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The Effects of "Three Good Things" Positive Psychotherapy on Nurses' Burnout

Not Applicable
Completed
Conditions
Burnout Syndrome
Nurse's Role
Interventions
Behavioral: "Three good things" therapy
Behavioral: Normal psychological instruction
Registration Number
NCT03645798
Lead Sponsor
Central South University
Brief Summary

A randomized, controlled trial was conducted for 73 Chineses nurses from The Second Xiangya Hospitcal of Central South University (33 in the experimental group, 40 in the control group). The experimental group received a six-month Wechat-based "three good things" positive psychotherapy from August 2015 to January 2016, while the control group only received normal psychological instruction from the hospital. A socio-demographic sheet, Malsach Burnout Inventory-General Survey, the Turnover Intention Scale, The Job Satisfaction Scale, The Job Performance Scale, General Self-efficacy Scale, The Trait Coping Style Scale (TCSS), The Connor-Davidson Resilience Scale (CD-RISC) were used to collect data prior to and immdediately after the intervention. The blood cortisol was also evaluated prior to and immdediately after the intervention. SPSS 23.0 was used for data analysis. Descriptive statistics, ANOVA, Chi-square test, repeated-measures analysis and T-test were employed to analyse the effect of "three good things" intervention on nurse burnout. We hypothesis that the "three good things" positive psychotherapy could alleviate nurses' burnout, turnover intention, improve their job performance, job satisfaction, self-efficacy, resilience, introduce nurses' to use positive coping strategies to overcome adversities. Moreover, their blood cortisol would be reduced after the intervention.

Detailed Description

Study design and sample In the present study, we used a randomized, controlled design to assess the effect of "three good things" positive psychotherapy from August 2015 to January 2016. Measures were administered before (T0) and immediately after (T1) the intervention.

The study sample were nurses recruited from one three-level general hospital in Changsha, Hunan, China. The sample size calculation was conducted via PASS statistical software (NCSS LCC, East Kaysville, UT, USA) . The effect size was 0.67, power was 0.80, and margin of error type Ⅰ was 0.05. Accordingly, the sample size was 64. Stochastic tables' law was used for group division. A total of 193 nurses completed the MBI-GS, and 102 nurses who met the inclusion criteria were randomly selected for the study. However, only 73 completed the study, with 33 in the experimental group and 40 in the control group.

Instruments A socio-demographic questionnaire, the Maslach Burnout Inventory-General Survey (MBI-GS), the turnover intention questionnaire, the Job Performance scale, the Job Satisfaction scale, the General self-efficacy Scale, the CD-RISC and the Trait Coping Style Scale were used to collect the data. The blood cortisol was also collected. The detail instruction of these scales could be found at Outcome Measures section.

Ethical consideration This study was approval by The Institutional Review Board (IRB) of Xiangya Nursing School, Central South University. Participants were informed about the objectives and procedures of the study before they began the survey. All data were held confidential. Only the research team could access the data.

Data analysis Data analysis was performed using SPSS 22.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics was used to describe demographic data, burnout, turnover intention, job performance, job satisfaction, self-efficacy, resilience, coping style and cortisol. Generalized repeated-measures analysis of variance (ANOVA) was used to demonstrate the effect of intervention and time-intervention interaction.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
73
Inclusion Criteria
  • registered nurses or licenced practical nurses
  • who provided direct care to residents
  • who's MBI-GS score were no less than 1.5
  • who didn't take any hormone therapy
  • were Chinese speakers.
Exclusion Criteria
  • student nurses
  • who suffered from diseases that influence their hormone levels
  • who participated similar studies
  • who had no interest in this study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
"Three good things" therapy group"Three good things" therapyThe experimental group received a six-month Wechat-based"three good things" positive psychotherapy from August 2015 to January 2016. Participants were directed to record three good things that went well each day. These things could be minor, ordinary, or important. Next to each good things, participants were required to answer the question:" Why did this good thing happen"?
Normal psychological instruction groupNormal psychological instructionThe control group only received normal psychological instruction from the hospital
Primary Outcome Measures
NameTimeMethod
The Maslach Burnout Inventory-General survey (MBI-GS) was used to assess the change of burnout from baseline to six months later.The MBI-GS was used to assess nurses' burnout prior to and immediately after the intervention.

This scale was developed by Maslach and Jackson (1981) and consists of 16 items over three metrics: emotional exhaustion (EE, five items), cynicism (CY, five items) and reduced professional efficacy (RPE, six items). The items were scored on a Likert scale from 0 (never) to 6 (everyday) (Schaufeli et al. 1996). The higher the scores on the three metrics, the higher level of burnout indicated. The Chinese version of the MBI-GS, developed by Li \& Shi (2003), also has a good validity and reliability. In this study, Cronbach alpha coefficients for EE, CY and RPE were 0.93, 0.83 and 0.82, respectively.

Secondary Outcome Measures
NameTimeMethod
The General Self-efficacy ScaleThe General Self-efficacy Scale was used to assess nurses' self-efficacy prior to and immediately after the intervention.

Self-efficacy was defined as the average score on the General Self-efficacy Scale. The scale is a single-dimension scale with 10 questiona. Each question is assigned points from 1 to 4, and the final score is the total score of the 10 questions. The Chinese versison also has a good validity and reliability with a Cronbach alpha is 0.88.

The Connor-Davidson Resilience Scale (CD-RISC)The CD-RISC was used to assess nurses' resilience prior to and immediately after the intervention.

The CD-RISC was used to measure nurses' resilience level (Connor \& Davidson 2003). This scale comprises 25 items over three metrics (tenacity, strength and optimism) that assess resilience or capacity to change and cope with adversity. Nurses were asked to rate each item with reference to the previous month. A 5-point Likert scale was used (0 = not true at all, 4 = true all the time.). The total score ranges from 0 to 100, with higher scores indicating higher levels of resilience. The Cronbach alpha coefficients of the Chinese version were 0.91 for the total score, 0.88, 0.80 and 0.60 for the three factors (Yu \& Zhang 2007).

The Trait Coping Style Scale (TCSS)The TCSS was used to assess nurses' coping styles prior to and immediately after the intervention.

The TCSS consists of 20 items over two metrics: positive coping style (PCS, 10 items) and negative coping style (NCS, 10 items). The items were scored on a five-point Likert scale from 1 to 5. The final scores of PCS and NCS were the total scores of their items. The Cronhach alpha coefficients of the two metrics were 0.70 and 0.69, respectively.

Trial Locations

Locations (1)

Central South University

🇨🇳

Changsha, Hunan, China

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