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4 "Stress management"
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Effect of an Integrated Stress Management program on the Stress Symptoms on the Stress Symptoms, Progressive Muscle Relaxation Method
Kuem Sun Han
Journal of Nurses Academic Society 1997;27(2):289-302.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.2.289
AbstractAbstract PDF

The main purpose of this study was to identify the effects of integrated stress management program on the stress symptoms of psychophysiological patients, especially patients with peptic ulcer. The study employed a quasi -experimental design using two different experiential groups. The samples in the integrated stress management program participated in autogenic training with biofeedback, discussions on effective coping method, cognitive, behavioral, and emotional management. They were also provided with an educational booklet on stress management and an tape on progressive muscle relaxation. Exch session lasted one hour and the program consisted of seven sessions over four weeks. The other group was only given an tape on progressive muscle relaxation. The data were collected from May 20 to september 25, 1996 A total 47 patients from ore university hospital located in Seoul participated, experiment group 1 (integrated stress management training) had 23 subjects and experiment group 2(progressive muscle relaxation training) had 24 subjects. The effects of these programs were measured by the stress symptom scale developed by Kogan(1991) which was translated by Lee(1892) and the healing status of the ulcer evaluated by a physician The data were analyzed using Chi-square test, t-test, ANOVA, repeated measure ANOVA. The result are as follows : 1. The integrated stress management group reported a significantly lower stress symptom score than the group given the progressive muscle relaxation only. 2. The integrated stress management group showed a significantly improved ulcer status as compared to the group given a progressive muscle relaxation only. In conclusion, it was found that the integrated stress management program was more effective in decreasing self-reported stress and physiological symptoms among patients with peptic ulcer as compared to the progressive muscle relaxation group. Based on this finding, the following suggestions can be made. 1. It is necessary to broaden the scope of nursing Practice for psychophysiological patients so nurses can include stress management as part of Patient care. 2. It is necessary to develop stress management Program for other patients whose symptoms are know to be related to stress. 3. It is necessary to replicated this study with a larger sample in different settings.

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Theoretical Bases and Technical Application of Breathing Therapy in Stress Management
Pyoung Sook Lee
Journal of Korean Academy of Nursing 1999;29(6):1304-1313.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1304
AbstractAbstract PDF

Breathing is essential for life and at the same time takes a role as a antidote for stress. In the Orient, it was recognized early that respiration, mind, and body have a relation that is inseparable and therefore proper breathing is so important. However, since the mechanism of therapeutic effect by breathing have not been verified, the treatment has been continued till recent years. From that which originated in the Orient, several techniques in the west have been developed to regulate breathing, and have been applying to the clinical situation and to studies, however scientific studies are still lacking. Recently, relaxed breathing has been used as an efficient strategy for breathing therapy as it has an effect on reducing physiological tension and arousal, and, therefore can be used as a basic technique to control or manage stress. In this study, in order to provide basic information and guidelines for clinical application, which will aid in the application of the theoretical basics of breathing therapy and its technique, a review of the literative was conducted. The findings are as follows: 1. Since proper breathing not only has, physically, the important function in supplying oxygen to the body but also gives a good emotional, or pleasant state of mind, it is the first step in controlling physical and mental health. 2. The basic types of breathing can be classified into two types; 'diaphragmatic breathing(relaxed breathing)' and 'chest breathing(stress breathing)'. In yoga type breathing, there are four kinds of breathing, 'upper breathing', 'mid breathing', 'down breathing', and 'complete breathing'. 3. The theoretical explanation of the positive thera peutic effect of breathing therapy techniques exemplifies good brain function, sufficient air flow through the nasal passages, diaphragmatic movement, light vagal stimulation, CO2 changes and cognitive diversion but in most studies, the hypothesis of CO2 is supported. 4. The technique of breathing is designated with many names according to the muscles and techniques used for breathing, and for control of stress, diaphragmatic breathing(relaxed breathing) is explained as a basic technique best used to manage of stress. 5. The relaxed-breathing includes slow diaphragmatic breathing, breath meditation, nasal breathing, yogic abdominal breathing, Benson's relaxed response, and quiet response.

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A Meta-Analysis of Effects of Job Stress Management Interventions(SMIs)
Jeong Hee Kim
Journal of Korean Academy of Nursing 2007;37(4):529-539.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.4.529
AbstractAbstract PDF
Purpose

This quantitative meta analysis sought to determine the effectiveness of SMIs.

Method

Forty-six experimental studies with a randomized or nonequivalent control group pre-post test design were included in the analysis. The selected studies were classified according to the sample characteristics, the types and methods of the interventions, and the types of outcome variables. Six intervention types were distinguished: cognitive-behavioral intervention(CBT), relaxation techniques(RT), exercise(EX), multimodal programs 1 and 2(MT1, 2), and organizationfocused interventions(OTs). Effect sizes were calculated for the 4 outcome categories across intervention types: psycho-social outcome, behavioral-personal resources, physiologic, and organizational outcome.

Results

Individual worker-focused interventions(ITs) were more effective than OTs. A small but significant overall effect was found. A moderate effect was found for RT, and small effects were found for other ITs. The effect size for OTs was the smallest. The interventions involving CBT and RT appeared to be the preferred means of reducing worker's psycho-social and organizational outcomes. With regard to physiologic outcomes, RT appeared to be most effective. CBT appeared to be most effective in reducing psycho-social outcomes. The effects of OT were non-significant, except for the psycho-social outcomes.

Conclusions

SMIs are effective. Interventions involving RT and CBT are more effective than other types.

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The Effects of Psychosocial Interventions to Improve Stress and Coping in Patients with Breast Cancer
Cho Ja Kim, Hea Kung Hur, Duck Hee Kang, Bo Hwan Kim
Journal of Korean Academy of Nursing 2006;36(1):169-178.   Published online February 28, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.1.169
AbstractAbstract PDF
Purpose

The purpose of this study was to examine stress, coping, and immune response effects of a psychosocial intervention program based on the PNI model and Stress-Appraisal-Coping for Korean patients with breast cancer.

Methods

A nonequivalent control group pretest-posttest design was used. The participants who had survived breast cancer and lived in Wonju city and the surrounding area were assigned to an intervention group (N=21) or a control group(N=18).We conducted a 12-week intervention, 2 hours a day weekly, and measured the variables at baseline, six and twelve weeks later. Dependent variables are: stress, anxiety-depression and anger, and immune response.

Results

Patients in the psychosocial intervention program reported significantly less stress perception (U=31.500, p=.023), more problem solving ability and less problem avoidance in coping (U=20.500, p= .013; U=29.500, p=.040), and less anxiety-depression (U=22.000, p=.023). No difference, however, was found in anger and immune responses between the two groups. Intervention effects were evident at week 6 and 12 for anxiety-depression, and at week 6 for problem avoidance in coping, the same time that NK cell counts and the T8 decreased.

Conclusions

These results suggested positive effects of a psychosocial intervention program. However, the results are inconclusive due to the small sample.

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