Biofeedback Intervention for Stress and Anxiety among Nursing Students: A Randomized Controlled Trial

Paul Ratanasiripong, Nop Ratanasiripong, Duangrat Kathalae, Paul Ratanasiripong, Nop Ratanasiripong, Duangrat Kathalae

Abstract

Purpose. It has been well documented that nursing students across the world experience stress and anxiety throughout their education and training. The purpose of this randomized controlled study is to investigate the impact of biofeedback intervention program on nursing students' levels of stress and anxiety during their first clinical training. Methods. Participants consisted of 60 second-year baccalaureate nursing students. The 30 participants in the biofeedback group received training on how to use the biofeedback device to assist in stress and anxiety management for 5 weeks while the 30 in the control group did not receive any training. Findings. Results indicated that the biofeedback group was able to maintain the stress level while the control group had a significant increase in the stress level over the 5-week period of clinical training. Additionally, the biofeedback group had a significant reduction in anxiety, while the control group had a moderate increase in anxiety. Conclusions. The better the nursing students can manage their stress and anxiety, the more successful they can be in their clinical training. Ultimately, the more psychologically healthy the nursing students are, the more likely they will flourish and graduate to become productive and contributing members of the nursing profession.

Figures

Figure 1
Figure 1
Pre- and postintervention mean scores for Perceived Stress Scale.
Figure 2
Figure 2
Pre- and postintervention mean scores for State Anxiety Scale.

References

    1. Beck DL, Srivastava R. Perceived level and sources of stress in baccalaureate nursing students. Journal of Nursing Education. 1991;30(3):127–133.
    1. Cook LJ. Inviting teaching behaviors of clinical faculty and nursing students’ anxiety. Journal of Nursing Education. 2005;44(4):156–161.
    1. Junious DL, Malecha A, Tart K, Young A. Stress and perceived faculty support among foreign-born baccalaureate nursing students. Journal of Nursing Education. 2010;49(5):261–270.
    1. Kang YS, Choi SY, Ryu E. The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. Nurse Education Today. 2009;29(5):538–543.
    1. Ratanasiripong P, Wang CCDC. Psychological well-being of Thai nursing students. Nurse Education Today. 2011;31(4):412–416.
    1. Suliman WA, Halabi J. Critical thinking, self-esteem, and state anxiety of nursing students. Nurse Education Today. 2007;27(2):162–168.
    1. Tully A. Stress, sources of stress and ways of coping among psychiatric nursing students. Journal of Psychiatric and Mental Health Nursing. 2004;11(1):43–47.
    1. Admi H. Nursing Students’ Stress during the Initial Clinical Experience. Journal of Nursing Education. 1997;36(7):323–327.
    1. Chan CKL, So WKW, Fong DYT. Hong Kong baccalaureate nursing students' stress and their coping strategies in clinical practice. Journal of Professional Nursing. 2009;25(5):307–313.
    1. Mahat G. Stress and coping: junior baccalaureate nursing students in clinical settings. Nursing Forum. 1998;33(1):11–19.
    1. Moscaritolo LM. Interventional strategies to decrease nursing student anxiety in the clinical learning environment. Journal of Nursing Education. 2009;48(1):17–23.
    1. Sharif F, Masoumi S. A qualitative study of nursing student experiences of clinical practice. BMC Nursing. 2005;4, Article 6
    1. Zupiria Gorostidi X, Huitzi Egilegor X, Jose Alberdi Erice M, et al. Stress sources in nursing practice. Evolution during nursing training. Nurse Education Today. 2007;27(7):777–787.
    1. Godbey KL, Courage MM. Stress-management program: intervention in nursing student performance anxiety. Archives of Psychiatric Nursing. 1994;8(3):190–199.
    1. Jones MC, Johnston DW. Evaluating the impact of a worksite stress management programme for distressed student nurses: a randomised controlled trial. Psychology and Health. 2000;15(5):689–706.
    1. Heaman D. The quieting response (QR): a modality for reduction of psychophysiologic stress in nursing students. Journal of Nursing Education. 1995;34(1):5–10.
    1. American Institute of Stress, Definition of Stress, 2012, .
    1. Spielberger CD. Manual for the State-Trait Anxiety Inventory (Form Y) Palo Alto, Calif, USA: Consulting Psychologists Press; 1983.
    1. Mimura C, Murrells T, Griffiths P. The association between stress, self-esteem and childhood acceptance in nursing and pharmacy students: a comparative cross-cultural analysis. Stress and Health. 2009;25(3):209–220.
    1. Yucha CB, Kowalski S, Cross C. Student stress and academic performance: home hospital program. Journal of Nursing Education. 2009;48(11):631–637.
    1. Melo K. Clinical Practice Anxiety among Third Year Baccalaureate Nursing Students in CBL and Those in Traditional Curricula. ProQuest Dissertations & Theses Database; 2008.
    1. Jimenez C, Navia-Osorio PM, Diaz CV. Stress and health in novice and experienced nursing students. Journal of Advanced Nursing. 2010;66(2):442–455.
    1. Shipton SP. The process of seeking stress-care: coping as experienced by senior baccalaureate nursing students in response to appraised clinical stress. Journal of Nursing Education. 2002;41(6):243–256.
    1. Biofeedback Certification International Alliance, Overview of Biofeedback, 2012, .
    1. Yucha C, Montgomery D. Evidenced-Based Practice in Biofeedback and Neurofeedback. Wheat Ridge, Colo, USA: Association for Applied Psychophysiology and Biofeedback; 2008.
    1. Leboeuf A. The effects of EMG feedback training on state anxiety in introverts and extraverts. Journal of Clinical Psychology. 1977;33(1):251–253.
    1. Ohkuma Y. Effects of evoking imagery on the control of peripheral skin temperature. Japanese Journal of Psychology. 1983;54(2):88–94.
    1. Utz SW. The effect of instructions on cognitive strategies and performance in biofeedback. Journal of Behavioral Medicine. 1994;17(3):291–308.
    1. Prato CA. Biofeedback Assisted Relaxation Training Program to Decrease Test Anxiety in Nursing Students. ProQuest Dissertations & Theses Database; 2009.
    1. Ratanasiripong P, Sverduk K, Hayashino D, Prince J. Setting up the next generation biofeedback program for stress and anxiety management for college students: a simple and cost-effective approach. College Student Journal. 2010;44:97–100.
    1. Erdfelder E, Faul F, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior Research Methods. 2009;41(4):1149–1160.
    1. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. Journal of Health and Social Behavior. 1983;24(4):385–396.
    1. Birks Y, McKendree J, Watt I. Emotional intelligence and perceived stress in healthcare students: a multi-institutional, multi-professional survey. BMC Medical Education. 2009;9(1, article 61)
    1. Reilly JER, Fitzpatrick JJ. Perceived stress and sense of belonging in doctor of nursing practice students. Journal of Professional Nursing. 2009;25(2):81–86.
    1. Kanji N, White A, Ernst E. Autogenic training to reduce anxiety in nursing students: randomized controlled trial. Journal of Advanced Nursing. 2006;53(6):729–735.
    1. Ross R, Zeller R, Srisaeng P, Yimmee S, Somchid S, Sawatphanit W. Depression, stress, emotional support, and self-esteem among baccalaureate nursing students in Thailand. International Journal of Nursing Education Scholarship. 2005;2, Article 25
    1. Beddoe AE, Murphy SO. Does mindfulness decrease stress and foster empathy among nursing students? Journal of Nursing Education. 2004;43(7):305–312.

Source: PubMed

3
購読する