Coping Behavior, Stress, Psychological
Conditions
Keywords
stress psychological, coping behavior
Brief summary
This randomized clinical trial aimed at evaluating the auriculotherapy as coping strategies in 75 nursing professionals in a University Hospital.
Detailed description
There is consensus that psychological and social factors can lead to physical health problems of individuals and coping strategies in stressful situations may be crucial for the mental, physical and social development of people. Taking care of professionals who provide health services is a key strategy, since good results depend on the service, especially in work teams healthy and, therefore, able to promote the humanization of service.
Interventions
The chinese auriculotherapy is a intervention used by Chinese Traditional Medicine in order to balance the body energy and to treat several kind of diseases using semi-permanent needles in specific points of the auricular pavilion.
We used the three points Shenmen, Kidney, and Brain Stem with mustard seeds, 1 time per week for 8 sessions.The subjects were instructed to stimulate the points three times a day.
Sponsors
University of Sao Paulo
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
23 Years to 61 Years
Healthy volunteers
Yes
Inclusion criteria
* Average and high score by the List of Stress Symptoms * Voluntary participation in the study * Availability of time for submission to the sessions
Exclusion criteria
* Pregnancy * Medical license or vacation during the period * Low score of stress
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Coping Strategy: Domain Social Support(After 60 Days) | after 60days | Scale information: Folkman and Lazarus Coping Strategy Inventory with 66 items. The scale is constructed by 8 different domains: confrontation, distancing, self-control, social support, acceptance of responsibility, escape avoidance, problem solving and positive reappraisal.The questions are scored by Likert scale: 0 (not used this strategy); 1 (used somewhat); 2 (used enough) and 3(used in large quantities) to the 66 items (Folkman and Lazarus Coping Strategy Inventory). It performed a summation of items and defined the scores: 0-4 points (not use this strategy), 5-9 (use this strategy a bit), 10-14 ( use this strategy quite) 14-18 (use strategy plenty). |
| Coping Strategy: Distancing Domain | after 75 days | The questions are scored by Likert scale: 0 (not used this strategy); 1 (used somewhat); 2 (used enough) and 3(used in large quantities) to the 66 items (Folkman and Lazarus Coping Strategy Inventory). It performed a summation of items and defined the scores: 0-4 points (not use this strategy), 5-9 (use this strategy a bit), 10-14 ( use this strategy quite) 14-18 (use strategy plenty). |
| Coping Strategy: Social Support Domain | after 60 days | Scale information: Folkman and Lazarus Coping Strategy Inventory with 66 items. The scale is constructed by 8 different domains: confrontation, distancing, self-control, social support, acceptance of responsibility, escape avoidance, problem solving and positive reappraisal.The questions are scored by Likert scale: 0 (not used this strategy); 1 (used somewhat); 2 (used enough) and 3(used in large quantities) to the 66 items (Folkman and Lazarus Coping Strategy Inventory). It performed a summation of items and defined the scores: 0-4 points (not use this strategy), 5-9 (use this strategy a bit), 10-14 ( use this strategy quite) 14-18 (use strategy plenty). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Stress Scale | after 60 days | Scale information: Stress Symptoms List (LSS)with 60 items (better outcome)Low score: 12/29 points; Medium score: 30/60 points; High score: 61/120 points; Very high score (worse outcome): \>120 points. |
Countries
Brazil
Participant flow
Recruitment details
Recruitment was conducted between January and September 2011 at University Hospital. Study participants were professionals from different sectors of the hospital after the invitation and 109 people answered the Stress Symptoms List. Obeying the exclusion criteria, 75 subjects were enrolled and randomized into three groups.
Pre-assignment details
Of the 109 subjects, 4 were eliminated for having a low level of stress and three for not belonging to nursing staff.
Participants by arm
| Arm | Count |
|---|---|
| Auriculotherapy by Needles The investigators used 3 points, Shenmen, Kidney, and Brain Stem with semi-permanent needles of 1.8 mm, 1 time per week for 8 sessions.
auriculotherapy by needles : The chinese auriculotherapy is a intervention used by Chinese Traditional Medicine in order to balance the body energy and to treat several kind of diseases using semi-permanent needles in specific points of the auricular pavilion. | 27 |
| Auriculotherapy by Seeds The investigators used the three points Shenmen, Kidney, and Brain Stem with mustard seeds, 1 time per week for 8 sessions.
auriculotherapy by seeds : We used the three points Shenmen, Kidney, and Brain Stem with mustard seeds, 1 time per week for 8 sessions.The subjects were instructed to stimulate the points three times a day. | 26 |
| Control Group Control Group didn't receive any treatment and was evaluated at the same time and the same way of interventions group | 22 |
| Total | 75 |
Baseline characteristics
| Characteristic | Auriculotherapy by Seeds | Control Group | Auriculotherapy by Needles | Total |
|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 26 Participants | 22 Participants | 27 Participants | 75 Participants |
| Age Continuous | 45.57 years STANDARD_DEVIATION 6.4 | 39.25 years STANDARD_DEVIATION 13.17 | 41.37 years STANDARD_DEVIATION 8.23 | 42.06 years STANDARD_DEVIATION 9.27 |
| Region of Enrollment Brazil | 26 participants | 22 participants | 27 participants | 75 participants |
| Sex: Female, Male Female | 25 Participants | 21 Participants | 25 Participants | 71 Participants |
| Sex: Female, Male Male | 1 Participants | 1 Participants | 2 Participants | 4 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 3 / 27 | 1 / 26 | 0 / 22 |
| serious Total, serious adverse events | 0 / 27 | 0 / 26 | 0 / 22 |
Outcome results
Primary
Coping Strategy: Distancing Domain
The questions are scored by Likert scale: 0 (not used this strategy); 1 (used somewhat); 2 (used enough) and 3(used in large quantities) to the 66 items (Folkman and Lazarus Coping Strategy Inventory). It performed a summation of items and defined the scores: 0-4 points (not use this strategy), 5-9 (use this strategy a bit), 10-14 ( use this strategy quite) 14-18 (use strategy plenty).
Time frame: after 75 days
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Auriculotherapy by Needles | Coping Strategy: Distancing Domain | 6.33 units on a scale | Standard Deviation 1.34 |
| Auriculotherapy by Seeds | Coping Strategy: Distancing Domain | 6.65 units on a scale | Standard Deviation 1.46 |
| Control Group | Coping Strategy: Distancing Domain | 7.36 units on a scale | Standard Deviation 2.32 |
Comparison: It was carried out the analysis of variance (ANOVA) among the groups at the follow up (after 75 days). The main objective was to compare the difference among the control group, seeds and needles and to recognize significant outcomes of auriculotherapy by seeds or needles.p-value: 0.039ANOVA
Comparison: Coping Strategy: Confrontation domainp-value: 0.029ANOVA
Primary
Coping Strategy: Domain Social Support(After 60 Days)
Scale information: Folkman and Lazarus Coping Strategy Inventory with 66 items. The scale is constructed by 8 different domains: confrontation, distancing, self-control, social support, acceptance of responsibility, escape avoidance, problem solving and positive reappraisal.The questions are scored by Likert scale: 0 (not used this strategy); 1 (used somewhat); 2 (used enough) and 3(used in large quantities) to the 66 items (Folkman and Lazarus Coping Strategy Inventory). It performed a summation of items and defined the scores: 0-4 points (not use this strategy), 5-9 (use this strategy a bit), 10-14 ( use this strategy quite) 14-18 (use strategy plenty).
Time frame: after 60days
Population: Of the 109 subjects, four were eliminated for having a low level of stress and three for not belonging to nursing staff;seven didn't appear in the first session. Some lost sessions and were also excluded. One abandoned the treatment because of the side effects, one didn't complete the questionnaire, seven went on vacation or sick leave(2).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Auriculotherapy by Needles | Coping Strategy: Domain Social Support(After 60 Days) | 8.81 units on a scale | Standard Deviation 2.5 |
| Auriculotherapy by Seeds | Coping Strategy: Domain Social Support(After 60 Days) | 8.73 units on a scale | Standard Deviation 3.2 |
| Control Group | Coping Strategy: Domain Social Support(After 60 Days) | 11.32 units on a scale | Standard Deviation 4.3 |
Comparison: It was carried out the analysis of variance (ANOVA) among the groups in the 3rd assessment (after 60 days) and at the follow up (after 75 days). The main objective was to compare the difference among the control group, seeds and needles and to recognize significant outcomes of auriculotherapy by seeds or needles.p-value: ,0ANOVA
Primary
Coping Strategy: Social Support Domain
Scale information: Folkman and Lazarus Coping Strategy Inventory with 66 items. The scale is constructed by 8 different domains: confrontation, distancing, self-control, social support, acceptance of responsibility, escape avoidance, problem solving and positive reappraisal.The questions are scored by Likert scale: 0 (not used this strategy); 1 (used somewhat); 2 (used enough) and 3(used in large quantities) to the 66 items (Folkman and Lazarus Coping Strategy Inventory). It performed a summation of items and defined the scores: 0-4 points (not use this strategy), 5-9 (use this strategy a bit), 10-14 ( use this strategy quite) 14-18 (use strategy plenty).
Time frame: after 60 days
Population: Of the 109 subjects, four were eliminated for having a low level of stress and three for not belonging to nursing staff;seven didn't appear in the first session. Some lost sessions and were also excluded. One abandoned the treatment because of the side effects, one didn't complete the questionnaire, seven went on vacation or sick leave(2).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Auriculotherapy by Needles | Coping Strategy: Social Support Domain | 8.81 units on a scale | Standard Deviation 2.5 |
| Auriculotherapy by Seeds | Coping Strategy: Social Support Domain | 8.73 units on a scale | Standard Deviation 3.2 |
| Control Group | Coping Strategy: Social Support Domain | 11.32 units on a scale | Standard Deviation 4.3 |
Secondary
Stress Scale
Scale information: Stress Symptoms List (LSS)with 60 items (better outcome)Low score: 12/29 points; Medium score: 30/60 points; High score: 61/120 points; Very high score (worse outcome): \>120 points.
Time frame: after 60 days
Population: Of the 109 subjects, four were eliminated for having a low level of stress and three for not belonging to nursing staff;seven didn't appear in the first session. Some lost sessions and were also excluded. One abandoned the treatment because of the side effects, one didn't complete the questionnaire, seven went on vacation or sick leave(2).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Auriculotherapy by Needles | Stress Scale | 59.84 units on a scale | Standard Deviation 23.04 |
| Auriculotherapy by Seeds | Stress Scale | 67.10 units on a scale | Standard Deviation 23.77 |
| Control Group | Stress Scale | 67.87 units on a scale | Standard Deviation 25.73 |
Comparison: The main objective was to compare the difference among the control group, seeds and needles and to recognize significant outcomes of auriculotherapy by seeds or needles.p-value: 0.023ANOVA