Volume 28, Issue 9 (12-2021)                   RJMS 2021, 28(9): 215-225 | Back to browse issues page

Research code: 01
Ethics code: IR.BPUMS.REC.1399.171
Clinical trials code: 01

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Sabzianpour B, Amini N, Azadi S, Direh E. Effectiveness of Lazarus-Based Multidimensional Therapy on Reducing Secondary Traumatic Stress and Generalized Anxiety in Nurses. RJMS. 2021; 28 (9) :215-225
URL: http://rjms.iums.ac.ir/article-1-7202-en.html
Assistant Professor of Psychology Department, Bushehr Branch, Islamic Azad University, Bushehr, Iran , amini_n2010@yahoo.com
Abstract:   (321 Views)
Background & Aims: Nurses in the hospital environment suffer a lot of psychological stress. These tensions include workplace pressure, shifts, type of services, nurses' care, communication with critically ill patients, and intra-organizational communication. Nurses are the mainstay of care in the treatment team, which makes up more than 75% of the treatment team and is the first group on the front line of the Covid-19 pandemic. The nurses' work environment leads to long-lasting stress, and this occurs in people who work as helpers who feel overwhelmed by the problems of others. One of the health problems of nurses is secondary traumatic stress. The term secondary traumatic stress refers to a problem in which the sufferer has not directly experienced the accident. It is associated with the survivors of a traumatic event. Therefore, stress, secondary trauma, is considered as an occupational injury due to providing direct services to people at risk. For more than forty years, the stress of the nursing profession has been proven worldwide. Stressful and stressful factors of life, such as job pressures, role conflicts, the existence of deprivations and social job inequalities, economic problems, low living standards of nurses cause or aggravate psychological stress on individuals. Anxiety, as a part of every human life, is present in everyone. Disseminated anxiety disorder is one of the most common anxiety disorders observed in the general population and clinical settings. The estimated prevalence of the disorder in general medical centers is 2.8% to 8.5% and in the general population from 1.6% to 5%. Another theory of psychotherapy, which is a kind of technical eclecticism, is the multifaceted treatment of Lazarus. In this type of treatment, the basic assumption is that patients have a special problem and should be treated using several special techniques. In this study, the process of changing and reducing secondary traumatic stress, psychosomatic disorders, and generalized anxiety in nurses was investigated by examining intrapersonal factors and emphasizing personal factors. One of the useful treatments to reduce stress and its side effects is Lazarus's multi-faceted treatment. Therefore, the main question of the present study is whether the multifaceted treatment based on the Lazarus approach affects reducing secondary traumatic stress and generalized anxiety in female nurses?

Methods: The present study was a quasi-experimental controlled study in which a pre-test-post-test design with a control group was conducted. The statistical population of this study consisted of all female nurses working in Ibn Sina specialized hospital in Tehran during the months of January 2018 to August 2020, from which 30 people were selected and randomly replaced in experimental (15 people) and control (15 people) groups. . Inclusion and exclusion criteria of this study were: age range 30-55 years, no mental illness and history of hospitalization in the psychiatric ward, no history of neurological and mental illness and history of hospitalization, ability to participate in group therapy sessions, Willingness to cooperate, exclusion criteria for the experimental group: not attending the intervention sessions for more than two sessions, unwillingness to continue attending the intervention sessions. To collect the necessary demographic data as basic information including age, marital status, education, socio-economic status, secondary traumatic stress questionnaires, Spielberger anxiety questionnaire was completed. The effectiveness of the research intervention was assessed using repeated-measures analysis of variance.
Results: The results of the present study showed that the mean of variables in the pre-test stage was not significantly different between the three groups, which indicates the homogeneity of the two groups in the pre-test stage, but the difference between the three groups in the post-test and follow-up stages was significant. Which can indicate the effectiveness of the intervention on the mentioned variables and the stability of effectiveness in the follow-up stage.
Conclusion: Based on the hypotheses of the present study; Lazarus's multifaceted therapy is effective in improving psychological variables (secondary traumatic stress and generalized anxiety disorder) in female hospital nurses; The results of the present study showed that the hypothesis has been confirmed and the multifaceted treatment based on Lazarus approach in the experimental group on the improvement of secondary traumatic stress and general anxiety in female nurses working in The hospital has been effective and has had a lasting effect (stability) over the control group over time. In the present explanation, it can be said that since Lazarus' approach is a non-guided method of client-centeredness, which increases his inner motivation for change by discovering and resolving client skepticism; thus, client ambivalence plays a central role in Lazarus' approach and, unlike other therapies, directly addresses and addresses resistance and ambivalence to change. This problem is very common in nurses working in hospitals who have been involved with patients for a long time and witness the complications of treatment and physical changes in patients who have psychiatric symptoms without physical complications. Lazarus' approach is effective in reducing and strengthening treatment outcomes in the field of problems related to nurses working in the hospital due to reducing resistance and strengthening internal credentials and motivations, capacity and talent, increasing knowledge, motivational skills. It can be argued that Lazarus' approach increases the participation and success of subsequent pragmatic therapies, thereby reducing psychiatric symptoms in nurses. Some of the limitations of this research were due to costly problems and lack of sufficient time, which may be specific to current research studies that are conducted in the form of a doctoral research project without using the facilities of an organization. In the following, all the limitations will be mentioned and in the discussion of suggestions, we will try. Provide solutions to address issues that can be addressed, with the hope that future research will face fewer limitations.
 
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Type of Study: Research | Subject: Clinical Psychiatry

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