Abstract: Although all professions are susceptible to work-related stress, the nursing profession has been identified as particularly stressful; indeed, oncology nursing is often described as being among the most stressful specialty areas. The current study tested the short-term effects of an innovative self-help stress management training for oncology nurses supported by mobile tools. The sample included 30 female oncology nurses with permanent status employed in six oncology hospitals in Milan, Italy. The stress inoculation training (SIT) methodology served as the basis of the training, with the innovative challenge being the use of mobile phones to support the stress management experience. To test the efficacy of the protocol, the study used a between-subjects design, comparing the experimental condition (SIT through mobile phones) with a control group (neutral video through mobile phones). The findings indicated psychological improvement of the experimental group in terms of anxiety state, anxiety trait reduction, and coping skills acquisition. This paper discusses implications for the implementation of this protocol in several contexts.
Abstract: Traditional stress management techniques require significant professional training and expertise to administer as well as people, time, and resources, which can be difficult to achieve. Thanks to the recent progress and diffusion of mobile electronic devices, it is possible today to set up and test an effective self-help stress management program outside a clinical setting. Although the efficacy of mobile self-help approaches have been tested through several studies, and promising applications can be developed, as yet no study has tested the feasibility of mobile platforms to actually elicit core affective states. In this study we used an advanced approach to assess the efficacy of these mobile platforms by recording and processing many psychophysiological measures, which extend the capabilities of the standard self-report questionnaires, objectifying the subjective. Our results seem to show the efficacy of inducing positive and negative affective states, using smart phones.
Abstract: Oncology nurses face extraordinary stresses that may lead to emotional exhaustion, a feeling of emotional distance from patients and burnout. The presentation describes the preliminary results of a study to test the effects of an innovative 4-week 8-session self-help stress management training for oncology nurses supported by mobile tools (Nokia N70 smarthphone). The sample included 16 female oncology nurses with permanent status employed in different oncology hospitals in Milan, Italy. The study used a between-subjects design, comparing the experimental condition (mobile phone stress management protocol) with a control group (neutral videos through mobile phones). In addition to a significant reduction in anxiety state at the end of each session, the experimental group demonstrated a significant improvement in affective change in terms of anxiety trait reduction and coping skills acquisition at the end of the protocol.
Abstract: The relationship between interactive media and stress has gained wide interest in the mental health area. In our research, we found that interactive experiences helped people manage their stress. By combining different techniques, which may produce more significant outcomes than single-strategy programs, we developed a stress management protocol to increase self-awareness, to control and relax oneself, induce positive emotions, and substitute negative emotions. Our stress management protocol was tested in a controlled study comparing three interactive experiences (virtual reality [VR], video, and audio). Results showed the efficacy of all three interactive experiences in inducing positive emotions and integrating different approaches to manage stress. In particular, VR showed better improvements related to the psycho-physiological changes. Implications of the results for worldwide healthcare services will be discussed.
Abstract: The aim of this study is to assess the efficacy of a specific stress management protocol, based on immersive Virtual Reality (VR), to be used as part of a multidisciplinary inpatient program for the treatment of obesity. The stress management protocol included imagery, relaxation and different cognitive behavioral approaches -- emotion focused coping, self-monitoring and record keeping. Forty (40) participants, all female, were recruited for the study at the San Giuseppe Hospital, Istituto Auxologico Italiano, Piancavallo (VB), Italy. Participants were chosen among the obese patients without a specific Binge Eating diagnosis but with high level of anxiety and a history of emotional eating. The sample was randomly distributed in three conditions as follows: (a) VR stress Management Protocol; (b) DVD based stress management protocol; (c) no treatment (control condition). Data show that the VR condition produced a significantly higher reduction in anxiety, as compared both to DVD and control groups. More, we found a significant correlation between changes in the emotional state and the level of presence: the more present the users felt, the higher the reduction in anxiety. This datum suggests the possible role of presence in mediating the effects of a stress management protocol.
Abstract: Many studies showed the ability of movies and imagery techniques to elicit emotions. Nevertheless, it is less clear how to manipulate the content of interactive media to induce specific emotional responses. In particular, this is true for the emerging medium virtual reality (VR), whose main feature is the ability to induce a feeling of "presence" in the computer-generated world experienced by the user. The main goal of this study was to analyze the possible use of VR as an affective medium. Within this general goal, the study also analyzed the relationship between presence and emotions. The results confirmed the efficacy of VR as affective medium: the interaction with "anxious" and "relaxing" virtual environments produced anxiety and relaxation. The data also showed a circular interaction between presence and emotions: on one side, the feeling of presence was greater in the "emotional" environments; on the other side, the emotional state was influenced by the level of presence. The significance of these results for the assessment of affective interaction is discussed.
Abstract: Test-taking anxiety or stress is very common among university students. It can be very distressing and sometimes debilitating. Exam anxiety involves physical components and emotional components that may be taken into account for managing and reducing anxiety. An approach to control exam anxiety is to learn how to regulate emotions. To help students in managing exam stress we developed a specific protocol based on mobile narratives--multimedia narratives experienced on UMTS/3G phones. 30 female university students (M=23.48; sd=1.24) who were going to perform an exam within a week were included in the trial. They were randomly divided in five groups according to the type and mobility of the medium used: (1) audio only narrative (CD at home); (2) audio only narrative (portable MP3); (3) audio and video narrative (DVD at home); (4) audio and video narrative (UMTS based); (5) control group. Audio/video narratives induced a reduction in exam anxiety in more than 80% of the sample vs 50% of the MP3 sample and 0% of the CD sample. Further, all the users who experienced mobile narratives on UMTS phones were able to relax before the exam, against 50% of DVD users and 33% of audio-only users. The trial showed a better efficacy of mobile narratives experienced on UMTS phones in reducing the level of exam stress and in helping the student to relax. These results suggest that for the specific sample considered--Italian university students--the media used for providing an anti-stress protocol has a clear impact on its efficacy.
Abstract: In the past decade, the use of virtual reality for clinical and research applications has become more widespread. However, the diffusion of this approach is still limited by three main issues: poor usability, lack of technical expertise among clinical professionals, and high costs. To address these challenges, we introduce NeuroVR (http://www.neurovr.org--http://www.neurotiv.org), a cost-free virtual reality platform based on open-source software, that allows non-expert users to adapt the content of a pre-designed virtual environment to meet the specific needs of the clinical or experimental setting. Using the NeuroVR Editor, the user can choose the appropriate psychological stimuli/stressors from a database of objects (both 2D and 3D) and videos, and easily place them into the virtual environment. The edited scene can then be visualized in the NeuroVR Player using either immersive or non-immersive displays. Currently, the NeuroVR library includes different virtual scenes (apartment, office, square, supermarket, park, classroom, etc.), covering two of the most studied clinical applications of VR: specific phobias and eating disorders. The NeuroVR Editor is based on Blender (http://www.blender.org), the open source, cross-platform suite of tools for 3D creation, and is available as a completely free resource. An interesting feature of the NeuroVR Editor is the possibility to add new objects to the database. This feature allows the therapist to enhance the patient's feeling of familiarity and intimacy with the virtual scene, i.e., by using photos or movies of objects/people that are part of the patient's daily life, thereby improving the efficacy of the exposure. The NeuroVR platform runs on standard personal computers with Microsoft Windows; the only requirement for the hardware is related to the graphics card, which must support OpenGL.
Abstract: Battlefield stress is the consequence of man being exposed to the hostile environment of combat. Combat stress is specifically caused by man's feat of the dangers of combat, and is fueled and tempered by other variables such as morale, cohesion, fatigue, confidence, training and intensity of the combat. Treatment is often as simple as giving soldiers time to rest for a few hours or days, to get a shower and some sleep, to talk about the feelings they have in the presence of a counselor. Only in rare cases soldiers undergo more serious psychological treatment. One of the best strategies for dealing with stress is learning how to relax. However, relaxing is difficult to achieve in a battlefield. In this chapter we suggest the use of mobile multimedia technology--PDA/cellular phones--for the provision of advanced coping techniques suitable to the battlefield context. Specifically, we developed a protocol based on mobile narratives, to be experienced on mobile multimedia technology--3G cellular phones or PDAs--like the one now under development by the US Army within the "Soldier as a System--SaaS" and "Future Combat Systems--FCS" projects. Mobile narratives are audio-visual experiences, implemented on mobile devices, in which the narrative component is a critical aspect to induce a feeling of presence and engagement. Through the link between the feeling of presence and the emotional state, mobile narratives may be used to improve the mood state in their users. The rationale of the approach and a preliminary test of the proposed method are presented and discussed.
Abstract: One of the best strategies for dealing with stress is learning how to relax. However, relaxing is difficult to achieve in typical real world situations. For this study, we developed a specific protocol based on mobile narratives - multimedia narratives experienced on UMTS/3G phones - to help workers in reducing commuting stress. In a controlled trial 33 commuters were randomly divided between three conditions: Mobile narratives (MN); New age music and videos (NA); no treatment (CT). In two consecutive days the MN and NA samples experienced during their commute trip 2 x 2 6-minute multimedia experiences on a Motorola A925 3G phone provided by the "TRE" Italian UMTS carrier: the MN sample experienced a mobile narrative based on the exploration of a desert beach; the NA sample experienced a commercial new age video with similar visual contents. The trials showed the efficacy of mobile narratives in reducing the level of stress experienced during a commute trip. No effects were found in the other groups. These results suggest that 3G mobile handsets may be used as relaxation tool if backed by a specific therapeutic protocol and meaningful narratives.
Abstract: Conflicting claims have been presented in the literature about on-line management of personal relationships. The current research, carried out in a substantially descriptive design, aimed to consider psychological and social features of a particular electronic environment, the Chat room. One hundred fifty-eight participants filled out an on-line questionnaire set, designed to investigate the personality traits and the prevailing interpersonal values of those participants who set up interpersonal relationships on-line. The Web research showed that, if sampling control and validity assessment were provided, it could be a valid alternative to a more traditional paper-based procedure. The results highlighted that Chat users were not an homogenous group, but were composed of different personality types. Basically, however, this specific virtual environment proved to be crowded with rather close individuals, who were looking for independence but who needed also to be supported and encouraged. They created deep on-line relationships, but these remained limited to the virtual world.
