Category: Stress

Psychological Therapies Research: Quantitative or Qualitative

Posttraumatic stress disorder (PTSD) treatment may be approached from both a psychotherapy and pharmacology standpoint. Psychological treatments of PTSD for adults have been highly recommended in the scholarly literature and the Veterans Health Administration and Department of Defense (VA/DoD) guidelines (Watkins et al., 2018). The nature of these recommendations is based on both qualitative and quantitative research. Watkins et al. (2018) conducted a meta-review of clinical, veteran, and military sample studies to demonstrate that patients prefer psychotherapy over medication alone. Interestingly, Watkins et al. (2018) note that the guidelines and research addressing specific medication for PTSD as a sole symptom treatment tend to approach the issue quantitatively. In contrast, many of the studies on therapy effects have used qualitative methods to study its effects (Watkins et al., 2018). Overall, qualitative research on the topic of using psychotherapy over medication alone prevailed over quantitative research.

Qualitative Research Advantages

The fundamental distinction between quantitative and qualitative research lies in the type of information one can obtain. Quantitative research in nursing is used to test a hypothesis or precisely measure a phenomenon, whereas qualitative research aids in understanding the thoughts or lived experiences of the target patient group (Rutberg & Bouikidis, 2018). Qualitative studies focus on exploring preferences, feelings, and perceptions, which will be more beneficial given the PICOT question that focuses on the feedback from PTSD patients about their treatment. Moreover, Rutberg & Bouikidis (2018) recommend selecting qualitative research if there is a desire to explore a presently understudied research topic. Qualitative research may provide a wealth of rich narratives from the surveyed patients, thereby allowing to uncover and address any hidden problems comprehensively. Therefore, the advantage of qualitative research, in this case, relates to the ability to investigate patients’ PTSD treatment experiences and uncover their meanings.

References

Rutberg, S., & Bouikidis, C. D. (2018). Focusing on the fundamentals: A simplistic differentiation between qualitative and quantitative research. Nephrology Nursing Journal, 45(2), 209–212.

Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258.

Introduction

In the introduction, we provide background information on the contagious COVID-19 pandemic, focusing on a recognizable demographic: hospital-based nurses dealing with stress, anxiety, and burnout. It collects and assesses prior COVID-19 research and the experiences of nurses adjusting to increased workloads. It first introduces the concept of evidence-based practice (EBP). Melnyk and Fineout-Overhold (2022) defined EBP as making decisions and providing patient care based on the most compelling research findings. The systematic application of EBP has been shown to improve patient outcomes and healthcare quality. The difficulties faced by nurses experiencing comparable levels of stress, despair, and physical suffering were highlighted in this article, which drew parallels between the current pandemic and the 2003 SARS epidemic. This research is significant because it bridges the gap between previous research and current knowledge.

Aims of the Research

The issue is discussed with a specific group of nurses who worked at the hospital suffering from stress, anxiety, and burnout. The introduction uses negative descriptive terms to explain the history of infectious pandemics. It overviews relevant past studies on the COVID-19 condition and the backdrop of nurses dealing with growing workloads. The objectives for each of the three criteria are clearly stated, with the author explaining the aims to the reader well throughout the content in the article’s title, abstract, and introduction.

Methodology

The qualitative technique used in the study is suitable for the research questions. The techniques portion of this article contains enough information, including diagrams and simple language, to accurately reproduce this research using the same equipment and under similar conditions. The qualitative method captures changing attitudes within the target group, provides a flexible approach, and is associated with fewer limitations than the quantitative methodology (O’Connor & Joffe, 2020). The qualitative technique allows the key questions to be answered and, eventually, supported conclusions to be formed.

Research Design

The researcher took a reasonable path in preparation, data collection and analysis, and conclusions derivation. Eighty nurses, predominantly women aged 18 to 65, who worked at a university hospital in Turkey and cared for COVID-positive patients were recruited (Dincer & Inangil, 2021). It was carried out with a good sample size, in line with acknowledged research ethics, and per Covid-19’s health policy criteria. This study appears to be real and trustworthy, of excellent quality since the purpose was clearly stated, and the research methodology is appropriate for the investigation. Additionally, random controlled trials could reduce bias by comparing two otherwise equal groups while blinding one. This study, which is objective, controlled, and rich in first-hand observations and experience, improves theoretical understanding of nursing culture by applying research knowledge and impact.

Techniques for Recruiting

This study was carried out in a university hospital in Turkey by nurses caring for COVID-19 patients throughout May 2020. To participate, the nurses had to meet several requirements. Firstly, no participant was expected to have any mental disorder (Dincer & Inangil, 2021). Second, it was not expected that the individual would have attended or been attending any stress and anxiety management classes. Finally, individuals’ permission to participate in the study was requested. This shows excitement and guarantees that a larger proportion of participants would complete the study. The recruitment strategy was, therefore, thorough and resulted in the selection of passionate persons for the study.

Data Collection

Zoom was utilized to conduct interviews, while Survey Monkey was used to gather online data. These two data collection strategies suit the study’s context and aims. Accessing internet resources was the best option because the study was conducted during a dangerous period. The data was gathered using inventories such as the State-Trait Anxiety, the Subjective Units of Distress scale, and the Descriptive Characteristics Form (Dincer & Inangil, 2021). Survey Monkey’s electronic self-access function and the restriction of repetitive data submissions from the same individual simplified data gathering and tracking (Abd Halim et al., 2018). To obtain anonymous replies, electronic and IP address records were fully deactivated to maintain secrecy.

Relationship between Researcher and Participants

The relationship between the participant and the researcher was closely monitored throughout the investigation. The researcher, therefore, ensured the nurses participated willingly, allowing each participant to leave at will. Only 72 completed the study, and 80 were recruited (Dincer & Inangil, 2021). Personal space was therefore offered, respecting all participants’ feelings and will as a requirement, according to Polgar and Thomas (2011). Additionally, the researcher protected the participant by choosing methods like zoom interviews to avoid spreading the Covid 19 virus. Although the Rosenthal effect is a disadvantage of a randomized controlled study, all participants were treated identically to give a sense of belonging.

Ethical Considerations

Researchers acted ethically since the essential ethical principles of informed consent and self-determination (the freedom to choose whether or not to participate) were addressed. Participants understood the study’s aim, risks, and planned use of the collected data. The researcher followed scientific excellence and quality standards and was certified to utilize the Emotional Freedom Technique, which eliminates risk to the greatest degree possible (Stapleton et al., 2020). The right to privacy and confidentiality was protected, ensuring that no one was coerced into participating and that everyone was informed of the scope of the study. Additionally, this instills trust in the participants by notifying them that their information would not be shared with third parties in line with the consent agreements.

Data Analysis

There was no risk of analytical bias because the data was meticulously collected. The analysis was carried out by an uninformed researcher of the researchers’ group designations. As a result, the chance of the analysis favoring some components over others was minimal. The Statistical Package for Social was used to analyze the data (Dincer & Inangil, 2021). The data showed a non-normal distribution, according to the Shapiro-Wilks test. Tools such as the Pearson Chi-Square test were used for the statistical analysis. Overall, the data analysis, in this case, was outstanding, indicating confidence in the result.

Statement of Findings

The researcher presented the findings clearly and transparently to communicate the results to the readers. The researcher offers analytical aspects that explain how various results were reached in addition to explanation. Finally, the intervention group had statistically significant stress, anxiety, and burnout decreases, all at (p.001). The control group did not show significant changes in the measured parameters. According to the findings, an online group intervention employing EFT decreased stress, anxiety, and burnout.

Conclusions and Purpose

This study stresses the necessity for an intervention to improve nurses’ job experiences. Nurses face significant physical and emotional pressures as the first line of defense in the fight against COVID-19, which may harm their mental health. After only one session of short, online group psychotherapy employing EFT, the problems were considerably eased. It is a simple and quick technique that nurses anywhere in the world can use to treat COVID-19, but there are still many unanswered questions, including how long the effects will last. Furthermore, the study serves as a foundation or pilot study for future research in the same field. The findings of this article might be used in future studies to provide more conclusive and accurate results.

References

Abd Halim, M., Foozy, C. F. M., Rahmi, I., & Mustapha, A. (2018). A review of live survey application: SurveyMonkey and SurveyGizmo. JOIV: International Journal on Informatics Visualization, 2(4-2), 309-312.

Dincer, B., & Inangil, D. (2021). The effect of emotional freedom techniques on nurses’ stress, anxiety, and burnout levels during the covid-19 pandemic: A randomized controlled trial. Explore, 17(2), 109-114.

Melnyk, B. M., & Fineout-Overhold, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.

O’Connor, C., & Joffe, H. (2020). Intercoder reliability in qualitative research: debates and practical guidelines. International journal of qualitative methods, 19, 1609406919899220.

Polgar, S., & Thomas, S. A. (2011). Introduction to research in the health sciences e-book. Elsevier Health Sciences.

Stapleton, P., Crighton, G., Sabot, D., & O’Neill, H. M. (2020). Reexamining the effect of emotional freedom techniques on stress biochemistry: A randomized controlled trial. Psychological Trauma: Theory, Research, Practice, and Policy, 12(8), 869.

The case analysis started with the presentation of a 40-year-old woman who was given a RA diagnosis 18 months prior. She had been doing well on her medication regime for more than a year when she came in for a follow-up selection with her well-being expert because she began facing flare-ups two months ago that were accompanied by hand pain and edema (“PRIME® Clinical Case Study,” n.d.). The patient had a promotion during the same period as her arc and was experiencing significant pressure at work.

The study also covered the epidemiological and pathophysiology of RA and looked at data linking psychological trauma to the emergence and aggravation of the clinical disease. According to the available research, perceived stress of any kind was linked to an annoyance or severity of RA signs such as edema and discomfort in the joints, increased synovial inflammation, and alterations in the degrees of inflammatory indicators (“PRIME® Clinical Case Study,” n.d.). The goal of the example reading was to determine whether developmental therapies that address stresses may substantially decrease disease severity and manifestations and enhance the patient’s quality of life in light of these findings relating RA symptoms to stress levels.

These were the major conclusions from the study on the impact of various behavioral and psychological approaches to stress mitigation that McCray and Agarwal analyzed in a 2011 study. First, p psychological and behavioral stress reduction techniques cannot replace a standard treatment plan for patients with reasonable to more severe RA (“PRIME® Clinical Case Study,” n.d.). Secondly, nonpharmacological therapies can lessen illness symptoms when employed as supplemental therapy. Finally, future study is essential to evaluate the advantages of both behavior and mental stress treatments.

Sampling Method

Focused model size was executed, a subset of the non-sampling strategy. The greatest predominant tactic is the one selected, in which respondents are carefully chosen grounded on pre-determined benchmarks, which includes tracing and choosing personalities who are skillful concerning or have particular knowledge with a subject of concern (Chien, 2019). The experimental participants in this subject were chosen since they all had a problem-solving of RA and were partaking in a non – pharmacologic, behavioral strain reduction program.

Concerns Regarding Reliability and Validity

The extent to which the apparatus assesses what it is designed to consider is a significant criterion in reviewing an experiment. It is typically described as the following inquiry: “To what notch do the study conclusions provide the correct response?” distinction and reliability identical to repeatability, consistency, and trustworthiness. The idea is that any significant outcome must be necessarily reproducible. Concerning validity, the scenario learning has some apprehensions because the metrics being studied need to indicate definitively what they are trying to measure (Chien, 2019). When the impacts of developmental distress treatments on RA patients were inspected, the outcomes showed a decrease in pressure, worry, and, to a slighter degree, the client’s ability to cope discomfort.

Some studies indicate a decrease in musculoskeletal problems, but they were unpredictable. The study also has dependability problems, as the findings are not frequently reproduced (Chien, 2019). When the outcomes of developmental stress reduction treatments were scrutinized, it was learnt that specific categories of patients displayed some changes in their signs while others did not. The current works yields inconsistent consequences. Further study is needed to define the direct influence of anxiety on RA manifestations advantages patients get from pharmacologic and nonpharmacological stress management

Defects and Inconsistencies in the Study

This writer contends that complications and illogicalities were apparent from the beginning of this examination. An underlying reason for the study of alleged RA pathogenic causes should have been encompassed while identifying the connection amid stress and RA. Moreover, the norms of dependability and validity are vital pillars of investigation (Chien, 2019). As stated in the previous portion of this report, this study has concerns with both relevance and consistency. The survey did not disregard additional fundamental linkages, did not use panels, and provided unpredictable results, considering the study unlawful and undependable.

References

Chien, L.-Y. (2019). Evidence-based practice and nursing research. Journal of Nursing Research, 27(4), 50–59. Web.

PRIME® Clinical Case Study: Stress management for patients with rheumatoid arthritis. (n.d.) Web.

Introduction

The narrative presented in Victor’s case shows that he meets the DSM-5 criteria for Posttraumatic Stress Disorder (PTSD). PTSD refers to the consistent maladaptive response that lasts for more than a month after undergoing disturbing events (Lehavot et al., 2018). The condition may develop after months, years, or decades, although in certain circumstances, patients might only begin showing it after many months of experiencing traumatic actions. The case demonstrates that Victor had rightly experienced distressing events that not only exposed him to serious calamitous sights but haunted him in many ways. The situation is further deteriorated by the fact that he took too long to receive professional assistance, making him encounter major turbulences in his life. Based on his explanation of the situation, he fits Criterion B trauma. The inference is backed by the fact that Victor’s traumatic situation is persistently manifesting intrusion symptoms such as nightmares, flashbacks, unwanted upsetting memories, and a lack of willingness to share previous hurtful events.

Victor depicts the criteria of avoidance in connection with upsetting events as supported by these indications. First, he made efforts to avert external reminders (objects, activities, people, or situations) that prompt distressing memories, thoughts, and feelings related to the past traumatic experience. For example, he avoids seeing colleagues from his infantry unit because such acts will remind him of the experiences he wishes not to reminisce about. Moreover, Victor experiences trauma-related feelings when he illustrates having disturbing memories regarding his shocking experiences every day, though he fails to share any of such particulars.

Victor displays symptoms of alterations in mood and cognition by the following evidence in the case. He shows reduced interest in some activities such as the job. For example, he reports that he finds it hard to execute his role as a security officer since it had turned boring coupled with too much time for thinking. He shows persistent negative emotional states such as becoming easily irritable. Victor’s marriage appears disrupted since his wife feels disconnected as things are not right coupled with the feeling of isolation. The patient has symptoms of alterations in reactivity and arousal concerning the shocking event. The situation is supported by evidence of difficulty with concentration combined with sleep disturbance. For example, he reports considerable challenges in sleeping where he “sleeps with one eye open” while on some instances when he falls into a deeper sleep, he experiences nightmares. However, the provided case shows that Victor does not meet the symptoms of stressors. For example, it does not document whether he was exposed to death, threatened, or actual injury, or threatened death.

In attempts to unravel missing information to establish whether Victor meets the criteria outlined in the PTSD assessment, it is prudent to ask fundamental missing questions that will go a long way in providing a detailed response to his case. For example, it will be important to know the duration that the symptoms have lasted and whether he has experienced indications that create distress or functional weakening. It will be essential to know whether Victor has used medication or abused substances that might result in exclusion conditions.

Differential Diagnoses

Within the realms of differential diagnoses of PSTD, it is essential to contemplate aspects such as depression, panic disorder, anxiety, phobia, and malingering. Other symptoms include the psychiatric display of health conditions, substance abuse, and dissociative disorders. Victor demonstrates symptoms characteristics of depression such as dysphoric mood coupled with disturbances in sleep. Moreover, he has trouble concentrating, thinking, making decisions, and memorizing things. The patient also shows symptoms of loss of interest as well as pleasure in certain activities. For example, Victor finds the duties of a security guard boring. He is also feeling irritated and struggles to get sleep and if at all he falls asleep, he experiences serious nightmares.

In another instance, Victor demonstrates symptoms and characteristics of a specific phobia such as avoidance and fear. In the course of battling the traumatic events experienced as an infantryman, he practices avoidance behavior to help him forget the hurtful events he previously encountered. For example, he also evades seeing his friends from his Reserve group since it will remind him of previous involvements. The symptoms of substance abuse and malingering do not fulfill the DSM-5 diagnostic criteria since Victor neither demonstrates a medical history of abuse of substances nor an overemphasis on the functional state before the traumatic state.

Conclusion

As Victor’s therapist, using Cognitive Processing Therapy (CPT) would be the most recommended treatment plan for this case. The CPT model helps in understanding that it is usual for individuals to experience psychological responses to traumatic actions. In the model, PTSD is explained to be occurring when something creeps into the channel of natural recovery from trauma. In most instances, it is an individual’s belief regarding why the upsetting event occurred that makes them have difficulties. The CPT model is an effective treatment plan for Victor since it concentrates on how he will comprehend the traumatic events and the aftermath experiences while helping him to establish more structured and helpful thoughts about the trauma (Roberge et al., 2021). The model helps in the patient’s recovery process by reducing distress associated with recollections of the trauma.

References

Lehavot, K., Katon, J. G., Chen, J. A., Fortney, J. C., & Simpson, T. L. (2018). Post-traumatic stress disorder by gender and veteran status.American Journal of Preventive Medicine, 54(1), 1-9.

Roberge, E. M., Harris, J. A., Weinstein, H. R., & Rozek, D. C. (2021). Treating veterans at risk for suicide: An examination of the safety, tolerability, and outcomes of cognitive processing therapy.Journal of traumatic stress, 34(6), 1228-1237.

Article Information

The article’s topic is Stress and Health: A Review of Psychobiological Processes. The study was published on 4^th September 2021 in the Annual Review of Psychology journal. The article has been authored by three authors, Daryl O’Connor, Julian Thayer, and Kavita Vedhara. In particular, Daryl O’Connor is affiliated with the School of Psychology at the University of Leeds. The second author, Thayer, has been affiliated with the Department of Psychological Science under the School of Social Ecology. The third author, Vedhara, is affiliated with the School of Medicine at the University of Nottingham. The article is a peer review, mainly accomplished by studying numerous articles.

Summary of the Article

The accumulative science connecting stress to adverse health impacts is massive. Stress can impact health directly via autonomic and neuroendocrine responses and indirectly via modifications in health conduct. Moreover, the studies researched within this article affirm that stress affects various biological schemes and that these systems interrelate with each other to familiarize and react to shifting ecological demands that are alleged as stressful (O’Connor et al., 2021). For instance, the authors have unearthed a thrilling advance in stress and health research concerning examining cortisol in hair. Hair cortisol delivers another biomarker of HPA initiation free from various restrictions of other biological measures. After detecting glucocorticoids in hair by 2004, scholars have investigated the reliability and validity of hair cortisol assessment (O’Connor et al., 2021). The study found that a one-centimeter segment delivers an amount of normal cortisol secretion in the past month, as a 3-cm hair portion gives an amount of cortisol discharge in the past three months. Thus, hair cortisol is a dependable pointer of chronic stress and strongly influences body mass index (BMI), increased blood pressure (BP), diabetes, and adiposity.

Reflection on Stress

I have learnt that stress is a normal experience, as controlled amount has its advantages and cons, but, but what matters the most is how one deals with it. People undergo increased stress, and this adversely affects their lives. More particularly, I have learned about the precise infections caused by stress. For instance, when stress increases or is prolonged, the dangers of mental health challenges and medical complications arise. Long-term stress contributes to psychological disorders, such as anxiety, depression, and sleep complications. Prolonged stress also enhances the danger of medical complications, for instance, headaches, gastrointestinal challenges, deteriorated immune system, high BP, and cardiovascular infection.

In my life, I expect stressors from my education, family, and relationships. Therefore, I plan to exercise more. Sharif et al. (2018) show that physical activity upsurges one’s whole health and sense of well-being, which places more energy in daily life. In other words, physical activities assist enhance the creation of the brain’s feel-good neurotransmitters, identified as endorphins. More specifically, I will engage in daily routines of morning and evening runs, side planks, pushups as well as lunges. Thus, by improving my exercises, I hope to eliminate stress’s physical and mental effects.

References

O’Connor, D., Thayer, J., & Vedhara, K. (2021). Stress and health: A review of psychobiological processes. Annual Review of Psychology, 72, 663–688. Web.

Sharif, K., Watada, A., Bragazzid, N., Lichtbroun, M., Amitala, H., & Shoenfeldbc, Y. (2018). Physical activity and autoimmune diseases: Get moving and manage the disease. Autoimmunity Reviews, 17(1), 53–72. Web.

Modern life offers a person constantly increased mental stress at work, on the street, and home. Mental trauma and overstrain of higher nervous activity underlie the development of many diseases, including those associated with the heart. Frequent stressful situations and various negative emotional impacts disrupt the regular activity of the cerebral cortex and centers of the hypothalamic region (Sara et al., 2018). Weakening of control from the cerebral cortex leads to a significant increase in the excitability of the vasomotor center and, consequently, to a violation of vascular tone. It is essential to study the degree of influence of stress on the development of coronary heart disease since, in this way, it will be possible to prevent it more successfully.

Violation of normal relations between people at work and at home and manifestations of increased irritability often lead to conflict situations harmful to nervous activity. Stress in the workplace appears primarily as a consequence of the fact that a person does not cope or loses control over what he does. Vaccarino et al. (2021) found that people with less control over work have a higher risk of being diagnosed with coronary heart disease. In addition, such a stress effect can accumulate and manifest later, complicating the analysis. However, the link between stressful situations and coronary heart disease is vital, as only 1 percent of people with high levels of work control have been diagnosed with coronary heart disease (Vaccarino et al., 2021). This indicates that stress adversely affects the cardiovascular system by overloading it.

Given the information studied, the prevention of the occurrence of coronary heart disease should reduce the level of stress. According to Peoples et al. (2019), this approach will reduce the risk of cardiovascular disease. This method also does not carry any side effects since it does not involve the use of drugs.

In conclusion, stress is harmful not only to the heart but also to the body as a whole. Therefore it is better to find solutions to problems so as not to expose the nervous system to stress. Many drugs will help reduce stress levels if it is impossible to do without them. However, it is worth consulting with a doctor, as self-administration can worsen the situation. Therefore, a reliable way remains to reduce the amount of work or other sources of stress.

References

Peoples, J. N., Saraf, A., Ghazal, N., Pham, T. T., & Kwong, J. Q. (2019). Mitochondrial dysfunction and oxidative stress in heart disease. Experimental & molecular medicine, 51(12), 1-13. Web.

Sara, J. D., Prasad, M., Eleid, M. F., Zhang, M., Widmer, R. J., & Lerman, A. (2018). Association between Work‐Related stress and coronary heart disease: a review of prospective studies through the job strain, Effort‐Reward balance, and organizational justice models. Journal of the American Heart Association, 7(9), e008073. Web.

Vaccarino, V., Almuwaqqat, Z., Kim, J. H., Hammadah, M., Shah, A. J., Ko, Y. A., Elon, L., Sullivan, S., Shah, A., Alkhoder, A., Lima, B., Pearce, B., Ward, L., Kunter, M., Hu, Y., Lewis, T., Garsia, E., Nye, J., Sheps, D., Raggi, P., Bremner, D. & Quyyumi, A. A. (2021). Association of mental stress–induced myocardial ischemia with cardiovascular events in patients with coronary heart disease. JAMA, 326(18), 1818-1828. Web.

The high rates of PTSD among veterans regardless of their ethnicity-related personal characteristics may be regarded as a disturbing issue that require efficient response. At the same time, the analysis of existing literature dedicated to the development and improvement of PTG indicates its overall prevalence in veterans (Palmer et al., 2017; Pietrzak et al., 2021; Wu et al., 2019). However, the methods of improvement of veterans’ health should be considered, and on the basis of multiple research, it is possible to establish strong correlation between social connectedness or support along with coping practices and PTG in veterans.

The severity of trauma and a veteran’s health and sociodemographic and psychosocial factors affect the efficiency of the recovery process. At the same time, multiple authors prove that social support and connectedness with family members, relatives, friends, and other members of the community contribute to PTG and the minimization of the signs of PTSD in veterans (Nordstrand et al., 2020; Blais et al., 2021). At the same time, studies indicate the prevalence of the efficiency of community support over support perceived from military sources (Blais et al., 2021). However, the level of support is impacted by attitudes and beliefs that exist in society. Thus, minority veterans report “heightened stress and lower social support in challenging times” (Blais et al., 2021, p. 2). In addition, the presence of discriminative practices during military service may be regarded as an additional factor that contributes to the severity of PTSD in minority veterans (Sohn & Harada, 2008). All in all, social support is essential for PTG, however, attitudes toward veterans’ sociodemographic variables may impact the efficiency of their recovery within the framework of social connectedness.

Professional assistance in relation to coping with PTSD is efficient as well. In particular, adaptive and maladaptive coping, active coping, spiritual coping, and emotional coping are associated with the development of PTG (Mattson et al., 2018). At the same time, the choice of coping style depends on post-trauma outcomes the purposes of the intervention, and veteran’s personality traits and individual characteristics. According to Pole et al. (2005), “coping style can predict the psychological consequences of traumatic stress, with the general finding being that active or problem-solving coping leads to better outcomes than passive or avoidance coping” (p. 146). Nevertheless, the use of coping style should consider a veteran’s ethnicity and associated cultural peculiarities and additional discrimination-related struggles.

References

Blais, R. K., Tirone, V., Orlowska, D., Lofgreen, A., Klassen, B., Held, P., Stevens, N., & Zalta, A. K. (2021). Self-reported PTSD symptoms and social support in US military service members and veterans: a meta-analysis. European Journal of Psychotraumatology, 12(1851078), 1-18. 78. Web.

Mattson, E., James, L., & Engdahl, B. (2018). Personality factors and their impact on PTSD and post-traumatic growth is mediated by coping style among OIF/OEF veterans. Military Medicine, 183(9-10), 475-480. Web.

Nordstrand, A. E., Bøe, H. J., Holen, A., Reichelt, J. G., Gjerstad, C. L., & Hjemdal, O. (2020). Social support and disclosure of war-zone experiences after deployment to Afghanistan—Implications for posttraumatic deprecation or growth. Traumatology, 26(4), 1-13. Web.

Palmer, E., Murphy, D., & Spencer-Harper, L. (2017). Experience of post-traumatic growth in U.K. veterans with PTSD: A qualitative study. Journal of the Royal Army Medical Corps, 163(3), 171–176. Web.

Pietrzak, R. H., Tsai, J., & Southwick, S. M. (2021). Association of symptoms of posttraumaticpost-traumatic stress disorder with posttraumaticpost-traumatic psychological growth among U.S. veterans during the COVID-19 pandemic. JAMA Network Open, 4(4). Web.

Pole, N., Best, S. R., Metzler, T., & Marmar, C. R. (2005). Why are Hispanics at greater risk for PTSD?. Cultural Diversity and Ethnic Minority Psychology, 11(2), 144-161.

Sohn, L., & Harada, N. D. (2008). Effects of racial/ethnic discrimination on the health status of minority veterans. Military Medicine, 173(4), 331-338. Web.

Wu, X., Kaminga, A. C., Dai, W., Deng, J., Wang, Z., Pan, X., & Liu, A. (2019). The prevalence of moderate-to-high posttraumatic growth: A systematic review and meta-analysis. Journal of Affective Disorders, 243, 408-415.

Stress is a complicated concept that affects women’s physical and mental health. It consists of stressors, one’s reaction, and behavior, attracting adverse outcomes, including depressive states and exhaustion. Illnesses can become a source of tension and impact the condition of a female’s health. The recently appeared virus of COVID-19 made people worldwide anxious and panic about other perspectives of life. Females have a more significant strain level during the pandemic (Mattioli et al., 2020). Apart from infecting, it can cause such consequences as nervousness, anxiety, and depression (Stepowicz et al., 2020). Examining the link between stress and COVID-19 is essential to denote its impact on women’s health.

It is vital to examine what is known about the connection of women’s stress to COVID-19. For instance, it is known that infection stress causes women’s anxiety. Another issue faced by females during the coronavirus was increased levels of stress hormones (Stepowicz et al., 2020). Moreover, pregnant women feared for their children’s health, leading to panic conditions. Depression and burnout are other examples associated with stress provoked by a virus. Furthermore, lockdown influenced women’s physical activity and eating habits and led to weight gain (Mattioli et al., 2020). Accordingly, anxiety about weight and appearance made many females stressed. Therefore, the stress caused by this disease affects women’s physical and mental health.

COVID-19 shocked millions of people; it brought confusion into the everyday life of individuals. An unhealthy lifestyle caused by quarantine brought damaging outcomes such as insomnia, irritability, overeating, and emotional disturbance (Mattioli et al., 2020). The importance of stress caused by this virus for women is vulnerability to stress factors, pregnancy tension, mental disorders, and adverse pregnancy outcomes. According to the research, women who lived through stress connected to COVID-19 had more than 14 points on Edinburgh’s depression scale; a person with more than 12 points is considered depressed (Medina-Jimenez et al., 2020). Moreover, coronavirus becomes a source of strain for pregnant women; apart from being anxious about the child’s health, it causes higher rates of cesarean sections (Stepowicz et al., 2020). The study depicted that stress hormones such as cortisol and adrenaline increased in women during COVID-19 (Stepowicz et al., 2020). Furthermore, pressure provoked by anxiety leads to such outcomes as depressive conditions in females.

There are measures that women can take to reduce stress levels. Managing stress can seem complicated, especially in modern conditions of intense lifestyle. Indeed, doctors recommend moderate physical activity to decline anxiety levels, stress, and relative depressive states (Stepowicz et al., 2020). Moreover, meditation and yoga help to reduce irritational and panic conditions. It is essential to note that positive outcomes from exercising contribute to general health improvement. Doing complicated and professional exercising is not required to reduce tension. Furthermore, moderate exercises are available at home and do not require special equipment. Reviewing eating habits and lifestyle and shifting to more healthy products to minimize overweight-related risks is recommended.

Overall, the link between COVID-19 and women’s stress is apparent. Anxious conditions caused by stressful events about coronavirus lead to an unhealthy lifestyle, making women consume more calories, which causes overweight and distress. Moreover, there are huge risks linked to pregnancy, as COVID-19 can bring adverse outcomes to pregnant women. Nervousness influences hormones; cortisol and adrenaline levels might increase and develop neurotic disorders. Nevertheless, physical exercise, healthy eating habits, and meditation decrease female stress levels.

References

Mattioli, A. V., Sciomer, S., Maffei, S., & Gallina, S. (2020). Lifestyle and stress management in women during COVID-19 pandemic: Impact on cardiovascular risk burden.American Journal of Lifestyle Medicine, 15(3), 356–359.

Medina-Jimenez, V., Bermudez-Rojas, M. D. L. L., Murillo-Bargas, H., Rivera-Camarillo, A. C., Muñoz-Acosta, J., Ramirez-Abarca, T. G., Esparza-Valencia, D. M., Angeles-Torres, A. C., Lara-Avila, L., Hernandez-Muñoz, V. A., Madrigal-Tejeda, F. J., Estudillo-Jimenez, G. E., Jacobo-Enciso, L. M., Torres-Torres, J., Espino-y-Sosa, S., Baltazar-Martinez, M., Villanueva-Calleja, J., Nava-Sanchez, A. E., Mendoza-Carrera, C. E.,… Martinez-Portilla, R. J. (2020). The impact of the COVID-19 pandemic on depression and stress levels in pregnant women: a national survey during the COVID-19 pandemic in Mexico.The Journal of Maternal-Fetal &Amp; Neonatal Medicine, 35(23), 4438–4441.

Stepowicz, A., Wencka, B., Bieńkiewicz, J., Horzelski, W., & Grzesiak, M. (2020). Stress and anxiety levels in pregnant and post-partum women during the COVID-19 pandemic.International Journal of Environmental Research and Public Health, 17(24), 1-9.

Dogs are incredibly resilient creatures that can withstand great hardship and still come out the other side wagging their tail. However, sometimes they need a little help to unlock their resilience and help them cope with stress. There are several ways to help a dog open their strength. One is to provide them with a safe and stable environment. Providing a safe environment means having a consistent routine and plenty of positive reinforcement (Tiira, 2019). Managing stress levels in dogs incorporates behavioral and physical changes that need to be enhanced.

Stress is a common problem for dogs and their owners, but it does not have to be a permanent part of their dog’s life. Understanding the causes and effects of stress can help their dogs overcome it and become more resilient. Many different things can cause stress in dogs, including changes in their environment, separation from their guardians, and fear of unfamiliar people or animals (Tiira, 2019). Some dogs are also more prone to stress than others due to genetics or previous experiences. The good news is that there are several things one can do to help their dogs to cope with stress and become more resilient. These include providing a safe and consistent environment, desensitizing their dogs to things that trigger their stress, and teaching them positive coping mechanisms.

Several key factors contribute to dealing with stress in dogs. The function of the sympathetic nervous system, the hypothalamic “fight or flight” response, becomes key as one of the stress relief mechanisms. The sympathetic system of the dog’s body becomes the area that regulates the fight or flight response. The response is triggered when the body perceives a threat causing the release of epinephrine and norepinephrine. When the arousal level increases, it helps the body prepare for action and deal with the cause of the stress. Fight or flight response is controlled by the hypothalamus, responsible for releasing adrenaline via the pituitary glands in response to a perceived threat. The stress response constitutes the release of energy to some critical body systems. Some of these areas include the heart, which causes a spike in the rates of relaxation and contraction, the pain perception system and the sensory areas.

A growing body of evidence suggests that chronic stress can lead to several health problems in dogs, including digestive, skin, and behavioral problems. Chronic stress can lead to an imbalance of hormones, including increased stress hormone cortisol. The heightened hormone levels can lead to a state of allostasis or wear and tear on the body, eventually leading to allostatic overload and a breakdown of the body’s systems (Tiira, 2019). Allostasis which represents the adaptation to change, allows the dog to develop mechanisms that help cope with stress. The body’s response to stress increases the hormone glucocorticoids, regulated via the negative feedback loop, to return to normal levels. The notable health impacts include decreased growth, cases of early death, heart problems, gastrointestinal disorders and immune problems.

When dogs are faced with a stressful situation, their bodies release cortisol. The hormone helps them to cope with the stress and to recover from it more quickly. It also allows them to build up a resistance to stress over time, making them more resilient (Chmelíková et al., 2020). The primary mechanism by which cortisol release manages stress is the prevention of initial responses from increasing rapidly and causing damage to the body together with inflammatory responses. Many factors can lead to toxic stress in dogs, including prenatal stress during gestation and adolescent stress, which present differences in brain functions between young and adults. However, the primary factor that contributes to toxic stress is the lack of maternal care. The puppies become the most affected since adaptation without maternal care to stress becomes a problem. Changes that depict behavioral and physical growth in dealing with stress become problematic for the puppies. The adults, however, become hyper-responsive to dealing with stress due to high anxiety levels.

Several other factors also contribute to stress management in dogs, mainly composed of the amygdala, hippocampus and prefrontal cortex. The amygdala is responsible for processing emotions, and it is especially active during times of stress. When the amygdala is stimulated, it sends signals to the hippocampus, which is responsible for memory and learning (Tiira, 2019). The hippocampus then sends signals to the prefrontal cortex, which is responsible for decision-making and executive function. The amygdala hence monitors the threat assessment and contains the memory of fear. The hippocampus is crucial in ensuring that it modulates the emotional response together with extinction. The last part, the prefrontal cortex, then regulates the impulses and fear levels, adequately coping with stress.

Stress relief mechanisms are composed of behavioral factors and the body systems. The body responds to stress by making various changes to prevent further damage, typically during inflammation. The increased hormonal levels are regulated via harmful feedback levels. Additionally, in terms of behavioral mechanisms, maternal care becomes a critical aspect right from the dogs are still young. Adult dogs that lack that maternal care while they are puppies develop anxiety and depression while at the same time showcase poor maternal care to their young ones.

References

Chmelíková, E., Bolechová, P., Chaloupková, H., Svobodová, I., Jovičić, M., & Sedmíková, M. (2020). Salivary cortisol as a marker of acute stress in dogs: a review. Domestic Animal Endocrinology, 72, 106428. Web.

Tiara, K. (2019). Resilience in Dogs? Lessons from Other Species. Veterinary Medicine: Research and Reports, Volume 10, pp. 159–168. Web.

Study Overview

The professional work of a nurse is characterized by high physical, mental, and emotional load. There are a number of reasons for the development of occupational stress in the professional nursing job (Sharma et al., 2014) including complexities of interaction with patients, colleagues, fellow members and doctors, professional work overload, non-satisfaction with material situations, conflictual relationships of collective work, conditions of personal life, and problems of professional growth and career. The nursing profession is one of the high-risk occupations due to the emergence of occupational stress.

Many studies including Gadirzadeh, Adib-Hajbaghery, and Abadi (2017), Mudallal, Othman, and Al Hassan (2017), and Williams (2014) have identified the influence of occupational stress on physicians’ performance and personality.

Numerous factors were found to affect the mental and physical wellbeing of nursing professionals. In this study, various strategies have been identified, which can help nursing professionals to reduce the occupational stress. The research is based on the primary research question – how nurses cope with job stress? The study collects data from six nursing professionals through a survey questionnaire and analyzing their responses.

Literature Review

Stress is one of the essential components of adaptation processes and the way of living of human beings. The body reacts to stress with the help of the “fight-or-flight” reaction. The stress response plays a vital role in the body’s defense and survival of living organisms (Filha, Costa, & Guilam, 2013), which is provided by periodic releases of catecholamines. However, the duration and frequency of such releases are significantly higher than physiological capabilities with the continuous stress faced by nurses in the healthcare services.

Eventually, regular releases of endorphins and catecholamines cause stress reactions and increase the possibilities of blood pressure, headache, cardiovascular diseases, depression, and many other health disorders.

Almost every individual struggle with different types of stress. However, occupational stress is a situation in which different job-related factors came in contact with a professional individual, changing his/her physiological and psychological condition in a way that he/she tends to depart from normal functioning (Filha et al., 2013).

In the context of nursing professionals, stress is one of the leading causes of impaired physical and mental health. Many factors contribute to the development of stress among nurses. The most common stressors include workload, the behavior of senior doctors and physicians, professional growth, and career (Lorenz & Guirardello, 2014).

According to the study by Sarafis et al. (2016), there is a correlation between occupational stresses, the behavior of nurses, and the quality of life concerning their health has been explored and investigated. It has been found that occupational stress negatively affects the health-related quality of life of nursing professionals, which also as an influence on patient outcomes (Sarafis et al., 2016).

The research literature describes the symptoms of stressful occupational disorders, and some of them disrupt the productivity of nurses. It includes memory impairment, increased distractibility, and lack of concentration at work. Furthermore, stress promotes violent behavior, dependence on various drugs, development of somatic diseases (especially cardiovascular), and causes an increase in the incidences of suicide among nurses. It is revealed in the study by Hosseinabadi et al. (2018) that stress at work in the nursing profession is the leading cause of exhaustion.

It is not possible to reduce or eliminate stress in the context of Exposure Prone Procedures (EPP), but nurses could learn how to react to it (Mudallal et al., 2017). The impact of stress on the body and the psyche of a person depends entirely on his/her response to stress. Therefore, nurses need to learn how to manage their reactions to stress.

A randomized controlled trial conducted by Jordan, Khubchandani, and Wiblishauser (2016) examines the effect of music on self-perceived stress among first-line nursing professionals. The findings of the study provide evidence for nurses to use relaxing and soothing music as a research-based intervention for reducing stress.

A study by Ghaffari, Dehghan-Nayeri, and Shali (2015) investigates humor therapy, mindfulness training, mentors, and peer instructors as strategies to reduce anxiety among nursing students in the clinical setting. Furthermore, the clinical environment serves as a significant learning environment for young nursing professionals, and it also presents many challenges that might result in nurses experiencing anxiety and stress (Williams, 2014).

Survey Methodology

The selected methodology for the study performs a mixed research by combing qualitative and quantitative methods of analysis. The qualitative part of the study includes a literature review of peer-reviewed research studies in the context of occupational stress and coping strategies followed by nursing professionals in a clinical setting.

The quantitative part of the study involves the collection of responses from six nurses (3 males and 3 females), who were purposively selected for this study (Creswell, 2014). The respondents were explained the purpose of the research and questions included in the questionnaire. They completed the survey in the presence of the researcher. The data was collected by using a closed ended questionnaire consisting of 12 questions.

Strategies used by nurses to cope with job stress were determined by using a closed-ended survey questionnaire. The responses of both male and female nurses helped in comparing their views to get a better understanding of occupational stress and coping strategies. The questionnaire includes questions related to demographics and work experience such as gender, age, working experience, working shift, and employment ward. Moreover, some of the questions inquire about physical and mental health symptoms experienced by nurses and anti-stress therapies that they prefer.

The language used for drafting questions is simple and all respondents easily understood them. While administering the survey, I felt that respondents were hesitant to participate. However, there was no need felt to change these questions after the researcher started administering the survey. If a similar study is carried out in the future, then I would add questions about other coping strategies. Furthermore, I would compare different nursing groups based on their demographics such as gender.

Results

The results of the study are derived from the analysis of the data collected through the survey. The results are demonstrated in the form of percentages for a better indication of the collected responses. The stress estimation is carried out by using different factors such as gender, age, employment ward, working shift, physical and mental health symptoms, and different anti-stress therapies.

Table 1 shows that the survey included three male participants and three female participants. It is also graphically represented in Figure 1.

Table 1. Gender.

Table 2 shows that four participants (66.6%) out of six are aged between 20 and 30 years. The other 33% of respondents are in the age group of 31 & above. It is also graphically represented in Figure 2.

Table 2. Age.

Table 3 shows that 50% of the respondents work in the day shift, whereas 33% of them work in the night shift. The remaining 16% work in the afternoon shift. These results are graphically represented in Figure 3.

Table 3. Working Shift.

Table 4 shows that 50% of study participants are unmarried. Moreover, 33% of them are married, and 16% are either divorced or separated. This finding is also graphically represented in Figure 4.

Table 4: Marital Status.

Table 5 shows that 33% of the participants are young nursing professionals with 1-6 years of experience. However, two participants are in the category of registered nurses having experience of 7-12 years, and the remaining 33% of the respondents are senior nursing professionals at the managerial level with more than 12 years of experience. These findings are also graphically represented in Figure 5.

Table 5. Work Experience.

Table 6 shows that 33% of the participants work in the surgical ward, whereas 16.7% of them work in the medical ward. Moreover, 33% of the respondents work in emergency and 16.7% work in the pediatric ward. These results are also represented in Figure 6.

Table 6. Employment Ward.

Table 7 shows that 50% of the study participants feel stressed daily or on alternate days, whereas 33% of them usually feel stressed once a week and only 16% replied that they feel stressful twice a week. It is also graphically shown in Figure 7.

Table 7: Feel stressed.

Table 8 shows that the majority of the participants, i.e., 66% indicated that they make medical errors on a daily basis due to the increased workload. Furthermore, the remaining 33% of them responded that they incur medical errors on a weekly basis. These results are also shown in Figure 8.

Table 8. Human Errors due to Workload.

Table 9 shows that depression and feeling tired and difficulty concentrating are the most common mental health symptoms indicated by all participants. However, changes in behavior were identified by 50% of the participants, whereas 33% of them show anger. It is also graphically represented in Figure 9.

Table 9. Mental Health Symptoms.

Table 10 shows that the majority of the participants (83%) feel dizziness and restlessness, which are the most common physical symptoms of stress. Moreover, difficulty in sleeping is also indicated by 50% of the participants, and 33% also reported that they experience specified cramps and muscle spasm due to anxiety and stress. Figure 10 graphically represents these results.

Table 10. Physical Health Symptoms.

Table 11 shows that 60% of the participants do physical exercise to reduce stress, whereas 33% of them choose practicing meditation for minimizing their anxiety. Furthermore, 50% of the participants prefer listening to music to lower their stress level, and the rest of them utilize massage therapy to ease tension and headache. The results are also represented in Figure 11.

Table 11. Anti-stress Therapy.

Table 12 shows that 66% of the participants think that humor and mindfulness therapy helps in reducing stress among nursing professionals. However, 33% of them do not have any idea about this therapy. The results are also graphically represented in Figure 12.

Table 12. Humor and Mindfulness Therapy.

Study Critique

The research was carried out to determine how different strategies help to cope with stress among nursing professionals. For this purpose, the research was conducted in two steps to present qualitative and quantitative information. In the qualitative part, different research studies related to stress and its impact on physical and mental conditions of nursing professionals have been retrieved. These studies help in identifying different strategies used for reducing stress among nurses.

They also assist in determining the significant stressors that influence the health-related quality of life of nursing professionals in the healthcare setting. In the quantitative part of this report, the data was collected by surveying six nursing professionals. The researcher collected information for research purpose only after getting consent from the participants. However, the participants’ personal information is not included in the report for ensuring their confidentiality.

The results of the study indicate that the majority of nursing professionals encountered stress-related mental and physical symptoms. Among them, the most common symptoms are depression, dizziness, feeling tired, restless, and difficulty in concentrating at work. Furthermore, the most common strategies used by nurses for reducing their stress are physical activities (yoga, work out, walk), music (soothing, trance, relaxing), and massage therapy. However, humor and mindfulness therapy is also considered significant in reducing anxiety and depression among nursing professionals.

Limitations of the Study

Insufficient representation of the nursing population due to the small sample size is a significant limitation of the current study design, which has a considerable impact on the research outcomes. The study also has an impact limitation as despite having complete data and statistics as intended, the study suffers from a limited impact due to the lack of regional focus.

As the survey collects data only from only one healthcare facility, its results could not be generalized to all nursing professionals. Moreover, the qualitative part of the study only includes secondary data and does not present any conceptual or comparative framework. The lack of theories and frameworks affect the reliability of the current work.

References

Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches. Thousand Oaks, CA: SAGE Publications Inc.

Filha, M. M., Costa, M. A., & Guilam, M. C. (2013). Occupational stress and self-rated health among nurses. Revista Latino-Americana de Enfermagem, 21(2), 475-83. Web.

Gadirzadeh, Z., Adib-Hajbaghery, M., & Abadi, M. J. (2017). Job stress, job satisfaction, and related factors in a sample of Iranian nurses. Nursing and Midwifery Studies, 6(3), 125-131. Web.

Ghaffari, F., Dehghan-Nayeri, N., & Shali, M. (2015). Nurses’ experiences of humour in clinical settings.Medical Journal of The Islamic Republic of Iran, 29(182), 1-11. Web.

Hosseinabadi, M. B., Etemadinezhad, S., Khanjani, N., Ahmadi, O., Gholinia, H., Galeshi, M., & Samaei, S. E. (2018). Evaluating the relationship between job stress and job satisfaction among female hospital nurses in Babol: An application of structural equation modeling. Health Promotion Perspectives, 8(2), 102-108. Web.

Jordan, T. R., Khubchandani, J., & Wiblishauser, M. (2016). The impact of perceived stress and coping adequacy on the health of nurses: A Pilot Investigation.Nursing Research and Practice, 2016, 1-11. Web.

Lorenz, V. R., & Guirardello, E. d. (2014). The environment of professional practice and burnout in nurses in primary healthcare. Revista Latino-Americana de Enfermagem, 22(6), 926-33. Web.

Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). The influence of leader empowering behaviors, work conditions, and demographic traits.The Journal of Health Care Organization, Provision, and Financing, 54, 1-10. Web.

Sarafis, P., Rousaki, E., Tsounis, A., Malliarou, M., Lahana, L., Bamidis, P., & Papastavrou, E. (2016). The impact of occupational stress on nurses’ caring behaviors and their health related quality of life.BMC Nursing, 15(1), 56-65. Web.

Sharma, P., Davey, A., Davey, S., Shukla, A., Shrivastava, K., & Bansal, R. (2014). Occupational stress among staff nurses: Controlling the risk to health. Indian Journal of Occupational and Environmental Medicine, 18(2), 52–56. Web.

Williams, K. T. (2014). An exploratory study: Reducing nursing students stress levels facilitate perceived quality of patient care. Open Journal of Nursing, 4(7), 17-23. Web.