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The Effect of Mindfulness Training Program on Nursing Staff Stress Level
The Effect of Mindfulness Training Program on Nursing Staff Stress Level
Author Name (First, Middle Initial, Last)
College of Health Professions, Western Governors University
D219: Scholarship in Nursing Practice
Instructor’s Name
Date
The Effect of Mindfulness Training Program on Nursing Staff Stress Level
Impact of the Problem on the Patient
Stress has emerged as one of the significant concerns facing healthcare professionals in healthcare facilities. The frontline healthcare workers most likely to experience stressors are nurses. Nurses experience high-stress levels due to complex job needs and demands, excessive responsibility, and high expectations (Babapour et al., 2022). Increased stress level among the nursing staff has significant adverse effects on patients. Firstly, nurses’ stress adversely affects patient quality of care. Supporting this statement, Babapour et al. (2022) reveal that stress causes a loss of concern for patients and increases occurrences of medical errors, adversely affecting patients’ quality of care. On a different note, Lim et al. (2022) urge that job stress among nurses curtail nurses’ organizational commitment and work efficiency, thus, reducing patient satisfaction. Furthermore, nursing staff job stress affects patient outcomes. Supporting this statement, Babapour et al. (2022) urge that nurses’ job stress endangers nurses’ mental and physical health reduces work efficiency and results in the provision of poor healthcare, which adversely impacts patient outcomes.
Impact of the Problem on the Organization
Increased stress levels among nursing staff adversely the healthcare facilities. Firstly, nurses’ stress causes increased organizational turnover. Research reveals that increased stress among nurses causes burnout, which increases organizational turnover (Kelly et al., 2021). Also, nurses’ stress adversely impacts organizational efficiency. Ardıç et al. (2022) reveal that nursing staff job stress lowers nurses’ job motivation, decreasing their performance. Consequently, this adversely affects the overall organizational performance. Lim et al. (2022) urge that managing nurses’ job stress is a significant way of promoting work efficiency in healthcare facilities and advancing nursing organizations. From this, it can be logically inferred that nursing staff job stress negatively impacts healthcare organizations; efficiency.
Identify the PICO components.
P – Nursing staff
I – implementing mindfulness
C – Not implementing mindfulness
O – Reduced stress levels
Evidence-Based Practice Question
In hospital nurses, does implementing mindfulness reduce stress levels compared to not implementing mindfulness?
Research Article
Background Introduction
The chosen research article is a study by Ghawadra et al. (2020), which examined the impact of a four-week mindfulness-based training intervention on improving job satisfaction, depression, stress, and anxiety among nurses. Ghawadra et al. (2020) revealed that nurses have high stress, depression, and anxiety due to job-related challenges. Increased emotional distress increases nurse burnout, reduces job satisfaction, decreases nursing productivity, and reduces the quality of patient care. Ghawadra et al. (2020) revealed that although mindfulness is recognized as a psychological intervention for reducing stress among healthcare professionals, there is a scarcity of Randomized Controlled Clinical Trials (RCTs) examining the impact of mindfulness on stress levels. This study was aimed at filling this research gap.
Methodology
The researchers utilized a RCT for nursing staff who were considered to have a moderate level of either depression, stress, or anxiety using DASS-21 tool adopted from a past study. The researchers used stratified block randomization to randomly assign participants to the control and intervention groups. Participants included ward nurses serving in Critical Care Units (ICU), pediatric, medical, obstetrics and gynecology, and surgical departments. The mindfulness intervention used in the study was MINDFULGym. It entailed a two-hour workshop, which was followed by four weeks of self-practice. Data were collected using a survey questionnaire to ensure optimal understanding of nurses. The sample size was determined using a sample size calculator programme known as G*Power 3.1. Participants were evaluated prior to the workshop, immediately after the implementation of intervention, and eight weeks later. Evaluations were performed using the Mindful Attention Awareness Scale, DAS Scale-21, and Job satisfaction scale.
Level of Evidence
Usually, studies are assigned levels of evidence based on the study’s methodological quality, design, validity, and pertinence to patient care. The selected research article has Level I evidence. This is because the study adopts a well-designed RCT, where participants were assigned to control and intervention groups using stratified blocked randomization. According to the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, Level I evidence involves experimental study using RCT design (Dang et al., 2022).
Data Analysis
SPSS Version 25.0 was utilized to analyze the data. Independent T-tests, Descriptive statistics, and Chi-Square tests were performed to compare groups for study outcomes and participant characteristics. The Generalized Estimating Equation (GEE) was utilized to examine the impact of MBT over time between the control and intervention groups as well as withi interaction between groups and time. Furthermore, the effect size formula was used to calculate the size of the effect.
Ethical Considerations
This study had Institutional Review Board (IRB) approval. It was approved by the University of Malaya Medical Centre’s (UMMC) Ethical Review Committee. Also, potential participants were fully informed about the study before being recruited to take part in the study. Furthermore, participants were given informed consent form to sign before participating in the study, which served as proof of their voluntary participation.
Quality Rating
According to quality guides, there are three categories of quality ratings of evidence, where quality rating A is high quality, B is good quality, and C is low quality. The chosen research article has high-quality evidence and hence has a quality rating of A. This is because it uses a RCT design. Dang et al. (2022) reveal that RCT studies have high-quality evidence and belong to quality rating A because they have generalizable results, are consistent, have a sufficient sample size, have consistent recommendations, and have definitive conclusions.
Analysis of the Results / Conclusions
GEE analysis results showed that there was a significant effect over time on depression (p<0.001), anxiety(p=0.001), stress(p<0.001), and mindfulness levels (p<0.001). However, it was insignificant for job satisfaction. In regards to the difference between groups, findings revealed significant effects on job satisfaction and anxiety, but effects were not significant on stress, mindfulness, and depression. Furthermore, results showed significant effects on interactions between group and time for job satisfaction increase (p=0.04) and anxiety reduction (p=0.008), with a small effect size for job satisfaction (0.221) and moderate size for anxiety (0.465). Thus, the researchers concluded that mindfulness-based training effectively improves job satisfaction and reduces anxiety levels among nursing staff.
This article helps answer the EBP question, which examines whether implementing mindfulness as compared to not implementing mindfulness reduce stress levels among nursing staff because it provides empirical evidence on the impact of mindfulness-based training intervention on stress level among nurses.
Non-Research Article
Background Introduction
The chosen non-research article is by Anderson (2021). In the article, the author evaluates mindfulness-based intervention for reducing stress among nurses who serve in the Critical Care Unit. Anderson (2021) reveals that serving in the critical care unit is very stressful for nurses. Given that mindfulness-based stress reduction programmes have emerged as a way to manage stress among nursing staff, the author introduced a quality improvement initiative to examine how the mindfulness-based intervention for reducing stress impacts nurses in terms of their perceived stress, quality of life, and sickness and absence rates, and mindfulness awareness.
Type of Evidence
The type of evidence used in this non-research article is a quality improvement project. This is clear even in the topic of the article, where the author has indicated that the article is a quality improvement project.
Level of Evidence
The Level of evidence for the selected non-research article is Level V. Based on the JHNEBP model, quality improvement evaluation is non-research evidence and has Level V evidence (Dang et al., 2022). Therefore, since the chosen non-research article is a quality improvement evaluation, it has Level V evidence.
Quality Rating
The chosen non-research article has a quality rating of B. According to the JHNEBP model quality guide, articles with good quality have a quality rating of B and are characterized by reasonable, consistent findings, a sufficient sample size, fairly definitive conclusions, and rational, consistent conclusions based on a reasonable comprehensive literature review that entails some reference of scientific evidence (Dang et al., 2022). The chosen non-research article has fairly consistent findings and uses a sufficient sample size. Also, the chosen article has a well-developed conclusion, and recommendations are made based on the conclusion drawn from the study.
Author’s Recommendations
Anderson (2021) concludes that mindfulness training has a positive outcome for nursing staff and patients and recommends that critical care nurses use mindfulness training since it is an accepted and feasible intervention for reducing nurses’ perceived stress, improving quality of life, and increasing awareness. The recommendations made by Anderson (2021) clearly indicate that mindfulness training assists in reducing stress among nursing staff, which provides an answer to the ERP question, which seeks to uncover whether implementing mindfulness as compared to not implementing mindfulness reduces stress levels among nursing staff.
Recommended Practice Change
The recommended practice change is implementing mindfulness training among nurses in healthcare facilities. Based on the articles reviewed, it is evident that mindfulness training assists in reducing stress levels among nursing staff.
Key Stakeholders
The three key stakeholders who would be involved in supporting the practice change recommendation include mindfulness coach, suppliers, financial organizations, and policymakers. The mindfulness coach would be involved in helping the nurses to remain mindful in life. Usually, mindfulness coaches utilize various coaching tools and techniques to assist clients in focusing better and relaxing more. Thus, this stakeholder will use these tools to help nurses relax and focus better. Suppliers and financial organizations will support the recommended practice change by providing the financial help required to implement the training programme. The finances will be used to pay coaches and purchase training materials. Lastly, policymakers will be involved in the recommended change by setting a mandatory training attendance policy to ensure all nurses attend the mindfulness training sessions.
Barrier to Implementation
One specific barrier that may be encountered during the implementation of the recommended practice change is limited staff time to attend mindfulness training sessions. Nursing is demanding, and most nurses do not have free time (Nebhinani et al., 2020). Also, most healthcare facilities face nurse shortages which force nurses serving there to work longer hours in a shift. This may limit the nurses’ ability to attend mindfulness training sessions as sometimes these sessions may begin while they are still on duty.
Strategy to Overcome the Implementation Barrier
One strategy to overcome the barrier of limited staff time to attend mindfulness training sessions is the use of online training. Hospitals can ensure that mindfulness training sessions are conducted online. Online training is convenient and will allow nurses to learn at their place and at their convenient time. Also, online learning requires less time than physical learning, which will help overcome the barrier of limited time.
Indicator to Measure the Outcome
One tool that can be used to measure the outcome of the recommended practice change is Depression Anxiety Stress Scales-21 Items (DASS-21). This is a set of 3 self-report scales intended to measure an individual’s emotional states of Depression, Anxiety, and Stress. Notably, the levels of depression, anxiety, and stress will be measured pre- and post-implementation of the mindfulness-based intervention. The score for stress will be used to determine if the stress level reduces upon implementation of the mindfulness training programme.
References
Anderson, N. (2021). An evaluation of a mindfulness‐based stress reduction intervention for critical care nursing staff: A quality improvement project. Nursing in critical care, 26(6), 441–448. https://doi.org/10.1111/nicc.12552Ardıç, M., Ünal, Ö., & Türktemiz, H. (2022). The effect of stress levels of nurses on performance during the COVID-19 pandemic: the mediating role of motivation. Journal of Research in Nursing, 27(4), 330-340. https://doi.org/10.1177%2F17449871211070982Babapour, A. R., Gahassab-Mozaffari, N., & Fathnezhad-Kazemi, A. (2022). Nurses’ job stress and its impact on quality of life and caring behaviors: a cross-sectional study. BMC nursing, 21(1), 1-10. https://doi.org/10.1186%2Fs12912-022-00852-yDang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins evidence-based practice for nurses and healthcare professionals: model and guidelines. Sigma Theta Tau.
Ghawadra, S. F., Lim Abdullah, K., Choo, W. Y., Danaee, M., & Phang, C. K. (2020). The effect of mindfulness‐based training on stress, anxiety, depression and job satisfaction among ward nurses: A randomized control trial. Journal of nursing management, 28(5), 1088-1097. https://doi.org/10.1111/jonm.13049Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(1), 96–102. http://dx.doi.org/10.1016/j.outlook.2020.06.008Lim, J. Y., Kim, G. M., & Kim, E. J. (2022). Factors Associated with Job Stress among Hospital Nurses: A Meta-Correlation Analysis. International Journal of Environmental Research and Public Health, 19(10), 5792-5807. https://doi.org/10.3390/ijerph19105792Nebhinani, M., Kumar, A., Parihar, A., & Rani, R. (2020). Stress and coping strategies among undergraduate nursing students: A descriptive assessment from Western Rajasthan. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 45(2), 172. https://doi.org/10.4103%2Fijcm.IJCM_231_19
Literature Review on How Music will integrate into the virtual world
Tarren Mason
ENGL 1102
Prof Smith
24 October 2022
Literature Review on How Music will integrate into the virtual world
Introduction
Music has shown a comprehensive integration of the virtual world. The integration gets based on the use of digital technology through inventions and innovation to facilitate future music development. Therefore, the paper analyzes how music has integrated into the virtual world through literature-reviewed sources.
Music Integration through YouTube
The study by Negus on the evolution of music from creator to data examines the post-record music industry and the digital conglomerate. The research describes the changing music industry through the identification of the three dynamics which underpin the shift towards the post-record music industry as opposed to the past methodology of musical production. The examination of evolutionary music production begins with redefining the content provider instead of the creative producer. The change extrapolates the historical changes in the music industry from the record pedagogy as a product of the producer’s content delivered to the audience. Through analytical approaches to the current social media video storage, the author creates a comprehensive description of the role of YouTube in the production and conveyance of contemporary and future music (Negus 380). As such, the study focuses on the tension between YouTube and the recording artist as a mechanism of disputes existing on the changing perception of the artist and the economic value of the recorded music in the virtual world, and the adoption of the virtual genre in the music industry. The third phase of the research creates a determinative framework through which the debate on the music virtual evolution affects the market in the present and future economic value. The exploration of the virtual value of the musical future enables the research to make a comparative analysis through the debate on the morality and the worth of music. The comparative analysis, therefore, conceptualizes the application of digital recording as a mechanism of acquiring the value as data rather than commercializing the art virtual and the sound expression (Negus 384). As a result, contemporary artists have predicted the application of the digital conglomerate, which will play a significant role in music production and delivery hence showing the virtual change in the music that defines the economic and moral value of future music. Most importantly, benefiting from musical production has shaped and has continued to shape the musical circulation of recording through the emergence of the music dynamics, patterns of conflict, and musical structures. As compared to the research by Serafin, the two studies have created a framework through which music has evolved economically through the changes in production and the perception of the producers and the consumers. The two studies also extrapolate how the changes in technologies have contributed to the economic changes of the producers, giving different approaches to the software application. The differences exist where the research by Serafin majors on the use of software to create changes in the music evolution while the Negus research extrapolates the economic value of music through the changes of the economic perception of music as portrayed by the current and the future use of the music technology.
The Application of Virtual Technology in Teaching and Learning of Music
The changing role of the teacher has been exhibited by the methodologies of teaching music education through the use of virtual technology, according to the study by Nart. The research compares the traditional approaches to music teaching with the contemporary and future use of technology to facilitate the learning of music by the students. The use of technology has created student-centered approaches as opposed to traditional teacher-centered approaches in teaching and the delivery of music education. Notably, the current and future music teaching and learning show how the teachers are no longer the source of musical knowledge and the channel for sharing eth musical information. However, the teacher’s work remains a guiding role to the students who will access the information and manage the process constructively (Negus 78). Currently, the teacher guiding the students in musical education must use the technological requirement to achieve the curriculum objectives. Compared with the previous research by Pransky (2001), the students are the next generation because they are native speakers of the digital language due to their extreme nature of spending much time on the internet and computers. The continuous use of the iPhone, video games, and television brands to examine the digital transformation of music has enabled teachers to guide the students to the evolutionary musical approaches (Negus 79). The study examines the musical evolution in the visual world using internet sources, publications, and current literature findings to examine the current and future of teaching and learning music in a visualized and technological world. As a result, the findings depicted using software in music education to provide effective and efficient education for teachers and learners. In contrast, the research by Nart bears similarities with the Negus study because of the need to generate contemporary and evolutionary approaches to music production. The evolution describes how music visualization has enabled music producers, teachers, and learners to adopt technological innovation to solve the historical challenges that were exhibited in the industry. Also, differences exist where the Nart study describes the student and teacher in the technological changes of music visualization while the Negus research focuses on the producers and the artists as a mechanism of visualizing the music economy.
The Use of Software to Simulate Music Visualization
The research by Serafin et al. on virtual reality musical instruments describing the state of arts, design principles, and future directions extrapolates the future of music in the virtual world. The explanation majors on the effects of contemporary technology on the development of music and the consumer or the learner’s perception. Currently, humans have exhibited rapid development in technological innovation and inventions in the field of music. The development has created the reality approaches through which the learners and the music producers have adopted the technologies to create a systematic overview and the musical adaptations to the contemporary listening and learning of music. Historically, the artist has used virtual musical instruments for a long duration; hence the study creates an evolutionary relationship between the current, past, and future of music through a paradigm of technological applications (Serafin 23). Notably, the study uses the term virtual to describe the application of software knowledge and applications to simulate the future of the music industry and music performance. The existing musical instruments and their control methods require a captivating interface for comprehensive sound and virtual; image expression. As such, the author depicts that the future of music involves the simulation of the music components delivered by the head mount display. Consequently, the future of music, as depicted by the study, asserts that it will fully be a form of immersive visualization even though the current musical practices have not yet received the attention of conceptualizing the methodology (Serafin 40). Most importantly, the study presents nine design guidelines that evaluate, examine and analyze different case study approaches that consider music production’s present, past, and future through evolutionary visualization. The study compares with the Nart research due to the use of software technology in the present and the future generation to develop music. However, differences exist where the two research where one uses the educational approaches to the students, and the Serafin research examines the industrial use of software to change the visualization and reality.
Conclusion
Overall, the review sources have provided the evolution of music through technology to facilitate the changes in the visual perception of music. The study by Nart compares the traditional and teacher-centered approaches to music studies with the contemporary and future student-centered learning of music to show the evolution and software innovation in music teaching and learning. Also, Negus, in his research, depicts how music has technologically evolved to form the visual perception that has encouraged the economic development of the producers. Moreover, the study by Sarafin creates an overview through which an individual can understand the role of software in music evolution and visualization. Therefore, future research should examine how technology has shaped the changes in music production, teaching, and learning.
Works Cited
Nart, Sevan. “Music software in the technology integrated music education.” Turkish Online Journal of Educational Technology-TOJET 15.2 2016: 78–84. https://eric.ed.gov/?id=EJ1096456
Negus, Keith. “From creator to data: the post-record music industry and the digital conglomerates.” Media, Culture & Society 41.3 2019: 367–384. https://journals.sagepub.com/doi/abs/10.1177/0163443718799395
Serafin, Stefania, et al. “Virtual reality musical instruments: State of the art, design principles, and future directions.” Computer Music Journal 40.3 (2016): 22–40. https://direct.mit.edu/comj/article-abstract/40/3/22/94804
Pre-American Revolutionary Period
Pre-American Revolutionary Period
During the eighteenth century, many Americans enjoyed a lot of liberty than other people in the world. They went on to pay low taxes and boycotted imports. In the American Revolution, slaves were not affected in any way by the tea taxes or the stamp duties. The black population was the main race used in the revolution, uprising and slavery. They were also used in mobilization of revolutionary groups.
In particular, the duties and taxes imposed, did not affect the black population and the slaves, but Gary Nash one of the successful historians states that “Even as the Civil Rights movement of the 1960s and 1970s created an intense interest in the seventeenth- and eighteenth century roots of America’s race problem, many historians continued to deny that the founding fathers could have done anything about slavery.”pg.5
Many historians have stated abolition of slavery in different southern states would lead to break down of political parties. In Gary Nash words, “In offering a political explanation for the failure of the revolutionary generation to abolish slavery, historians of our era have usually cited the fragility of the new nation.”pg.6. The leaders’ certainty to attempt stopping force abolition on the southern states would destroy the politically aware union that was united during the war and after.
When social upheaval was experienced in the towns and cities where the blacks lived, the black people got a chance to flee. According to estimates done by Thomason Jefferson, thirty thousand slaves had run away when the British invaded Virginia in 1781. Some of the slaves united with the black regiment of Virginia’s governor Lord Dunmore’s, where the governor promised them freedom in exchange of the slaves disobeying their masters. Some of the slaves and blacks were recruited to join guerilla bands fighting the patriots. In search of freedom, many of these blacks and slaves succumbed to diseases, malnutrition and battle wounds. Towards the end of the American Revolution, many black loyalists were exiled to Jamaica and others to Florida. The black community in America came from people who were slaves during the revolution.
They were either liberated by state law; others rebelled or ran away and managed to stay in America. The population of the African American increased during the nineteenth century. While this population was completely of diverse racial origin before the war started, many blacks can now express the role done by free men. In addition, the black population reminds the white population that the color of a skin cannot dictate abilities or freedom of a person.
During the American Revolution, slave rebellions supported the theory of Governor Robert that any emergency dividing the white people could enable the slaves to rebel. A white man in New York heard slaves collaborating on how to get gun powders for an insurgence plot. In Georgia, slaves formed a revolution in December 1774 killing four whites. They were later captured and burned to death. Few slaves with little education were able to create a written challenge to the bondage hypocrisy between wars for freedom. In Massachusetts, a group of black people petitioned the state assembly and Boston’s governor in 1773 conveying gratitude for the slave abolishment attempts saying that the people of Boston seem like they have being actuated by justice principles. In 1775, the African American population from Bristol and Worcester appealed the Committees of Correspondence for support in getting their freedom.
In their response, the Worcester County Convention passed a resolution stating that any human race enslavement had being abolished. Some white and black abolitionists kept wider appeals that addressed the general public and state assemblies. In Virginia, the black population signed up with the British army so that they could attain freedom. More than five thousand black people were serving in colonial militias and involved themselves in revolution battles. Crispus Attucks, who was a black man, was among the five colonists who were shot dead in the Boston massacre. In Bunker Hill, black soldiers were among the people who fought at the first main revolutionary clash. Among them was Salem Poor from Massachusetts.
He was a slave and acquired his freedom in 1769 through a lot of struggle. Other fourteen officers in the same regime like Salem Poor petitioned the Massachusetts general court to mention poor as one of the brave soldiers who had behaviors of an experienced officer. Even thought there were more than four thousand colonist who fought at Bunker Hill, Poor was the only one whose existing records indicated that he was singled out for his extraordinary services. When the war came to an end, one white person wrote a biography remembering his terror when the Bunker Hill hostilities started. He saw bodies of soldiers lying on the Boston Common.
One of the things that heartened him was a Negro’s body wounded and blood running down the body. The Negro was saying that the he was not minding of the wounds he had. In 1775, Continental Generals informed the congress there were Negroes in various regiments in Massachusetts. Slave commanders like George Washington showed fears and at the determination of representatives who were from South Carolina an area with a lot of slaves, the black population was barred from joining the Continental Army. When times became tougher for the colonists after fighting for a year, the Continental Congress reevaluated. Washington agreed by allowing some northern states to plead with black people.
In addition, in 1776, Washington re-authorized mobilization for blacks who had experience in military. In 1777, as the situation of Continental Army became worried due to disappearances from nasty encampments from the winter, mobilization was extended for all the black population. When the British Military shifted its operations in the black territory in the late 1778, upper south states unwillingly accepted the black population. Gordon Wood (118) stated that “the Virginia army and navy were full of African Americans and slaves served as alternatives for their masters in North Carolina and Delaware.” Authorization of slave mobilization was done in Maryland and the black populations were also recruited.
In conclusion, the white population in the lower south states was firmly in opposing the mobilization of the black population who were working in the rice swamps. Even when the congress offered 1,000 dollars for every slave they mobilized in 1779, south Carolina and Georgia went on to refuse. They tried to reimburse more than twice the 400 dollars they presented to slave owners in Rhode Island. Even when a large population of the blacks remained to be poor, the success stories were termed to be powerful symbols for the whole black community. The white population questioning racial equality and black populations’ ability saw the success. When the revolution took place, South Carolina and Georgia hardened their dependence on slave labor and the strong resistance to any kind of mobilization. When hundreds of mulattoes fled the revolution in Haiti for America, the black population did not populate the lower south until 1790s.
Bibliography
Gary, Nash, Race and Revolution (Madison, WI: Madison House, 1990), 1-10.
Virginia Declaration of Rights, 12 June 1776, http://www.ushistory.org/declaration/related/vabor.htm, accessed 26 October 2012.
Gordon S. Wood, The Radicalism of the American Revolution (New York: Vintage Books, 1991), 118.