Stressors

 The hospitalization of premature neonates in the neonatal intensive care unit (NICU) is very stressful for parents.

 This study aimed to assess the stressors in parents of premature neonates hospitalized at the NICU in Ali-Ibn-Abitaleb Hospital of Rafsanjan, Kerman, Iran, within November 2020 to September 2021.

 This cross-sectional descriptive study was conducted at the NICU of Ali-Ibn-Abitaleb Hospital of Rafsanjan. A total of 204 parents with premature neonates admitted to the NICU were selected by the convenience sampling method. The data collection tool was a demographic data form and the Parental Stress Scale: Neonatal Intensive Care Unit. The data were analyzed using descriptive and analytic statistic tests, such as the one-sample t-test, by SPSS software (version 22).

 The most stressful item was in the “sights and sounds” domain belonging to “sudden alarm noises” for both parents, and “needles and tubes put in” in the “neonate’s behavior” domain. The major causes of stress in “parental role alterations” subscales were relevant to “feeling helpless about how to help neonate” and “being separated from neonate” in fathers and mothers, respectively. The comparison of parental stress scores in the total scale for mothers and fathers showed that mothers had higher stress scores in “sights and sounds” and “neonate’s behavior” domains; however, fathers’ scores were higher in “parental role alterations” without any significant differences (P > 0.05).

 Parents of premature neonates deal with NICU stress levels. Nurses’ manners concerning parents play a major role in handling the stressed situation.

High level of stress experienced by residents is one of the important factors of the reduction in their efficiency and the increase in their error rate and poor clinical performance.

The present study was conducted to review, identify and categorize the most important stressors of residents.

In this narrative review study, English articles were reviewed by electronic search of Education Resources Information Center (ERIC), PubMed, ProQuest, Scopus and Google Scholar search engine over the last 10 years (2013-2022).

Based on the data, 89 stressors were extracted from 12 articles, and then divided into six categories of "stressors related to care and treatment, stressors related to interpersonal and intrapersonal communication, social stressors, stressors related to course management and planning, stressors related to teaching and learning and stressors related to residents' drive and desires".

The identification and categorization of stressors in the present study made it possible that the planners and practitioners of residency courses can design and implement effective solutions to reduce the negative impacts of residents' stressors and, as a result, provide better conditions for their learning and training during the course.

Asthma is a very prevalent condition. A significant proportion of patients with asthma will engage in travel for work or leisure purposes. Patients may be fearful of travel, especially during the current COVID-19 global pandemic. However, there are health benefits to be obtained, including leaving an area of high air pollution and travelling to an area of lower air pollution, travelling to high altitude, the beneficial effects of a low trigger environment and the psychological benefits associated with travel. Travel can be associated with improved diet and increased vitamin D exposure. Caution should be taken with alcohol consumption as it may worsen asthma. Whilst bariatric surgery has been shown to improve asthma symptoms and control, there are dangers associated with bariatric surgery tourism that the traveller should be made aware of. Travellers with asthma may experience jet lag and a worsening in their symptoms. Caution is required around exogenous melatonin use. Optimal asthma control pre‑travel is essential. The destination should be carefully considered, in terms of air pollution, altitude and possible environmental triggers. Pre-travel, written asthma management plans should be reviewed and updated if necessary. Patients should carry more asthma medications than they think is necessary, including oral corticosteroids and a pressurised metered dose inhaler via spacer. Travellers with asthma should have a self‑management plan in the event of exacerbations occurring during travel.

Stress is a subjective experience which creates an obstacle in a person’s path of achieving his or her goals. It creates negative outcomes among the population. Medical curriculum is very vast and stressful. As doctors are the very important part of society, medical students must be allowed to learn their trade in a stress‑free environment. The present study aimed to assess the perceived stress, various sources of stress among medical undergraduate students, and the coping strategies adopted.

This was a cross‑sectional study conducted among medical under‑graduate students studying at a tertiary care hospital situated in Mumbai city of Maharashtra between January and June 2018. Using purposive sampling technique, a total of 450 medical students from 1st year to final year were invited to participate in the study. A self‑administered questionnaire consisting of sociodemographic details and perceived stress scale questions was used. Logistic regression analysis was carried out to assess the determinants of stress. Odds ratio, 95% confidence interval was calculated. P < 0.05 was considered statistically significant.

The overall response rate was 79.11%, with 356 out of 450 students returning the questionnaire. Among 356 participants, 324 participants (91%) were suffering from high levels of stress. Factors such as curriculum vastness, frequency of examination, competition with peer, performance in examinations, worry about future, loneliness, relation with opposite sex, and quality of food played a major role in creating additional stress.

The perceived stress was higher among female medical students. Academic factors are greater perceived cause of stress in medical students in this study. A substantial proportion of medical undergraduate students were found to be stressed which necessitates appropriate and timely interventions. Reframing the academic curriculum along with examination and evaluation patterns, incorporating extracurricular activities, and establishment of counselling cells in the institution is the need of the hour.

There is a growing interest in examining alterations in telomere length as a reliable biomarker of general health, as well as a marker for predicting later morbidity and mortality. Substantial evidence shows that telomere length is associated with aging; telomere shortening acts as a “counting mechanism” that drives replicative senescence by limiting the mitotic potential of normal (but not malignant) cells. In this Correspondence, we attempt to answer the question of why recently published papers about telomere length alterations increase our uncertainty rather than reduce it. This discussion includes three major research areas regarding telomere length: environmental stressors, aging, and life span. Our review suggests that activation of telomerase activity due to stressors in space might be a double-edged sword with both favorable and unfavorable consequences. The selection of an effect’s consequence must clearly elucidate the experimental conditions as well as associated stressors. In this Correspondence, we attempt to answer the question of why recently published papers about telomere length alterations increase our uncertainty rather than reduce it. The selection of an effect’s consequence must clearly elucidate the experimental conditions as well as associated stressors. Both positive and negative consequences must be clearly addressed in order to bolster the conclusions, as well as identify future research directions.

Dental education can be a critical wellspring of stress among dental students, and studies have observed higher levels of stress among dental students than in the all‑inclusive community. The present study aims to evaluate the perceived stress among dental undergraduate students, the sources of stress, and an association of perceived stress with sociodemographic characteristics and various stressors.

A cross‑sectional study was conducted among 380 undergraduate dental students (from 1st year to final year) in a private dental college, Kanpur. A self‑administered questionnaire was used to collect data regarding sociodemographic profile, perceived stress using Perceived Stress Scale‑14, and academic, psychosocial, and environmental stressors. Data were analyzed using IBM SPSS Statistics‑Version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0, Armonk, NY, USA: IBM Corp.).

The mean perceived stress score was 30.25 ± 1.914. The median perceived stress score was 30. Statistically significant (P < 0.001) values were found for higher age group and year of studying Bachelor of Dental Surgery (BDS) were important sociodemographic determinant of stress. Vastness of academic curricula, frequency of examination (P < 0.05), and fear of failure/poor performance in examinations were important academic determinants of stress. High parental expectations and family problems were important psychosocial stressors. Accommodation away from home was an important predictor of stress (P < 0.001).

This study revealed that there are various sociodemographic (age and year of study in BDS), academic (curricula, frequency of examination, and performance level) determinants and predictors of stress (type of accommodation), along with psychosocial stressors (parental expectation and family problems). Dental colleges should develop stress management programs to promote gender and social equity and strategies to improve psychological support services. The stress management programs reported either helped to reduce the number of stressors or enhance stress coping skills, using relaxation techniques such as deep breathing, yoga, and stress management programs.

The pediatric hospital is an environment with a high level of stress for most parents. Parents experience high levels of stress if their children are hospitalized due to the fear for the loss of their child’s life.

The objective of this study was to evaluate stress factors in parents of hospitalized children.

This study was conducted from January to July 2019 at the General Pediatrics Department of Fieri Regional Hospital. The study sample was composed of 200 parents, of which 86 (43.3%) were males and 114 (56.7%) were females. The parents chosen as our sample had their children hospitalized for at least 5 days.

Our results showed that 80% of the sample was stressed out by waiting at the hospital, whereas 42% of them felt stressed also by their child’s oral problems. Parents of hospitalized children (83%) felt stressed about the painful techniques applied to their children. Nearly 65% of them were stressed out by the hospital environment; child's sleep bruxism was considered another stressor by 39% of the sample.

This study claims that parents of hospitalized children experience stress from different stressors such as dental visits, waiting for the diagnosis, and sleep bruxism. There are other factors which do not influence parental stress including residence, divorced parents, and hospital conditions.

Coronary artery disease (CAD) is one of the major causes of mortality all over the world. In this relation, coronary artery bypass grafting (CABG) is one of the most important treatments for CAD patients. However, it leads to a lot of stress in the patient. The aim of this study was to use the Neuman model to moderate the stressors in patients undergoing coronary artery bypass graft.

This study was a randomized clinical trial of two groups performed on patients admitted to the coronary artery bypass graft; and the study completed with 64 patients. The intervention was performed by the researcher according to the format of the Neuman Model, which included the investigation of the stressors, and the determination of the goals and strategies for the actions. Intrapersonal, interpersonal, and extra personal factors were evaluated using a Revised Cardiac Surgery Stressor Scale (RCSSS). The intervention program was designed by the researcher based on prevention levels using scientific resources. The collected data were analyzed in SPSS ver. 13 using descriptive and inferential statistics.

Before the intervention, the mean score of the stressors was not significantly different between the two groups. But immediately after the intervention and before discharging the intervention group, it was significantly less than the control group.

Using a Neuman-based program as an effective and low-cost intervention can moderate the stressors and reduce the stress of patients awaiting coronary artery bypass graft. This theory can be a good guide to offering the roles needed to provide health services in the community.

Nowadays, stress has been tagged a global phenomenon. Many undergraduate students undergo considerable stress, and a variety of sources of stress have been identifed among university students. The aim of this study is to identify the level of perceived stress and its predictors among medical and nonmedical Minia University students. This was a cross‑sectional study comparing between medical and nonmedical students in Minia University, conducted during the period from March to April 2017. The sample consisted of 314 medical and 291 nonmedical students chosen through cluster random sampling as a section was chosen randomly from each academic year and collectively form the fnal sample. Data were collected through interview by a questionnaire inquiring about sociodemographic data, common stressors as academic, fnancial, family, and transportation stressors and Cohen Perceived Stress Scale 10. The prevalence of perceived stress was slightly higher (88.9%) among medical students than among nonmedical students (83.5%). Severe stress was found among (18.8%) of medical students compared to (12.4%) among nonmedical students (P < 0.05). The signifcant predictors of perceived stress were academic
stressors, no exercise and being female among medical students, and were academic and fnancial stressors among nonmedical students. Medical students perceived more stress than nonmedical students. The academic stressors were signifcant predictors among all students; hence, there is a need for the establishment of students counseling unit, to facilitate coping with the stress of study and examination.

Living with hemodialysis is a permanent challenge due to the need for adaptation to the treatment plan, related complications, and dietary constraints. Therefore, the quality of life in such patients is influenced by physical and psychological stressors posed by these challenges. The aim of this study was to investigate the relationship between stressors and coping strategies in hemodialysis patients, Qazvin, Iran. A descriptive cross-sectional correlational design was used to investigate the relationship between physiological and psychosocial stressors and coping strategies among Iranian patients undergoing hemodialysis in 2018. Samples consisted of 140 patients recruited through the simple random sampling method from a large referral hemodialysis center affiliated to Qazvin University of Medical Sciences, Iran. A demographic variables form, hemodialysis stressors scale (HSS,) and Ways of Coping Scale- revised (WOCS-R) were employed for data collection. SPSS version 24 was used for data analysis. The majority of the patients (49.2%) had moderate and 3.6% of them had severe physiological stressors. With regard to psychosocial stressors, 51.4% had moderate and 3.6% of the participants had severe stressors. The majority of the participants used “distancing” strategies. Pearson’s correlation showed that strategies of escape avoidance and physiological stressors had a significant positive correlation (r = 0.2, P = 0.004), and strategies of problem solving (r = 0.2, P = 0.01), escape avoidance (r = 0.3, P = 0.000), and self-control (r = 0.1, P = 0.03) had a significant positive correlation with psychosocial stressors. The majority of the hemodialysis patients had moderate to severe stress in physiological and psychosocial dimensions. They often used negative strategies for coping with stressors. The above-mentioned challenges are considered as risks to patients’ well-being and require the attention of policy-makers and managers to provide comprehensive and high-quality services.

Open-heart surgery is a stressful, life-threatening experience inducing fear and anxiety in many patients and their families. The present study was conducted to design an inventory assessing the stressors in open-heart surgery patients and evaluate its psychometric properties. This study was accomplished in two phases. The first phase involved a qualitative study during which in-depth interviews were carried out with 21 therapists and patients with a history of heart surgery. In addition, the primary items of the inventory were extracted by reviewing the literature and available questionnaires through a qualitative approach. In the second phase, the face, content, and construct validities of the inventory were investigated using the exploratory factor analysis with 360 participants. In addition, the reliability of the developed instrument was examined using Cronbach’s alpha and intraclass correlation coefficient (ICC). Based on the findings obtained in the first phase, a pool of items was prepared. The findings of the exploratory factor analysis revealed a five-factor structure that explained 50.45% of the structural variance with a Kaiser-Meyer-Olkin value of 0.921 (P < 0.001). The first (12 items), second (13 items), third (seven items), fourth (eight items), and fifth (10 items) factors were named as “stressors in the intensive care unit”, “stressors related to the fear of uncertain future”, “internal stressors”, “stressors related to treatment team and facilities”, and “preoperative stressors”, respectively. The Cronbach’s alpha coefficient of the final version of the inventory, entailing 50 items, was obtained as 0.87. In addition, the ICC between the test and retest scores was estimated at 0.94. Given the fact that the meaning, concept, and factors associated with any phenomenon are influenced by sociocultural context and they vary from country to country, it is necessary to use a questionnaire designed based on the experiences and concepts expressed by the individuals living in the same context. According to the findings, the developed 50-item Cardiac Surgery Stressor Inventory is a simple, valid, and reliable tool for the measurement of stressors in open-heart surgery patients.