LO39: Stress inoculation training: a critical review for emergency medicine

Introduction: In high stakes, performance-oriented professions, the ability to execute in stressful situations is both a prerequisite and an intense focus of training. Stress Inoculation Training (SIT) is a three-step cognitive-behavioural intervention aimed at reducing stress that may play a role in helping EM teams prepare for high acuity events. We conducted a systematic review of literature in medicine and performance-oriented professions to inform the development of an EM-focused SIT curriculum. Methods: An electronic search of Ovid MEDLINE, Web of Science Core Collection, PsychINFO, ProQuest and Scopus was conducted. Inclusion criteria were studies investigating the impact of stress inoculation training on performance and anxiety reduction. Data extraction included recording of performance and anxiety domains measured in each study and the details of how the stress inoculation training was delivered. Screening of articles, data extraction, and summarization were conducted by two independent reviewers using a standardized data extraction tool. Results: Our search yielded 431 studies; 40 were screened for full-text review and 10 met inclusion criteria. A total of 930 trainees throughout the 10 studies were enrolled. Four studies consisted of students in varying disciplines, including law, technology, education, and general undergraduate students, and 4 studies were composed of military personnel. No papers directly examined the effect of stress inoculation training on performance in healthcare. A change in performance and a reduction in anxiety and/or stress was noted in 90% of studies. Training length, experience of trainer, or group size did not appear to impact outcomes. Notably, heart rate variability (HRV) did not appear to be affected throughout the studies included, while cortisol and subjective stress were consistently reduced. Conclusion: SIT is an effective tool for enhancing performance and reducing stress and anxiety in high intensity environments. Studies examining the effect of EM-focused SIT on individual, team and patient-orient outcomes are needed.

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Impact on Decisions to Start or Continue Medicines of Providing Information to Patients about Possible Benefits and/or Harms

Medical Decision Making ◽

10.1177/0272989x11400420 ◽

2011 ◽

Vol 31 (5) ◽

pp. 767-777 ◽

Cited By ~ 5

Author(s):

Rachel A. Crockett ◽

Stephen Sutton ◽

Fiona M. Walter ◽

Megan Clinch ◽

Theresa M. Marteau ◽

...

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Data Extraction ◽

Decisional Conflict ◽

Mean Difference ◽

Data Sources ◽

Inclusion Criteria ◽

Data Synthesis ◽

Study Selection ◽

The Impact

Background. The impact of providing information about medicines to patients on decisions about starting or continuing them is unknown. Purpose. To estimate the impact on decisions to start or continue medicines, of providing information to patients about possible benefits and/or harms. Data Sources. Electronic searches from 1980 to October 2010; reference and citation searches of included studies. Study Selection. Two investigators assessed studies' eligibility against inclusion criteria: randomized or pseudorandomized trials; participants older than 16 years and deciding for themselves; one group received information about possible benefits and/or harms of a potentially beneficial medicine, compared with another who did not; d) a measure of decision about starting or continuing a medicine. Data Extraction. One investigator extracted all data, checked by a second. Data Synthesis. Eight studies were included, covering a range of medicines. There was no consistent impact of interventions on decisions about whether to start or continue medicines (pooled odds ratio 1.08; 95% confidence interval [CI], 0.69–1.70; P = 0.74). Among those who received more information, knowledge was increased (pooled mean difference 8.47; 95% CI 2.17–14.77; P = 0.008), and decisional conflict was reduced (pooled mean difference -0.15; 95% CI -0.24 to -0.06; P = .001). Limitations. A small number of studies across different clinical contexts, of uncertain heterogeneity, were included. Conclusions. Providing information to patients about possible benefits and/or harms has no consistent effect on the number who decide to start or continue medicines, although it increases patients' knowledge and reduces their decisional conflict.

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Effects of exercise-based prehabilitation in children undergoing elective surgeries: a systematic review

F1000Research ◽

10.12688/f1000research.74493.2 ◽

2022 ◽

Vol 10 ◽

pp. 1262

Author(s):

Jean Noronha ◽

Stephen Samuel ◽

Vijay Pratap Singh ◽

H Shivananda Prabhu

Keyword(s):

Outcome Measures ◽

Exercise Intervention ◽

Data Extraction ◽

Controlled Trial ◽

Pulmonary Complications ◽

Anxiety Reduction ◽

Postoperative Outcomes ◽

Inclusion Criteria ◽

Randomized Controlled ◽

Post Surgery

Background: Prehabilitation is a therapeutic strategy involving preoperative physical exercises, nutritional support, and stress and anxiety reduction. This approach has been gaining popularity and has been seeing effective results in adults in terms of improving pre and postoperative outcomes. The purpose of this review was to summarise the evidence about the effects of exercise-based prehabilitation programs on various outcome measures in children post elective surgeries. Methods: PubMed, Scopus, Web of Science, PEDro, CINAHL/EBSCO and EMBASE electronic databases were searched from inception to June 2021. Based on the inclusion criteria, titles and abstracts were independently screened by the authors. After that, a data extraction table of the selected studies which included the participants, type, and details of exercise intervention, outcome measures and results were analysed after which the quality assessment of the studies was done. Results: The search yielded 2219 articles of which three articles fulfilled the inclusion criteria with two studies being randomized controlled trials and one being a quasi-experimental pre-post type of study. One randomized controlled trial was on the effects of exercise-based prehabilitation in reducing pulmonary complications post cardiac surgeries in children and the other two studies were on the effects of prehabilitation on functional capacity & pulmonary function. All the three articles found that exercise-based prehabilitation had a positive effect on children’s post-surgery. Conclusion: Although there is a paucity of evidence-based literature, we conclude based on the existing literature retrieved by our review that exercise-based prehabilitation improves postoperative outcomes and helps in reducing postoperative complications in children undergoing various surgeries.

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The Impact of Stress Inoculation Training on Cognitive Emotion Regulation and Psychological Problems of the Mothers of Blind Children

Quarterly Journal of Child Mental Health ◽

10.52547/jcmh.8.1.4 ◽

2021 ◽

Vol 8 (1) ◽

pp. 27-42

Author(s):

Ehsan Bahramfar ◽

Mohammad Ashori ◽

◽

Keyword(s):

Emotion Regulation ◽

Psychological Problems ◽

Stress Inoculation ◽

Cognitive Emotion Regulation ◽

Stress Inoculation Training ◽

Blind Children ◽

The Impact

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Area deprivation measures used in Brazil

Revista de Saúde Pública ◽

10.11606/s1518-8787.2018052000933 ◽

2018 ◽

Vol 52 ◽

pp. 83 ◽

Cited By ~ 1

Author(s):

Maria Yury Travassos Ichihara ◽

Dandara Ramos ◽

Poliana Rebouças ◽

Flávia Jôse Oliveira ◽

Andrêa J. F. Ferreira ◽

...

Keyword(s):

Health Research ◽

Small Area ◽

Data Extraction ◽

Public Health Research ◽

Area Deprivation ◽

Inclusion Criteria ◽

Small Areas ◽

Country Level ◽

The Impact ◽

Deprivation Measure

OBJECTIVE: To describe and assess currently used area-based measures of deprivation in Brazil for health research, to the purpose of informing the development of a future small area deprivation index. METHODS: We searched five electronic databases and seven websites of Brazilian research institutions and governmental agencies. Inclusion criteria were: studies proposing measures of deprivation for small areas (i.e., finer geography than country-level) in Brazil, published in English, Portuguese or Spanish. After data-extraction, results were tabulated according to the area level the deprivation measure was created for and to the dimensions of deprivation or poverty included in the measures. A narrative synthesis approach was used to summarize the measures available, highlighting their utility for public health research. RESULTS: A total of 7,199 records were retrieved, 126 full-text articles were assessed after inclusion criteria and a final list of 30 articles was selected. No small-area deprivation measures that have been applied to the whole of Brazil were found. Existing measures were mainly used to study infectious and parasitic diseases. Few studies used the measures to assess inequalities in mortality and no studies used the deprivation measure to evaluate the impact of social programs. CONCLUSIONS: No up-to-date small area-based deprivation measure in Brazil covers the whole country. There is a need to develop such an index for Brazil to measure and monitor inequalities in health and mortality, particularly to assess progress in Brazil against the Sustainable Development Goal targets for different health outcomes, showing progress by socioeconomic groups

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The Effectiveness of Stress Inoculation Training in Reducing Stress on Intensive Care Nurses

Proceedings of the 3rd International Conference on Psychology in Health, Educational, Social, and Organizational Settings ◽

10.5220/0008586801680173 ◽

2018 ◽

Author(s):

Aufa Putri Suryanto ◽

Ilham Nur Alfian

Keyword(s):

Intensive Care ◽

Stress Inoculation ◽

Stress Inoculation Training ◽

Intensive Care Nurses ◽

Reducing Stress

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The Impact of a Cognitive Behavioral Group Counseling Program Based on Stress Inoculation Training on Reducing Posttraumatic Stress among a Sample of Students from Al al-Bayt University

Journal of Educational and Psychological Studies [JEPS] ◽

10.24200/jeps.vol7iss2pp122-132 ◽

2013 ◽

Vol 7 (2) ◽

pp. 122

Author(s):

Yusef M. Migdady

Keyword(s):

Traumatic Stress ◽

Group Counseling ◽

Stress Inoculation ◽

Counseling Program ◽

Post Traumatic Stress ◽

Stress Inoculation Training ◽

Behavioral Group ◽

Post Traumatic ◽

The Impact ◽

Experimental Group

The aim of this study was to examine the impact of a cognitive behavioral group counseling program based on stress inoculation training in reducing post-traumatic stress among a sample of students from Al al-Bayt University. The sample of the study consisted of 16 students who achieved the highest score on a scale for post-traumatic stress disorder. These students were distributed randomly into two groups: experimental group consisting of 8 students (2 males and 6 females) and a control group consisting of 8 students (3 males and 5 females). The researcher used the experimental method; the application of the program took four weeks with two meetings per week. Analysis of covariance (ANCOVA) was used to know the experimental treatment effect on post-traumatic stress. The results showed statistically significant differences between the experimental and control groups, favoring the experimental group, on all dimensions of the scale. The study concluded that the counseling program -based on stress inoculation training- was effective in reducing post-traumatic stress.

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Effects of exercise-based prehabilitation in children undergoing elective surgeries: a systematic review

F1000Research ◽

10.12688/f1000research.74493.1 ◽

2021 ◽

Vol 10 ◽

pp. 1262

Author(s):

Jean Noronha ◽

Stephen Samuel ◽

Vijay Pratap Singh ◽

H Shivananda Prabhu

Keyword(s):

Outcome Measures ◽

Exercise Intervention ◽

Data Extraction ◽

Controlled Trial ◽

Pulmonary Complications ◽

Anxiety Reduction ◽

Postoperative Outcomes ◽

Inclusion Criteria ◽

Randomized Controlled ◽

Post Surgery

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The Impact of TimeSlips on Undergraduate Students in Service Learning With Older Adults

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00171 ◽

2020 ◽

pp. 1-8

Author(s):

Sabine Heuer

Keyword(s):

Older Adults ◽

Service Learning ◽

Undergraduate Students ◽

Attitude Scale ◽

Evidence Based ◽

Attitudes Toward Older Adults ◽

Students Attitudes ◽

Attitude Shift ◽

The Impact ◽

Journal Entries

Purpose Future speech-language pathologists are often unprepared in their academic training to serve the communicative and cognitive needs of older adults with dementia. While negative attitudes toward older adults are prevalent among undergraduate students, service learning has been shown to positively affect students' attitudes toward older adults. TimeSlips is an evidence-based approach that has been shown to improve health care students' attitudes toward older adults. The purpose of this study is to explore the change in attitudes in speech-language pathology students toward older adults using TimeSlips in service learning. Method Fifty-one students participated in TimeSlips service learning with older adults and completed the Dementia Attitude Scale (DAS) before and after service learning. In addition, students completed a reflection journal. The DAS data were analyzed using nonparametric statistics, and journal entries were analyzed using a qualitative analysis approach. Results The service learners exhibited a significant increase in positive attitude as indexed on the DAS. The reflective journal entries supported the positive change in attitudes. Conclusions A noticeable attitude shift was indexed in reflective journals and on the DAS. TimeSlips is an evidence-based, patient-centered approach well suited to address challenges in the preparation of Communication Sciences and Disorders students to work with the growing population of older adults.

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