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Abstract

Stress contributes significantly to poor health outcomes in patients with chronic conditions, yet structured interventions for stress management remain underutilized in routine care. This study evaluated the effectiveness of an 8-week stress management program on psychological, physiological, and quality-of-life outcomes. A randomized controlled trial was conducted with 120 patients (56 intervention, 58 control). Participants in the intervention group received weekly sessions incorporating mindfulness, breathing exercises, and cognitive-behavioral strategies. Outcomes included perceived stress (PSS), anxiety and depression (HADS), quality of life (WHOQOL-BREF), blood pressure, salivary cortisol, and heart rate variability (HRV). Assessments were performed at baseline, week 8, and week 12. Data were analyzed using repeated-measures ANOVA, and effect sizes were calculated with Cohen’s d. The intervention group demonstrated significant reductions in PSS scores (26.1 ± 4.8 to 15.2 ± 3.9; 42% decrease, d = 1.02) compared to minimal change in controls. Anxiety and depression scores declined by 42% (d = 0.89) and 38% (d = 0.82), respectively. WHOQOL-BREF scores improved across all domains, most notably in the psychological domain (+14.2 points, d = 0.95). Physiological outcomes supported these findings: systolic blood pressure decreased by 11.8 mmHg, cortisol levels by 27%, and HRV improved by 18% in the intervention group, with no significant changes in controls. Adherence was high (92% completed ≥80% of sessions), and 87% of participants rated the program as “very helpful.” Stress management interventions are effective, feasible, and well-accepted, producing clinically meaningful improvements in psychological, physiological, and quality-of-life outcomes. These results support their integration into standard healthcare practice.