Sage Journals: Discover world-class research

Abstract

The purpose of this research was to examine the holistic effects of combined complementary therapies in reducing stress in college students. This convergent mixed-method study provided aromatherapy, massage, and meditation music sessions to college students (N = 50) just before finals week. Paired t-tests analyzed pre-session and post-session perceived stress and anxiety as well as objective physiological measures, including salivary cortisol, heart rate, and blood pressure. There was a significant difference in the scores for perceived stress before and after the sessions, t(49) = 4.72, p < .001, as well as pre-anxiety and post-anxiety, t(49) = 10.27, p < .001. Additionally, salivary cortisol levels significantly reduced from pre-session to post-session t(49) = 2.76, p = .008; and a significant reduction in heart rate from pre-session to post-session, t(49) = 3.73, p < .001. This study demonstrates that 20 min of brief complementary interventions can alter students’ subjective holistic health perspectives, with objective physiological data confirming changes that promote health and wellbeing.

Keywords

healthcare providers self-care aromatherapy essential oils meditation music mindfulness massage therapy stress management relaxation complimentary therapies stress and coping anxiety mental health salivary cortisol nursing nurses educators college students

Get full access to this article

View all access options for this article.

References

American College Health Association (ACHA). (2023). National College Health Assessment III: Undergraduate student reference group executive summary spring 2023. https://www.acha.org/documents/ncha/NCHA-III_SPRING_2023_UNDERGRAD_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf

American Holistic Nurses Association (AHNA) (n.d.). Retrieved Feb. 10, 2024. https://www.ahna.org/About-Us/What-is-Holistic-Nursing

American Nurses Association, & American Holistic Nurses Association (2021). Holistic nursing: Scope and standards of practice (4th ed.).

American Psychological Association (APA). (2022). Stress in America 2022. Retrieved July 19, 2024. https://www.apa.org/news/press/releases/stress/2022/concerned-future-inflation

Beiter

Nash

McCrady

Rhoades

Linscomb

Clarahan

Sammut

(2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173, 90–96. https://doi.org/10.1016/j.jad.2014.10.054

Blood

A. J.

Zatorre

R. J.

(2001). Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. Proceedings of the National Academy of Sciences, 98(20), 11818–11823. https://doi.org/10.1073/pnas.191355898

Boon

Verhoef

O’Hara

Findlay

Majid

(2004). Integrative healthcare: Arriving at a working definition. Alternative Therapies in Health and Medicine, 10(5), 48–56. PMID: 15478786.

Bost

Wallis

(2006). The effectiveness of a 15 minute weekly massage in reducing physical and psychological stress in nurses. Australian Journal of Advanced Nursing, 23(4), 28–33. https://doi.org/10.37464/2006.234.1920

Cabin

R. J.

Mitchell

R. J.

(2000). To Bonferroni or not to Bonferroni: When and how are the questions. Bulletin of the Ecological Society of America, 81(3), 246–248. http://www.jstor.org/stable/20168454

10.

Cervellin

Lippi

(2011). From music-beat to heart-beat: A journey in the complex interactions between music, brain and heart. European Journal of Internal Medicine, 22(4), 371–374. https://doi.org/10.1016/j.ejim.2011.02.019

11.

Cleveland State University Recreation Center (CSU) (n.d.). Shine Well. https://csurec.com/shine-well/

12.

Cohen

Kamarck

Mermelstein

(1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. https://doi.org/10.2307/2136404

13.

Deng

Cherian

Khan

N. U.

Kumari

Sial

M. S.

Comite

Gavurova

Popp

(2022). Family and academic stress and their impact on students’ depression level and academic performance. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.869337

14.

Dorn

L. D.

Lucke

J. F.

Loucks

T. L.

Berga

S. L.

(2007). Salivary cortisol reflects serum cortisol: Analysis of circadian profiles. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 44(3), 281–284. https://doi.org/10.1258/000456307780480954

15.

Dunn

O. J.

(1961). Multiple comparisons among means. Journal of the American Statistical Association, 56(293), 52. https://doi.org/10.2307/2282330

16.

Earl E. Bakken Center for Spirituality and Healing, University of Minnesota. (2022). Principles of integrative nursing. https://www.csh.umn.edu/education/focus-areas/integrative-nursing/principles-integrative-nursing

17.

El-Farhan

Rees

D. A.

Evans

(2017). Measuring cortisol in serum, urine and saliva—are our assays good enough? Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 54(3), 308–322. https://doi.org/10.1177/0004563216687335

18.

Faul

Erdfelder

Lang

A. G.

Buchner

(2007). GPower 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191. https://doi.org/10.3758/BF03193146

19.

Frisch

(2001). Standards for holistic nursing practice: A way to think about our care that includes complementary and alternative modalities. OJIN: The Online Journal of Issues in Nursing, 6(2). https://doi.org/10.3912/ojin.vol6no02man04

20.

Frisch

N. C.

Rabinowitsch

(2019). What’s in a definition? Holistic nursing, integrative health care, and integrative nursing: Report of an integrated literature review. Journal of Holistic Nursing, 37(3), 260–272. https://doi.org/10.1177/0898010119860685

21.

Habibi

Damasio

(2014). Music, feelings, and the human brain. Psychomusicology: Music, Mind, and Brain, 24(1), 92–102. https://doi.org/10.1037/pmu0000033

22.

Jafari-Koulaee

Elyasi

Taraghi

Ilali

E. S.

Moosazadeh

(2020). A systematic review of the effects of aromatherapy with lavender essential oil on depression. Central Asian Journal of Global Health, 9(1). https://doi.org/10.5195/cajgh.2020.442

23.

Johnson

C. E.

(2019). Effect of inhaled lemon essential oil on cognitive test anxiety among nursing students. Holistic Nursing Practice, 33(2), 95–100. https://doi.org/10.1097/hnp.0000000000000315

24.

Koelsch

Fritz

v. Cramon

D. Y.

Müller

Friederici

A. D.

(2006). Investigating emotion with music: An FMRI study. Human Brain Mapping, 27(3), 239–250. https://doi.org/10.1002/hbm.20180

25.

Koithan

(2009). Introducing complementary and alternative therapies. The Journal for Nurse Practitioners, 5(1), 18–20. https://doi.org/10.1016/j.nurpra.2008.10.012

26.

Kreitzer

M. J.

(2015). Integrative nursing: Application of principles across clinical settings. Rambam Maimonides Medical Journal, 6(2). https://doi.org/10.5041/rmmj.10200

27.

Kreitzer

M. J.

Koithan

(2019). Integrative nursing (2nd ed.). Oxford University Press.

28.

Kreitzer

M. J.

Koithan

Sullivan

S. D.

Nunez

Voss

(2022). Integrative nursing and the ana scope and standards of practice: Expanding the reach of nursing for families and society. Creative Nursing, 28(4), 228–233. https://doi.org/10.1891/cn-2022-0041

29.

Leach

M. J.

Wiese

Thakkar

Agnew

(2018). Integrative health care—toward a common understanding: A mixed method study. Complementary Therapies in Clinical Practice, 30, 50–57. https://doi.org/10.1016/j.ctcp.2017.12.007

30.

Lee

E.-H.

(2012). Review of the psychometric evidence of the perceived stress scale. Asian Nursing Research, 6(4), 121–127. https://doi.org/10.1016/j.anr.2012.08.004

31.

Lewis-Hunstiger

(2023). Permission to care for ourselves. Creative Nursing, 29(1), 9–17. https://doi.org/10.1177/107845352202900110

32.

Matshaka

Downing

Ntshingila

(2024). Facilitating holistic nursing through the development of mindfulness: A model for student nurses. Journal of Holistic Nursing, 42(4), 409–419. https://doi.org/10.1177/08980101241245824

33.

Merriam

S. B.

Baumgartner

L. M.

(2020). Learning in adulthood: A comprehensive guide (4th ed). Jossey-Bass.

34.

NCCIH (National Center for Complementary and Integrative Health) (2019). Massage therapy: What you need to know. National Institute of Health. Retrieved February 10, 2024. https://www.nccih.nih.gov/health/massage-therapy-what-you-need-to-know

35.

NCCIH (National Center for Complementary and Integrative Health) (2022). Music and health: What you need to know. National Institute of Health. Retrieved February 10, 2024. https://www.nccih.nih.gov/health/music-and-health-what-you-need-to-know

36.

NCES (National Center for Education Statistics). (2023). Undergraduate degree fields. Condition of Education. U.S. Department of Education, Institute of Education Sciences. Retrieved July 19, 2024. https://nces.ed.gov/programs/coe/indicator/cta

37.

Nilsson

(2022). Spiritual self-care management for nursing professionals: A holistic approach. Journal of Holistic Nursing, 40(1), 64–73. https://doi.org/10.1177/08980101211034341

38.

Olfson

Cosgrove

C. M.

Wall

M. M.

Blanco

(2023). Suicide risks of health care workers in the US. JAMA, 330(12), 1161–1166. https://doi.org/10.1001/jama.2023.15787

39.

Prado

J. M.

Kurebayashi

L. F.

Silva

M. J.

(2012). Efficacy of auriculotherapy for the reduction of stress in nursing students: A randomized clinical trial. Revista Latino-Americana de Enfermagem, 20(4), 727–735. https://doi.org/10.1590/s0104-11692012000400013

40.

Reecer

(2022, July 21). Shine well at Cleveland State redefines campus wellness. Campus Rec Magazine. Retrieved July 20, 2024. https://campusrecmag.com/shine-well-at-cleveland-state-redefines-campus-wellness/

41.

Rodrigues

A. C.

Loureiro

M. A.

Caramelli

(2010). Musical training, neuroplasticity and cognition. Dementia & Neuropsychologia, 4(4), 277–286. https://doi.org/10.1590/S1980-57642010DN40400005

42.

Shimba

Ikuta

(2020). Immune-enhancing effects of glucocorticoids in response to day–night cycles and stress. International Immunology, 32(11), 703–708. https://doi.org/10.1093/intimm/dxaa048

43.

Tabish

S. A.

(2008). Complementary and alternative healthcare: Is it evidence-based? International Journal of Health Sciences, 2(1), V–IX. PMID: 21475465.

44.

Toda

Morimoto

(2008). Effect of lavender aroma on salivary endocrinological stress markers. Archives of Oral Biology, 53(10), 964–968. https://doi.org/10.1016/j.archoralbio.2008.04.002

45.

U. S. Bureau of Labor Statistics (2023). Healthcare occupations: Characteristics of the employed. Spotlight on Statistics. https://www.bls.gov/spotlight/2023/healthcare-occupations-in-2022

46.

Varney

Buckle

(2013). Effect of inhaled essential oils on mental exhaustion and moderate burnout: A small pilot study. The Journal of Alternative and Complementary Medicine, 19(1), 69–71. https://doi.org/10.1089/acm.2012.0089

47.

Vining

R. F.

McGinley

R. A.

Maksvytis

J. J.

K. Y.

(1983). Salivary cortisol: A better measure of adrenal cortical function than serum cortisol. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine, 20(6), 329–335. https://doi.org/10.1177/000456328302000601

48.

Vora

L. K.

Gholap

A. D.

Hatvate

N. T.

Naren

Khan

Chavda

V. P.

Balar

P. C.

Gandhi

Khatri

D. K.

(2024). Essential oils for clinical aromatherapy: A comprehensive review. Journal of Ethnopharmacology, 330, 118180. https://doi.org/10.1016/j.jep.2024.118180

49.

Williams

S. G.

Fruh

Barinas

J. L.

Graves

R. J.

(2022). Self-care in nurses. Journal of Radiology Nursing, 41(1), 22–27. https://doi.org/10.1016/j.jradnu.2021.11.001

50.

Worwood

V. A.

(1996). The fragrant mind: Aromatherapy for personality, mind, mood, and emotion. New World Library.

The Holistic Effect of Complementary Interventions in Reducing Stress in College Students

Abstract

Keywords

Get full access to this article

References