Depression and Anxiety Are Associated with Physical Performance in Patients Undergoing Cardiac Rehabilitation: A Retrospective Observational Study

Background: Cardiac rehabilitation (CR) combined with stress management training has been shown to be associated with fewer clinical events than CR alone. However, there have been no reports on the associations of CR with the psychological condition and detailed physical activities evaluated on the same day. Method: One hundred outpatients who participated in a CR program were graded on the hospital anxiety and depression scale (HADS). We divided them into a high HADS group (n = 32) and a normal HADS group (n = 68) and investigated by whole patients, ischemic heart disease (IHD) patients, and heart failure patients. Results: Overall, the patient age was 70.5 ± 9.6 years, the percentage of males was 73.0%, and the body mass index was 23.4 (21.7–26.0) kg/m2. In the high HADS group, overall functional mobility was poor and the distance in a two-minute walking test was short. Especially in IHD patients, the high HADS group showed high fat mass in body composition and low exercise tolerance and ventilator equivalents in cardiopulmonary exercise test. Conclusions: Depression and anxiety involved poor physical performance in CR outpatients and particularly involved low exercise tolerance in IHD patients. To evaluate accurate physical performance, it is necessary to investigate psychological condition.

Pelatihan Manajemen Stress Kepada Penderita Penyakit Kronis di Desa Warisa

ABSTRAK Penyakit kronis yang telah diderita selama bertahun-tahun dapat mengganggu pada semua aspek kehidupan penderitanya seperti masalah finansial, Karir, gangguan peran, termasuk masalah psikososial, akibatnya, penderita penyakit kronis seringkali juga mengalami stress kronis yang selanjutnya dapat memperburuk penyakit dan menurunkan kualitas hidup penderitanya. Di Desa Warisa didapatkan jumlah penderita penyakit kronis sebanyak 83 Orang hanya dari 3 jaga (lingkungan). Tujuan Pengabdian Kepada Masyarakat ini adalah untuk meningkatkan pengetahuan dan kemampuan penderita penyakit kronis di Desa Warisa terkait manajemen stress melalui kegiatan pelatihan. Kegiatan ini dilakukan dengan memberikan penyuluhan terkait manajamen stress yang baik dilanjutkan dengan pelatihan manajemen stress dengan relaksasi napas dalam dan relaksasi otot progresif. Kegiatan ini diikuti oleh 29 peserta termasuk 2 kader dan dari hasil evaluasi didapatkan peningkatan pengetahuan peserta sebesar 22.4% yaitu sebelum penyuluhan (63%) dan setelah penyuluhan (85.4%). Dari hasil observasi juga didapatkan sebagian besar peserta mampu melakukan kembali gerakan latihan relaksasi otot progresif secara mandiri namun, ada 5 Peserta yang belum mampu melakukan gerakan latihan secara mandiri yang kemudian diberikan pendampingan lanjutan. Hasil dari kegiatan ini diharapkan dapat menjadi dasar pembentukan program kesehatan jiwa di puskesmas khususnya terkait pelayanan psikososial bagi penderita penyakit kronis. Kata Kunci: Manajemen stress, Penyakit kronis, Relaksasi otot progresif ABSTRACT Chronic illness that has been suffered for years can interfere with all aspects of people with chronic illness such as financial problems, career, role performance, and psychosocial aspects. as a result, People who suffer from chronic diseases often experience chronic stress that worsens disease severity and reduces the quality of life. In Warisa Village, there were 83 people who were identified with chronic diseases from only 3 hamlets. The purpose of this Community Service was to increase the knowledge and ability of People with chronic disease in Warisa Village regarding stress management through training. This activity was carried out by delivering health education related to positive stress management followed by stress management training with deep breathing relaxation and Progressive Muscle Relaxation (PMR). This activity was attended by 29 participants including 2 Cadres and from the evaluation process, it was found that the participants' knowledge increased by 22.4% in which before counseling (63%) and after counseling (85.4%). From the observations, it was also found that most of the participants were able to perform PMR independently, however, there were 5 participants who had not been able to perform PMR independently and were then given further assistance. The results of this activity are expected to be the first step to developing mental health programs in Community Health Centers, especially related to psychosocial services for people with chronic diseases. Keywords: Stress management, Chronic illness, Progressive Muscle Relaxation

Good soldier syndrome. Do organizational cynicism and work alienation matter?

PurposeThe purpose of this study is to examine the impact of organizational cynicism (OCyn) on organizational citizenship behavior (OCB) among bank employees with a focus on the role of work alienation (WA) as a potential mediator.Design/methodology/approachUsing standardized questionnaire, data were collected from 381 employees working in the banking sector of Punjab, a northern state of India. Statistical techniques such as hierarchical multiple regression and confirmatory factor analysis along with PROCESS macro were used for data analysis.FindingsResults reveal that OCyn has a significant negative effect on OCB. Further, WA is found to be significantly partially mediating the relationship between the aforementioned constructs.Research limitations/implicationsThis study pertains to a single sector i.e., banking sector restricting the generalizability to other industrial and vocational settings. Further, it may be difficult to draw any causal inferences as the research design adopted for this study is cross-sectional in nature.Practical implicationsIn order to promote OCBs among bank employees, the formation of negative workplace attitudes such as OCyn and WA needs to be regulated. This can be achieved through improving communications network, encouraging participative decision-making activities, conducting psychological counseling and stress management training sessions.Originality/valueThis study is one of the scarce empirical research works that have substantiated the direct impact along with the indirect impact of OCyn (through work alienation) on OCB among bank employees.

Emergency physicians’ experience of stress during resuscitation and strategies for mitigating the effects of stress on performance

ObjectiveThis study explored the perspectives and behaviours of emergency physicians (EPs), regularly involved in resuscitation, to identify the sources and effects of any stress experienced during a resuscitation as well as the strategies employed to deal with these stressors.MethodsThis was a two-centre sequential exploratory mixed-methods study of EPs consisting of a focus group, exploring the human factors related to resuscitation, and an anonymous survey. Between April and June 2020, the online survey was distributed to all EPs working at Australia’s largest two major trauma centres, both in Melbourne, and investigated sources of stress during resuscitation, impact of stress on performance, mitigation strategies used, impact of the COVID-19 pandemic on stress and stress management training received. Associations with gender and years of clinical practice were also examined.Results7 EPs took part in the focus group and 82 responses to the online survey were received (81% response rate). The most common sources of stress reported were resuscitation of an ‘unwell young paediatric patient’ (81%, 95% CI 70.6 to 87.6) or ‘unwell pregnant patient’ (71%, 95% CI 60.1 to 79.5) and ‘conflict with a team member’ (71%, 95% CI 60.1 to 79.5). The most frequently reported strategies to mitigate stress were ‘verbalising a plan to the team’ (84%, 95% CI 74.7 to 90.5), ‘implementing a standardised/structured approach’ (73%, 95% CI 62.7 to 81.6) and ‘asking for help’ (57%, 95% CI 46.5 to 67.5). 79% (95% CI 69.3 to 86.6) of EPs reported that they would like additional training on stress management. Junior EPs more frequently reported the use of ‘mental rehearsal’ to mitigate stress during a resuscitation (62% vs 22%; p<0.01) while female EPs reported ‘asking for help’ as a mitigator of stress more frequently than male EPs (79% vs 47%; p=0.01).ConclusionsStress is commonly experienced by EPs during resuscitation and can impact decision-making and procedural performance. This study identifies the most common sources of stress during a resuscitation as well as the strategies that EPs use to mitigate the effects of stress on their performance. These findings may contribute to the development of tailored stress management training for critical care clinicians.

THE ROLE OF WORK STRESS MANAGEMENT TRAINING ON IMPROVING THE PERFORMANCE OF FIELD OFFICERS AT GEDEBAGE BANDUNG LANDFILL

ABSTRAK Pengelolaan sampah di Kota Bandung dikelola dengan membuat beberapa tempat penampungan sementara (TPS) dan tempat pembuangan akhir (TPA). Dari sekian banyak TPS yang dinilai kinerjanya menurun adalah TPS Gedebage. Penelitian ini adalah hasil pengembangan dari pengabdian kepada masyarakat yang dilaksanakan untuk menanggulangi tingkat stress kinerja petugas lapangan pengangkut sampah. Adapun jenis penelitian adalah kuantitatif, dengan menelaah peran pelatihan penanggulangan stres kerja pada peningkatan kinerja petugas lapangan di TPA Gedebage, Bandung. Kumpulan Subyek penelitian yang ditelaah adalah petugas kebersihan lapangan di Kelurahan Cisaranteun Kidul, dengan menggunakan teknik sampel sampling jenuh diperoleh sebanyak 37 orang sampel. Dalam menganalisis data yang diperoleh, dibutuhkan data yang mempunyai tingkat akurasi yang baik dan dapat dipercaya agar hasil penelitian mampu mengambarkan kondisi yang sebenarnya terjadi pada objek penelitian, adapun penelaahan data dalam penelitian ini menggunakan teknik deskriptif dan verifikatif. Temuan dalam penelaahan yaitu pelatihan penanggulangan stres kerja yang diikuti oleh petugas lapangan angkutan sampah Perusahaan Daerah (PD) Kebersihan Kota Bandung UPT Gedebage dapat dinyatakan menurunkan tingkat stress kerja. Berdasarkan hasil penelitian secara parsial menunjukan bahwa pelatihan penanggulangan stress kerja berpengaruh signifikan terhadap kinerja petugas pada bagian pengangkutan sampah (pengemudi Triseda) yang bertugas di Kelurahan Cisaranteun Kidul, Bandung. Kata kunci: pelatihan, stress kerja, kinerja pegawai. ABSTRACT Waste management in the city of Bandung is managed by making several temporary shelters (TPS) and final disposal sites (TPA). One of the polling stations whose performance has decreased is the Gedebage TPS. This exploration is the consequence of the advancement of community service which is carried out to overcome the stress level of the performance of the waste transporter field officers. To complete this research, the method used is a quantitative method, where the object to be studied is the role of work stress management training in improving the performance of field officers at Gedebage TPA, Bandung. The populace that will be utilized in this review is the waste transportation officer (Triseda driver) on duty in Cisaranteun Kidul Village, using a saturated sampling technique, 37 samples were obtained. In analyzing the data obtained, it takes data that has a good level of accuracy and can be trusted so that the research results are able to depict the real conditions that happen in the object of research, while the data analysis techniques in this study are descriptive and verification analysis. The findings in this study are that the training for dealing with work stress, which was attended by field officers of the Regional Cleanliness Company (PD) of Bandung City, UPT Gedebage, can be stated to reduce the level of work stress. Based on the results of the partial study, it showed that the training to overcome work stress had a significant effect on the performance of officers in the waste transportation section (Triseda drivers) who served in Cisaranteun Kidul Village, Bandung. Keywords: training, job stress, employee performance.

Comparative effectiveness of guided internet-based stress management training versus established in-person group training in employees – study protocol for a pragmatic, randomized, non-inferiority trial

Background Occupational stress is a major public health challenge that requires a variety of evidence-based preventative approaches to increase their reach within the working population. Behavioral stress management interventions are considered an established approach for occupational stress prevention. Both in-person group-based stress management training (gSMT) and individual Internet-based training (iSMT) have been shown to be effective at reducing stress in employees. However, there remains a lack of evidence on the comparative efficacy of the newer digital format compared to well-established, in-person, group-based training. This study aims (1) to directly compare an evidence-based iSMT with an established gSMT on stress in employees, (2) to analyze the two conditions from a cost perspective, and (3) to explore moderators of the comparative efficacy. Methods In a randomized, controlled, non-inferiority trial employees from the general working population will be allocated to iSMT or gSMT. The primary outcome will be perceived stress, assessed using the Perceived Stress Scale, three months after randomization. The non-inferiority margin for the primary outcome measure will be set at 2 points (Cohen’s d = 0.29). This trial will also compare the two interventions from a health economics perspective, and conduct explorative analyses to identify potential effect moderators. Discussion To reach a larger proportion of the working population, well-established gSMT should be complemented with interventions that fit today’s society’s increasingly digital lifestyle. The current trial will provide evidence supporting the responsible implementation of Internet-based stress management training if the digital format proves to at least be non-inferior to established group-based training. Additional explorative moderator analyses may guide future practices to aid in matching select programs with select users. Trial registration German Register of Clinical Studies (DRKS): DRKS00024892, date of registration: 2021-04-09. Protocol version: 02, 16-10-2021.

The impact of stress management training on stress-related coping strategies and self-efficacy in hemodialysis patients: a randomized controlled clinical trial

Introduction Dialysis causes many psychological and social problems, such as stress and inefficiency in patients, which should be considered in health promotion interventions. Therefore, this study aimed to determine the impact of stress management training on stress coping strategies and the self-efficacy of these patients in southeastern Iran. Methods This quasi-experimental study was a randomized controlled clinical trial was conducted on hemodialysis patients from December 2019 to January 2020. Patients who met inclusion criteria were selected with the convenience sampling method and divided into the two groups of intervention (n = 30) and control (n = 30) by using the block randomization method. Participants in the intervention group were trained in a stress management training program in 8 one-and-a-half-hour sessions, held twice a week. Data were measured with stress coping strategies and general self-efficacy questionnaires before, immediately, and 1 month after the intervention. SPSS18 was used for data analysis. Results The study results showed that the scores of stress coping strategies and the self-efficacy score in all their dimensions were significantly different between the intervention and control groups (P < 0.001). Conclusion The present study results showed that stress management training programs promoted stress coping strategies and self-efficacy in hemodialysis patients. Health planners and nurses are recommended to use these easy, feasible, and inexpensive interventions to reduce stress and increase self-efficacy. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20160914029817N10. Date of registration: October 7, 2021. URL: https://en.irct.ir/trial/58540. Registration timing: a retrospective.

Stress among pediatric oncology staff. A systematic review

Cancer is considered one of the dominant life-threatening diseases in children. Working in the field of pediatric oncology, although rewarding, can be a source of stress and emotional burden for health care providers. The aim of this systematic review was to summarise the evidence regarding the occupational stress of health care providers working with pediatric cancer patients. Extensive search of the Pubmed and Scopus databases was performed to identify studies relevant to the topic. Initial search retrieved 657 studies. The reviewing investigators, after applying the inclusion/exclusion criteria, extracted data to critically appraise the quality of evidence. The final step of search concluded in 23 studies of heterogeneous design. Results revealed two main domains of which occupational stress derived from i) the interaction of the health care provider with the patient and the family, and ii) several organisational factors, such as hierarchical structures, experience, workload, and low organisational support. Literature on the stress of pediatric oncology staff is limited. The rather small sample sizes of the studies, the heterogeneity of methodological design, the lack of assessment from a sociological point of view, as well as the limited psychometric instruments adapted to pediatric oncology staff, make the validity of the results questionable. Further research is warranted to obtain a more accurate view of the field, to identify a cause-effect relation between work-related stress and pediatric oncology staff, and, more importantly, to guide future recommendations on support systems and stress management training within pediatric oncology settings.