Stress Less Lara, Belinda, Stephanie, Jacquie, Lauren

The effect of exercise on stress reduction amongst nurses

Goals: To evaluate the effectiveness of yoga and cardiovascular exercise on stress reduction for nurses aged 20 -30 years over a 6 weeks period.

Objectives: Reduce stress level by participating in 2 x 60 min classes

per week of yoga for a 6 week period Reduce stress level by completing 5 X 30 min runs for a 6

week period Compare the effectiveness of yoga and cardiovascular on

the level of stress reduction using the Nursing Stress Scale, the DASS21& the 5 items Likert Stress rating Scale.

Interest in the topic Relevant to our lifestyle Sustainable and relatable throughout

transitioning into professional practice Interventions are feasible and

interesting for participation Overall health benefits within a holistic

lifestyle

Problem Stress causes:

Workplace, responsibilities, roles, shift work, expectations, time restrictions

Significance: Correlation between burnout and fair to poor quality of care and

increase risk of failure to recognise patient distress Patient safety issues and effects on functionality of nursing

profession Increased risk of accidents/errors

Impact: Negative outcomes- feelings of loss of faith/confidence/self-

esteem, fighting with spouses, depression/anxiety Growing resentment of nursing duties Unhealthy lifestyles/behaviours

Magnitude: Occupational stress is “ubiquitous in nursing” (Lim et al., 2010) Increased risk of developing burnout

Examples of other approaches to stress reduction

Primary interventions – addressing causes of stress Workplace modifications – rostering,

ratios, leadership, support, appreciation Secondary interventions – addressing

effects of stress Massage, music, smoking, social events,

relaxation training, prayer, psycho-education

Intervention - Yoga Breathing, posture, strengthening and meditation exercises

Benefits mental and physical wellbeing to enhance the mind body and soul (Li & Goldsmith, 2012).

Endorsed by the US (Li & Goldsmith, 2012) . Physiological – lowers BP and HR

Acts on the parasympathetic nervous system rather than HPA (McCafffery et al, 2005)

Psychological – decision making, concentration (Ross & Thomas, 2010) 60-90 minutes 2-3 times per week is required for beneficial effects

(Jackson, 2013) Its suggested yoga assists in altering attitude towards perceived stress

(Galbraith & Brown)

Our Study – Each participant will complete 2 x 60 min yoga classes per week for 3 weeks

Intervention - Cardiovascular exercise 20-30 minutes of aerobic exercise has a calming effect for up to several

hours due to hormonal responses (altered dopamine and serotonin level), resulting in altered mood and perceived stress (Robson, 2011)

Provides a release and distraction from stressor Recommended 150minutes of moderate intensity or 75minutes of

vigorous aerobic exercise per week is required for beneficial results (Jackson, 2013)

Non ward based exercise includes riding/walking to work, yoga classes in break (Harpell et al, 2013)

Limitations Lack of opportunity and resources e.g. Bike rack, yoga classes, quiet rooms Short term effects only. Participant needs to complete regular exercise to

remain an effective measure to reduce stress Our Study – Each participant will complete 30 min X 5 times per week

for 3 weeks

Evaluation Process: collection of data online (monkeysurvey.com), incl.

Demographic. Use of validated evaluation tools: Nursing Stress Scale (Gray-Toft & Anderson, 1981)at 0, +3 &+6

weeks DASS21(Sinclair et al., 2012) at 0 & weekly 5 items Likert Stress rating Scale (Davey et al., 2007) at 0, before

and after every yoga or cardio intervention & at + 6 weeks. Impact : reduction in stress by week 1on Likert Scale with peak

effect at week 6 statistically significant on all tools . Outcome: 80% of all diseases and illnesses are related to stress:

coronary heart disease, cancer, migraine, hypertension and sleep disturbances (Seaward, 1999).

The expected outcome is a positive impact on overall stress levels and nurse wellbeing, job satisfaction and morbidity and mortality showed by a reduced number of sick days taken by nurses.

Reference Seaward, B. (1999). Managing stress: principles and strategies for health and wellbeing. Jones and Bartlett,

Sudbury. Davey, H. M., Barratt, A. L., Butow, P. N., & Deeks, J. J. (2007). A one-item question with a likert or visual

analog scale adequately measured current anxiety. Journal of Clinical Epidemiology, 60(4), 356-60. Galbraith, N., & Brown, K. (2011). Assessing Intervention Effectiveness for Reducing Stress in Student Nurses:

Quantitative Systematic Review. Journal of Advanced Nursing, 1, 1-13. Gray-Toft P. & Anderson, J. (1981). The Nursing Stress Scale: Development of an instrument. Journal of

Psychopathology and Behavioral Assessment, 3(1), 11-23. Harpell, B., Dwyer, T., Reid-Searl, K., Burke, K., Caperchione, C., & Gaskin, C. (2013). Nurses and Stress:

Recognising Causes and Seeking Solutions. Journal of Nursing Management, 21, 628-647. Jackson, E. (2013). Stress Relief: The Role of Exercise in Stress Management. ACSM's Health and Fitness

Journal, 17(3), 14-19. Li, A., & Goldsmith, C. (2012). The Effects of Yoga on Anxiety and Stress. Alternative Medicine Review, 17(1),

21-35. Robson, R. (2011). A Critical Assessment of the Acute Effects of Yoga and Cardiovascular Exercise of Markers

of Mood and Stress. Journal of Yoga and Physical Therapy, 1(4), 1-7. Sinclair, S. J., Siefert, C. J., Slavin-Mulford, J., Stein, M. B., Renna, M., & Blais, M. A. (2012). Psychometric

evaluation and normative data for the depression, anxiety, and stress scales-21 (DASS-21) in a nonclinical sample of U.S. adults. Evaluation & the Health Professions, 35(3), 259. Retrieved from http://ezproxy.library.usyd.edu.au/login?url=http://search.proquest.com/docview/1032943245?accountid=14757

Lim J., Bogossian F. and Ahern K. (2010). Stress and coping in Australian nurses: a systematic review. International Nursing Review, 57, 22-31 

Welker-Hood, K. (2006). Does Workplace Stress Lead to Accident or Error? American Journal of Nursing, 106, 9, 104