii) mandala painting; (iv) control group. Outcomes of all groups in terms of stress-reduction were compared by measuring self-reported perceived stress (STAI-State and visual analogue stress scale) and salivary biomarker levels (Cortisol and Immunoglobulin A).

RESULTS:

Fifty-seven complete data sets (n = 12-16 for each group) were analysed. All distraction-focused interventions showed stress and anxiety reduction in everyday school situations. By contrast, on days with examinations, stress reductions did not reach statistical significance in regard to self-reported psychological stress. At the same time, interventions resulted in significantly decreased levels of stress biomarkers (P < .001).

CONCLUSIONS:

Our preliminary findings suggest positive but situation-dependent effects of distraction-focused interventions in academic settings. Further research should investigate the complex relationship between physiological and psychological stress parameters.

KEYWORDS:

anxiety; distraction; nursing; physiological stress; psychological stress; randomized controlled trial

PMID:
31724291
DOI:
10.1111/ijn.12788

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