Measuring Outcomes of Stress Management Education on Mental Health Staff
Background: A great deal is known about the sources of stress at work for mental health nurses, namely how to measure stress and its impact on a range of outcome indicators. Research completed with nursing students showed a greater reduction of anxiety in an autogenic training group than in two comparison groups, as evidenced by scores on the State Trait Anxiety Inventory. Meta-analysis indicate that stress management workshops and behavioral technique training can be effective in reducing stress as well. Research that examines the practical application of stress reduction techniques and the resulting ability to moderate or minimize stressors for this population, however, is lacking.
Methods: Behavioral Health staff attended a workshop which included education on the following stress management skills: self-awareness through mind and body, emotion scan, autogenic training, and diaphragmatic breathing. Qualitative information was gathered regarding participants’ experiences of the workshop. Perception of stress was measured using the State-Trait Anxiety Inventory for Adults and questions about the use of stress management techniques. Surveys were completed at three time points; pre-workshop (Time 0), one month (Time 1) after workshop completion and two months (Time 2) after workshop completion. A generalized estimating equation (GEE) was chosen to determine whether the workshop (provided in between Time 0 and Time 1) decreased state-anxiety risk (SA) and trait-anxiety risk (TA).
Results: All participants (n=37) completed both the state-anxiety risk and trait-anxiety risk measures for Time 0. Of these, 21 completed both measures at Time 1, and 15 completed both measures at Time 2. State-anxiety decreased from Time 0 (M = 36.70, SD = 9.65) to Time 1 (M = 35.19, SD = 8.45), and again at Time 2 (M = 34.33, SD = 9.47). Though state-anxiety risk decreased over time, there was not a significant difference between the groups, Chi2 = 1.74, p = .1868. There were no significant differences across time for the trait-anxiety risk (TA) variable, Chi2 = 1.95, p = 1.621. While the TA variable decreased from Time 0 (M = 37.81, SD = 9.79) to Time 1 (M = 35.71, SD = 8.36), the trait-anxiety risk increased from Time 1 to Time 2 (M = 36.33, SD = 8.31). Qualitative evidence is currently being reviewed, though preliminary anecdotal evidence from participants who have utilized the skills taught in the workshop indicates improved ability to manage stress and greater job satisfaction.
Implications: This study adds to the literature on the ability of stress management training interventions to moderate or minimize stressors for behavioral health staff. Lack of consistency between the quantitative and anecdotal evidence of this study indicates a need for additional studies with larger sample sizes and in depth qualitative analysis. The decreasing completion rate seen in this study points to a possibly critical flaw in intervention methodology for behavioral health staff – lack of time and motivation for participation.