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effective and adaptive in dealing with stress. The
experiential use of this kind of skill enhances self-
respect and self-efficacy among clients
(Meichenbaum, 2007; Kawaharada et al., 2009).
Deep breathing as a relaxation method is
effective and easy to use. This is especially so in
situations that create emotional or physiological
reactions. Deep breathing inhibits and
hyperpolarizes the nervous system. This process
activates the parasympathetic autonomous nervous
system (Jerath, et al., 2006). This causes a relaxed
sensation in subjects when dealing with stress.
Cognitive reframing is also a skill that is
effective and easy to use. This is especially so in
situations that need quick responses. The
participants tend to use this strategy in situations in
which they are unable to unwind using deep
breathing strategy. Cognitive reframing helps
subjects to think more positively and this is said to
be an effective emotional coping method
(Kawaharada, et al., 2009). This perspective change
leads to a decrease in cortisol response due to stress
(Gaab, et al., 2003).
SIT as a stress management intervention works
by influencing cognitive and affective processing in
subjects. They become better at appraising stressful
situations (Herman & Cullinan, 1997, cited in Gaab
et al., 2003). Experiential exercise in this training is
also an effective mediator to reduce stress (Gaab, et
al., 2003). Therefore, it can be concluded that SIT
works by changing subjects’ emotion, cognition and
behavior in dealing with stress, which leads to a
decrease in stress.
Recommendations for future research and
application are based on the limitations of this study.
One limitation of this study is that the duration is too
short, therefore making the evaluation incomplete.
The number of sessions might also be insufficient
for SIT to work properly. Longer duration of the
study and additional sessions in the training might
give better results in evaluating and explaining the
effectiveness of SIT on intensive care nurses.
5 CONCLUSION
SIT is an effective intervention to reduce stress on
intensive care nurses. It has an effect size of 0.3
which means this intervention has a medium effect.
This is due to the change in cognitive processing of
the subjects in appraising stressful situations. This
change prompts new emotions and evaluations
toward their environment. This also initiates the
subjects to develop new behaviors that are more
effective and adaptive.
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