Resilience Skills Training Versus Metacognitive Therapy: A Comparison of Effectiveness on Anxiety in Nurses Working in Intensive Care Units and Emergency Department

Abstract

Background: Anxiety is an outcome of a stressful work environment, like the clinical environment, which decreases the mental health level and delays the provision of services to patients. Objectives: This study examined the effects of resilience skills training and metacognitive therapy on nurses’ anxiety working in Intensive Care units (ICUs) and Emergency Department (ED). Methods: This randomized controlled field trial was carried out on 54 nurses working in ICU, PICU, NICU, and ED of Valiasr Hospital, Birjand, Iran. The participants were allocated via permuted-block randomization into three groups of resilience, metacognitive therapy, and control. Research instruments included a demographics form and the Spielberger anxiety inventory. Parametric statistics (e.g., ANOVA, repeated-measures ANOVA, Chi-square, and Fisher’s exact test) were used for data analysis in SPSS (V.19) (P < 0.05). Results: In the resilience group, the mean scores of trait and state anxiety significantly decreased immediately and one month after the intervention compared to before the intervention (P < 0.001). However, there was no significant difference in the metacognitive therapy group in terms of the mean score of trait and state anxiety at the three stages of the study (P > 0.05). There were significant differences between the three groups in terms of trait and state anxiety mean score changes before and immediately after the intervention, as well as before and one month after the intervention (P < 0.05). Conclusions: Resilience skills training was more efficient than metacognitive therapy in the attenuation of anxiety in ICU and ED nurses. Nursing managers are proposed to hold resilience skills training to control nurses’ anxiety.

The Relationship between Metacognitive Beliefs with Clinical Belongingness and Resilience among Novice Nurses in Neonatal Intensive Care Units

“…In a study by Han in Korea, a significant relationship was established among metacognition, shared leadership, and resilience [ 35 ]. This study was consistent with the results of Hasani's study [ 36 ] and the study of Yoosefi and Karimipoor [ 37 ]. In explaining these findings, it can be said that belief and awareness of individual abilities and inabilities, which are considered to be part of the characteristics of the metacognition system, strengthen motivation, and initiate a series of actions to win the task.…”

The effect of resilience training with mHealth application based on micro-learning method on the stress and anxiety of nurses working in intensive care units: a randomized controlled trial

“…The sample size was also estimated to be about 24 nurses in each group, according to the sample size formula, the mean and standard deviation (SD) reported in the previous study [ 9 ], with a 95% confidence interval, and a 80% test power. …”

“…Some researchers suggest that resilience skills training based on Nan Henderson’s Resiliency Training Program can reduce the job stress and anxiety of emergency and intensive care nurses. This program consisted of self‑confidence reinforcement, management of emotions and feelings, coping with stress, anger management, effective communication, problem‑solving, decision‑making, purposeful planning to achieve goals, and foresight [ 6 , 9 ]. Other study utilized mindfulness, gratitude, self-care, and social support to enhance the resilience of nurses and mitigate their stress and anxiety [ 10 ].…”

Comparing the effect of resilience skills training and metacognitive therapy on job stress in nurses: An experimental study

“…[ 26 ] (2013) on depression of female students and Hasani et al . [ 27 ] (2020) on the anxiety of nurses. There was no significant difference between the two groups in the first study, but in the second study, the resilience group showed better results.…”

“…There was no significant difference between the two groups in the first study, but in the second study, the resilience group showed better results. [ 26 27 ] Nevertheless, there is no research, as yet, to compare the effects of these two programs on the work stress of Iranian nurses. This study had two aims: (1) to examine whether resilience skills training and MCT can improve the job stress of nurses working in intensive care units and emergency departments and (2) to compare the effect of these two programs on the job stress of nurses.…”