National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (2)
- Ambulatory Care and Surgery (1)
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- Burnout (1)
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- Pregnancy (3)
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- (-) Stress (23)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedBurnett-Zeigler IE, Waldron EM, Hong S
Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health.
In this study the investigators evaluated the feasibility of using an activity monitor to support mindfulness practice, reduce self-reported stress and physiological indicators of stress. They found that there were no significant changes in self-reported stress, depression, post-traumatic stress and mindfulness from baseline to eight-weeks; pulse pressure and standard deviation of pulse pressure increased over time; and those who were high on the non-judge mindfulness subscale had a lower standard deviation pulse pressure and spent less time stressed.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler IE, Waldron EM, Hong S .
Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health.
Complement Ther Clin Pract 2018 Nov;33:93-99. doi: 10.1016/j.ctcp.2018.09.001..
Keywords: Depression, Health Information Technology (HIT), Behavioral Health, Patient-Centered Outcomes Research, Stress
Sutherland S, Brunwasser SM
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
This review evaluates the degree to which recent studies provide evidence that prenatal maternal stress (PNMS) has a varying effect on child health outcomes depending on the child's biological sex. “Stress” includes negative life events, psychological stress, and established stress biomarkers. A review of 50 peer-reviewed articles revealed that most found evidence of either sex-specific associations or significant PNMS (x) stress interactions for at least one outcome. Sex-dependent effects were strongest in the group of studies that evaluated child neural/nervous system development and temperament.
AHRQ-funded; HS022990.
Citation: Sutherland S, Brunwasser SM .
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
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Keywords: Children/Adolescents, Newborns/Infants, Outcomes, Pregnancy, Sex Factors, Stress
Simpkin AL, Khan A, West DC
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
This study examined how stress from uncertainty is related to resilience among medical residents and whether those attributes are related to depression and burnout. The investigators surveyed 86 residents in pediatric residency programs from 4 urban freestanding children’s hospitals in North America in 2015. They used the Physicians’ Reaction to Uncertainty Scale to measure stress from uncertainty, the 14-item Resilience Scale to measure uncertainty, the Harvard National Depression Scale for depression, and the Maslach Burnout Inventory for burnout. There was a response rate of 58.1%. Five residents met depression criteria, and 15 residents met the burnout criteria. Depressed and burned out residents both had higher mean levels of stress compared to residents who neither depressed nor burned out.
AHRQ-funded; HS022986.
Citation: Simpkin AL, Khan A, West DC .
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
Acad Pediatr 2018 Aug;18(6):698-704. doi: 10.1016/j.acap.2018.03.002..
Keywords: Burnout, Stress, Depression, Provider: Physician, Behavioral Health, Provider, Education: Continuing Medical Education, Hospitals
Garfield CF, Simon CD, Rutsohn J
Stress from the neonatal intensive care unit to home: paternal and maternal cortisol rhythms in parents of premature infants.
The purpose of the study was to examine cortisol diurnal rhythms, a physiologic marker of stress, over the transition from the critical care setting to home for fathers and mothers of very low-birth-weight infants, including how cortisol is associated with psychosocial stress and parenting sense of competence. The investigators noted that fathers may be especially susceptible to stressors during this transition.
AHRQ-funded; HS020316.
Citation: Garfield CF, Simon CD, Rutsohn J .
Stress from the neonatal intensive care unit to home: paternal and maternal cortisol rhythms in parents of premature infants.
J Perinat Neonatal Nurs 2018 Jul/Sep;32(3):257-65. doi: 10.1097/jpn.0000000000000296..
Keywords: Caregiving, Newborns/Infants, Newborns/Infants, Stress, Transitions of Care
Khandelwal N, Hough CL, Downey L
Prevalence, risk factors, and outcomes of financial stress in survivors of critical illness.
The objective was to describe the prevalence of financial stress among critically ill patients and their families and explore associations between financial stress and psychologic distress. It found that factors associated with financial stress included female sex, young children at home, and baseline financial discomfort. Also, financial stress after critical illness was common and associated with symptoms of anxiety and depression.
AHRQ-funded; HS022982.
Citation: Khandelwal N, Hough CL, Downey L .
Prevalence, risk factors, and outcomes of financial stress in survivors of critical illness.
Crit Care Med 2018 Jun;46(6):e530-e39. doi: 10.1097/ccm.0000000000003076.
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Keywords: Critical Care, Healthcare Costs, Risk, Patient-Centered Outcomes Research, Stress
Abelson JS, Chait A, Shen MJ
Sources of distress among patients undergoing surgery for colorectal cancer: a qualitative study.
The objective of this qualitative study was to explore sources of distress among colorectal cancer patients undergoing surgery. The investigators found that patients identified sources of stress at preoperative, in-hospital recovery and postoperative stages. Sources of stress included, but were not limited to: emotional reaction to diagnosis, negative emotional reaction to having a surgery, dealing with distressing physical symptoms and complications after surgery.
AHRQ-funded; HS000066.
Citation: Abelson JS, Chait A, Shen MJ .
Sources of distress among patients undergoing surgery for colorectal cancer: a qualitative study.
J Surg Res 2018 Jun;226:140-49. doi: 10.1016/j.jss.2018.01.017..
Keywords: Adverse Events, Cancer, Cancer: Colorectal Cancer, Stress, Surgery
Muzny CA, Perez AE, Eaton EF
Psychosocial stressors and sexual health among Southern African American women who have sex with women.
This study identifies psychosocial stressors, including sexual health, among Southern African American women who have sex with other women. Stressors included alcohol/drug use at last sexual encounter, and intimate partner violence (IPV). Incarceration was associated with STI history. All these stressors were also associated if they had sex with men.
AHRQ-funded; HS023009.
Citation: Muzny CA, Perez AE, Eaton EF .
Psychosocial stressors and sexual health among Southern African American women who have sex with women.
LGBT Health 2018 May/Jun;5(4):234-41. doi: 10.1089/lgbt.2017.0263..
Keywords: Racial and Ethnic Minorities, Sexual Health, Stress, Women
Anton NE, Beane J, Yurco AM
Mental skills training effectively minimizes operative performance deterioration under stressful conditions: results of a randomized controlled study.
This study demonstrated that giving residents mental skills training significantly increases performance during surgery under stressful conditions. A randomized controlled study was done with twenty-four residents to test laparoscopic suturing skills with and without external stressors. Both groups experienced decreased performance when stress was applied, but the group who had gone through the mental skills curriculum (MSC) significantly outperformed the control group. The researchers feel this finding supports including this training in the curriculum for surgical residents.
AHRQ-funded; HS22080.
Citation: Anton NE, Beane J, Yurco AM .
Mental skills training effectively minimizes operative performance deterioration under stressful conditions: results of a randomized controlled study.
Am J Surg 2018 Feb;215(2):214-21. doi: 10.1016/j.amjsurg.2017.09.039..
Keywords: Education: Continuing Medical Education, Education: Curriculum, Stress, Surgery
Ramchand R, Ayer L, Kotzias V
Suicide risk among women veterans in distress: perspectives of responders on the veterans crisis line.
The researchers used a qualitative approach to gain insight about the concerns and nature of comments regarding suicidal ideation and intent among women veterans calling the Veterans Crisis Line (VCL). Interviewing 54 VCL call responders, the authors concluded that efforts to prevent and treat the consequences of military sexual trauma; to recognize, prevent, and treat non-suicidal self-harm; and to restrict access to lethal means most commonly reported among women veteran callers may be helpful to mitigate suicide risk in this vulnerable group of veterans.
AHRQ-funded; HS000029.
Citation: Ramchand R, Ayer L, Kotzias V .
Suicide risk among women veterans in distress: perspectives of responders on the veterans crisis line.
Womens Health Issues 2016 Nov - Dec;26(6):667-73. doi: 10.1016/j.whi.2016.07.005.
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Keywords: Behavioral Health, Prevention, Stress, Women
Sumner JA, Khodneva Y, Muntner P
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
Using data from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study, the authors examined associations among depressive symptoms and stress, alone and in combination, and incident cardiovascular disease (CVD) and all-cause mortality as a function of socioeconomic status. They found that screening for a combination of elevated depressive symptoms and stress in low-income persons may help identify those at increased risk of incident CVD and mortality.
AHRQ-funded; HS023009.
Citation: Sumner JA, Khodneva Y, Muntner P .
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
J Am Heart Assoc 2016 Oct 10;5(10). doi: 10.1161/jaha.116.003930.
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Keywords: Cardiovascular Conditions, Depression, Social Determinants of Health, Stress, Stroke
Garfield CF, Simon CD, Rutsohn J
Paternal and maternal testosterone in parents of NICU infants transitioning home.
This study examined testosterone levels for parents of very low-birth-weight infants, including links between salivary testosterone and infant factors (such as breast-feeding), psychosocial stress, and changes over time. Using multilevel modeling approaches, the researchers reported significant associations between paternal testosterone by time and psychosocial adjustment and between both paternal and maternal testosterone and infant feeding mode.
AHRQ-funded; R21 HS020316.
Citation: Garfield CF, Simon CD, Rutsohn J .
Paternal and maternal testosterone in parents of NICU infants transitioning home.
J Perinat Neonatal Nurs 2016 Oct/Dec;30(4):349-58. doi: 10.1097/jpn.0000000000000218.
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Keywords: Newborns/Infants, Stress, Caregiving, Hospital Discharge
Senders A, Sando K, Wahbeh H
Managing psychological stress in the multiple sclerosis medical visit: patient perspectives and unmet needs.
Psychological stress can negatively impact multiple sclerosis. To further understand how stress is addressed in the multiple sclerosis medical visit, 34 people with multiple sclerosis participated in focus groups. Transcripts were analyzed by inductive thematic analysis. The majority of participants did not discuss stress with their provider, citing barriers to communication such as lack of time, poor coordination between specialties, physician reliance on pharmaceutical prescription, and patient lack of self-advocacy. Participants recommended several ways to better manage psychological well-being in the clinical setting. These findings provide a foundation for future studies aimed at minimizing the detrimental effect of stress in multiple sclerosis.
AHRQ-funded; HS017582.
Citation: Senders A, Sando K, Wahbeh H .
Managing psychological stress in the multiple sclerosis medical visit: patient perspectives and unmet needs.
J Health Psychol 2016 Aug;21(8):1676-87. doi: 10.1177/1359105314562084.
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Keywords: Care Management, Neurological Disorders, Ambulatory Care and Surgery, Stress
Witt WP, Mandell KC, Wisk LE
Infant birthweight in the US: the role of preconception stressful life events and substance use.
The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women's alcohol and tobacco use before and during pregnancy, and infant birthweight. It concluded that PSLEs and women's tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby.
AHRQ-funded; HS000063; HS000083.
Citation: Witt WP, Mandell KC, Wisk LE .
Infant birthweight in the US: the role of preconception stressful life events and substance use.
Arch Womens Ment Health 2016 Jun;19(3):529-42. doi: 10.1007/s00737-015-0595-z.
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Keywords: Newborns/Infants, Pregnancy, Stress, Substance Abuse, Women
Kaplan RM, Milstein A
AHRQ Author: Kaplan RM
Financial strain and cancer outcomes.
This editorial discusses an article by Lathan et al. in the same issue that documents the strong associations between socioeconomic status and longevity. The editorial argues that many of the variables in that article are measured with error and, as a result, the multivariable analysis resulted in only partial adjustment. Two variables of particular importance, education and ethnicity, are discussed.
AHRQ-authored.
Citation: Kaplan RM, Milstein A .
Financial strain and cancer outcomes.
J Clin Oncol 2016 May 20;34(15):1711-2. doi: 10.1200/jco.2016.66.8079.
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Keywords: Cancer, Health Status, Healthcare Costs, Low-Income, Outcomes, Social Determinants of Health, Stress
Rhoten BA
Body image disturbance in adults treated for cancer - a concept analysis.
The author analyzed the concept of body image disturbance in adults who have been treated for cancer as a phenomenon of interest to nurses. Rhoten used Walker and Avant's 8-step method of concept analysis and concluded that a better understanding of body image disturbance in adults treated for cancer will assist nurses and other clinicians in identifying this phenomenon and will assist nurse scientists in developing instruments that accurately measure this condition, along with interventions that will promote a better quality of life for survivors.
AHRQ-funded; HS022990.
Citation: Rhoten BA .
Body image disturbance in adults treated for cancer - a concept analysis.
J Adv Nurs 2016 May;72(5):1001-11. doi: 10.1111/jan.12892.
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Keywords: Behavioral Health, Cancer, Stress
Mathur MB, Epel E, Kind S
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
The researchers conducted a systematic review and meta-analysis to determine the association between self-reported, perceived psychological stress (PS) and telomere length (TL). They found that increased PS was associated with a very small decrease in TL and that this relationship was similar between sexes. They concluded that the association may be stronger with known major stressors and is similar in magnitude to that noted between obesity and TL. The authors recommended that futre research assess for potential confounders and use longitudinal, multidimensional models of stress.
AHRQ-funded; HS019816.
Citation: Mathur MB, Epel E, Kind S .
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
Brain Behav Immun 2016 May;54:158-69. doi: 10.1016/j.bbi.2016.02.002.
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Keywords: Evidence-Based Practice, Genetics, Stress
Rocque GB, Taylor RA, Acemgil A
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
This study assessed the feasibility and impact of using distress assessments to frame lay navigator interactions with geriatric patients with cancer who were enrolled in navigation between January 1, 2014, and December 31, 2014. It concluded that lay navigators were able to routinely screen for patient distress at a high degree of penetration using a structured distress assessment.
AHRQ-funded; HS013852.
Citation: Rocque GB, Taylor RA, Acemgil A .
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
J Natl Compr Canc Netw 2016 Apr;14(4):407-14.
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Keywords: Elderly, Cancer, Tools & Toolkits, Stress, Behavioral Health
Heberlein EC, Picklesimer AH, Billings DL
The comparative effects of group prenatal care on psychosocial outcomes.
This study compared the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care. It used a prospective cohort study of women who chose CP group or individual prenatal care. Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 percent greater increase in prenatal planning-preparation coping strategies in late pregnancy and a 4.9 percent greater decrease in postpartum depressive symptom scores.
AHRQ-funded; HS021975.
Citation: Heberlein EC, Picklesimer AH, Billings DL .
The comparative effects of group prenatal care on psychosocial outcomes.
Arch Womens Ment Health 2016 Apr;19(2):259-69. doi: 10.1007/s00737-015-0564-6.
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Keywords: Pregnancy, Stress, Depression, Outcomes
Edrees H, Brock DM, Wu AW
The experiences of risk managers in providing emotional support for health care workers after adverse events.
The authors surveyed members of the American Society for Health Care Risk Management (ASHRM) about their training, experience, competence, and comfort with providing emotional support to health care workers. Risk managers who were comfortable listening to and supporting health care workers were more likely to report prior training. Most respondents expressed a preference to receive additional training.
AHRQ-funded; HS019531.
Citation: Edrees H, Brock DM, Wu AW .
The experiences of risk managers in providing emotional support for health care workers after adverse events.
J Healthc Risk Manag 2016 Apr;35(4):14-21. doi: 10.1002/jhrm.21219.
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Keywords: Adverse Events, Medical Errors, Stress, Patient Safety
Abdelrahman AM, Bingener J, Yu D
Impact of single-incision laparoscopic cholecystectomy (SILC) versus conventional laparoscopic cholecystectomy (CLC) procedures on surgeon stress and workload: a randomized controlled trial.
The goal of this study was to compare surgeon stress and workload between single-incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC). It concluded that surgeon heart rate, salivary cortisol level, instrument usability, and Surg-TLX ratings indicate that SILC is significantly more stressful and physically demanding than the CLC.
AHRQ-funded; HS023146.
Citation: Abdelrahman AM, Bingener J, Yu D .
Impact of single-incision laparoscopic cholecystectomy (SILC) versus conventional laparoscopic cholecystectomy (CLC) procedures on surgeon stress and workload: a randomized controlled trial.
Surg Endosc 2016 Mar;30(3):1205-11. doi: 10.1007/s00464-015-4332-5.
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Keywords: Provider, Provider: Physician, Stress, Surgery
Sawchuk CN, Roy-Byrne P, Noonan C
The association of panic disorder, posttraumatic stress disorder, and major depression with smoking in American Indians.
This survey asked whether lifetime panic disorder, posttraumatic stress disorder, and major depression were related to lifetime cigarette smoking in two geographically distinct American Indian tribes. It found that the odds of smoking were two times higher in Southwest participants with panic disorder and major depression, and 1.7 times higher in those with posttraumatic stress disorder, after controlling for sociodemographic variables.
AHRQ-funded; HS010854.
Citation: Sawchuk CN, Roy-Byrne P, Noonan C .
The association of panic disorder, posttraumatic stress disorder, and major depression with smoking in American Indians.
Nicotine Tob Res 2016 Mar;18(3):259-66. doi: 10.1093/ntr/ntv071.
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Keywords: Depression, Tobacco Use, Racial and Ethnic Minorities, Stress
Johnson TJ, Hickey RW, Switzer GE
The impact of cognitive stressors in the emergency department on physician implicit racial bias.
The researchers sought to determine if physicians have different levels of implicit racial bias post-ED shift versus preshift and to examine associations between demographics and cognitive stressors (e.g., fatigue, stress, time pressure, and complex decision-making) with bias. They concluded that resident implicit bias remained stable overall preshift to postshift, cognitive stressors (overcrowding and patient load) were associated with increased implicit bias.
AHRQ-funded; HS017587.
Citation: Johnson TJ, Hickey RW, Switzer GE .
The impact of cognitive stressors in the emergency department on physician implicit racial bias.
Acad Emerg Med 2016 Mar;23(3):297-305. doi: 10.1111/acem.12901.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Stress, Provider: Health Personnel
Cummings DM, Kirian K, Howard G
Consequences of comorbidity of elevated stress and/or depressive symptoms and incident cardiovascular outcomes in diabetes: results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.
The authors evaluated the impact of comorbid depressive symptoms and/or stress on adverse cardiovascular (CV) outcomes in individuals with diabetes compared with those without diabetes. They concluded that comorbid stress and/or depressive symptoms are common in individuals with diabetes and together are associated with progressively increased risks for adverse CV outcomes.
AHRQ-funded; HS023009.
Citation: Cummings DM, Kirian K, Howard G .
Consequences of comorbidity of elevated stress and/or depressive symptoms and incident cardiovascular outcomes in diabetes: results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.
Diabetes Care 2016 Jan;39(1):101-9. doi: 10.2337/dc15-1174.
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Keywords: Cardiovascular Conditions, Depression, Diabetes, Patient-Centered Outcomes Research, Stress