Introduction
The learning process is arduous for anyone, mainly because of the heavy workload. Nevertheless, it is worth highlighting medicine as a field and, in particular, nursing as one of the most difficult professions to study. This can be explained by the fact that the level and amount of responsibility and knowledge required are unusually high. Constant focus and spending all the time on professional development often leads to great stress and even emotional burnout. To protect young specialists from such negative consequences of work, several methods have been developed to relieve them emotionally.
The active pace of modern life often leads to changes in the human condition, fatigue, and the need for rest. Factors such as the complexity of work, outlook, and lifestyle contribute to stress. If stress and fatigue are ignored, it can lead to such nasty consequences as emotional burnout and frustration. It is important to note that burnout is not a disease, but it can seriously affect an individual. In May 2019, the World Health Organization described the signs of emotional burnout syndrome, but experts did not include it in the list of medical diagnoses (Stillwell et al., 2010b). The syndrome is defined as a phenomenon caused by prolonged stress. It is a factor that can influence the development of diseases. It is difficult for a person to cope with such pressure, and burnout is considered a natural consequence of it.
It is essential to understand that the modern world is very complicated and saturated; that is why it is tough to determine the frustration state. Nevertheless, a person should monitor the atmosphere at work and rest and work through their psychological problems to prevent burnout. Otherwise, such a condition can lead to more severe consequences and mental disorders (Stillwell et al., 2010b). PICO question: In nursing students, does relaxation and meditation help with stress management and burnout compared to those who do not meditate and do not relax?
Literature Review
One of the most urgent problems of social physiology is the creation of functional prerequisites for improving the health of people engaged in strenuous types of professional activity. For professionals, it is characteristic of modern professional activity to take a huge amount of information in minimum time to decide to act. In some cases, this takes place against the background of strenuous muscular activity. (Stillwell et al., 2009) The combination of the two conditions leads to the development of significant psycho-emotional strain, a decrease in work efficiency, and an increase in the possibility of human health disturbance.
This area was the key in the study Effectiveness of music therapy and progressive muscle relaxation in reducing stress before exams and improving academic performance in nursing students: A randomized trial. An important role in psychological research and theorizing about the effects of relaxation belongs to Jacobson. Studying methods of objective registration of emotional states, he found that during negative emotional reactions, the tension of skeletal muscles and corresponding vegetovascular shifts are always revealed (Gallego-Gómez et al., 2020). Each type of emotional reaction there corresponds to a tension of a certain muscle group. For example, depressive states are naturally accompanied by the tension of the respiratory muscles; spasm of muscles of articulation and phonation occurs during emotions of fear (Gallego-Gómez et al., 2020). Based on these studies, the author concluded that emotional reactions can be objectively measured by their external muscular expression.
Also separately reviewed is music therapy, the main principle of which is the suppression of cortisol. It should be noted that studies have been carried out, which consist of monitoring, timely recording, and observation of the patients (Gallego-Gómez et al., 2020). Biochemical studies, for example, have shown a correlation between cortisol and glucose levels in the body, which has led to the discovery of a relationship between music and the above-mentioned muscular relaxation (Stillwell et al., 2009). Thanks to all the information obtained, the evidence base has been gathered, which makes it possible to assert the effectiveness and scientificity of these methods.
However, it should be noted that the evidence base is not as strong as suggested by the authors. The fact is that one of the methods was to study cortisol released during the stress of learning. It is important to point out that the authors linked the entire study to the learning process, so it is worth examining the arguments on the spectrum of this area (Stillwell et al., 2009). The patients who took part in the experiment had not been tested for levels and causes of cortisol before, so no objective level of study stress was detected (Gallego-Gómez et al., 2020). This, in turn, does not allow one to conclude that the above-mentioned exercises are effective specifically against emotional burnout due to study.
An example of an effective and clear evidence base, which can be called unshakable, is the results and methods of another study. Exploring The Effects Of An online asynchronous mindfulness meditation intervention with nursing students On Stress, mood, And Cognition: A descriptive study examines the root causes of stress in nurses, which narrows the scope of analysis. In addition, the study analyzed absolutely all relevant data in such a way that conclusions are extremely objective (Spadaro & Hunker, 2016). For example, mindfulness was correlated with stress, which allowed the source of cortisol to be identified – cognition of large amounts of information. In addition, the online program, given as a treatment method, was pre-programmed in such a way that based on its characteristics, it was easier for specialists to identify the correct correlations in all the experimental processes (Spadaro & Hunker, 2016). Finally, the attention factor was touched upon, namely the absence of distraction in the entire program, which does not harm the educational process. Notably, this aspect was omitted in the previous article. Thus, the evidence base of this study is clear and concise, with no controversial or unexplained points.
It makes sense to identify the criteria of a good evidence base to understand the method by which articles are evaluated. The Evidence-Based Practice, Step by Step: Searching for the Evidence, clearly articulates the methods of evidence orientation. One of the basic principles of evidence review is that it should be uncontroversial and transparent (Stillwell et al., 2010a). It means that evidence is meant that conclusion or connection, the identification of which is argumentative and not contradictory to already existing knowledge. Sometimes evidence for the effectiveness of a particular method of influence is based on its effect on “surrogate” points (Stillwell et al., 2010a). The growing interest in surrogate points can be explained by the possibility of significantly reducing the sample size, duration, and cost of clinical trials. Surrogate points in assessing treatment effects are possible in situations where it is difficult and unethical to use basic outcome measures (Stillwell et al., 2010c). In obtaining reliable information when seeking answers to formulated clinical questions, it should be remembered that different types of studies have different values (Stillwell et al., 2010c). Turning to the articles analyzed above, the value of the conclusions of the second study prevails over the first.
Evidence from modern evidence-based methods in large controlled clinical trials using the randomized, controlled method of studying the effectiveness of drugs forms the basis of evidence-based medicine. However, it should be remembered that both poor-quality meta-analyses and RCTs with serious methodological flaws are inferior in importance to a large and well-organized cohort study (Stillwell et al., 2010a). A study called a “case series” is considered the lowest level in the hierarchy of evidence. It is not even evidence, but suspicion, so it is not desirable to use such studies when looking for an answer to a clinical question.
Conclusion and Answer to the Clinical Question
Based on the present study, the best method of relaxation for stent mediators is an approach with an online program. This assertion is supported by the following arguments. The conclusion of the study suggests that the online program is aimed specifically at reducing the stress resulting from the learning process. This allows us to be convinced of the effectiveness of this approach from the point of view of the question. In addition, we have touched on the aspect of attention, which is extremely important in the context of learning. In other words, the proposed mechanics should contribute to, but not interfere with, the final result. The result should be understood as the training of nurses with a controlled level of stress. Not exceeding the norm. These actions are necessary for the prevention of emotional burnout and clinical diagnoses. The development of evidence-ba sed medicine is gaining momentum worldwide. More and more interventions are receiving evidence-based evidence. In modern conditions, the use of evidence-based medicine data in the practice of a physician is an indicator of professionalism.
References
Gallego-Gómez, J. I., Balanza, S., Leal-Llopis, J., García-Méndez, J. A., Oliva-Pérez, J., Doménech-Tortosa, J., Gómez-Gallego, M., Simonelli-Muñoz, A. J., & Rivera-Caravaca, J. M. (2020). Effectiveness of music therapy and progressive muscle relaxation in reducing stress before exams and improving academic performance in nursing students: A randomized trial. Nurse Education Today, 84, 104217. Web.
Spadaro, K. C., & Hunker, D. F. (2016). Exploring the effects of an online asynchronous mindfulness meditation intervention with nursing students on stress, mood, and cognition: A descriptive study. Nurse Education Today, 39, 163–169. Web.
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., and Williamson, K. M. (2009). Evidence-Based Practice: Step by Step: Igniting a Spirit of Inquiry, American Journal of Nursing, 109, 49-52. Web.
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., and Williamson, K. M. (2010a). Evidence-Based Practice: Step by Step: Searching for the Evidence. American Journal of Nursing, 110, 41-47. Web.
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., and Williamson, K. M. (2010b). Evidence-Based Practice: Step by Step: Asking the Clinical Question A Key Step in Evidence-Based Practice, American Journal of Nursing, 110, 58-61. Web.
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., and Williamson, K. M. (2010c). Evidence-Based Practice: Step by Step: The Seven Steps of Evidence-Based Practice, American Journal of Nursing, 110, 51-53. Web.