اثربخشی آموزش ذهنیت‌سازی بر کاهش فرسودگی همدلانه ناشی از ترومای ثانویه و بهبود تنظیم هیجان در پرستاران بخش مراقبت‌های ویژه

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه روانشناسی بالینی، دانشکدۀ علوم پزشکی، واحد نجف‌آباد، دانشگاه آزاد اسلامی، نجف‌آباد، ایران.

2 گروه روانشناسی بالینی، دانشکدۀ علوم و فناوری‌های پزشکی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران (نویسنده مسئول).

3 گروه روانشناسی بالینی، دانشکدۀ علوم و فناوری‌های پزشکی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران.

4 گروه مشاوره، دانشکدۀ علوم انسانی، واحد قم، دانشگاه آزاد اسلامی، قم، ایران.

5 گروه روانشناسی بالینی، دانشکدۀ علوم پزشکی،واحد آشتیان، دانشگاه آزاد اسلامی، آشتیان، ایران.

چکیده

زمینه و هدف: این پژوهش با هدف تعیین اثربخشی آموزش ذهنیت‌سازی (Mentalization-Based Training) بر کاهش فرسودگی همدلانه و بهبود تنظیم هیجان در پرستاران ICU انجام شد.
روش کار: این مطالعه یک کارآزمایی نیمه‌تجربی با طرح پیش‌آزمون-پس‌آزمون و گروه کنترل همراه با پیگیری سه ماهه بود. جامعه پژوهش شامل پرستاران ICU بیمارستان‌های تهران بود که از میان آن‌ها ۴۰ نفر به صورت تصادفی در دو گروه مداخله (۲۰ نفر) و کنترل (۲۰ نفر) قرار گرفتند. پس از حذف ۵ نفر ، ۳۵ شرکت‌کننده (۱۶ نفر در گروه مداخله و ۱۹ نفر در گروه کنترل) مطالعه را تکمیل کردند. گروه مداخله طی ۸ جلسه ۹۰ دقیقه‌ای آموزش‌های ذهنیت‌سازی را دریافت کردند. داده‌ها با استفاده از پرسشنامه فرسودگی همدلانه (CFI) و پرسشنامه تنظیم هیجان (ERQ) جمع‌آوری و با روش تحلیل کوواریانس (ANCOVA) و تحلیل واریانس با اندازه‌گیری مکرر (Repeated Measures ANOVA) تحلیل شدند.
یافته‌ها: نتایج نشان داد که آموزش ذهنیت‌سازی تأثیر معناداری بر کاهش نمرات فرسودگی همدلانه (شامل ترومای ثانویه و خستگی همدلی) و بهبود استراتژی‌های تنظیم هیجان داشت. در مرحله پس‌آزمون، نمره کل فرسودگی همدلانه در گروه مداخله به طور معناداری کاهش یافت (F=18.52, P<0.001) و نمرات بازارزیابی شناختی افزایش (F=22.15, P<0.001) و سرکوب بیان کاهش یافت (F=15.48, P<0.001). این اثرات در مرحله پیگیری سه ماهه نیز پایداری خود را حفظ کردند.
نتیجه‌گیری: آموزش ذهنیت‌سازی به عنوان یک مداخله ساختاریافته و کارآمد، می‌تواند با تقویت مرزبندی عاطفی و بهبود تنظیم هیجان، از فرسودگی همدلانه پرستاران ICU جلوگیری کند.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The Effectiveness of Mentalization-Based Training on Reducing Compassion Fatigue Due to Secondary Traumatic Stress and Improving Emotion Regulation in ICU Nurses

نویسندگان [English]

  • Zahra Rahimi Rad 1
  • Hanieh Abbasi 2
  • Fatemeh Razzaghi 3
  • Zahra Kalhor 4
  • Zahra Sadat Mohseni Nia 5
1 Department of Clinical Psychology, Faculty of Medicine , Na.C., Islamic Azad University, Najafabad, Iran
2 Department of Clinical Psychology, Faculty of Medical Science and Technologies, Islamic Azad University, SR.C., Tehran, Iran. (Corresponding Author)
3 Department of Clinical Psychology, Faculty of Medical Science and Technologies, Islamic Azad University, SR.C., Tehran, Iran.
4 Department of Counseling, Faculty of Humanities, Islamic Azad University, Qo.C., Qom, Iran.
5 Department of Clinical Psychology, Faculty of Medicine, Ash.C., Islamic Azad University, Ashtian, Iran.
چکیده [English]

Background and Objective: This study aimed to determine the effectiveness of Mentalization-Based Training on reducing compassion fatigue and improving emotion regulation in ICU nurses.
Methods: This was a quasi-experimental study with a pretest-posttest design and a control group, including a three-month follow-up. The study population consisted of ICU nurses from hospitals in Tehran. Forty participants were randomly assigned to an intervention group (n=20) and a control group (n=20). After exclusions (4 dropouts in the intervention group and 1 in the control group), data from 35 participants (16 in the intervention group and 19 in the control group) were analyzed. The intervention group received eight 90-minute sessions of mentalization-based training. Data were collected using the Compassion Fatigue Index (CFI) and the Emotion Regulation Questionnaire (ERQ) and analyzed using Analysis of Covariance (ANCOVA) and Repeated Measures ANOVA.
Results: The results showed that mentalization-based training had a significant effect on reducing compassion fatigue scores (including secondary traumatic stress and compassion fatigue) and improving emotion regulation strategies. In the post-test phase, total compassion fatigue scores decreased significantly in the intervention group (F=18.52, P<0.001), while cognitive reappraisal scores increased (F=22.15, P<0.001) and expressive suppression scores decreased (F=15.48, P<0.001). These effects were maintained at the three-month follow-up.
Conclusion: Mentalization-based training, as a structured and effective intervention, can prevent compassion fatigue in ICU nurses by enhancing emotional boundary-setting and improving emotion regulation.

کلیدواژه‌ها [English]

  • Mentalization
  • Compassion Fatigue
  • Secondary Traumatic Stress
  • Emotion Regulation
  • ICU Nurses

مراجع

  1. Shirom, A. (2015). The effects of emotional labor and cognitive effort on subsequent task performance and fatigue. Journal of Applied Psychology, 100(4), 1088-1098.
  2. Stoeckel, M. K., & Brouwers, E. (2020). Compassion fatigue in nurses: A review of the literature. Journal of Clinical Nursing, 29(11-12), 1948-1962.
  3. Figley, C. R. (2002). Compassion fatigue: Psychotherapeutic challenges for professionals of the helping trades. Haworth Press.
  4. Li, H., et al. (2021). Prevalence of compassion fatigue among nurses: A systematic review and meta-analysis. International Journal of Nursing Studies, 118, 103912.
  5. Wu, Q., et al. (2022). Compassion fatigue, burnout, and job satisfaction among ICU nurses: A cross-sectional study. Nursing Ethics, 29(1), 123-135.
  6. Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Vicarious trauma and job satisfaction among social workers, psychologists, counselors, and social workers. Journal of Traumatic Stress, 19(5), 625-636.
  7. Neame, S. (2004). Compassion fatigue and vicarious traumatization: How to maintain your health. Psychology Publishing.
  8. Cain, J. H. (2018). Compassion fatigue: Coping with secondary traumatic stress in those who serve the secondarily traumatized. Springer Publishing Company.
  9. Fonagy, P., & Allison, E. (2014). The role of mentalization and epistemic trust in the therapeutic relationship. Psychotherapy, 51(3), 372-380.
  10. Luyten, P., et al. (2017). Mentalization-based treatment for personality disorders: A specific approach to the treatment of severe personality pathology. Oxford University Press.
  11. Bateman, A., & Fonagy, P. (2016). Mentalization-based treatment for personality disorders: A practical guide. Oxford University Press.
  12. Gable, S. L., & Reis, H. T. (2001). Apparent responsiveness to daily positive events: Social recruitment of positive events. Journal of Social and Personal Relationships, 18(3), 323-355.
  13. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348-362.
  14. Kotsou, I., et al. (2019). Can emotions be taught? A critical review and agenda for future research. Emotion Review, 11(1), 28-39.
  15. Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are. Guilford Press.
  16. van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
  17. Herman, J. L. (1992). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. Basic Books.
  18. Figley, C. R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner/Mazel.
  19. Calvoso, D. J., et al. (2017). Compassion fatigue and burnout: A comparison of nurses and physicians. Journal of Nursing Care Quality, 32(2), 156-163.
  20. Leavell, B. M., et al. (2012). Secondary traumatic stress in nurses: A systematic review. Archives of Psychiatric Nursing, 26(1), 1-10.
  21. Stoeckel, M. K. (2018). Compassion fatigue: A new concept in nursing. Nursing Management, 49(3), 24-29.
  22. Allen, J. G. (2012). Mentalization-based treatment for borderline personality disorder: A practical guide. Oxford University Press.
  23. Target, M., & Bateman, A. (2008). Mentalization-based treatment for personality disorders. Oxford University Press.
  24. Fonagy, P., et al. (2016). Mentalization-based treatment for borderline personality disorder: A randomized controlled trial. American Journal of Psychiatry, 173(1), 67-75.
  25. Luyten, P., et al. (2017). Mentalization-based treatment for personality disorders: A specific approach to the treatment of severe personality pathology. Oxford University Press.
  26. Bateman, A., & Fonagy, P. (2016). Mentalization-based treatment for personality disorders: A practical guide. Oxford University Press.
  27. Tabachnick, B. G., & Fidell, L. S. (2019). Using Multivariate Statistics (7th ed.). Pearson.
  28. Field, A. (2018). Discovering statistics using IBM SPSS statistics. Sage publications.
  29. Pallant, J. (2020). SPSS survival manual: A step by step guide to data analysis using IBM SPSS. Routledge.
  30. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Erlbaum.
  31. Faul, F., et al. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191.
  32. Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155-159.
  33. Maxwell, S. E., & Delaney, H. D. (2004). Designing experiments and analyzing data: A model comparison perspective. Psychology Press.
  34. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191.
  35. Tabachnick, B. G., & Fidell, L. S. (2019). Using Multivariate Statistics (7th ed.). Pearson.
  36. Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Routledge.
  37. Figley, C. R. (2002). Compassion fatigue: Psychotherapeutic challenges for professionals of the helping trades. Haworth Press.
  38. Sharifi, N., et al. (2019). Reliability and validity of the Compassion Fatigue Index in Iranian nurses. Journal of Clinical Psychology, 11(2), 234-245.
  39. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348-362.
  40. Kamali, A., et al. (2016). Norming of the Emotion Regulation Questionnaire (ERQ) in the Iranian student population. Epistemological Psychology Quarterly, 5(18), 89-102.
  41. Bateman, A., & Fonagy, P. (2016). Mentalization-based treatment for personality disorders: A practical guide. Oxford University Press.
  42. Fonagy, P., & Luyten, P. (2009). Mentalization-based treatment. Psychotherapy: Theory, Research, Practice, Training, 46(1), 13-22.
  43. Midgley, N., & Target, M. (2014). Mentalization-based treatment for children and adolescents. Routledge.
  44. Luyten, P., & Fonagy, P. (2019). The neurobiology of social understanding and interaction: Mentalization and its neural correlates. Current Opinion in Psychology, 29, 1-7.
  45. Demarzo, M. M., et al. (2020). Mindfulness and compassion-focused interventions for healthcare professionals: A systematic review. Frontiers in Psychology, 11, 567.
  46. Allen, J. G. (2012). Mentalization-based treatment for borderline personality disorder: A practical guide. Oxford University Press.
  47. Bateman, A., & Fonagy, P. (2016). Mentalization-based treatment for personality disorders: A practical guide. Oxford University Press.
  48. Schuengel, C., et al. (2013). Mentalization in nursing care: A conceptual framework. Journal of Advanced Nursing, 69(5), 1050-1059.
  49. Fonagy, P., et al. (2016). Mentalization-based treatment for borderline personality disorder: A randomized controlled trial. American Journal of Psychiatry, 173(1), 67-75.
  50. Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are. Guilford Press.
  51. Luyten, P., et al. (2017). Mentalization-based treatment for personality disorders: A specific approach to the treatment of severe personality pathology. Oxford University Press.
  52. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348-362.
  53. Kotsou, I., et al. (2019). Can emotions be taught? A critical review and agenda for future research. Emotion Review, 11(1), 28-39.
  54. Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 20-28.
  55. Gross, J. J. (2015). Emotion regulation: Current status and future prospects. Psychological Inquiry, 26(1), 1-26.
  56. Butler, E. A., & Gross, J. J. (2004). Emotion regulation and culture: Are the two sides of the same coin? Journal of Social and Clinical Psychology, 23(1), 101-125.
  57. Siegel, D. J. (2012). The developing mind: How relationships and the brain interact to shape who we are. Guilford Press.
  58. Midgley, N., & Target, M. (2014). Mentalization-based treatment for children and adolescents. Routledge.
  59. Luyten, P., & Fonagy, P. (2019). The neurobiology of social understanding and interaction: Mentalization and its neural correlates. Current Opinion in Psychology, 29, 1-7.
  60. Schuengel, C., et al. (2013). Mentalization in nursing care: A conceptual framework. Journal of Advanced Nursing, 69(5), 1050-1059.
  61. Allen, J. G. (2012). Mentalization-based treatment for borderline personality disorder: A practical guide. Oxford University Press.
مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 69، شماره 3
خرداد1405
خرداد 1405
صفحه 339-345

فایل ها

هم رسانی

ارجاع به این مقاله

آمار