Johnson, AnnMiller, Claire2022-07-222022-07-222022https://repository.tcu.edu/handle/116099117/54269Stress is linked to many different pathological disorders in various body systems and can trigger inflammation which in turn correlates with certain disease states (Yaribeygi et al., 2017). Interleukin-6 (IL-6) is a pro-inflammatory cytokine that triggers immune response to help the body return to homeostasis by affecting different types of cells. The presence of IL-6 is increased during periods of environmental stress (Tanaka et al., 2014). This study examined the effects of a web-based smiling exercise on stress levels in nursing students. Additionally, it explored the correlation between stress and IL-6. Participants (n=14) were evenly divided into a control group and a smiling group. The smiling group completed the intervention prior to their vital sign checkoff, a stressful event for nursing students. Each participant completed stress visual analog scales pre-checkoff, during checkoff and post-checkoff and provided a saliva sample for IL-6 analysis. For pre-checkoff and during checkoff, the smiling group had a lower average reported stress level. However, the difference between the groups was not statistically significant (p>0.05). Twelve participants had elevated IL-6 levels and there was moderate correlation between reported stress levels during checkoff and IL-6 levels. Further research needs to be done with a larger sample size to determine if the IL-6 levels and correlation are significant and to further explore the intervention. These study findings highlight the importance of focusing on the health and wellness of nursing students.stresssmilinginterleukin-6nursing students