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Reducing Stress Levels in Healthcare

This research explores whether the application of various holistic interventions reduces stress levels among inpatient healthcare workers. 
Read more: Reducing Stress Levels in Healthcare

AUTHOR:

Brooke Hunsberger ADN, RN, Wangmo Gurung BSN, RN, Breanna Halter MSN, RN , Elizabeth Clemmer BSN, RN

DATE: August 2023

BACKGROUND

Healthcare workers face increased susceptibility to both psychological and physiological stress, contributing to a diminished overall quality of life and impaired work performance (Lai et al., 2020; Tain et al., 2020). Voung et al. (2020) discovered that a substantial proportion of nurses, ranging from 35-45%, experience high levels of burnout. The repercussions of heightened work-related stress extend to the job performance of nursing staff, impacting the quality of care they deliver and resulting in a higher incidence of medical negligence (Hung, 2020). Additionally, the long-term effects of stress, as highlighted by Voung (2020), include symptoms such as nervousness, anxiety, and insomnia, collectively contributing to a reduced quality of life for those affected.

PICO

P- health care workers/ hospital staff
I- aromatherapy
C- healthcare workers that do not utilize aromatherapy 
O- decreased stress levels 

PICO

For inpatient healthcare workers, does the use of different holistic interventions reduce stress levels?

P – inpatient healthcare workers
I – Holistic interventions (mindfulness, aromatherapy, coloring)
C – No use of holistic interventions
O – decrease in stress levels

EVIDENCE

Aromatherapy has a rich historical tradition of providing health benefits to the mind, body, and spirit. Hippocrates, considered the father of modern medicine, advocated for aromatherapy, emphasizing the significance of aromatic baths and scented massage for good health (Farrer, 2020). This simple and cost-effective approach employs pure essential oils to promote physical, psychological, and emotional balance. Aromatherapy has been shown to enhance mood, decrease overwhelming emotions, encourage a sense of wellbeing, improve sleep, provide comfort and calmness, and relieve tension headaches (Vivek & Yadav, 2013). Complementary practices like guided meditation, as explored by Moral (2017), aim to achieve a calm and peaceful state of mind by targeting various sensory perceptions. Additionally, research by Holt et al. (2019) and Kaimal et al. (2019) suggests that incorporating activities such as coloring can result in reduced anxiety, improved mindful attention, creative cognition, increased positive affect, creative agency, and self-efficacy, as well as a decrease in negative affect, anxiety, perceived stress, and burnout.

OUTCOMES

The stress-relief interventions provided demonstrated a significant decrease in the average Post-Traumatic Stress Survey Scores among participants. Aromatherapy emerged as the most widely embraced method, with 100% of participants incorporating it for stress relief. Mindfulness practices through guided videos were adopted by 20% of participants, while 25% engaged in stress relief through coloring pages. Aromatherapy patches and clips were unanimously reported as the most effective method for alleviating work stress. The top-rated scents included lavender, orange-peppermint, and sandalwood. Participants attributed benefits such as diverting attention from stressors, relieving headaches, and promoting relaxation and clearer thinking to these interventions. 

IMPLEMENTATION

Healthcare providers on each unit completed a Perceived Stress Scale Pre-Survey as part of data collection for an ongoing study. Over the course of a month, holistic interventions were provided on the unit for staff use. These interventions included aromatherapy patches and clips with four different scents: Lavender, promoting relaxation, comfort, pain reduction, and anxiety relief; Lavender-Sandalwood, offering similar benefits to Lavender; Lavender-Peppermint, promoting relaxation during pain, comfort, and alleviating queasiness; and Orange-Peppermint, uplifting and soothing nausea. Additionally, staff had access to a 5-minute guided meditation QR code for an easy and cost-free relaxation method and various coloring pages, recognized as a healthy and cost-effective means to relieve stress, decrease anxiety, and enhance overall mood. A Perceived Stress Scale Post-Survey was administered after the intervention, enabling a comparison of pre- and post-survey scores to assess the effectiveness of the interventions in reducing stress.

NEXT STEPS

The next steps involve implementing stress relief stations on each unit with a stock of assorted aromatherapy patches and clips.

REFERENCES

Farrar, A. J., & Farrar, F. C. (2020). Clinical aromatherapy. Nursing Clinics of North America, 55(4), 489–504. https://doi.org/10.1016/j.cnur.2020.06.015 

Holt, N. J., Furbert, L., & Sweetingham, E. (2019). Cognitive and affective benefits of coloring: two randomized controlled crossover studies. Journal of American Art Therapy Association, 36(4), 200-208. https://doi.org/10.1080/07421656.2019.1645498 

Kaimal, G., Carrol-Haskins, K., Mensinger, J. L., Dieterich-Hartwell, R. M., Manders, E., & Levin, W. P. (2019). Outcomes of art therapy and coloring for professional and informal caregivers of patients in a radiation oncology unit: a mixed methods pilot study. European Journal of Oncology Nursing, 42, 153-161. https://doi.org/10.1016/j.ejon.2019.08.006 

Moral, A. (2017). Guided meditation: a regimen for mental health. Indian Journal of Health and Wellbeing, 8(2), 180-182. 

Vivek, D & Yadav, S. (2013). Aromatherapy for stress relive. International Journal of Research and Development in Pharmacy and Life Services, 2(3), 398-403. 

Voung, L. (2020). Staffing ratios and Burnout : American Journal of Nursing. American Journal of Nursing. https://journals.lww.com/ajnonline/Fulltext/2020/05000/Staffing_Ratios_and_Burnout.4.aspx 

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