Effectiveness of Positive Psychological Intervention on Resilience Improvement in Nurses
NCT Number: NCT06572202
Status: NOT_YET_RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Nurses|Resilience, Psychological|Positive Psychology
Interventions: BEHAVIORAL: Positive Psychology Intervention
Sponsor: Fitria Endah Janitra
Sex: ALL
Age: ADULT
Enrollment: 80
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: SINGLE (OUTCOMES_ASSESSOR)|Primary Purpose: SUPPORTIVE_CARE
Start Date: 2024-09-09
Completion Date: 2025-06-09
Locations: Sultan Agung Islamic Teaching Hospital, Semarang, Jawa Tengah, Indonesia

Summary:
The nursing profession, comprising over 27.9 million individuals and representing 59% of the health sector, plays a critical role in frontline healthcare globally. However, nurses face significant workplace stress due to factors like high mortality rates and ethical dilemmas, which can negatively impact their mental health. Resilience has emerged as a crucial concept in mitigating workplace stress and protecting nurses' psychological well-being. Studies show a negative correlation between stress and resilience, with higher resilience linked to better psychological outcomes and lower rates of burnout. Resilience, a dynamic process of positive adaptation to stress, can be enhanced through interventions like positive psychology, which focuses on developing traits such as perseverance, interpersonal skills, and emotional stability. These interventions have been shown to reduce burnout, improve job satisfaction, and potentially enhance patient care, making them vital in addressing the unique challenges nurses face.

Gap of Knowledge:

Although existing research has demonstrated the effectiveness of positive psychology interventions in reducing depression, anxiety, burnout, and stress among healthcare workers, including nurses, there is a need for more targeted randomized controlled trials (RCTs) that specifically address the unique stressors and work environments of nurses. Furthermore, the long-term effects of these interventions on nurses' resilience, stress, burnout, and job satisfaction require further exploration through well-designed RCTs.

Research Aims and Hypothesis:

The present study aims to

1. evaluate whether a positive psychology intervention, based on evidence-based activities from several positive psychology theories, can improve resilience in nurses, and
2. assess whether this intervention can also enhance stress levels, reduce burnout, and improve job satisfaction among nurses.

The hypotheses are:

1. the positive psychology intervention will improve nurses' resilience;
2. the intervention will positively impact stress, burnout, and job satisfaction; and
3. it will be more effective for nurses with low resilience in improving these outcomes.

Primary Outcome Measures: Resilience, Resilience will be measure with the Connor Davidson Resilience Scale (CD-RISC). The CD-RISC was developed in the United States to measure individuals' ability to cope effectively when faced with adversity (Connor \& Davidson, 2003). The revised scale includes 25 items and three dimensions (tenacity, strength, and optimism). Each item is rated on a Likert-type scale ranging from 0 (not at all) to 4 (almost always). The Cronbach's alpha value for the CDRISC 25 has been reported to be 0.91 in a study on a sample of nurses (Arias González et al., 2015)., pre-test, immediately after intervention, 3 months follow-up, 6 months follow-up, 12 month follow-up
Secondary Outcome Measures: Stress, Stress will be measured by the Perceived Stress Scale (PSS). The PSS-10 is a 10-item questionnaire that is widely used to assess stress levels in young people and adults aged 12 and above. The Cronbach's alpha value for the Perceived Stress Scale (PSS-10) in nurses has been reported to be 0.93 in a study in South Africa (Engelbrecht, 2022)., pre-test, immediately after intervention, 3 months follow-up, 6 months follow-up, 12 month follow-up|Anxiety, Anxiety will be measured using the Generalized Anxiety Disorder 7 (GAD-7) scale. The GAD-7 is a brief, seven-item self-report questionnaire designed to identify probable cases of generalized anxiety disorder and to measure the severity of the symptoms. The Cronbach's alpha for the GAD-7 has been reported to be 0.92 in a study by Spitzer et al. (2006)., pre-test, immediately after intervention, 3 months follow-up, 6 months follow-up, 12 month follow-up|Depression, Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 is a nine-item self-report tool that is used to screen for the presence and severity of depression. Each item is scored from 0 to 3, providing a total score ranging from 0 to 27, with higher scores indicating greater severity of depressive symptoms. The Cronbach's alpha for the PHQ-9 has been reported to be 0.89 in a study by Kroenke et al. (2001)., pre-test, immediately after intervention, 3 months follow-up, 6 months follow-up, 12 month follow-up|Burnout, Burnout will be measure with The Maslach Burnout Inventory (MBI). MBI is a psychological assessment instrument that measures burnout as a continuum on three different dimensions: Emotional Exhaustion, Depersonalization, and reduced Personal Accomplishment. The MBI is considered the "gold standard" for measuring burnout. The Cronbach's alpha value for the Maslach Burnout Inventory (MBI) in nurses has been reported to range from 0.70 to 0.90, indicating good internal consistency and reliability (Trigo et al., 2018)., pre-test, immediately after intervention, 3 months follow-up, 6 months follow-up, 12 month follow-up|Work performance, Work performance will be measured by the Individual Work Performance Questionnaire (IWPQ). The IWPQ assesses individual work performance across three dimensions: task performance, contextual performance, and counterproductive work behavior. This questionnaire includes items that evaluate how well nurses plan and execute their work, their willingness to help colleagues and take on additional responsibilities, and their ability to avoid counterproductive behaviors. The IWPQ is known for its reliability, with Cronbach's alpha values typically ranging from 0.70 to 0.85 across different dimensions, making it a dependable tool for measuring work performance., pre-test, immediately after intervention, 3 months follow-up, 6 months follow-up, 12 month follow-up|Physical health, To measure physical health outcomes, blood pressure will be assessed. Blood pressure will be assessed using automated blood pressure monitors, which provide reliable and easy-to-use measurements of both systolic and diastolic pressures., pre-test, immediately after intervention, 3 months follow-up, 6 months follow-up, 12 month follow-up