Self-regulation
Can a brief imagery-and-planning exercise lower nurses' stress?
Open access · cc by · source: Europe PMC
Nurses taught a short wish-obstacle-plan exercise reported somewhat less stress and more work engagement three weeks later than nurses who only reflected on stress, although the overall group differences were borderline.
Study at a glance
- Design
- RCT — Randomised 3 (control vs MCII vs MCII plus an if-then plan for when/where to practise it) x 2 (baseline vs 3 weeks) design delivered online; participants did one written session and were asked to rehearse the strategy mentally each day; ANCOVA on follow-up scores adjusting for baseline, plus intention-to-treat analysis
- N
- N=105 · 105 nurses completed both assessments (33 MCII, 34 MCII plus plan, 38 control) out of 129 randomised; intention-to-treat analyses used all 129 with baseline values carried forward
- Population
- Nurses working in German health-care institutions (mostly hospitals), mean age about 40, mostly female
- Outcome
- Overall stress index (perceived stress questionnaire plus physical stress symptoms) and work engagement (UWES-9) after 3 weeks, adjusted for baseline
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Key findings
The omnibus difference in stress change across the three groups was just short of significance (p = 0.062), but the MCII group reported significantly less stress than the control group in a pairwise comparison (p = 0.019). The MCII group also showed more work engagement than both other groups. Unexpectedly, adding a plan for when and where to practise did not help: that group did not differ from the controls on either outcome, and the same pattern held in intention-to-treat analyses.
Methodology
Nurses from across Germany were randomly assigned online to one of three conditions. All wrote about what less stress at work would mean to them and named a personal wish. The MCII group then imagined the best outcome of that wish, identified and imagined their main inner obstacle, and formed an if-then plan to overcome it, and were asked to repeat these steps mentally every day for three weeks; a second group did the same but also made an if-then plan for when and where to practise. Stress, physical symptoms and work engagement were measured before and three weeks after.
Limitations
The key effects were small and fragile: the overall tests were borderline and the pairwise differences no longer reached conventional significance after correcting for multiple comparisons. All outcomes were self-reported after only three weeks, participants volunteered knowing the study was about stress reduction, and there was no measure of whether or how often they actually practised the exercise. The control group received no active alternative, so the study cannot say whether MCII beats standard stress-management training or simply any attention-matched activity.
How this study connects
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