Page 524 - Encyclopedia of Nursing Research

STReSS mAnAgemenT n 491

yielded equivocal results. Snyder (1993) crit-
StreSS management ically reviewed all 54 stress-related inter-
vention studies appearing in the nursing S
literature from 1980 through 1990. The types
Stress management is a broad term that of stress management interventions used
encompasses a wide range of methods included relaxation strategies (e.g., progres-
intended to prevent stress or effectively sive muscle relaxation, imagery, meditation,
manage it as evidenced by low levels of breathing techniques, massage, music), edu-
stress emotions and improved coping abil- cational strategies, and use of social support
ities. “Stress management interventions are groups. A major flaw of most of the inter-
deliberate actions taught to patients to help vention studies was an inadequate descrip-
achieve outcomes” (Synder, 2000, p. 179). tion of the intervention used, and there was
Coping strategies are actions self-initiated a lack of attempts to explain the theoretical
by a person to manage stress. Coping strat- link between the intervention and outcome
egies are typically categorized as direct measures. manipulation checks as a way to
action/problem focused aimed at alleviat- assure that subjects mastered the interven-
ing or decreasing the intensity of perceived tion also were lacking in the intervention
threat or palliative/emotion focused aimed studies. Studies using sensation information
at decreasing or keeping in check the inten- (e.g., Johnson, Rice, Fuller, & endress, 1978)
sity of stress emotions experienced (lazarus and studies using progressive relaxation
& Fokman, 1984). techniques (e.g., pender, 1985) have demon-
nurse researchers have studied stress strated positive effects on health-related out-
management interventions and coping strat- comes such as less anxiety and an increased
egies in various groups of people, including sense of well-being.
nurses, student nurses, and patients. It is inter- Since 1995, there has been little theo-
esting to note that majority of these studies retical knowledge gained through nursing
have been conducted by nurse researchers in research about the effectiveness of stress
european and Asian countries. Some of the management interventions or coping strat-
coping strategies frequently used by nurses to egies. The two common findings, consis-
manage stress include taking action, drawing tent with lazarus (1966) and lazarus and
on past experiences, using problem-solving Folkman (1984), are that (a) direct action or
techniques, using humor, talking over prob- problem-focused coping strategies and cog-
lems with coworkers, accepting the situation, nitive restructuring strategies are related to
taking breaks (escaping from the situation), decreased stress-related outcomes such as
using diversions, using relaxation, and exer- anxiety, other negative mood states, and an
cise (lewis & Robinson, 1986; petermann, increased sense of well-being; and (b) pallia-
Springer, & Farnsworth, 1995). Coping strate- tive or emotion-focused strategies are related
gies taken to prevent stress involve balancing to increased anxiety, other negative mood
demands and resources, focusing on the pos- states, and distress. The most common theme
itive in difficult situations, maintaining per- is that stress is a subjective phenomenon that
ceived choice and sense of personal control, is experienced differently by each person.
building social support, and viewing diffi- The most common outcomes measured as
cult situations as challenges that can bring dependent variables have been stress emo-
gain or benefit through learning (Dionne- tions such as anxiety, other negatively toned
proulz & pepin, 1993; lyon, 1996). mood states, and depression.
nursing research studies on the effects A comprehensive review of litera-
of stress management interventions with ture dated 2005–2010 revealed that both
various patient population groups have qualitative and quantitative studies have