Evidence map›Paper›PMID 42288813›Full record

ArticleBMC nursing2026

The effect of the integrated stress response reduction intervention on cellular aging in middle-aged nurses: a pilot study.

Hwasook Cho, Hyunwook Kang, MeiLing Song, Nahyun Kim

Abstract read
In one paragraph

Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Hwasook ChoDepartment of Nursing, Keimyung University Dongsan Hospital, Graduate School of Keimyung University, 1035 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea.ORCID http://orcid.org/0000-0003-3023-2710
Hyunwook KangCollege of Nursing, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon-si, Gangwon-do, 24341, Republic of Korea.ORCID http://orcid.org/0000-0003-0222-1184
MeiLing SongCollege of Nursing, Daegu Health College, 15 Yeong-ro, Buk-gu, Daegu, 41453, Republic of Korea.ORCID http://orcid.org/0000-0002-4903-9067
Nahyun KimCollege of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea. drkim@kmu.ac.kr.ORCID http://orcid.org/0000-0002-3005-2720

Funding

the National Research Foundation of Korea 2020R1A2C1006590
6 · The paper itself

Abstract

backgroundNurses experience persistently high levels of occupational stress, which negatively impacts their health and the quality of patient care. Chronic psychological stress is closely linked to physiological dysregulation and cellular aging processes through stress-response pathways. However, limited evidence exists regarding whether stress management interventions targeting these mechanisms can influence cellular aging biomarkers in nurses. This study evaluated the effects of an Integrated Stress Response Reduction Intervention (iSRI) on cellular aging among middle-aged nurses.

methodsA non-randomized controlled pilot study was conducted with 60 nurses aged 45-60 years recruited from two tertiary hospitals. Participants were allocated to either an intervention group (n = 31) or a control group (n = 29). The 12-week iSRI comprised biofeedback, cognitive-behavioral education, mindfulness, and exercise. Outcomes included perceived stress levels and biochemical markers (serum cortisol, IL-6, and SOD). Cellular aging was assessed via leukocyte telomere length (LTL) and mitochondrial DNA copy number (mtDNAcn) using qPCR.

resultsFollowing the intervention, the iSRI group showed a significant decrease in perceived stress levels, with a significant group ⋅ time interaction (p =.012). Regarding biochemical markers, serum cortisol showed a significant group ⋅ time interaction (p =.001), although no significant between-group difference was observed post-intervention. SOD levels increased significantly in the intervention group compared to the control group (p =.031), showing a robust interaction effect (p =.001). Regarding cellular aging markers, a significant between-group difference in LTL was observed post-intervention (p =.002), and this difference remained significant after controlling for covariates (p =.047). However, the longitudinal effect for LTL was not statistically significant (p =.263). No significant changes were observed in IL-6 and mtDNAcn.

conclusionsThe 12-week iSRI demonstrated an initial protective effect on preserving LTL, which was associated with reductions in perceived stress and subsequent improvements in cortisol and SOD. These findings suggest that mechanism-based stress management may help support telomere preservation, a hallmark of cellular aging. Given the exploratory nature of this pilot study, further larger-scale randomized controlled trials are warranted to confirm whether such interventions can induce sustained shifts in biological aging trajectories. TRAIL REGISTRATION: The study was registered in CRIS (KCT0011526; registration date: 23 January 2026; retrospectively registered).

Indexed as

BiofeedbackCellular senescenceMitochondriaNon-randomized controlled trialNursesPsychological stressTelomere

Identifiers

PMID42288813
PMCPMC13330248

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.