Mindfulness-Based Art Therapy for Nurses: Difficulties in Emotion Regulation, Burnout, and Psychological Flexibility

NCT06706505 | Completed

• 1 other identifier: GAZI-HEM-MA-01
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to examine the effects of mindfulness-based art therapy on the difficulties in emotional regulation, burnout, and psychological resilience levels of nurses working in the earthquake-affected region. The main questions it aims to answer are: Does MBAT reduce the burnout levels of nurses working in the earthquake-affected region? Does MBAT reduce the emotional regulation difficulties of nurses working in the earthquake-affected region? Does MBAT increase the psychological resilience levels of nurses working in the earthquake-affected region? Researchers plan to compare the intervention group where MBAT is applied and the control group where no intervention is applied to see the effects of MBAT on nurses. Participants : The intervention group will receive MBAT once a week for 5 weeks. The control group will receive MBAT again after the application is completed, if they are willing. Follow-up tests will be administered before the intervention, after it is completed, and at the 3rd and 6th months."\*\*

Conditions

Mental Health Wellness 1; Burnout, Professional

Keywords

art therapy; mindfulness; emotional regulation; burnout; psychological flexibility; nurses

Outcome Measures

Primary Outcomes (3)

• Difficulties in Emotion Regulation Scale - 16 item version (DERS-16)

  The Difficulties in Emotion Regulation Scale (DERS) was developed by Gratz and Roemer (2004) to assess emotional regulation difficulties. A shorter version was created by Bjureberg et al. (2016) and adapted into Turkish by Yiğit and Güzey Yiğit (2019). The DERS-Short Form consists of 16 items and measures five factors: acceptance, clarity, goals, strategies, and impulsivity. The acceptance subscale measures rejection of emotional responses; clarity assesses understanding emotions; goals evaluates focus on goal-directed behavior during emotional experiences; strategies measures access to emotion regulation strategies; and impulsivity evaluates control over impulses when experiencing negative emotions. Higher scores indicate greater difficulties. The scale's internal consistency (Cronbach's alpha) is 0.92, with subscale consistency ranging from 0.78 to 0.87.

  7 months

• Maslach Burnout Inventory (MBI)

  The Maslach Burnout Inventory (MBI), developed by Maslach and Jackson in 1981 to measure burnout, was adapted into Turkish by Ergin in 1992. The scale consists of 22 items and utilizes a 5-point Likert scale (0: Never, 1: Very rarely, 2: Sometimes, 3: Often, 4: Always). The MBI assesses three dimensions of burnout: emotional exhaustion (items 1, 2, 3, 6, 8, 13, 14, 16, 20), depersonalization (items 5, 10, 11, 15, 22), and personal accomplishment (items 4, 7, 9, 12, 17, 18, 19, and 21). Items in the personal accomplishment subscale are reverse-coded. Higher scores on emotional exhaustion and depersonalization, and lower scores on personal accomplishment, reflect greater burnout. The Turkish version's Cronbach's alpha coefficients were 0.83 for emotional exhaustion, 0.65 for depersonalization, 0.72 for personal accomplishment, and 0.93 overall (Ergin, 1992).

  7 months

• The Psychological Flexibility Scale

  The original Psychological Flexibility Scale was developed by Francis, Dawson, and Golijani Moghaddam (2016). A Turkish adaptation, consisting of 37 items, was created by Karakuş and Akbay (2020) to assess psychological flexibility in adults. The original scale contained 23 items, while the Turkish version includes 28 items across five subscales: "values and behaviors aligned with values" (items 1, 7, 9, 13, 16, 19, 21, 26, 27, 28), "being in the present moment" (8, 14, 18, 20, 22, 23, 25), "acceptance" (2, 3, 5, 6, 24), "contextual self" (4, 10, 12), and "defusion" (11, 15, 17). Items 2, 3, 5, 6, 8, 18, 20, 22, 23, 24, and 25 are reverse-scored. The scale's total score ranges from 28 to 196, with higher scores indicating greater psychological flexibility. The internal consistency reliability coefficient was 0.79.

  7 months

Study Arms (2)

Mindfulness based art therapy

EXPERIMENTAL

Prior to the MBAT intervention, data collection forms were administered and randomization was performed. Following the pre-test, participants in this group will attend weekly MBAT sessions for five weeks. Post-intervention, data collection forms will be administered again. Subsequent follow-up assessments will be conducted at 3 and 6 months.

Behavioral: Mindfulness-based art therapy

Therapy waiting list

NO INTERVENTION

Following the pre-test and randomization, the control group will receive follow-up assessments concurrently with the intervention group at predetermined intervals (post-intervention, 3 months, and 6 months). Upon completion of the research, the participants assigned to the control group will undergo the MBAT intervention.

Interventions

Mindfulness-based art therapy BEHAVIORAL

MBAT combines art therapy and mindfulness to promote self-awareness and emotional well-being. It uses art to express thoughts and feelings, while cultivating mindfulness skills. MBAT addresses stress, anxiety, and emotional regulation. Grounded in research, it's an effective therapeutic approach. The mindfulness-based art therapy sessions were designed based on the literature, drawing on the researches. By integrating art therapy techniques and mindfulness practices, the sessions were developed. Expert opinions were sought from specialists in the field to ensure the content validity of the sessions, and necessary adjustments were made accordingly. The MBAT application consists of five sessions in total. Each session has a specific theme and is designed to last 90-120 minutes.

Mindfulness based art therapy

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• To have provided active care for individuals affected by the earthquake for at least three months
• To voluntarily agree to participate in the study.

You may not qualify if:

• To have received or be currently receiving training or individual/group therapy in art therapy or mindfulness.
• To have a condition that would prevent them from actively participating in the sessions, comprehending the scales, and completing them.
• To fail to attend two consecutive study sessions for any reason
• To voluntarily withdraw from the study at any time

Sponsors & Collaborators

• Mehtap Ağaç: lead

Study Sites (1)

Kahramanmaras Sutcu Imam University

Kahramanmaraş, Onikişubat, 46000, Turkey (Türkiye)

Location

Related Publications (7)

• Bjureberg J, Ljotsson B, Tull MT, Hedman E, Sahlin H, Lundh LG, Bjarehed J, DiLillo D, Messman-Moore T, Gumpert CH, Gratz KL. Development and Validation of a Brief Version of the Difficulties in Emotion Regulation Scale: The DERS-16. J Psychopathol Behav Assess. 2016 Jun;38(2):284-296. doi: 10.1007/s10862-015-9514-x. Epub 2015 Sep 14.

  PMID: 27239096 RESULT

• Ergin C. Doktor ve hemsirelerde tukenmislik ve Maslach tukenmislik olceginin uyarlanmasi. VII. Ulusal Psikoloji Kongresi, 22th September 1992. Ankara (Turkey).

  RESULT

• Maslach C, Jackson SE. Maslach Burnout Inventory--ES Form (MBI). 1981. https://doi.org/10.1037/t05190-000

  RESULT

• Francis AW, Dawson DL, & Golijani-Moghaddam N. The development and validation of the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT). Journal of Contextual Behavioral Science. 2016: 5(3): 134-145. https://doi.org/10.1016/j.jcbs.2016.05.003

  RESULT

• Karakuş S, Akbay SE. Psychological Flexibility Scale: Adaptation, Validity and Reliability Study. Mersin University Journal of the Faculty of Education. 2020: 16(1): 32-43. https://doi.org/10.17860/mersinefd.665406

  RESULT

• Yiğit İ, Guzey Yiğit, M. Psychometric Properties of Turkish Version of Difficulties in Emotion Regulation Scale-Brief Form (DERS-16). Current Psychology. 2019: 38: 1503-1511. https://doi.org/10.1007/s12144-017-9712-7.

  RESULT

• Gratz, KL, Roemer, L. Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment. 2004: 26: 41-54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94

  RESULT

MeSH Terms

Conditions

Burnout, Professional; Emotional Regulation; Burnout, Psychological

Condition Hierarchy (Ancestors)

Occupational Stress; Occupational Diseases; Stress, Psychological; Behavioral Symptoms; Behavior; Self-Control; Social Behavior

Study Officials

• Mehtap Ağaç, PhD

  Kahramanmaras Sutcu Imam University

  PRINCIPAL INVESTIGATOR

• Sultan Ayaz Alkaya, Professor

  Gazi University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: In randomized controlled trials, it is crucial for groups to be equal and balanced in terms of baseline characteristics. To achieve this, simple stratified randomization based on gender was used to assign nurses to the intervention and control groups. To prevent bias, both researchers and participants were blinded to group assignments until after randomization. Due to the study's nature, blinding the researcher administering the intervention and participants was not feasible. However, a pre-test was administered before randomization. A blind technique was applied with the help of an independent statistician. Participants were randomly assigned using a number generator, and a third party conducted a coin flip to determine group assignments. The data will be coded by a nursing expert to ensure the statistician remains unaware during analysis. Group codes will be revealed after data analysis to minimize bias.
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: PhD

Model Details: pre-test post-test follow-up and control group experimental study

Study Record Dates

• First Submitted: November 25, 2024
• First Posted: November 26, 2024
• Study Start: December 1, 2024
• Primary Completion: December 5, 2024
• Study Completion: June 5, 2025
• Last Updated: December 31, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)