title: [Effect of a "Like!" seal on the stress reactions of nurses in a hospital].
abstract: OBJECTIVE
  Improving the work environment is effective as a primary measure against mental health disorders. The aim of this study was to verify the hypothesis that using a "Like!" seal would promote friendly relations in the workplace, and reduce the stress reactions of nurses in a hospital. The "Like!" seal was inspired by "Thanks" cards conveying appreciation mutually, "OK" cards conveying the recognition of good points, and the "Like" button frequently used in social networking services.
  
  
  METHODS
  The subjects were 362 nurses working in a university hospital, of whom, 156 (43.1%) permitted the use of data collected before and after the intervention. A total of 151 (41.7%) subjects were analyzed. The intervention using the "Like!" seal lasted 8 weeks. The controls were 105 nurses who answered the same questionnaire in the same hospital and who permitted the use of the collected data. The question items comprised: basic attributes, the Brief Job Stress Questionnaire, the Sense of Coherence (SOC) scale, the Brief Scales for Coping Profile (BSCP), the lifestyles (HPI), and the number of uses of the "Like!" seal. To examine the effects of the intervention, a two-way analysis of variance was performed. To examine the factors related to changed psychological symptoms, a multiple linear regression analysis (stepwise method) was performed with the variation as the dependent variable.
  
  
  RESULTS
  The number of uses of the "Like!" seal was 7,010 seals in total, and 19.4 seals on average per nurse. Many seals read phrases showing thanks and/or approval. Psychological symptoms showed a significant interaction. The scores increased in the intervention group after the intervention, but showed no change in the control group. Among the subscales of SOC, manageability showed a significant interaction. Increased scores were found in the intervention group after the intervention, but there was no change in the control group. Multiple linear regression analysis revealed that two factors were related to the variation of psychological symptoms. They were: the variation of manageability, and the number of seals used per nurse.
  
  
  CONCLUSIONS
  The "Like!" seal which encourages mutual conveyance of feelings of thanks and/or approval has the potential to reduce the stress reactions of nurses.
authors.affiliation: Graduate School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, Wakayama 641-0011, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Yoshida
authors.forename: Kazuko
authors.initials: K
authors.lastname: Yamada
authors.forename: Ikuharu
authors.initials: I
authors.lastname: Morioka
mesh_terms: D000328:Adult; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D009741:Nursing Staff, Hospital / Q000523:psychology*; D016273:Occupational Exposure / Q000517:prevention & control*; D016272:Occupational Health; D011322:Primary Prevention / Q000379:methods*; D012944:Social Support; D013315:Stress, Psychological / Q000517:prevention & control* / Q000523:psychology*; D011795:Surveys and Questionnaires; D017132:Workplace / Q000523:psychology*; D055815:Young Adult