Acceptance and commitment therapy on perceived stress and psychological flexibility of psychiatric nurses: a randomized control trial

Abstract

Background Nursing in psychiatric wards is considered a highly stressful career due to the type of patients and the problem of communicating with them. Finding appropriate solutions to overcome this stress can improve the general health of nurses and improve their quality of work. The aim was to investigate the impact of Acceptance and Commitment Therapy (ACT) on the perceived stress (PS) and psychological flexibility (PF) of nurses in psychiatric wards. Methods A total of 70 nurses of Razi Psychiatric Center of Tehran were randomly selected and divided into two experimental and control groups of 35. In addition to routine interventions, the experimental group was provided with eight 2-h sessions of ACT training, whereas the control group only received routine interventions. Prior to the intervention sessions and a month after the last session, demographic information, PS scale, and Acceptance and Action Questionnaire (2nd Edition) were completed in both groups. Results There was a significant difference regarding the PS level (P = 0.002) and PF (P = 0.001) in the control and experimental groups; the experimental group showed lower PS and higher PF. Conclusions ACT can lead to reduced PS and improved PF, which can be considered as a solution to empower nurses working in psychiatric wards. Trial registration This was registered in Iranian Registry of Clinical Trials (IRCT) (clinical trial code: IRCT20180506039557N1. Registered 2018-10-31. Retrospectively registered, https://en.irct.ir/trial/31040

Effect of a group‐based acceptance and commitment therapy programme on the mental health of clinical nurses during the COVID‐19 sporadic outbreak period

“…In the present study, we found that the decrease rate of mental health was positively associated with the decrease rate of perceived stress and positively associated with the increase rate of resilience after the intervention. These results were in accordance with previous research in the therapy of stress among psychiatric nurses (Zarvijani et al, 2021 ), which reported that the variations in psychological flexibility during. Long‐term mental health distress may lead to disruptions in work performance and daily life, and studies have recommended that ACT improving psychological flexibility may cause a decrease of mental health symptoms (Ost, 2014 ).…”

“…This was consistent with the previous study, which showed that an employee assistance programme could not relieve the stress of medical staff during the COVID‐19 pandemic (Wang et al, 2020 ). However, this finding was not consisted with Zarvijani et al ( 2021 ), whose study found that ACT could reduce psychiatric nurses' perceived stress. The reason might be that Zarvijani et al carried their study in 2018 when the COVID‐19 pandemic had not occurred.…”

“…In this study, G*Power program version 3.1.9.7 was used to calculate the sample size, and a Cohen's d of 0.30, a significance level of 0.05 and power of 0.90 were used for the calculation (Zarvijani et al, 2021 ), with an estimated sample size of 119. However, more participants were recruited into this study.…”

“…Compared with alternative methods, the ACT had supporting findings on the effectiveness on patients' problems, such as depression, anxiety, chronic pain and cancer adaptation (Du et al, 2021 ; Mathew et al, 2021 ; Twohig & Levin, 2017 ). Meanwhile, the ACT showed positive effects in healthcare professionals working with dementia by reducing anxiety and burnout (Montaner et al, 2021 ) and could reduce perceived stress and improve psychological flexibility of nurses working in psychiatric wards (Zarvijani et al, 2021 ).…”

Mediating role of self-compassion in the relationship between psychological flexibility and psychological well-being in women with breast cancer

“…Studies have shown that individuals with high levels of psychological in exibility did not adjust with type 2 diabetes [58]. Another study showed that nurses who had high levels of psychological in exibility experienced higher levels of stress, because they were not able to accept their own circumstances and could not accept their own thoughts and feelings [59].…”