Non-Pharmacological Management of Occupational Stress in Health Professionals: Integrative Review

Authors

  • Eduarda Braga Rossi Universidade São Leopoldo Mandic de Araras, Araras, SP, Brasil
  • Alexandra Nogueira Mello Lopes Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
  • Mariane Dresch Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.
  • Carina Cadorin Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.
  • Cibele Duarte Parulla Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.
  • Patrícia Maurello Neves Bairros Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.
  • Aline Maria de Mello Hospital Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.
  • Ticiane Santana Gomes Santiago Universidade de Fortaleza; Fortaleza, Ceará, Brasil.
  • Liliana Antoniolli Universidade Federal do Rio Grande do Sul; Porto Alegre, RS, Brasil.

Keywords:

Complementary therapies, Occupational stress, Healthcare staff, Patient Care Team, Workers' health

Abstract

Objective: to explore non-pharmacological interventions for managing stress among health professionals, highlighting integrative and complementary practices. Method: This is an integrative review, operationalized according to the PRISMA protocol. The following databases were consulted: PUBMED, EMBASE, SCOPUS and LILACS, to search for original articles published in English, Portuguese or Spanish between January 2020 and July 2024. Results: The final sample consisted of 39 publications, of which 29% addressed mindfulness alone and 10% combined mindfulness with acupuncture, relaxation, yoga or music therapy; 15% addressed yoga practice alone, 8% aromatherapy and 8% implemented relaxation and/or conscious breathing techniques. Of the studies, 57.5% were clinical trials, 20% were quantitative exploratory studies and 10% were before-and-after experimental studies. Conclusion: ICPs contribute to non-pharmacological stress management and recovery, promoting well-being among health professionals, whose psychophysiological benefits appear to be positive and sustainable, promoting healthier and more sustainable work environments.

Author Biographies

Eduarda Braga Rossi, Universidade São Leopoldo Mandic de Araras, Araras, SP, Brasil

Graduanda de Medicina, Universidade São Leopoldo Mandic de Araras, Araras, SP, Brasil

ID ORCID: https://orcid.org/0009-0006-5528-7266

ReseacherID: LRU-0791-2024

ID Lattes: http://lattes.cnpq.br/4875593462616949

Alexandra Nogueira Mello Lopes, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil

Enfermeira. Mestre e Doutora em enfermagem pela UFRGS. Especialista em Cardiologia e Terapia Intensiva. 

Enfermeira assistencial no Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil. 

Orcid: 0000-0002-7484-4287

ResearcherID: LRU-0585-2024

Lattes: http://lattes.cnpq.br/9205920432628923

Mariane Dresch, Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.

Enfermeira. Consultora em Amamentação. Especialista em Saúde do Adulto e do Idoso.

Enfermeira clínica/geriátrica no Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.

ID ORCID: https://orcid.org/0000-0003-22893391

ResearcherID: LRU-0599-2024

ID Lattes: http://lattes.cnpq.br/2456611047978208

Carina Cadorin, Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.

Enfermeira. Mestre em Prevenção e Assistência em Saúde Mental e Transtornos Aditivos. Especialista em Cardiologia, Enfermagem Oncológica, Liderança em Enfermagem e Enfermagem Clínico-Cirúrgica.

Enfermeira do Serviço de Enfermagem Clínica no Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.

ID ORCID: https://orcid.org/0009-0004-1270-247X

ResearcherID: 

ID Lattes: https://lattes.cnpq.br/3021560419979426  

Cibele Duarte Parulla, Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.

Enfermeira. Doutora e Mestre em Enfermagem. Especialista em Terapia Intensiva.

Enfermeira do Serviço de Educação em Enfermagem no Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.

ID Orcid: 0000-0003-2178-6906

ResearcherID FPN-4495-2022 

ID lattes: http://lattes.cnpq.br/3024705739120869

Patrícia Maurello Neves Bairros, Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.

Enfermeira. Especialista  em terapia intensiva adulto; em saúde do trabalhador; em educação profissional em enfermagem. Mestranda em Enfermagem UFRGS. 

Enfermeira Assistencial  CTI adulto no Hospital de Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.

ID ORCID https://orcid.org/0000-0003-3174-8823

ResearcherID: LRU-1077-2024

ID Lattes http://lattes.cnpq.br/0344411232896797

Aline Maria de Mello, Hospital Clínicas de Porto Alegre; Porto Alegre, RS, Brasil.

Enfermeira. Mestre em Assistência em Saúde Mental e Transtornos Aditivos. Especialista em Psiquiatria e Saúde Mental. MBA em gestão de negócios em saúde. MBA em auditoria em saúde.

Enfermeira no Hospital Clínicas de Porto Alegre; Porto Alegre, RS, Brasil. 

ID ORCID: https://orcid.org/0000-0003-4468-3870

ResearcherID: LRU- 5039-2024

ID Lattes: https://lattes.cnpq.br/5430990980094071

Ticiane Santana Gomes Santiago, Universidade de Fortaleza; Fortaleza, Ceará, Brasil.

Mestre em Tecnologia e Inovação em Enfermagem. 

Universidade de Fortaleza; Fortaleza, Ceará, Brasil.

ID ORCID: 0000-0003-4923-2868

ResearcherID: LSI-6654-2024

ID Lattes: http://lattes.cnpq.br/3544421020067628

Liliana Antoniolli, Universidade Federal do Rio Grande do Sul; Porto Alegre, RS, Brasil.

Doutora em Enfermagem e Pós doutora em Epidemiologia pela Universidade Federal do Rio Grande do Sul. Especialista em Gestão, Governança e Tecnologia em Saúde.

Tutora científica-acadêmica e para desenvolvimento profissional; e enfermeira de auditoria.

ID ORCID: 0000-0003-0806-9910

ResearcherID AEA-1516-2022

ID Lattes: http://lattes.cnpq.br/4278333120557916

References

Ribeiro RP, Marziale MHP, Martins JT, Galdino MJQ, Ribeiro PHV. Estresse ocupacional entre trabalhadores de saúde de um hospital universitário. Rev Gaúcha Enferm [Internet]. 2018 Jul 23;39. Disponível em: https://www.scielo.br/j/rgenf/a/93bFnj3GkbyPtrpjyGvn8cj/?lang=pt

Santos Érika KM, Durães RF, Guedes M de S, Rocha MFO, Rocha FC, Torres JDRV, Barbosa HA. O estresse nos profissionais de saúde: uma revisão de literatura. HU Rev [Internet]. 2019 Nov 7 [citado 2024 Sep 13];45(2):203-11. Disponível em: https://periodicos.ufjf.br/index.php/hurevista/article/view/25645

Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Política nacional de práticas integrativas e complementares no SUS: atitude de ampliação de acesso. 2. ed. Brasília: Ministério da Saúde; 2015.

Schwambach LB, Queiroz LC. Uso de Práticas Integrativas e Complementares em Saúde no tratamento da depressão. Physis [Internet]. 2023;33:e33077. Available from: https://doi.org/10.1590/S0103-7331202333077

Pereira EC, Rocha MP da, Fogaça LZ, Schveitzer MC. Occupational health, integrative and complementary practices in primary care, and the Covid-19 pandemic. Rev Esc Enferm USP. 2022;56. Disponível em: https://doi.org/10.1590/1980-220X-REEUSP-2021-0362

Azevedo ML, Xavier MC, Menezes CB. Conhecimento, recomendação e uso de mindfulness por psicólogos clínicos brasileiros. Psicol ciênc prof. 2022;42:e237527. Disponível em: https://doi.org/10.1590/1982-3703003237527

Lambert KG, Aufricht WR, Mudie D, Brown LH. Does a phone-based meditation application improve mental wellness in emergency medicine personnel? Am J Emerg Med. 2020;38(12):2740–1. Disponível em: https://doi.org/10.1016/j.ajem.2020.04.058

Lee D, Lee WJ, Choi SH, Jang JH, Kang DH. Long-term beneficial effects of an online mind-body training program on stress and psychological outcomes in female healthcare providers: a non-randomized controlled study. Medicine. 2020;99(32):e21027. Disponível em: https://doi.org/10.1097/MD.0000000000021027

Pascual K, Fredman A, Naum A, Patil C, Sikka N. Should mindfulness for health care workers go virtual? A mindfulness-based intervention using virtual reality and heart rate variability in the emergency department. Workplace Health Saf. 2023;71(4):188–94. Disponível em: https://doi.org/10.1177/21650799221123258

Chen H, Liu C, Cao X, Hong B, Huang DH, Liu CY, et al. Effects of loving-kindness meditation on doctors’ mindfulness, empathy, and communication skills. Int J Environ Res Public Health. 2021;18(8):4033. Disponível em: https://doi.org/10.3390/ijerph18084033

Nourian M, Nikfarid L, Khavari AM, Barati M, Allahgholipour AR. The impact of an online mindfulness-based stress reduction program on sleep quality of nurses working in COVID-19 care units: A clinical trial. Holist Nurs Pract. 2021;35(5):257-63. Disponível em: https://doi.org/10.1097/HNP.0000000000000466

Asadollah F, Nikfarid L, Sabery M, Varzeshnejad M, Hashemi F. The impact of loving-kindness meditation on compassion fatigue of nurses working in the neonatal intensive care unit: A randomized clinical trial study. Holist Nurs Pract. 2023;37(4):215-22. Disponível em: https://doi.org/10.1097/HNP.0000000000000590

Joshi SP, Wong A-KI, Brucker A, Ardito TA, Chow S-C, Vaishnavi S, Lee PJ. Efficacy of transcendental meditation to reduce stress among health care workers: A randomized clinical trial. JAMA Netw Open. 2022;5(9):e2231917. Disponível em: https://doi.org/10.1001/jamanetworkopen.2022.31917

Purdie DR, Federman M, Chin A, Winston D, Bursch B, Olmstead R, Bulut Y, Irwin MR. Hybrid delivery of mindfulness meditation and perceived stress in pediatric resident physicians: A randomized clinical trial of in-person and digital mindfulness meditation. J Clin Psychol Med Settings. 2023;30(2):425-34. Disponível em: https://doi.org/10.1007/s10880-022-09896-3

Desai K, O’Malley P, Van Culin E. Impact of heartfulness meditation practice compared to the gratitude practices on wellbeing and work engagement among healthcare professionals: Randomized trial. PLoS One. 2024;19(6):e0304093. Disponível em: https://doi.org/10.1371/journal.pone.0304093

Braun SE, Dow A, Loughan A, Mladen S, Crawford M, Rybarczyk B, et al. Treinamento de mindfulness para estudantes profissionais de saúde: Um estudo piloto controlado por lista de espera sobre resultados psicológicos e relevantes para o trabalho. Terap Complement Med. 2020;51:102405. Disponível em: https://doi.org/10.1016/j.ctim.2020.102405

Hesmert D, Klocke C, Stolz R, Huber R, Samstag Y, Hübner K, et al. Exploring the gap: attitudes, knowledge, and training needs in complementary and integrative medicine among healthcare professionals at German university hospitals. Front Med. 2024;11. Disponível em: https://doi.org/10.3389/fmed.2024.1408653

Sangoi KCM, Silva FS, Simonetti SH, Fontana RT. Autocuidado de trabalhadores de uma UTI COVID-19. Nursing (Ed. Bras., Impr.). 2022;25(287):7692–7702. Disponível em: https://doi.org/10.36489/nursing.2022v25i287p7692-7702

Bhardwaj P, Pathania M, Bahurupi Y, Kanchibhotla D, Harsora P, Rathaur VK. Efficacy of mHealth aided 12-week meditation and breath intervention on change in burnout and professional quality of life among health care providers of a tertiary care hospital in north India: a randomized waitlist-controlled trial. Front Public Health. 2023;11:1258330. Disponível em: https://doi.org/10.3389/fpubh.2023.1258330

Yıldırım D, Çiriş Yıldız C. The effect of mindfulness-based breathing and music therapy practice on nurses’ stress, work-related strain, and psychological well-being during the COVID-19 pandemic: A randomized controlled trial. Holist Nurs Pract. 2022;36(3):156-65. Disponível em: https://doi.org/10.1097/HNP.0000000000000511

Taylor J, Stratton E, McLean L, Richards B, Glozier N. How junior doctors perceive personalised yoga and group exercise in the management of occupational and traumatic stressors. Postgrad Med J. 2022;98(1161):e10. Disponível em: https://doi.org/10.1136/postgradmedj-2020-139191

Narayanan S, Tennison J, Cohen L, Urso C, Subramaniam B, Bruera E. Yoga-based breathing techniques for health care workers during COVID-19 pandemic: interests, feasibility, and acceptance. J Altern Complement Med. 2021;27(8):706–9. Disponível em: https://doi.org/10.1089/acm.2020.0536

Taylor J, McLean L, Richards B, Glozier N. Personalised yoga for burnout and traumatic stress in junior doctors. Postgrad Med J. 2020;96(1136):349-57. Disponível em: https://doi.org/10.1136/postgradmedj-2019-137413

Sis Çelik A, Yarali S. The effect of laughter yoga on the psychological resilience and sleep quality of nurses during the pandemic: A randomized controlled trial. Altern Ther Health Med. 2023;29(5):146-52. Disponível em: https://pubmed.ncbi.nlm.nih.gov/37023316/

Guerra PC, Santaella DF, D’Almeida V, Santos-Silva R, Tufik S, Len CA. Yogic meditation improves objective and subjective sleep quality of healthcare professionals. Complement Ther Clin Pract. 2020;40:101204. Disponível em: https://doi.org/10.1016/j.ctcp.2020.101204

Mandal S, Misra P, Sharma G, Sagar R, Kant S, Dwivedi SN, Lakshmy R, Goswami K. Effect of structured yoga program on stress and professional quality of life among nursing staff in a tertiary care hospital of Delhi-A small scale phase-II trial. J Evid Based Integr Med. 2021;26:2515690X21991998. Disponível em: https://doi.org/10.1177/2515690X21991998

Mahdood B, Imani B, Khazaei S. Effects of inhalation aromatherapy with Rosa damascena (damask rose) on the state anxiety and sleep quality of operating room personnel during the COVID-19 pandemic: A randomized controlled trial. J Perianesth Nurs. 2022;37(4):493-500. Disponível em: https://doi.org/10.1016/j.jopan.2021.09.011

Shin YK, Lee S-Y, Lee J-M, Kang P, Seol GH. Effects of short-term inhalation of patchouli oil on professional quality of life and stress levels in emergency nurses: A randomized controlled trial. J Altern Complement Med. 2020;26(11):1032-8. Disponível em: https://doi.org/10.1089/acm.2020.0206

Emadikhalaf M, Ghods AA, Sotodeh-Asl N, Mirmohamadkhani M, Vaismoradi M. Effects of rose and lavender scents on nurses’ job stress: A randomized controlled trial. Explore (NY). 2023;19(3):371-5. Disponível em: https://doi.org/10.1016/j.explore.2023.01.002

Santos VHM, Maia MCW, Rézio LA, Bittencourt MN, Leite VF. Repercussões vivenciadas por profissionais de saúde atendidos com práticas integrativas e complementares durante a pandemia. Rev Rene (Online). 2022;23:e80668. Disponível em: https://doi.org/10.15253/2175-6783.20222380668

Hsieh HF, Huang IC, Liu Y, Chen WL, Lee YW, Hsu HT. The effects of biofeedback training and smartphone-delivered biofeedback training on resilience, occupational stress, and depressive symptoms among abused psychiatric nurses. Int J Environ Res Public Health. 2020;17(8):2905. Disponível em: https://doi.org/10.3390/ijerph17082905

Jourabchi Z, Satari E, Mafi M, Ranjkesh F. Effects of Benson’s relaxation technique on occupational stress in midwives. Nurs. 2020;50(9):64-8. Disponível em: https://doi.org/10.1097/01.NURSE.0000694836.00028.28

Ganjeali S, Farsi Z, Sajadi SA, Zarea K. The effect of the demonstration-based progressive muscle relaxation technique on stress and anxiety in nurses caring for COVID-19 patients: A randomized clinical trial. BMC Psychiatry. 2022;22(1):791. Disponível em: https://doi.org/10.1186/s12888-022-04456-3

Silva NO, Kuba G, Kurebayashi LFS, Turrini RNT. Efeito da auriculoterapia chinesa sobre o humor de profissionais de saúde: estudo piloto. Rev Enferm UFSM. 2021;11:e53–e53. Disponível em: https://doi.org/10.5902/2179769261883

Lee S-N, Kim B, Park H. The effects of auricular acupressure on stress, anxiety, and depression of outpatient nurses in South Korea. Complement Ther Clin Pract. 2021;44:101447. Disponível em: https://doi.org/10.1016/j.ctcp.2021.101447

Silva J, Silva DB, Nascimento LC, Gomes RA, Freire GG, Gondim ALM, Braga LP. Promoção da saúde mental dos trabalhadores da saúde: as práticas integrativas e complementares como estratégias de cuidado. Rev Ciênc Plur. 2022;8(3):29054. Disponível em: https://doi.org/10.21680/2446-7286.2022v8n3

Rosamond RL, Giarratano G, Orlando S, Sumner J, Devier D, McDaniel LS, Wardell DW. Healing touch: A strategy for acute care nurses’ stress reduction. J Holist Nurs. 2023;41(4):347-59. Disponível em: https://doi.org/10.1177/08980101221142193

Dincer B, Inangil D. The effect of emotional freedom techniques on nurses’ stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial. Explore (NY). 2021;17(2):109-14. Disponível em: https://doi.org/10.1016/j.explore.2020.11.012

Carneiro ÉM, Oliveira LFA, Silva DAA, Sousa JBF, Timóteo RP, Neto OB, et al. Effects of the laying on of hands on anxiety, stress and autonomic response of employees in a hospital: a double-blind randomized controlled trial. Complement Ther Med. 2020;52. Disponível em: https://doi.org/10.1016/j.ctim.2020.102475

Zucchetti G, Ciappina S, Bottigelli C, Campione G, Parrinello A, Piu P, Lijoi S, Quarello P, Fagioli F. Reiki intervention for supporting healthcare professional care behaviors in pediatric palliative care: A pilot study. Palliat Support Care. 2024;22(3):493-8. Disponível em: https://doi.org/10.1017/S1478951523001852

Jadidi A, Irannejad B, Salehi M, Safarabadi M. Effect of Stachys lavandulifolia on occupational stress in emergency medical technicians. Explore (N Y). 2023;19(6):803–5. Disponível em: https://doi.org/10.1016/j.explore.2023.04.003

Afrasiabi J, McCarty R, Hayakawa J, Barrows J, Lee K, Plouffe N, Schomberg J. Effects of acupuncture and acupressure on burnout in health care workers: a randomized trial. J Trauma Nurs. 2021;28(6):350–62. Disponível em: https://doi.org/10.1097/JTN.0000000000000614

Beverly E, Hommema L, Coates K, Duncan G, Gable B, Gutman T, et al. A tranquil virtual reality experience to reduce subjective stress among COVID-19 frontline healthcare workers. PLoS One. 2022;17(2):e0262703. Disponível em: https://doi.org/10.1371/journal.pone.0262703

Kline JA, VanRyzin K, Davis JC, Parra JA, Todd ML, Shaw LL, Haggard BR, Fisher MA, Pettit KL, Beck AM. Randomized trial of therapy dogs versus deliberative coloring (art therapy) to reduce stress in emergency medicine providers. Acad Emerg Med. 2020;27(4):266-75. Disponível em: https://doi.org/10.1111/acem.13939

Published

2024-11-20

How to Cite

Rossi, E. . B., Lopes, A. N. M., Dresch, M., Cadorin, C., Parulla, C. D., Bairros, P. M. N., … Antoniolli, L. (2024). Non-Pharmacological Management of Occupational Stress in Health Professionals: Integrative Review. Revista De Divulgação Científica Sena Aires, 13(Esp. 2), 1142–1157. Retrieved from https://rdcsa.emnuvens.com.br/revista/article/view/446

Issue

Section

Literature Review