ArticlePDF Available


This study assessed feasibility and effect of weekly, 15-min chair massages during work for 38 nurses. Mean Perceived Stress Scale-14 (PSS-14), Smith Anxiety Scale (SAS), linear analog self-assessment scale (LASA), and symptom visual analog scale (SX-VAS) scores were tracked at baseline, 5 weeks, and 10 weeks. Of 400 available massage appointments, 329 were used. At 10 weeks, mean PSS-14 score decreased from 17.85 to 14.92 (P = .002); mean SAS score, from 49.45 to 40.95 (P < .001). Mean LASA score increased from 42.39 to 44.84 (P = .006); mean SX-VAS score, from 65.03 to 74.47 (P < .001). Massages for nurses during work hours reduced stress-related symptoms.
P02.70. Feasibility and effect of chair massage
offered to nurses during working hours on stress
related symptoms: a pilot study
D Engen, B Bauer, A Vincent, C Luedtke, L Loehrer, S Cha, T Chon, L Dion, N Rodgers, D Wahner-Roedler
From International Research Congress on Integrative Medicine and Health 2012
Portland, Oregon, USA. 15-18 May 2012
To assess the feasibility and effect of chair massage
offered to hospital nurses during working hours on
stress related symptoms.
Single arm study performed between 10/15/2010 and 12/
24/2010 at an academic medical center. A mass e-mail
was sent to all nurses working in an inpatient psychiatric
and an outpatient pain rehabilitation unit. The first 40
respondents were enrolled; two were excluded due to
missing enrollment data. A 15 minute chair massage
once a week for 10 weeks was provided by one of three
Certified Massage Therapists available 3 days a week.
Instruments used included the Perceived Stress Scale
(PSS-14), Smith Anxiety Scale (SAS), and Linear Analo-
gue Scale Assessment (LASA) scale. Mean and standard
deviations of PSS-14, SAS and LASA scores at baseline
and at 10 weeks were calculated and analyzed with the
paired t-test. Any p-value <0.05 was considered statisti-
cally significant.
The median age of 38 participants (5 males, 33 females)
was 47 years (range 21-65). All participants completed the
3 instruments used at the beginning and end of the study.
Of 380 available massage appointments, 278 were used
(mean 7.13, range 1-10 massages per participant). Stress
related symptoms improved as follows: the mean PSS-14
score decreased from 17.85 to 14.92 (p=0.0015), and the
mean SAS score from 49.45 to 40.95 (p<0.0001). The
mean LASA score increased from 42.39 to 44.84
(p=0.0055). Thirty participants (78.95%) felt that their
overall job satisfaction improved because of the massages,
and 23 (60.53%) were willing to pay $10 to $25 for a 15
minute chair massage if available at work.
Offering chair massages for nurses in a psychiatric/pain
rehabilitation unit during working hours - although diffi-
cult to do due to busy clinical schedules - reduced stress
related symptoms significantly and was highly appreciated
by the nurses.
Published: 12 June 2012
Cite this article as: Engen et al.: P02.70. Feasibility and effect of chair
massage offered to nurses during working hours on stress related
symptoms: a pilot study. BMC Complementary and Alternative Medicine
2012 12(Suppl 1):P126.
Submit your next manuscript to BioMed Central
and take full advantage of:
Convenient online submission
Thorough peer review
No space constraints or color figure charges
Immediate publication on acceptance
Inclusion in PubMed, CAS, Scopus and Google Scholar
Research which is freely available for redistribution
Submit your manuscript at
Mayo Clinic, Rochester, USA
Engen et al.BMC Complementary and Alternative
Medicine 2012, 12(Suppl 1):P126
© 2012 Engen et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativec, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
... On the whole, 58 individuals selected (29 participants in each group) based on a previous study. (26) The confidence level of 95%, the power of 80%, the reported standard deviation for occupational stress level 6.75, and the effect size of 3.5, based on reported the minimum difference between the means, were considered. ...
... (25,12) Scholars have paid attention to the coping skills for occupational stress, offering various methods for accommodation for occupation-related stressors for the emergency medical service staff. (22,26,27) Moreover, certain approaches have been put forward with regard to coping with occupational stress; among them are the use of traditional complementary therapeutic methods like aromatherapy, music therapy, and massage therapy. ...
... Certain contradictory reports have been documented on this topic. Some researchers have introduced massage therapy as a standalone measure, or in combination with other complementary medical interventions, as an effective intervention in decreasing occupational stress, (3,26,28) while the results of some other studies suggest the inefficiency of massage on occupational stress. (8,17) Although different rates of efficacy of this intervention exist in various individuals, occupations, and organizational situations, and the manual or electronic performance of the massage seems logical in the long-run and the short-run, there are limited scientific reports on the efficacy of this intervention in diminishing occupational stress among EMS staff. ...
Full-text available
Background Results of various studies indicate that emergency medical service (EMS) staff suffer from occupational stress that adversely affects their quality of life and their care quality. Purpose This study aimed at determining the effect of massage on occupational stress experienced by emergency medical service staff. Setting Prehospital emergency medical services stations of a city in the southwest of Iran. Participants A total of 58 members of staff of the emergency medical services, working in prehospital emergency medical services stations. Research Design In this randomized controlled trial, a total of 58 EMS staff were selected from prehospital EMS stations, according to inclusion and exclusion criteria, and then assigned in two groups (29 in massage and 29 in control group) randomly by the minimization method. The intervention group received Swedish massage, twice a week for four weeks in the morning after the end of the work shift. Each massage session lasted 20–25 minutes. Subjects in the control group received no intervention. The level of occupational stress of the two groups was measured under the same conditions before and after the intervention by using the expanded nurses’ occupational stress scale (ENSS). Data were analyzed with the SPSS16 software by using the chi-squared test, paired and independent-sample t tests, one-way ANCOVA. P value < .05 was considered as the level of significance. Results The mean and SD of total occupational stress scores in the control group was 114.41±30.11 in pretest and reach to 112.58± 30.62 in posttest stage. Also the mean and SD of total occupational stress scores in the intervention group was 130.20±26.45 in pretest and reach to 110.41±21.75 in posttest stage. A one-way ANCOVA showed that there is a significant effect of massage on EMS staff’s occupational stress level after controlling for pretest score (p = .001). Conclusions The training and the application of massage therapy can serve as an effective method in reducing occupational stress in emergency medical centers.
... Studies using CHAIR-M in health workers used pre-and postintervention designs in volunteers who signed up to receive a massage. (32,35) Given the negative impact of chronic stress and musculoskeletal pain on occupational health and the absence of controlled clinical trials using CHAIR-M in health workers, the objective of this study was to evaluate the effectiveness of the CHAIR-M to reduce chronic stress and musculoskeletal pain in an Oncology Nursing team. Thus, the question to answer is, "Can chair massage reduce chronic stress and musculoskeletal pain in an Oncology Nursing team?" ...
... (32) A single-arm clinical trial with nurses from the psychiatric unit and the pain rehabilitation clinic applied 10 sessions of CHAIR-M for 15 minutes, once a week, for 10 weeks during rest time or coffee breaks, and found a significant decrease in stress and anxiety symptoms after the intervention, mainly in nurses of the 12-hour shift between the fifth and sixth week. (35) Another single-arm study which delivered CHAIR-M to ambulatory Oncology nurses, found that they used around four sessions of 15-minute CHAIR-M with a significant decrease in perceived stress, but no difference in systolic and diastolic blood pressure or heart rate. (48) Studies with CHAIR-M applied to nursing professionals have focused on stress, but it is possible to find CHAIR-M delivered to other workers. ...
Full-text available
Background: There is a high prevalence of moderate-to-high levels of chronic stress among nurses, as well as an occurrence of musculoskeletal disorders. Purpose: To evaluate the effectiveness of chair massage to reduce chronic stress and musculoskeletal pain in the Oncology Nursing team. Setting: Two teaching cancer hospitals, one public and the other private, in São Paulo city, Brazil. Participants: A total of 60 women from the Oncology Nursing team. Research design: A randomized controlled trial divided into two groups: chair massage and control without intervention. Intervention: The massage group received two chair massage sessions lasting 15 minutes, twice a week, for three weeks. Main outcome measure: Reduction of stress and pain measured by the List of Signs and Symptoms (LSS) and the Brief Pain Inventory (BPI), respectively. Results: The average age was 32 (± 5.3) years. There was a reduction of stress measured by the LSS with a statistical difference in the group-time interaction (p < .001), with a Cohen's d value of 1.21 between groups. The BPI analysis showed a statistically significant difference in the group-time interaction for general activity (p < .008), mood (p < .03), work (p < .000), and sleep (p = .03), with reduced pain interference in these components. Conclusion: Chair massage reduced stress and pain interference in the team's daily life activities, bringing a positive impact in the context of work stress and pain in Oncology nursing professionals.
... During the treatment, the physiotherapist performs massage techniques, acupressure and stretching, focusing mainly on the area around the neck, head, upper limbs and back [20,21]. Chair massage as a form of prophylaxis has also been used among other professional groups exposed to musculoskeletal overload [21,22]. ...
... Similar results were obtained by other researchers using this form of prophylaxis of musculoskeletal problems among other professional groups [21,38,39]. Special attention was paid to such benefits as reduction of stress, improvement of sleep comfort, reduction of pain, headaches, as well as reduction of tension and stress, the participants reported relaxation and inflow of energy, and increased mobility of the cervical spine [22,40]. ...
Full-text available
Due to the occurrence among musicians of musculoskeletal problems associated with playing a musical instrument, it is necessary to use prophylaxis. The aim of the study was to compare the effectiveness of two physioprophylaxis methods: chair massage and an original set of exercises. The study lasted four weeks and consisted of eight 15-min meetings (chair massage/exercises). The study was conducted on 44 music students assigned to three groups (chair massage/exercise program/control group). The algometric measurements and questionnaire were conducted. Health problems associated with playing an instrument was reported by 86.4% of the participants. The largest changes in pain threshold concerned the trigger points of the muscles with the highest pain sensitivity, i.e., upper part of trapezius ones, and reached 25-34% in relation to the initial values. For the trigger points of the levator scapulae and lower part of trapezius, the increase in the pain threshold was between 20 and 28%. Raising the pain threshold was observed both after each session and meeting by meeting, and these differences were most visible in the massage group. This effect was particularly visible from the fourth treatment. Chair massage and exercise should be used regularly, and significant results can be obtained after two weeks.
... 33 of these records were filtered, with the most common reason being the lack of a nonintervention control group or other physical relaxation comparison group (15 studies). 28,[44][45][46][47][48][49][50][51][52][53][54][55][56][57] Furthermore, seven studies were excluded due to non-randomized or quasi-randomized designs, 32,58-63 eight for inadequate data, [64][65][66][67][68][69][70][71] and three due to interventions that included vigorous aerobic or weight training exercise. [72][73][74] Finally, 15 studies that met our inclusion criteria were included in this meta-analysis ( Figure 1 and Table 1). ...
Full-text available
Objectives Work related stress is a major occupational health problem that is associated with adverse effects on physical and mental health. Healthcare workers are particularly vulnerable in the era of COVID-19. Physical methods of stress relief such as yoga and massage therapy may reduce occupational stress. The objective of this systematic review and network meta-analysis is to determine the effects of yoga, massage therapy, progressive muscle relaxation, and stretching on alleviating stress and improving physical and mental health in healthcare workers. Methods Databases were searched for randomized controlled trials on the use of physical relaxation methods for occupational stress in healthcare workers with any duration of follow-up. Meta-analysis was performed for standard mean differences in stress measures from baseline between subjects undergoing relaxation vs non-intervention controls. Network meta-analysis was conducted to determine the best relaxation method. Results Fifteen trials representing 688 healthcare workers were identified. Random-effects meta-analysis shows that physical relaxation methods overall reduced measures of occupational stress at the longest duration of follow-up vs baseline compared to non-intervention controls (SMD −0.53; 95% CI [−0.74 to −0.33]; p < .00001). On network meta-analysis, only yoga alone (SMD −0.71; 95% CI [−1.01 to −0.41]) and massage therapy alone (SMD −0.43; 95% CI [−0.72 to −0.14]) were more effective than control, with yoga identified as the best method (p-score = .89). Conclusion Physical relaxation may help reduce occupational stress in healthcare workers. Yoga is particularly effective and offers the convenience of online delivery. Employers should consider implementing these methods into workplace wellness programs.
... Evidence supports using massage to reduce stress in the workplace and specifically in health care and nursing. Engen et al. (2012) reported that offering weekly 15-minute massages for nurses (inpatient psychiatric nurses and outpatient pain rehabilitation nurses) during work hours over a 10-week period provided a significant reduction in stress-and anxiety-related symptoms. Similarly, Brennan and DeBate (2006) found that 10-minute chair massages provided a greater reduction in nurses' perceived stress compared to a 10-minute coffee break. ...
Background: High stress levels over time can contribute to compassion fatigue and burnout and negatively affect individual health and well-being. Objectives: A pre-/post-test initiative was implemented to determine the effects of massage chair sessions on ambulatory cancer center nurses (RNs and advanced practice providers) based on their perceived stress, blood pressure (BP), and heart rate (HR). Methods: A mechanical massage chair was available for 20-minute sessions in a secure room, and nurses self-recorded perceived stress using a visual analog scale, as well as BP and HR using a wrist cuff device. Descriptive statistics and paired t tests were used to assess nurse characteristics and differences before and after massage chair sessions. Findings: Nurses participated in 200 massage chair sessions during a six-month period. Significant reductions were noted in perceived stress, systolic and diastolic BP, and HR. These data indicate that providing a relaxing room with chair massage has favorable effects on nurses' perceived stress, BP, and HR.
... Conventional table massage is not the only type of massage therapy to provide anxiety reduction benefits. Engen and colleagues [7] found that one 15 minute chair massage per week for 10 weeks was associated with reductions in stress and anxiety among a sample of Mayo Clinic nurses during work hours. The chair massage offered the advantage that busy workers did not need to disrobe or require the extended time away from work to receive a full hour table massage. ...
Full-text available
Background and Objectives: Several studies have shown that nurses working in the ICUs experience high levels of anxiety. Anxiety can not only negatively affect them, but may decrease the quality of care provided by them. The present study aimed to assess the effect of Valerian on anxiety among nurses working in the ICUs of Zanjan teaching hospitals. Materials and Methods: In this clinical trial, nurses working morning and evening shifts were recruited for the study. A dose of 530 mg Herbal Sedamin capsules containing dried roots of Valeriana Officinalis was consumed by the nurses in the intervention group twice a day for one week. The control group received a placebo. The Spielberger's State-Trait anxiety inventory was completed by the nurses at baseline and after the intervention. The independent t-test and paired t-test were used to analyse data. Results: After the intervention in two groups (Valerian and Placebo), the trait and state anxiety scores were significantly lower than before the intervention. But there were no significant differences in the trait and state anxiety scores of the questionnaire between the experimental group and control groups after the intervention (P= 0.846). Conclusion: It seems that the special and different nature of the ICUs has hampered the effectiveness of this herbal medicine. Further studies with higher doses, or in other settings are suggested.
This quality improvement initiative originated in the cardiac intensive care unit (CICU) at a 637-bed licensed Magnet teaching hospital with the rating of level 1 trauma center. The CICU has 12 beds, with a staff of 59 nurses (RNs). The nursing staff expressed increased stress and discomfort when communicating with patients and their families when providing end-of-life care. Selected evidence-based techniques for stress reduction and active listening skills were taught in 4- to 5-minute mini sessions during the morning huddle 3 days per week for 4 weeks. The program was evaluated using pretest, posttest, and 2 follow-up surveys composed of 5 statements and 2 open-ended questions. The survey tool was developed by researchers in accordance with the relevant literature. The results showed improved communication as demonstrated by the surveys. Nurses also reported feeling more supported by their colleagues and supervisors. The project was conducted in 1 CICU, therefore limiting the generalizability of the results.
Purpose: To examine the feasibility of a brief mindfulness intervention and to reduce nurse stress and burnout in an inpatient medical unit. Design: Single-arm, pre/post test study design. Method: Perceived Stress Scale (PSS), Maslach Burnout Inventory (MBI), and pre/post demographic questionnaires given at pre-intervention (baseline) and 6 weeks post-intervention. Intervention effectiveness was compared between the pre-survey ( N = 52) and post-survey ( N = 33). Five choices were offered to inpatient staff: a guided mindfulness CD, soothing sounds machine with a breathing technique instructional, mindfulness prompts, a journal, and water/snacks during six consecutive weekends. Findings: The mean PSS score did not improve and demonstrated a slight increase during the six-weekend intervention. However, mean MBI scores for the subscales of emotional exhaustion and depersonalization did demonstrate improvement as evident by decreased scores. Additionally, the mean MBI score for the subscale of personal accomplishment also improved with increased scores. Qualitative themes were positive and included relaxation, nourishment, and refocus. Majority of participants (75%) perceived the intervention as being effective or very effective in reducing stress at work. Respondents were "interested" or "very interested" in continuing a similar intervention in the future (84.9%). Conclusion: The improvement in scores for the MBI measures were a positive finding. The intervention was low cost, individualized, and accessible. The feasibility and perceptions of the intervention's effectiveness has positive implications for the well-being of nurses.
Aims and objectives: To assess the effectiveness of aromatherapy and massage on relieving stress in nurses. Background: Nurses face uncommon levels of stress in medical settings. Stress has a negative impact on nurses' well-being and the organisation where they work. Aromatherapy and massage are important strategies for stress reduction. However, the effectiveness of aromatherapy and massage on relieving stress in nurses currently lacks understanding. Design: Systematic review. Method: We performed a quantitative systematic review using Cochrane methods. We searched existing literature in the following databases: PubMed, PsycINFO, Embase, Web of Science and Cochrane Library, to examine any experimental design studies published from the earliest date available to August 2017 in English. Risk of bias per outcome was assessed. Results: A total of 10 articles met the inclusion criteria, including aromatherapy (n = 4), massage (n = 4) and aromatherapy massage (n = 2). Most studies reported that aromatherapy and massage exert a beneficial effect on the stress of nurses. One study showed that the aromatherapy massage with music interventions has no effect on the stress of nurses. However, the number of the studies is limited and has high or unclear risk of bias. Conclusion: This review revealed that the evidence does not sufficiently prove that aromatherapy, massage and aromatherapy massage are effective for reducing job-related stress of nurses. We need to conduct high-quality studies to verify the effects of these interventions on nurses' stress levels in the future. Moreover, we need to integrate outcome measures of stress levels for developing more appropriate tools than the ones used as present. Relevance to clinical practice: Nurses' stress has a negative impact on their own and organisation where they work. All available opportunities should be taken to reduce nurses' stress. It will be beneficial for nurse shortage.
Full-text available
Cardiac sonographers frequently have work-related muscular discomfort. We aimed to assess the feasibility of having sonographers receive massages during working hours in an area adjacent to an echocardiography laboratory and to assess relief of discomfort with use of the massages with or without stretching exercises. A group of 45 full-time sonographers was randomly assigned to receive weekly 30-minute massage sessions, massages plus stretching exercises to be performed twice a day, or no intervention. Outcome measures were scores of the QuickDASH instrument and its associated work module at baseline and at 10 weeks of intervention. Data were analyzed with standard descriptive statistics and the separation test for early-phase comparative trials. Forty-four participants completed the study: 15 in the control group, 14 in the massage group, and 15 in the massage plus stretches group. Some improvement was seen in work-related discomfort by the QuickDASH scores and work module scores in the 2 intervention groups. The separation test showed separation in favor of the 2 interventions. On the basis of the results of this pilot study, larger trials are warranted to evaluate the effect of massages with or without stretching on work-related discomfort in cardiac sonographers. NCT00975026
Full-text available
Assess the effects of workplace-based massage therapy on physiological and psychological outcomes. We used afield experiment in which 28 participants were randomly assigned into either an experimental (n = 14) or control (n = 14) group. The experimental group received weekly massage treatments at work for a four week period while the control group did not. Both strain and blood pressure were significantly reduced during treatment for the experimental group but not for the control group. This study provides initial support for the effectiveness of workplace-based massage therapy as part of a comprehensive workplace health strategy.
Full-text available
Long-term care staff have high levels of musculoskeletal concerns. This research provided a pilot program to evaluate the efficacy of employer-funded on-site massage therapy on job satisfaction, workplace stress, pain, and discomfort. Twenty-minute massage therapy sessions were provided. Evaluation demonstrated possible improvements in job satisfaction, with initial benefits in pain severity, and the greatest benefit for individuals with preexisting symptoms. A long-term effect was not demonstrated.
Objective To evaluate the effectiveness of a 10 min chair massage on the stress perception of hospital nurses in comparison to a routine “coffee break” during a working shift. Methods Eighty-two bedside nurses, (M=4M=4; F=78F=78), mean age of 34.77±9.32, within a small, suburban hospital, participated in this study to determine the effect a 10-min on-site chair massage (n=41n=41) had on their stress perception in comparison to a 10-min “coffee break” (n=41n=41). The feasibility of incorporating a massage into their workload during a shift was also considered. Using the Perceived Stress Scale (PSS), stress perception was assessed in an experimental pre-test–post-test design and analyzed using t-tests for dependent samples. Results Stress perception was significantly lower in the massage group (P<.05P<.05) and was not significantly changed in the control group. Also, 86% of the nurses scheduled to participate in the study were able to do so within their normal workday. Conclusion Incorporating chair massage into a nurse's hospital shift is feasible and a 10 min session reduces the stress perception of the nurse more so than the standard “coffee break”. This study focused on a one-time intervention for the 82 nurses enrolled. Further study on the longer term feasibility and effects of chair massage on this population and others in high stress professions is warranted.
A pilot study was conducted to assess the feasibility and efficacy of massage therapy for cardiac catheterization laboratory staff. Staff members (N = 50) were randomly assigned to 5 or 10 weekly 30-min massages, followed by outcomes assessment. A control group (n = 10) receiving no massage therapy underwent comparable assessment. Visual analog scales, the t test, and the repeated measures model evaluated fatigue, pain, relaxation, stress/anxiety, tension/discomfort, and scheduling ease at baseline, 5 weeks, and 10 weeks. The Aickin separation test was used to assess feasibility of further research. Overall, 90% (337/375) of massage appointments were used. No significant effects were observed, but the Aickin separation test supported further research on massage therapy for fatigue, pain, relaxation, and tension/discomfort. Conducting massage therapy in the workplace is logistically feasible. Larger, longitudinal trials are warranted to better evaluate its effects on staff.
The primary aim of the study was to assess the feasibility of incorporating a single-session meditation-training program into the daily activities of healthy employees of a tertiary-care academic medical center. The study also assessed the most preferred duration of meditation and the effect of the meditation program on perceived stress, anxiety, and overall quality of life (QOL). Seventeen healthy clinic employees were recruited for this study. After an initial group instruction session covering basic information about meditation, Paced Breathing Meditation (PBM) was taught to the participants. Participants were instructed to self-practice meditation with the help of a DVD daily for a total of 4 weeks. The DVD had three different programs of 5, 15, and 30 minutes with a menu option to choose one of the programs. (1) Patient diary, (2) Perceived Stress Scale (PSS), (3) Linear Analogue Self-Assessment (LASA), (4) Smith Anxiety Scale (SAS). Primary outcome measures were compared using the paired t-test. All participants were female; median age was 48 years (range 33-60 y). The 5-minute meditation session was practiced by 14 participants a total of 137 times during the 4-week trial period, the 15-minute session by 16 participants a total of 223 times, and the 30-minute session by 13 participants 71 times. The median number of days practiced was 25 (range 10-28 d); the average total time practiced was 394 minutes (range 55-850 min). After 4 weeks of practice, the scores of the following instruments improved significantly from baseline: PSS (P < .0001), SAS (P = .0005), LASA (P = .0005). No relationship was noted between the length of time practiced and improvement of PSS, SAS, and LASA scores. This pilot study indicates the feasibility of teaching meditation in a single training session to health care employees. The study shows that 15 minutes once or twice a day is the most feasible duration of meditation practice. The study also provides promising preliminary efficacy data of this program for improving stress, anxiety, and QOL.
The aim of this study was to determine the effects of workplace manual technique interventions for female participants on the degree of joint range of motion and on the level of musculoskeletal ache, pain, or discomfort experienced when performing workplace responsibilities. Nineteen (19) female volunteers were given chair massages on-site twice per week for 1 month. Participants included individuals in administration and management from a company in Ljubljana, Slovenia. A total of 19 female volunteers 40-54 years of age enrolled for this study. Fifteen (15) of them completed all measurements. The Cornell Musculoskeletal Discomfort Questionnaire was used, and range-of-motion measurements in degrees were taken. Subjects completed a series of self-report questionnaires that asked for information concerning musculoskeletal discomfort for the neck, upper back, and lower back in the form of a body diagram. A range-of-motion test (to compare the change in joint angles) was performed with a goniometer to assess cervical lateral flexion, cervical flexion, cervical extension, lumbar flexion, and lumbar extension. Between the first and the last measurements, a significant difference (p<0.05) was found in increased range of motion for cervical lateral flexion (28.8%). Wilcoxon signed rank test showed a significant increase (p<0.05) in range of motion for cervical lateral flexion (42.4±6.3 to 48.3±7.3), cervical extension (63.2±12.4 to 67.2±12.3), and a significant decrease (p<0.05) in the Cornell Musculoskeletal Discomfort Questionnaire values for the neck (2.7±0.8 to 1.9±0.6) and the upper back (2.7±0.7 to 2.2±0.8) from the phase 2 to 3. Significant reductions were also shown in the Cornell Musculoskeletal Discomfort Questionnaire values for the neck (2.8±0.8 to 1.9±0.6) and the upper back (2.7±0.8 to 2.2±0.8) from the phase 1 to 3. On-site massage sessions twice per week for 1 month are the most effective interventions (compared to one session or no massage intervention) for decreasing the duration of musculoskeletal ache, pain, or discomfort and for increasing range of motion.
Predictors of depressive symptoms were identified in a sample of 150 female medical-surgical hospital nurses. Participants completed a demographic questionnaire and instruments to measure occupational stress (Nursing Stress Scale), major life events (Social Readjustment Rating Scale), somatic symptoms (Patient Health Questionnaire-15), and depressive symptoms (Center for Epidemiologic Studies-Depression Scale; CES-D) during a one time survey. Thirty-five percent of the nurses scored > or = 16 on the CES-D, the cutoff for mild to moderate depressive symptoms. Fatigue or low energy (43%), pain in their extremities or joints (30%), trouble sleeping (29%), back pain (28%), and headaches (18%) were the primary somatic complaints. Depressive symptoms were positively correlated with somatic symptoms (r = .55, p < .01), major life events (r = .41, p < .01), and occupational stress (r = .29, p < .01). Years employed in the hospital setting (r = -.22, p < .01) and household income (r = -.18, p < .05) were inversely related to depressive symptoms. Hierarchical multiple regression was used to identify predictors of nurses' depressive symptoms. Somatic symptoms (beta = .39, p < .01), occupational stress (beta = .18, p < .05), major life events (beta = .18, p < .05), and income (beta = -.15, p < .05) accounted for 34% of the variance in nurses' depressive symptom scores. The information from this study can guide the development of interventions to reduce depressive symptoms among hospital nurses. Reductions in depressive symptoms can advance health and quality of life for the hospital nurse. Symptom alleviation or reduction may improve nursing care delivery when distressing symptoms interfere with professional performance among nurses.
This study focused on the degree of burnout experienced by nurses in intensive care units and nonintensive care units. Nurses in both the surgical and medical ICUs, as well as nurses in the intermediate surgical and medical units and general surgical and medical units of a large, university hospital were the subjects. The data indicated that nurses in the ICUs did not differ in level of burnout from nurses in the other units. Across units, however, nurses who were characterized as more "hardy" experienced lower levels of burnout than nurses lower in this construct.
This paper presents evidence from three samples, two of college students and one of participants in a community smoking-cessation program, for the reliability and validity of a 14-item instrument, the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The PSS showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance. In all comparisons, the PSS was a better predictor of the outcome in question than were life-event scores. When compared to a depressive symptomatology scale, the PSS was found to measure a different and independently predictive construct. Additional data indicate adequate reliability and validity of a four-item version of the PSS for telephone interviews. The PSS is suggested for examining the role of nonspecific appraised stress in the etiology of disease and behavioral disorders and as an outcome measure of experienced levels of stress.