Cognitive Behavioral Therapy and Ageism

NCT04319393 | Completed

• 1 other identifier: 20180217
• Study Type: interventional
• Target: 110
• Locations: 1 country
• Sites: 1

Brief Summary

Background: Healthcare settings must be a patient-friendly environment for the investigator's older adults who are in an imperative need for compassionate healthcare when approaching their later life. However, older adults until this moment are experiencing age discriminative acts by nurses who are supposed to act in favor of their patients. Ageism is not always a result of either negative attitudes or misconceptions toward older adults, but to the innate fear of death where nurses perceive older adults as a powerful reminder of death. Although cognitive-behavioral therapy (CBT) is well known for targeting psychological distresses, to date, no research has investigated its effectiveness in relieving nurses' death anxiety and ageism. This study examined the effectiveness of CBT to relieve nurses' death anxiety and ageism toward older adults. Methods: A randomized controlled trial was conducted during August 2019 in the university hospital. A total of 110 nurses selected through proportional stratified sampling and randomly assigned to the experimental and control groups. The intervention consisted of six two-hour training sessions delivered in five modules with the integration of different CBT exercises. The effect of CBT was assessed on measures of a series of validated questionnaires of study variables before and after the training sessions.

Conditions

Ageism

Keywords

Cognitive Behavioral Therapy; Older Adults; Nurses; Death anxiety; Randomized Clinical Trials

Outcome Measures

Primary Outcomes (2)

• Ageism

  The Fraboni Scale of Ageism (FSA) (Fraboni et al., 1990) was used to measure nurses' ageist attitudes toward older adults. The FSA is a 29-item scale measuring the attitudinal and affective aspects of ageism. The FSA has three positive items (e.g., "Old people can be very creative"), which were reverse coded before calculating the total score. Each item of the FSA has four possible responses, including: "1= strongly disagree,"; "2= disagree,"; " 3=agree,"; and " 4= strongly agree". The possible range of the total score of the FSA is from 29 to 116. Higher scores indicate greater levels of ageist attitudes. The internal consistency reliability of the FSA in this study was high (Cronbach's alpha = 0.89), which is very close to the original research (0.86) (Fraboni et al., 1990)

  Two months

• Death anxiety

  Death anxiety was measured using The revised Collett-Lester Fear of Death Scale (CL-FODS) (Lester \& Abdel-Khalek, 2003). The CL-FODS is a 28-item scale measure death anxiety about four main aspects of death and dying, including: " your own death,"; "your own dying"; " the death of others,"; and " the dying of other". Each subscale has seven items answered on a 3-point intensity scale (ranged from 1= "no" to 5= "very"). The CL-FODS had very satisfactory reliability scores ranged from .88 to .93, and good internal consistency scores ranged from .74 to .90 in the original study. In the current study, the internal consistency reliability was satisfactory (Cronbach's alpha= 0.79)

  two Months

Secondary Outcomes (3)

• symbolic immortality

  Two Months

• self-esteem

  two Months

• interpersonal relationship

  two Months

Study Arms (2)

CBT Nurses

EXPERIMENTAL

Interventional group

Behavioral: Cognitive Behavioral Therapy

Consultation Nurses

NO INTERVENTION

Control Group

Interventions

Cognitive Behavioral Therapy BEHAVIORAL

The CBT intervention was carried out through six two-hour sessions over a month. The intervention group was divided into three subgroups of 18 to 19 nurses each. It was required for each subgroup to attend two CBT sessions to complete the intervention. The CB therapist followed the same structure in the delivery of each CBT session. The CBT session was delivered in five modules: generating objectives and outcomes, enhancing self-esteem and interpersonal relationships, changing beliefs regarding symbolic mortality, and changing attitudes regarding death anxiety. The first session began with highlighting the objectives of the CBT. Then, a detailed presentation of the intervention modules was provided to the nurses with integration of CBT exercises, including cognitive restructuring, graded exposure, mindfulness meditation, interpersonal skills training, and activity scheduling

CBT Nurses

Eligibility Criteria

• Age: 22 Years - 45 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• The eligible participants in this study were nurses caring for older adults and working in the hospital for at least one year of clinical experience.

You may not qualify if:

• Nurses working in Pediatric, maternity, and psychiatric departments
• Nurses with clinical experience less than one year

Sponsors & Collaborators

• Jordan University of Science and Technology: lead

Study Sites (1)

King Abdullah University Hospital

Irbid, 22110, Jordan

Location

Related Publications (1)

• Rababa M, Alhawatmeh H, Al Ali N, Kassab M. Testing the Effectiveness of Cognitive Behavioral Therapy in Relieving Nurses' Ageism Toward Older Adults: A Randomized Controlled Trial. Cognit Ther Res. 2021;45(2):355-366. doi: 10.1007/s10608-020-10167-4. Epub 2020 Oct 20.

  PMID: 33100426 DERIVED

MeSH Terms

Conditions

Ageism; Necrophobia

Interventions

Cognitive Behavioral Therapy

Condition Hierarchy (Ancestors)

Prejudice; Social Behavior; Behavior; Social Discrimination

Intervention Hierarchy (Ancestors)

Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Mohammad Rababa, PhD

  Jordan University of Science and Technology

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: CARE PROVIDER
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 19, 2020
• First Posted: March 24, 2020
• Study Start: January 1, 2019
• Primary Completion: September 1, 2019
• Study Completion: November 1, 2019
• Last Updated: March 24, 2020

Record last verified: 2020-03

Locations

JO (1)