Table 1.
Summary of articles included in the current literature review.
| Author (year) and place | Sample size and setting | Design | Duration and components | Measurement tools | Follow-up | Main findings |
|---|---|---|---|---|---|---|
| Alkhawaldeh et al. (2020), Jordan | Total (N = 184): Treatment (n = 92); Control (n = 92); CHCC |
Cluster-RCT | 2-week SMIP (six 2-hour sessions twice a day) Waitlist control group | NSS Brief COPE Scale | Baseline, after the intervention and follow-up 2 months after the intervention | ↓ stress after the intervention and at follow-up (p =0.001) ↑ coping strategies after intervention and at follow-up (p =0.001) |
| Bahmanzadeh and Haji Alizadeh (2017), Iran | Total (N = 30): Treatment (n = 15); Control (n = 15); Hospital |
Quasi-experimental, pretest-posttest study with control | 8-week cognitive-behavioral training (75 min/week) Passive control group | DASS WHOQOL-BREF | Baseline and after the intervention | ↓ stress and anxiety (p < 0.05) ↑ quality of life (p < 0.05) |
| Bernburg et al. (2019), Germany | Total (N = 86): Treatment (n = 44); Control (n = 42); Psychiatric hospitals |
Randomized controlled pilot study | 12-week mental health program (1.5–2 h/week) Waitlist control group | PSQ ERSQ-27 BRCS SWOP-K9 QRI Evaluation form | Baseline and three follow-ups over a period of 36 weeks (after 3 months, T1; after 6 months, T2; after 12 months, T3) | ↓ stress at T1 (p < 0.01), T2 (p < 0.01) and T3 (p < 0.01) ↑ for all additional outcomes at T1, T2and T3 (p < 0.05) ↑ program evaluation |
| Bernburg et al. (2020), Germany | Total (N = 94): Treatment (n = 47); Control (n = 47); Hospital |
RCT | 12-week work-related self-care skill training (1.5 h/week) Waitlist control group | PSQ COPSOQ MBI-EE ERSQ-27 Evaluation form | Baseline and three follow-ups over a period of 36 weeks (after 3 months, T1; after 6 months, T2; after 12 months, T3) | ↓ stress at T1 (p < 0.001), T2 (p < 0.001) and T3 (p < 0.01) ↑ emotional exhaustion and emotion regulation skills at T1, T2and T3 (p < 0.05) ↑ job satisfaction at T1 (p = 0.01) ↑ program evaluation |
| Calder Calisi (2017), USA | Total (N = 46): Treatment (n =24); Control (n =22); General Hospital |
Randomized, waitlist control design | 8-week RR (45-min session; self-practice 10-20 min twice a day) Waitlist control group | STAI Semantic differential scales | Baseline and after the intervention | ↓ anxiety (p = 0.02) and stress (p = 0.003) ↑ confidence in teaching RR (p < 0.001) |
| Cohen-Katz et al. (2005), USA | Total (N = 27): Treatment (n = 14); Control (n = 13); Academic-community—based Hospital |
Pretest-posttest control group design with randomization | 8-week MBSR program (2.5 h/week; home-based practice 6 days/week) Waitlist control group | MBI BSI MAAS Evaluation form | Baseline (T1), after the intervention (T2) and 3-month follow-up (T3) | ↓ emotional exhaustion (MBI) at T2 and T3 (p < 0.05) ↑ MAAS at T2 (p = 0.004) and T3 (p = 0.002) ↑ program evaluation |
| Collier et al. (2018), USA and UK | Total (N = 16): Treatment (n = 8); Control (n = 8); Psychiatric inpatient unit (Hospital and Mental Health Services) |
Randomized trial | 4-week MSET (two 40-min sessions/week) Control group; standard unit lounge | Pulse rate STAI POMS Evaluation form | Before and after each session | ↓ pulse rate (p = 0.001), in State scale (p < 0.001) and Trait scale (p = 0.015) ↑ Confusion Bewilderment sub-scale of POMS (p = 0.004) ↑ program evaluation |
| Ghawadra et al. (2020), Malaysia | Total (N = 249: Treatment (n = 123); Control (n = 126); Teaching hospital |
RCT | 4-week mindfulness-based intervention (2-hour workshop; self-practice guided by a website) Waitlist control group | DASS-21 JSS MAAS | Baseline, after the intervention and follow-up 8 weeks after the intervention | ↓ stress (p < 0.001), anxiety (p = 0.001) and depression (p < 0.001) over time ↑ mindfulness (p < 0.001) over time ↑ job satisfaction (p < 0.001) |
| Gollwitzer et al. (2018), Germany | Total (N = 129): Treatment (MCII, n = 41; IIMCII, n = 41); Control (n = 47); Health institutions |
Randomized factorial design | 3-week MCII (mental exercise daily) 3-week IIMCII (modified mental exercise daily) Passive control group | PSQ-20 Physical symptoms subscale of BOSS II UWES-9 | Baseline and after the intervention | ↓ stress in the MCII group compared to the control group (p = 0.019) ↑ work engagement in the MCII group as compared to the IIMCII (p = 0.029) and the control group (p = 0.046) |
| Hersch et al. (2016), USA | Total (N = 104): Treatment (n = 52); Control (n = 52); Hospital |
RCT | 12-week web-based BREATHE program (unlimited online access) Waitlist control group | NSS Symptoms of Distress Coping with Stress WLQ Use of Substances for Stress Relief Drinking Quantity and Frequency Understanding Depression and Anxiety Nurses Job Satisfaction Scale | Baseline and after the intervention | ↓ stress (p < 0.001) and NSS sub-scales (p < 0.05) apart from sub-scale lack of support No effect on additional outcomes |
| Hsieh et al. (2020), Taiwan | Total (N = 135): Treatment (BT, n = 49; SDBT, n = 47) Control (n = 39); Psychiatric wards |
Quasi-experimental study | 6-week BT (1 h/week) 6-week SDBT (once a week) Waitlist control group | CES-D OSI-2 RS Physiological parameters (HRV: SDNN, LF, HF; RR) Rehabilitation strength chart Simplified health scale | Baseline and after the intervention | ↓ stress (p =0.013) in SDBT group ↑ depressive symptoms (p < 0.001), resilience (p < 0.001), and respiration rate for BT (p < 0.001) and SDBT (p = 0.002) |
| Hwang and Jo (2019), Korea | Total (N = 60): Treatment (n = 30); Control (n = 30); College hospital |
RCT | 4-week app-based stress-management program (twice a week for at least 10 min) Waitlist control group | PSSKOSS(PHQ)-9(GAD)-7Korean-Emotional Labor scaleWHO-5 Well-Being IndexSelf-efficacy (Likert) scaleEvaluation form | Baseline and after the intervention | ↓ stress (PSS, p = 0.035; KOSS, p = 0.04) and emotional labor (p = 0.027)↑ well-being (p = 0.005) and self-efficacy (p = 0.025)↑ program evaluation |
| Kurebayashi et al. (2012), Brazil | Total (N = 75): Treatment (Needle group, n = 27; Seed group, n = 26); Control (n = 22); Teaching hospital |
RCT | 8-week auriculotherapy with needles (eight sessions, 5-10 min/week) 8-week auriculotherapy with seeds (eight sessions, 5-10 min/week) Passive control group | LSS Folkman and Lazarus' Ways of Coping questionnaire | Baseline, after 4 sessions, after 8 sessions and follow-up 15 days after the intervention | ↓ stress after 8 sessions (p = 0.020) and at follow-up (p = 0.003) in the needle group ↑ Distancing domain (p = 0.039) and Confrontive Coping domain (p = 0.029) at follow-up in the needle group ↑ Seeking Social Support domain (p = 0.022) after 8 sessions in the seed group |
| Lary et al. (2019), Iran | Total (N = 70): Treatment (n = 35); Control (n = 35); Teaching hospital |
Quasi-experimental study | 6-week McNamara educational method (1 h/week) Waitlist Control group | SRI | Baseline, after the intervention and follow-up 8 weeks after the intervention | ↓ stress (p = 0.021) over time |
| Lin et al. (2019), China | Total (N = 90): Treatment (n = 44); Control (n = 46); General hospital |
Randomized controlled design | Modified 8-week MBSR program (group sessions 2 h/week and home-based practice 20 min × 6 days/week) Waitlist control group | PSS PANAS CD-RISC MMSS | Baseline, after the intervention (T1), and follow-up 3 months later (T2) | ↓ stress and negative affect at T1 (p < 0.01) and T2 (p < 0.05) respectively ↑ positive affect at T1 and T2 (p < 0.05) and resilience at T2 (p < 0.05) No effect on job satisfaction |
| McElligott et al. (2003), USA | Total (N = 20): Treatment (n = 12); Control (n = 8); University Hospital |
Quasi-experimental design | 4-week AMMA therapy (1 h/week) Control group; 4-week STTP | Physiologic Parameters (blood pressure, heart rate, pulse oximetry, and skin temperature) VAS Evaluation interview questionnaires | Baseline, before and after each treatment, and at completion of the study | ↓ anxiety over time No effect on physiologic parameters ↑ program evaluation |
| Moeini et al. (2011), Iran | Total (N = 58): Treatment (n = 29); Control (n = 29); Training hospital |
Quasi-experimental study | 3-week cognitive-behavioral program based on PRECEDE model (five 60-90 min sessions) Passive control group | NSS Questionnaire based on PRECEDE model Evaluation form | Baseline and follow-up 1.5 months after the intervention | ↓ stress (p < 0.001) ↑ PRECEDE model constructs and stress management behaviors (p < 0.001) |
| Nazari et al. (2015), Iran | Total (N = 66): Treatment (n = 33); Control (n = 33); ICUs (Hospital) |
RCT | 4-week massage therapy (25-min sessions twice a week) Passive control group | OSI | Baseline, after the intervention and follow-up 2 weeks after the intervention | ↓ stress (p < 0.001) and subscale scores (p < 0.05) over time |
| Niva et al. (2020), India | Total (N = 30): Treatment (n = 15); Control (n = 15); Tertiary care hospital |
RCT | Mahamantra chanting intervention for 45 days (20 min/day) Passive control group | Stress biomarkers (Serum cortisol, DHEA-S, SAA) Biochemical parameters (Glucose and lipid profile) | Baseline and follow-up after 2 menstrual cycles after the intervention | ↓ serum cortisol (p = 0.012), SAA level (p = 0.04), glucose (p = 0.001), HbA1c (p = 0.041), total cholesterol (p < 0.001), LDLc (p < 0.001) and TGL (p = 0.17) ↑ HDLc (p = 0.033) |
| Orly et al. (2012), Israel | Total (N = 36): Treatment (n = 20); Control (n = 16); Hospital |
Pre-posttest design study with control | 16-week CBI course (4 h/week) and five job-related 3-hour seminars Control group; five job-related 3-hour seminars | SOC PSS POMS | Baseline and after the intervention | ↓ stress (p < 0.05) and POMS fatigue (p < 0.05) ↑ SOC (p < 0.05) and POMS vigor (p < 0.05) |
| Palumbo et al. (2012), USA | Total (N = 14): Treatment (n = 7); Control (n = 7); Hospital |
RCT | 15-week Tai Chi program (group practice 45 min/week and self-practice at least 10 min × 4 days /week) Passive control group | SF-36 Health Survey NSS PSS Sit-and-reach test Isometric knee extensor strength test dynamometer Functional reach test Nordic Musculoskeletal Questionnaire WLQ Work absenteeism | Baseline and after the intervention | No effect on stress ↑ work productivity (p = 0.03) and functional reach (p < 0.01) |
| Prado et al. (2018), Brazil | Total (N = 168): Treatment (Auriculotherapy, n = 56; Placebo, n = 56); Control (n = 56); Hospital |
Randomized, single-blind, controlled trial | Auriculotherapy with stress points (12 sessions, twice a week) Sham auriculotherapy with sham points (12 sessions, twice a week) Waitlist control group | LSS | Baseline, after eight sessions, 12 sessions and follow-up 15 days after the end of the applications | ↓ stress in the treatment group after eight sessions and at follow-up (p < 0.001) ↓stress in the placebo group after 12 sessions (p < 0.001) and at follow-up (p < 0.05) |
| Singh and Jain (2017), India | Total (N = 40): Treatment (n = 20); Control (n = 20); Hospital |
Pre-posttest design with control | Self-help intervention (four 30-min sessions with an interval of 10 days) Passive control group | Psychosocial Stress Questionnaire Occupational Stress Index | Baseline and after the intervention | ↓ occupational stress and in psychosocial stress (p < 0.01) |
| Villani et al. (2013), Italy | Total (N = 30): Treatment (n = 15); Control (n = 15); Oncology hospital |
Between-subjects design | 4-week M-SIT (15-min sessions twice a week) Control group; neutral stimuli (15-min sessions twice a week) | MSP STAI COPE-4 JCQ | Baseline, before and after each session, after the intervention | ↑ state anxiety (p < 0.001), trait anxiety (p = 0.041) and coping skills acquisition (p < 0.05) |
| Walker (2006), USA | Total (N = 98): Treatment (n = 58); Control (n = 40); Hospital |
Quasi-experimental design | 4-week HRTT HeartTouch technique (3-hour educational session; self-practice; 1-hour session 2 weeks after the initial session; final follow-up session) Control group (2-hour educational session; final follow-up session) | PSS SWB DRS Diary HeartTouch questionnaire | Baseline and after the intervention | ↓ stress (p < 0.001), and ↑ hardiness (p < 0.001) and spiritual well-being (p < 0.05) in the treatment group ↓ stress (p < 0.001) and ↑ hardiness (p < 0.05) in the control group |
| Wang et al. (2017), Taiwan | Total (N = 78): Treatment (MBSR, n = 35; Humanities class, n = 35); Control (n = 12); Hospital |
Quasi-experimental design | 8-week MBSR intervention (3 h/week) 8-week humanities class (3 h/week) Passive control group | FFMQ NSC | Baseline (T0), after 1st month of MBSR (T1), after the intervention (T2), at 3rd month (T3) and 6th month (T4) | ↑ mindfulness (p = 0.031) in the MBSR group |
| Yang et al. (2018), China | Total (N = 100): Treatment (n = 50); Control (n = 50); Psychiatric departments |
Pre-posttest design with control | 8-week MBSR therapy (once a week; either group training or home-based practice) Control group; routine psychological support | SCL-90 SDS SAS NSS | Baseline and after the intervention | ↓ stress, anxiety and depression scores (p < 0.001) ↑ mental health (p < 0.001) |
↓ decrease, ↑ improvement or positive. AMMA therapy, a healing art of therapeutic massage; BOSS II, Burnout Screening Scales II inventory; Brief COPE Scale, Brief Coping Orientations for Experienced Problems Scale; BRCS, Brief Resilient Coping Scale; BREATHE, Stress Management for Nurses program; BSI, Brief Symptom Inventory; BT, biofeedback training; CBI, cognitive-behavioral intervention; CD-RISC, Connor–Davidson Resilience Scale; CES-D, Center for Epidemiological Studies Depression; CHCC, Comprehensive Health Care Centers; COPE, Brief Coping Orientation to Problems Experienced questionnaire; COPSOQ, Copenhagen Psychosocial Questionnaire; DASS, Depression, Anxiety and Stress Scale; DHEA-S, sulphated metabolite of dehydroxyepiandrosterone; DRS, Dispositional Resilience Scale; ERSQ-27, Emotion Regulation Skills Questionnaire; FFMQ, five facet mindfulness questionnaire; GAD-7, Generalized Anxiety Disorder; HbA1c, glycated hemoglobin; HDLc, high density lipoprotein cholesterol; HF, high frequency; HRTT, HeartTouch technique; HRV, heart rate variability; IIMCII, modified strategy of MCII; JCQ, Job Content Questionnaire; JSS, Job Satisfaction Scale for Nurses; KOSS, Korean Occupational Stress Scale; LDLc, low density lipoprotein cholesterol; LF, low frequency; LSS, Stress Symptom List; MAAS, Mindfulness Attention Awareness Scale; MBI-EE, emotional exhaustion subscale of the Maslach Burnout Inventory; MBSR, mindfulness-based stress reduction; MCII, mental contrasting with implementation intentions; MMSS, McCloskey/Mueller satisfaction scale; MSET, multisensory environmental therapy; M-SIT, Mobile Stress Inoculation Training; MSP, Mesure du Stress Psychologique; NSC, nurse stress checklist; NSS, Nursing Stress Scale; OSI, Occupational Stress Inventory; OSI-2, Occupational Stress Indicator; PANAS, positive and negative affect schedule; PHNs, public health nurses; PHQ-9, Patient Health Questionnaire; POMS, Profile of Mood States; PRECEDE, predisposing, reinforcing and enabling factors; PSQ, Perceived Stress Questionnaire; PSQ-20, Perceived Stress Questionnaire-20; PSS, Perceived Stress Scale; QRI, German Quality of Relationship Inventory; RCT, Randomized controlled trial; RR, Relaxation Response; RR, respiration rate; RS, Resilience Scale; SAA, salivary alpha amylase; SAD, stress, anxiety or depression; SAS, Self-rating anxiety scale; SCL-90, Symptom Checklist-90; SDBT, smartphone-delivered biofeedback training; SDNN, standard deviation of normal to normal; SDS, Self-rating depression scale; SMIP, stress management interventional program; SOC, Sense of Coherence; SRI, Stress Response Inventory; STAI, State Trait Anxiety Inventory; STTP, Standardized Touch Therapy Protocol; SWB, Spiritual Well-Being Scale; SWOP-K9, Self-Efficacy, Optimism and Pessimism questionnaire; TGL, triglycerides; UWES-9, Utrecht Work Engagement Scale; VAS, Visual Analog Scale; WHOQOL-BREF, World Health Organization Quality-of-Life Scale; WLQ, Work Limitations Questionnaire.