@article{ref1,
title="Distraction-focused interventions on examination stress in nursing students: effects on psychological stress and biomarker levels. A randomized controlled trial",
journal="International journal of nursing practice",
year="2019",
author="Gebhart, Verena and Buchberger, Waltraud and Klotz, Isabella and Neururer, Sabrina and Rungg, Christine and Tucek, Gerhard and Zenzmaier, Christoph and Perkhofer, Susanne",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Nursing students all over the world experience high levels of stress with negative impacts on their health, emotional state and performance. <br><br>AIM: This study aimed to investigate the effects of distraction-focused interventions on examination stress and anxiety in nursing students. <br><br>METHODS: A randomized controlled, parallel trial design was conducted from January to June 2016. After baseline measurement, 72 participants were randomized to one of the following groups (n = 18 each): (i) animal-assisted therapy; (ii) music therapy; (iii) mandala painting; (iv) control group. Outcomes of all groups in terms of stress-reduction were compared by measuring self-reported perceived stress (STAI-State and visual analogue stress scale) and salivary biomarker levels (Cortisol and Immunoglobulin A). <br><br>RESULTS: Fifty-seven complete data sets (n = 12-16 for each group) were analysed. All distraction-focused interventions showed stress and anxiety reduction in everyday school situations. By contrast, on days with examinations, stress reductions did not reach statistical significance in regard to self-reported psychological stress. At the same time, interventions resulted in significantly decreased levels of stress biomarkers (P <.001). <br><br>CONCLUSIONS: Our preliminary findings suggest positive but situation-dependent effects of distraction-focused interventions in academic settings. Further research should investigate the complex relationship between physiological and psychological stress parameters.<br><br>© 2019 John Wiley & Sons Australia, Ltd.<p /> <p>Language: en</p>",
language="en",
issn="1322-7114",
doi="10.1111/ijn.12788",
url="http://dx.doi.org/10.1111/ijn.12788"
}