The Impact of Cognitive Behavioral Stress Management Training Program on Job Stress in Hospital Nurses: Applying PRECEDE Model

Babak Moeini, Seyed Mohammad Mehdi Hazavehei, Zahra Hosseini, Teamur Aghamolaei, Abbas Moghimbeigi


Background: Nursing is one of the most stressful jobs. The present study aimed to determine the effect of a cognitive-behavioral stress management training program based on PRECEDE model on stress reduction among nurses.

Methods: In this quasi-experimental study, which was conducted in 2010, 58 female nurses in Hamadan, northwest Iran were enrolled in the study and were divided into two equal groups included 29 nurses from one Hospital and 29 nurses from the other as intervention and control groups respectively. The data collection tool was a self-administered questionnaire including demographic characteristics and nursing stress scale (NSS). In addition, a questionnaire based on PRECEDE model was used in order to assess predisposing, reinforcing and enabling factors. The intervention was a training program including five sessions during three weeks in which relaxation and problem-solving training was thought. A pre-test and a post-test were performed 1.5 months apart. The t-test, Mann Whitney and Willxocon statistical tests were used for data analysis at 95% significant level using SPSS 13.

Results: The baseline score average of job stress was 113.0 and 109.8 for intervention and control groups respectively (P=0.250). After intervention, score average of job stress decreased to 94.0 in experimental group while that of control group remained relatively unchanged (109.2), (P < 0.001). A significant difference was found in PRECEDE model constructs and stress management behaviors in intervention group compared to control group after training interventions (P < 0.001). 

Conclusion: Training programs based on PRECEDE model might be effective on decreasing job stress in nurses.


Nursing stress;PRECEDE model;Stress management

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