The study was undertaken to evaluate the effects of a cognitive-behavioral stress management program on psychosocial stress, mood states, and ways of coping with stress for emergency department (ED) nurses.

The study design was a non-equivalent control group with a pre/post design. The study was conducted from July 1, to September 30, 2016. The sample population comprised nurses who work in ED in Seoul, South Korea. The sample size was 79 which included 39 in the experimental group and 40 in the control group. Seven sessions of a program (50 minutes/session) were provided over 4weeks. Data were analyzed using descriptive statistics: the χ²-test and the t-test with the SPSS/WIN 21.0 program.

There were statistically significant differences in psychosocial stress, mood states, and ways of coping with stress between the experimental group and the control group. However, the sub-hypothesis regarding the degree of using passive coping skills was not supported.

The results of this study indicate that a cognitive-behavioral stress management program for ED nurses is effective in reducing psychosocial stress, changing mood states positively, and improving ways of coping with stress effectively.

This study aims to identify factors influencing burnout in nurses during COVID-19 disaster situations.

The research subjects were 131 nurses who had the experience of nursing patients during the COVID-19 pandemic, and were selected through convenience sampling. The collected data were subjected to percentage, mean and standard deviation, t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression analysis using the SPSS version 24.0 program.

Burnout in nurses showed a statistically significant correlation with anxiety, PTSD, and depression. It was also confirmed that nurses’ depression and shift work were important factors that had significant effects on burnout.

In preparation for new infectious diseases that are expected to become more frequent in the future, a policy to supply nursing manpower and prevent burnout is necessary. In addition, it is necessary to introduce various work systems and develop and disseminate intervention programs for depression and burnout.

The purpose of this study was to identify the relationships between social support, pregnancy stress, and anxiety of pregnant women and to determine their effect on health-related quality of life.

A total of 202 pregnant women participated in this study. The collected data were analyzed by the frequency and percentage, mean and standard deviation, independent t-test, ANOVA, Pearson’s correlation coefficients, and hierarchical multiple regression analysis using the STATA/IC 15.1 program.

As a result of this study, the major factors affecting the health-related quality of life of pregnant women were identified as anxiety, educational level, social support, and marital satisfaction. Social support has a positive effect on the health-related quality of life of pregnant women (β=0.27, p< .001), but anxiety had a negative effect (β=−0.56, p<.001).

When planning nursing interventions to improve the health-related quality of life of pregnant women, strategies for lowering the anxiety and improving the social support of pregnant women should be considered.

Understanding and managing the health of children diagnosed with food allergies and their families are becoming increasingly important. The purpose of this study was to verify the mediating effect of parenting stress on the relationship between the health problems of children with food allergies and the perceived health status of parents.

A self-report questionnaire was administered to 80 parents of children diagnosed with allergies to determine the child’s food allergy characteristics, concerns about the child’s health, parents’ health status, and parenting stress, through which the number of allergy-inducing foods, the structural relationship between health concerns about children, parenting stress, and perceived parental health status, and the indirect effects of parenting stress were verified.

Parenting stress statistically significantly mediated the relationship between children’s health problems and perceived health status of parent.

Reducing the parenting stress of parents of children with food allergies can increase parents’ health status. Since parental health is an important factor in child management, it is suggested that parenting stress interventions be included in the comprehensive management of children with food allergies.

The purpose of this study is to determine the degree of perceived stress, fine dust risk perception, and resilience in patients with respiratory and circulatory disorders, and investigate the relationship between these variables.

A questionnaire survey was conducted on 184 patients with respiratory and circulatory diseases over the age of 20 and analyzed using descriptive statistics, Pearson’s correlation coefficient, and stepwise regression analysis using the SPSS program.

The study found perceived stress, resilience, family relationship, and type of disease to be factors affecting the stress response of people with respiratory and circulatory disorders.

Understanding the perceived stress, resilience, family relationship, and type of respiratory and circulatory disorder prevents stress response and contributes to stress nursing.

Distractive emotion regulation, which relieves arousal through attention shift, protects individuals from strong stress. Distractive emotion regulation is widely used in everyday life and although it has great implications in the context of adaptation such as to addiction, it is generally not considered separately from avoidant regulation, it has neither been clearly defined nor measured.

Through a literature review and qualitative analysis, we selected adults’ distractive emotion regulation behaviors. We explored the construct by developing measurement on the distractive behaviors that adults use to regulate emotion.

Factor analysis revealed that distractive emotion regulation consisted of four factors: “consumption distraction” concerned with activities such as shopping, internet use, and TV viewing; “arousal control distraction” related to activities such as exercise, bathing, and deep breathing; “reserving distraction” pertaining to activities such as eating, sleeping, and listening to music; and “aggressive distraction” involving behaviors such as bullying, physical destructiveness, or cursing. Each factor had a different correlation with stress coping dimensions and subjective well-being.

Distractive emotion regulation is a multidimensional concept composed of sub-factors with different functions and clinical implications in daily life.

The purpose of this study is to verify the mediating effects of dissociation experience, relationship addiction, and internalized shame in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood.

Two hundred and thirty-eight adults participated in this study. They were administered the Korean versions of the Trauma Antecedents Questionnaire, Impact of Event Scale-Revised, Dissociative Experiences Scale, Relationship Addiction Questionnaire, and Internalized Shame Scale. The data were analyzed with descriptive statistics, correlation analysis, reliability analysis, and structural equation modeling.

First, dissociation and internalized shame had a double mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood. Second, relationship addiction and internalized shame had a double mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood. Third, dissociation, relationship addiction, and internalized shame had a triple mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood.

Therapeutic intervention for revictimization should address symptoms such as dissociation, relationship addiction, and internalized shame. In addition, people with complex trauma experiences in childhood-adolescence require preventive intervention to avoid further exposure to interpersonal trauma.

Immobilization as restraint stress is recognized as a psychologically stressful event. The stress responses alter both neuroendocrine and neurochemistry in an acute and long-term manner. We investigated whether the effect of chronic repetitive restraint stress could elicit levels of corticosterone and related neurochemical alterations.

Nine-week-old Sprague-Dawley rats (the stressed group) were subjected to restraint stress in a hemi-cylindrical apparatus nocturnally in seven consecutive days. The handled control group was a sustained-controlled husbandry, and the stressed group was returned to the same home cage immediately after daily restraint sessions. On day 14, all subjects were sacrificed and neurochemical assessment was performed. Plasma corticosterone levels were measured on days 1, 7, and 14 following a 7-day recovery period. The activity of exploration was measured on day 5 of the stress session for 5 min to expose the novel open field. On day 14, tyrosine hydroxylase, c-fos, and NADPH-diaphorase immunohistochemistry was performed in the locus coeruleus and hypothalamic PVN (paraventricular nucleus) in the brain, respectively.

The repetitive restraint stress elicits a retarded growth pattern and lowers locomotive activity at the acute phase. During the stressed session, higher levels of plasma corticosterone and nNOS (neuronal nitric oxide synthase) activity in the hypothalamus. Furthermore, the upregulated changes were prolonged seven days after the stress-free recovery period, chronically.

Chronic repetitive restraint stress may acutely alter neuroendocrine and behavioral changes via the hypothalamic-pituitary-adrenal axis, and its phenomenon is sustained as a physiological maladaptation, depending on neurochemical alterations related to hypothalamic nNOS activity.

This study is a randomized control trial (RCT) to compare the effects of the electrocardiogram waveform simulation-based Healing Rhythm System on stress, electroencephalography (EEG), heart rate, and anxiety on healthy college students. Healthy college students without any disease were recruited. A total of 68 participants were collected and analyzed in 31 experimental groups, 17 placebo group, and 20 control group.

The analysis method was repeated measurement of ANOVA and it was conducted 8 times in total. The effect measurement was checked before and after exposure to stressors and six times every five minutes after intervention.

The results of the study showed that stress was significantly different in the experimental group at 10 minutes (F=4.33, p=.017) and 15 minutes after the intervention, and the EEG was significantly different in the experimental group at the relative alpha Fp1, F3 (F=5.753, p=.005) after the intervention, and the heart rate was significantly different in the experimental group at 15 minutes and 20 minutes (F=3.586, p=.033). The anxiety was significantly different in the experimental group after the pre and post-treatment of stressors (F=18.609, p<.001).

Therefore, HR system will be widely used as a program to induce calming to healthy university students in stressful situations.

The purpose of the study was to test the moderating role of self-control in the relationship between daily stress and online social networking addiction of adolescents.

The daily stress scale, online social networking addiction scale, and self-control scale were administered to a sample of 225 adolescents. The data were analyzed using SPSS 25.0 and SPSS PROCESS macro.

The results were as follows: First, correlation analysis was conducted to examine the relationship among daily stress, self-control, and online social networking addiction. Daily stress was significantly positively correlated with online social networking addiction. In contrast, self-control was significantly negatively correlated with daily stress. Second, the interaction between self-control and daily stress played a more prominent role in protecting against online social networking addiction in adolescents who reported lower daily stress than those who reported higher daily stress.

This result suggested that it is necessary to strengthen the positive aspects of self-control to adolescents who have difficulty managing their online social networking addiction.

Recently it has been reported that the prevalence of hwabyung is increasing in Korean young adults. The purpose of the present study was to estimate genetic and environmental influences on Hwabyung-personality, a risk factor for the development of hwabyung. Hwabyung-personality is characterized by high levels of anger, impulsivity, harm-avoidance, social reward, and self-transcendence and a low level of self-directedness.

The hwabyung-personality scale was administered to 1476 twins [mean (SD) age=18.9 (±3.1 years)] via a telephone interview. Maximum likelihood twin correlations were computed and model- fitting analyses were performed.

Monozyogotic (MZ) twin correlations were significantly higher than dizygotic (DZ) twins in hwabyung-personality scale in males and females, suggesting the presence of genetic influences on hwabyung-personality. DZ twin correlations were close to zero, indicating that genetic influences on hwabyung-personality are non-additive and that shared environmental infleunces are negligible. Model-fitting analysis revealed that genetic and non-shared environmental influences on hywabyung- personality were 39% (95% CI=30%, 48%) and 61% (95% CI=54%, 69%), respectively. These estimates were not significantly different between males and females.

Genetic influences on hwabyung-personality found in the present study suggest that genetic vulnerability should be incorporated in prevention as well as treatment of hwabyung symptoms.

The purpose of this study was to examine the mediating effects of Mindfulness-Based Stress Reduction Program on Stress response, self-efficacy, emotional intelligence and burnout among nurses.

The study was a nonequivalent control group pretest-posttest design, with 34 participants (experimental group: 17, control group: 17). The Mindfulness-Based Stress Reduction program for Small and Medium Sized Hospital Nurses for this study was conducted in pre-class, in-class, and post-class stages for a total of 8 weeks Data were analyzed with an independent t-test and repeated measures ANOVA.

The experimental group showed significant improvement in stress response (F=3.37, p=.041), burnout (F=3.38, p=.040), emotional intelligence (F=5.10, p=.009) and self-efficacy (F=3.51, p=.049).

The results of this study show that MBSR program is an effective stress management method for small and medium Sized Hospital Nurses. Therefore, the MBSR program is recommended to nurses and health care providers for stress management.

The purpose of this study was to estimate the effects of stress on metabolic syndrome (MS) among Korean adults (age≥20).

The total subject 6,458 (weighted subjects=41,717,139) were recruited from the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-2, 2017). Data were analyzed by t-test, ANOVA, χ² and logistic regression considering strata, cluster and weight using SAS V9.3 program.

The prevalence of MS and stress (≥high) was 31.9% and 27.5%. The very low stress group had significant higher prevalence of MS and MS score (number of clinical MS Component) then others (p=.002, p<.001). The odds ratio (OR) of MS with stress were 0.67∼0.77 (p<.01, p=.15) in unadjusted model. After all covariates (age, sex, body mass index (BMI), education, marriage, income, occupation, smoking, alcohol, exercise) adjusted, finally ORs weren’t significant (0.99≤OR≤-1.22, 0.12≤p≤.96). However, HDL cholesterol, HBP (high blood pressure), and FBS (fasting blood sugar) had significant relation with stress, respectively (1.14≤OR≤1.18, 1.66≤OR≤2.01, 1.33≤OR≤1.47, all p<.001).

This study indicates that stress was not independently associated with metabolic syndrome prevalence risk. However, HDL cholesterol, HBP, and FBS were significantly increased in low and high stress group then very low group.

College students experience stress related to its demands. Providing adequate resources to improve stress management remains a challenge. Dominance, Influence, Steadiness, Conscientiousness (DISC) is an instrument that accounts for multidimensionality of personality and has been used widely in research and industry. The purpose of this study was to examine DISC behavioral style with perceived stress, coping behavior, and personal satisfaction among college students.

Data were collected from 255 college students using self-reported questionnaire. Univariate descriptive statistical analysis was performed to explore sociodemographic characteristics of the sample. Possible association between sociodemographic variables and perceived stress, coping, personal satisfaction were examined using bivariate analysis with T-tests for independent samples and Chi-square. ANOVA was used to assess possible association between DISC profiles and the following three variables: perceived stress, coping, and personal satisfaction. A Scheffe test was performed post hoc to test for differences in DISC behavioral style and measures of perceived stress, coping, and personal satisfaction.

The distribution of DISC behavioral styles were 49.4%, 23.2%, 18.8%, and 8.6% respectively for dominance, influence, steadiness, and conscientiousness. Perceived stress and personal relationship varied significantly with DISC behavioral style (p=.001 and p=.019 respectively). Variation in DISC behavioral style did not demonstrate a significant association with stress coping (p=.383).

Providing stress coping management tailored to DISC behavioral style may be an effective way to improve stress reduction and personal satisfaction among college students.

Negative urgency is a tendency to engage in rash behaviors when experiencing negative emotions such as depression, anxiety, and stress, and is known to predict addictive behaviors. This study aimed to investigate the effect of negative urgency on smartphone addiction as one of behavioral addictions.

Self-report questionnaires were administered to 350 college (graduate) students to assess the level of depression, anxiety, stress, negative urgency, and smartphone addiction.

Regression and bootstrapping analyses showed that negative urgency partially mediated the relationships between each of depression, anxiety, and stress and smartphone addiction, even after controlling for age, sex, and average time spent on smartphone per day.

Negative emotions such as depression, anxiety, or stress affect smartphone addiction through negative urgency. This finding suggests that intervention for smartphone addiction should focus not only on negative emotions but also on reducing negative urgency. Further implications and limitations of this study are discussed.

The purpose of this study was to examine the mediating effects of achievement goals (performance approach goal, mastery approach goal, performance avoidance goal) on the link between role stress and burnout and engagement.

A total 224 non-commissioned officers agreed to the purpose of this study were participated. A correlation analysis was performed by using SPSS 21.0, and Structural Equation Modeling (SEM) was performed by using AMOS 20.0.

This study were as follows. As a result of comparing the research model including the performance approach goal and the competition model except the performance approach goal, the competition model was excellent. In addition, performance avoidance goal was partially mediated in the relationship between role stress and burnout. In addition, the mastery approach goal was partially in the relationship between role stress and engagement.

The results imply that improving mastery approach goal and decreasing performance avoidance goal is very important for non-commissioned officers. Therefore, the military authorities should develop various strategies to decrease performance avoidance goal and improve the mastery approach goal.

The purpose of this study was to identify the relationship between stress, role conflict and quality of life among graduate students in nursing.

A cross-sectional descriptive study design was used. After IRB approval, the data were collected using structured questionnaires from the 98 graduate students in nursing. The data were collected from September 10 to November 30, 2018. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression by using SPSS 25.0 statistical program.

Nursing graduate students were experiencing more stress on their facing task than the interpersonal dimension of stress, and had the greatest difficulty in playing the role of their families due to their work and school responsibilities. Stress and role conflict of nursing graduate students were negatively correlated with quality of life. There was a significant positive correlation between stress and role conflict. The variables affecting the quality of life of nursing graduate students were identified by stress and working status.

To improve the quality of life for nursing graduate students, it is necessary to help balance the roles between work, school, and family through appropriate stress management.

This study was conducted to examine job stress, sleep quality, and fatigue and identify major variables that influence work engagement in order to develop an intervention program for shift duty nurses to enhance their work engagement.

The subjects of this study were 170 nurses working with shift duty at one university hospital and one general hospital located in G city. Data were collected from February to March 2018 with structured questionnaires, and analyzed by descriptive statistics, t-test, ANOVA, Scheffe’s test, Pearson correlation coefficients, and multiple regression.

The mean scores of job stress, sleep quality, fatigue, and work engagement were 3.87, 1.57, 4.64, and 2.36, respectively. The work engagement was negatively correlated with job stress, sleep quality, and fatigue. The most powerful variable influencing work engagement was sleep quality and the model showed explanatory power of 22.5%.

The results of this study indicate that the quality of sleep is most important factor affecting work engagement of shift nurses. This study suggest that it is necessary a variety of strategies in order to improve the quality of sleep and to intervene in job stress and fatigue, eventually lead to enhancing nursing performance.

The purpose of this study was to explore the association between the high perceived stress of adults and the types and amounts of their physical activities.

The subjects consisted of 5,624 adults aged 20 and older from the 2017 Korean National Health and Nutrition Examination Survey data. The three types of physical activity (aerobic activity, muscular exercise and walking) were investigated and the amounts of physical activity were calculated with time used in each activity were calculated. To examine the association between the high perceived stress and physical activity, complex samples multiple logistic regression analyses were performed with controlling participants’ demographic and socio-economic, health status and health behavior characteristics.

There were 1,539 people (27.36%) in the high stress perceived group, and the subjects in the high stress perceived group seemed to perform less time to walking (weighted mean: 217.23 minutes/ week) than the low or not stress perceived group (weighted mean: 241.09 minutes/week). The proportion of subjects doing muscular exercise 3 or more days in a week seemed to higher in the lower stress perceived group than the high stress perceived group. The multiple logistic regression analyses results showed significant correlations between walking or doing muscular exercise and high-perceived stress (p<0.01). Additionally, the proportion of activity at work seemed to be a significant factor in the perceived stress level.

There appears to be a correlation between physical activity especially muscular activity and perceived stress, such that further studies will lead to improvements in stress management strategies.