Although participatory workplace improvement programs are known to provide favorable
effects on high stress occupations like nursing, no studies have confirmed its effect
using biomarkers. The aim of this study was to determine whether a participatory workplace
improvement program would decrease stress-related symptoms as evaluated by biomarkers and
self-reported stress among hospital nurses. Three actions to alleviate job stress, which
were determined through focus group interviews and voting, were undertaken for two months.
A total of 31 female Japanese nurses underwent measurement of inflammatory markers,
autonomic nervous activity (ANA), and perceived job stress (PJS) at three-time points;
before the program (T1), within a week after the completion of the program (T2), and three
months after the program (T3). A series of inflammatory markers (Interferon-γ, Interleukin
(IL)-6, and IL-12/23p40) decreased significantly at T2, and IL-12/23p40 and IL-15
significantly decreased at T3 compared to T1, while ANA and PJS remained unchanged. Our
participatory program exerted beneficial effects in reducing inflammatory responses, but
not for ANA and PJS. Further investigations with a better study design, i.e., a randomized
controlled trial, and a larger sample size are warranted to determine what exerted
beneficial effects on inflammatory markers and why other outcomes remained unchanged.