Objective: Many stress management programs employ a variety of techniques to alter or reduce stressful thoughts and feelings, but few studies have targeted only one intervention to assess its singular effect on anger, spirituality, and quality of life. Most stress management techniques also require a quiet place and period of time to implement and this can hinder daily practice. The purpose of this study was to assess the efficacy of a portable mantram (mantra) intervention on outcomes of anger, spiritual well being, and quality of life enjoyment and satisfaction in a sample of veterans and staff.
Design: A pretest, posttest quasi-experimental design was used to assess the efficacy of the intervention. Outcome measures included the short form Spielberger state-trait anger scales, Ellison’s total spiritual well being scale, and Endicott’s quality of life enjoyment and satisfaction of general activities subscale.
Sample: The non-random sample (N=69) consisted of veterans (n=33) and healthcare staff (n=36) who received care or worked at a veterans hospital in southern California during the year 2001. They ranged in age from 26 to 81 years (x=55.1, sd=12.02) and 50.7% were males.
Intervention: The 5-week course consisted of how to choose and repeat a mantram to interrupt the stress response and replace unwanted thoughts using the guidelines of Eknath Easwaran, a spiritual teacher of meditation. It was supported by research on Benson’s “faith factor” and the “relaxation response.” Group sessions were 1-1/2 hours per week and were facilitated by two psychiatric clinical nurse specialists.
Methods: Human subjects committee approval was obtained from the institution. Participants were recruited through flyers and emails to register for the intervention. Following the first class, an invitation to participate in the study was given along with written informed consent. Participants filled out questionnaires after the first and last class to assess the outcome measures.
Findings: Pre- and posttest measures of the anger-state and anger-trait scales resulted in no differences in anger state but a significant drop in anger trait from a pretest mean of 17.4 (sd=5.2) to posttest mean of 15.7 (sd=4.88), t=3.08, df=30, p < .01. No significant differences in spiritual well being were found. The quality of life satisfaction and enjoyment of general activities subscale increased from a pretest mean of 70.42 (sd=9.79) to a posttest mean of 77.39 (sd=9.77) t=-4.16, df=31, p <.001.
Conclusion: These findings show preliminary evidence that a mind-body-spiritual approach to stress management that is portable, immediate, and requires no additional time, place, or equipment can assist in reducing anger and can improve quality of life satisfaction and enjoyment in a sample of veterans and staff. Although there were no changes in spiritual well being during this 5-week intervention, additional assessments of spirituality may be needed several months after the course to find an effect. Further research is needed to compare results with a control group, assess adherence to the intervention, and examine its effects on physiological measures of stress.
Impact: This work is significant to nursing because it addresses the importance of complementary/integrative therapies as a resource in promoting health and managing stress. The intervention can be taught to various patient groups and staff.
This material is the result of work supported with resources and use of facilities at the VA San Diego Healthcare System.
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