Stress management interventions for intensive and critical care nurses: A systematic review

Abstract

Background The level of occupational stress of nurses working in intensive and critical care units is high. Although many studies have assessed the effectiveness of stress management interventions among intensive and critical care nurses, the methodological quality of these studies remains unclear. Purpose The purpose of this review was to summarize and appraise the methodological quality of primary studies on interventions for management of occupational stress among intensive and critical care nurses. Methods This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A comprehensive literature search was conducted to identify primary studies that assessed the effectiveness of interventions in managing occupational stress among intensive and critical care nurses using multiple databases from January 2009 to June 2019. Results Twelve studies published between 2011 and 2019 were eligible for inclusion. These included studies were classified as being of good or fair quality. The consensus across the included studies was that, compared with control condition, cognitive‐behavioural skills training and mindfulness‐based intervention were more effective in reducing occupational stress among intensive and critical care unit nurses. Conclusion Further research should focus on methodologically strong studies by blinding the outcome assessors, using Randomized Controlled Trial (RCT) design with an active control group, using standardized assessment tools, and reporting enough details about the stress management intervention‐related adverse events. Relevance to clinical practice This review demonstrates the need for high methodological quality studies to rigorously evaluate the effectiveness of stress management interventions before it can be recommended for use in clinical practice to reduce stress in intensive and critical care unit nurses. In addition, attention should be given to developing research protocols that place more emphasis on interventions aimed at the organization level to address the growing problem of occupational stress among intensive and critical care nurses.

Nurses' stressors and their quality of life: A study on nurses caring for older patients

“…Occupational stress management was shown to be the key to enhance quality of life in nurses working in older people care settings. Providing stress management training (SMT) such as cognitive behavioural skills training and relaxation techniques is highly recommended for nurses to deal with difficult work situations and raise their abilities regarding cognitive self‐control (Alkhawaldeh, Soh, et al, 2019; Krölla, Doeblerb, & Nüescha, 2017; Singh, 2017). Therefore, nurse educators and leaders should support nurses working with older people by conducting SMT to reduce the impact of the occupational stress on their quality of life.…”

“…Occupational stress, sometimes called job stress, is the physical and emotional reactions that happen when the requirements of the work do not match the nurse's abilities and resources (Nakhli, 2013). Nurses face extraordinary stressors in the medical environment (Alenezi, Aboshaiqah, & Baker, 2018; Alkhawaldeh et al, 2019; Alkhawaldeh et al, 2019; Galdikien, Asikainen, Balciunas, & Suominen, 2014). This is especially for older people care settings, where patients often exhibit many of symptoms such as agitation that can be stressful for the healthcare providers (Zwijsen et al., 2014).…”

Mental distress and influencing factors in nurses caring for patients with COVID‐19

“…When facing the current pandemic situation, nurses are confronted with unprecedented challenges, such as large volumes of patients with critical conditions, high death rate, often limited resources to care for patients, and severe shortages of personal protective equipment (PPE). Compounding the current situation is nurses' existing high levels of job‐related stress or burnout 3,4 . All these concerns can exert significant psychological strains on nurses, which may lead to nurses' mental distress, such as post‐traumatic stress disorder (PTSD) and perceived stress.…”

Remember why you became a nurse in the first place

“…In relation to interventions, there is some evidence in favour of cognitive‐behavioural approaches and mindfulness, and the impact of approaches to address burnout appears to be enhanced when they are applied at an organizational level, rather than at the level of the individual . In general, however, most reviews conclude that there are very few studies of a good enough quality in this field for anything definitive to be recommended for the prevention of work‐related stress in critical care.…”