Investigation of the Effect of Mindfulness-Based Psychoeducation on Defense Mechanisms and Mindful Awareness in Nursing Students

Year 2024, Volume: 14 Issue: 3, 667 - 675, 30.09.2024

Burcu Demir Gökmen , Meryem Fırat

https://doi.org/10.33808/clinexphealthsci.1286603

Abstract

Objective: Today, there is a growing interest in mindfulness-based therapies. Such practices can be beneficial by contributing to the personal and professional development of nursing students. In this study, the effect of mindfulness-based psychoeducation applied to Turkish nursing students on defense mechanisms and mindfulness was evaluated.
Methods: The research was designed as a quasi-experimental study with a control group. Psychoeducation was delivered online between 08.03.2021 and 17.05.2021 in 16 sessions over 8 weeks. Data were collected using the Defense Style Questionnaire and the Awareness Scale. Percentage distributions, t-test, chi-square test, and paired samples t-test were used to analyze the data.
Results: It was found that the students’ use of mature defenses and mindful awareness increased after the mindfulness-based psychoeducational, and the differences between the experimental-control groups and the mean scores of the pretest-posttest data were significant (p<.05).
Conclusions: If mindfulness-based psychoeducation can be integrated into the curriculum of nursing students, it may help them to better understand themselves and their environment and to cope with the difficulties they encounter in their professional practice by supporting their personal development.

Keywords

mindfulness, psychoeducation, defense mechanisms, awareness, nursing of students

Supporting Institution

no

Project Number

no

Thanks

We would like to thank our nurse students for his/her role in the completion of this study.

References

• Freud A, eds. Erim Y, translation editör. The Ego and the Mechanisms of defense. 4th ed. Istanbul: Metıs; 2015.
• American Psychiatric Association, (APA) American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 50th ed. Washington: American Psychiatric Press; 2013.
• Andrews G, Singh M, Bond M. The defense style questionnaire. Journal of Mental Disorders 1993;181:246-256.
• Zhang LF. Defense mechanisms and thinking styles. J Cogn Educat Psychol. 2015;14:163-179. DOI:10.1891/19458959.14.2.163
• Karagiannopoulou E, Milienos FS, Athanasopoulos V. Associations between defense styles, approaches to learning, and achievement among university students. Front. Educ. 2018;3:53. DOI: 10.3389/feduc.2018.00053
• Shehata AHMG, Ramadan FH. Relationship between emotional regulation strategies and self reported ego defense styles among nursing interns at Alexandria, Main University Hospital. IOSR-JNHS. 2017;6(1):14-23. DOI:10.9790/1959.060.1021423
• Perry JC, Bond M. Addressing defenses in psychotherapy to improve adaptation. Psychoanal. Inq. 2017;37:153-166. DOI:10.1080/07351.690.2017.1285185
• Ozen-Akın G, Eken FO, Ebadi H. The relationship between coping, defense mechanisms and causal uncertainty. J Soc Sci Ins, Ata Uni. 2021;25(suppl):416-432. DOI: 10.53487/ataunisosbil.827010 (Turkish)
• Di Giuseppe M, Orrù G, Gemignani A, Ciacchini R, Miniati M, Conversano C. Mindfulness and defense mechanisms as explicit and ımplicit emotion regulation strategies against psychological distress during massive catastrophic events. Int J Environ Res Public Health 2022;4;19(19):12690. DOI: 10.3390/ijerph191912690.
• Atalay Z. Mindfulness Conscious Awareness. 1th ed. Istanbul: Inkilap Kitabevi; 2019 (Turkish)
• Ozyesil Z, Arslan C, Kesici S, Deniz ME. Adaptation of the mindful attention awareness scale into Turkish. Education and Science 2011; 36(160): 224-235.
• Yazgan NN. Examining the relationship between attachment styles and cognitive flexibility of defense mechanisms to adults. Journal of Social, Humanities and Administrative Sciences 2019;5(14):150-159. DOI:10.31589/JOSHAS.92 (Turkish)
• Hersoug AG, Wærsted M, Lau B. Defensive functioning moderates the effects of nondirective meditation. Front Psychol. 2021;12:629784. DOI: 10.3389/fpsyg.2021.629784
• Di Giuseppe M, Nepa G, Prout TA, Albertini F, Marcelli S,et al. Stress, burnout, and resilience among healthcare workers during the covid-19 emergency: The role of defensemechanisms. Int. J. Environ. Res. Public Health 2021;18:5258.DOI: 10.3390/ijerph1810525
• Karaca A, Yildirim N, Ankarali H, Açıkgöz F, Akkuş D. Nursing students’ perceived levels of clinical stress, stress responses and coping behaviors. Journal of Psychiatric Nursing 2017;8(1):32-39. DOI: 10.14744/phd.2017.22590
• Yuksel A, Yilmaz EB. The effects of group mindfulness-based cognitive therapy in nursing students: A quasi-experimental study. Nurse Educ. 2020;85:104268. DOI: 10.1016/j.nedt.2019.104268.
• Regan A, Howard RA, Oyebode JR. Emotional exhaustion and defense mechanisms in ıntensive therapy unit nurses. The Journal of Nervous and Mental Disease 2009;197(5):330-336. DOI: 10.1097/NMD.0b013e3181a20807
• Emavardhana T, Tori CD. Changes in self-concept, ego defense mechanisms, and religiosity following seven-day vipassana meditation retreats. Journal for the Scientific Study of Religion 1997;36:194-206. DOI: 10.2307/1387552
• Babl A, Grosse-Holforth M. Perry JC, Schneider N, Domman E, Heer S, Stahli A, Aeschbacher N, Eggel M, Eggenberg J, Sonntag M, Berger T, Caspar F. Comparison and change of defense mechanisms over the course of psychotherapy in patients with depression or anxiety disorder: Evidence from a randomized controlled trial. J Affect Disord. 2019;1(252):212-220. DOI: 10.1016/j.jad.2019.04.021
• Roten Y, Djillali S, Crettaz von Roten F, Despland JN, Ambresin G. Defense mechanisms and treatment response in depressed in patients. Front. Psychol. 2021;12:633939. DOI: 10.3389/fpsyg.2021.633939
• Sparado KC, Hunker DF. Exploring the effects of an online asynchronous mindfulness meditation intervention with nursing students on stress, mood and cognition: A descriptive study. Nurse Educ. 2016;39:163-169. DOI:10.1016/j.nedt.2016.02.006
• Noble H, Reid J, Walsh IK, Ellison SE, McVeigh C. Evaluating mindfulness training for medical and PhD nursing students. Br J Nurs. 2019;28(12):798-802. DOI:10.12968/bjon.2019.28.12.798.
• Cheli S, De Bartolo P, Agostini A. Integrating mindfulness into nursing education: A pilot nonrandomized controlled trial. International Journal of Stress Management 2020;27(1):93-100. DOI:10.1037/str0000126
• Ahmad F, El Morr C, Ritvo P, Othman N, Moineddin R, MVC Team. An eight-week, web-based mindfulness virtual community intervention for students’ mental health: Randomized controlled trial. JMIR Ment Health 2020;7(2):e15520. DOI: 10.2196/15520
• Noone P, Gannon M, Mee L, Smyth S, Ivory J, Byrne E. Student nurses well-being and the impact of mindfulness (SWIM). On J Complement & Alt Med. 2020;4(2):1-4. DOI: 10.33552/ojcam.2020.04.000585
• McVeigh C, Ace L, Ski CF, Carswell C, Burton S, Rej S, Noble H. Mindfulness-based ınterventions for undergraduate nursing students in a university setting: A narrative review. Healthcare 2021;9:1493. DOI: 10.3390/healthcare9111493
• Veigh CM, Reid J, Carswell C, Ace L, Walsh I, Graham-Wisener L, Rej S, Potes A, Atkinson K, Edginton T, Noble H. Mindfulness as a well-being initiative for future nurses: A survey with undergraduate nursing students. BMC Nurs. 2021;20:253. DOI:10.1186/s12912.021.00783-0
• Çapık C, Statistical power analysis and its use in nursing research: basic information. Anatol. J Nurs Health Sci. 2014;17(4):268-274. (Turkish)
• Yilmaz N, Gencoz T, Ak M. Psychometric properties of the defense style questionnaire: A reliability and validity study. Turkish Journal of Psychiatry 2007;18(3):244-253.
• Brown KW, Ryan RM. The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology 2003;84(4): 822-848.
• Harris R.eds. HT Karatepe, KF Yavuz. translate editors. ACT Made Simple: A quick start for acceptance and commitment therapy. 4th ed. Istanbul: Litera Publishing; 2019.
• Hayes SC, Smith S. Eds. Yavuz N, Ilkay S. Get Out of Your Mind and Into Your Life.1th ed. Istanbul: Litera Publishing; 2021.
• Frey A, Totton A. eds. I Am Here Now. 1th ed. Istanbul: Destek Publishing; 2016.
• Van Vliet M, Jong MC, Jong M. A mind-body skills course among nursing and medical students: A pathway for an improved perception of self and the surrounding world. Glob. Qual. Nurs. Res. 2018;5:233.339.3618805340. DOI:10.1177/233.339.3618805340
• Dubert CJ, Schumacher AM, Locker Jr L, Gutierrez AP, Barnes VA. Mindfulness and emotion regulation among nursing students: Investigating the mediation effect of working memory capacity. Mindfulness 2016;7:1061-1070. DOI:10.1007/s12671.016.0554-6
• Azak A. Determining mindfulness levels in nursing students. Journal of Education and Research in Nursing 2018;15(3):170-176. DOI: 10.5222/HEAD.2018.170
• El Morr C, Ritvo P, Ahmad F, Moineddin R, MVC Team. Effectiveness of an 8-week web-based mindfulness virtual community intervention for university students on symptoms of stress, anxiety, and depression: Randomized controlled trial. JMIR Ment Health 2020;17;7(7):e18595. DOI: 10.2196/18595
• Öztürk Ş. The effect of a distance-delivered mindfulness-based psychoeducation program on the psychological well-being, emotional intelligence and stress levels of nursing students in Turkey: A randomized controlled study. Health Educ Res. 2023;11;38(6):575-586. DOI: 10.1093/her/cyad040.
• Romeo A, Benfante A, Geminiani GC, Castelli L. Personality, defense mechanisms and psychological distress in women with fibromyalgia. Behav. Sci. 2022;12:10. DOI: 10.3390/bs12010010
• Van der Riet P, Jones TL, Russel CA. The effectiveness of mindfulness meditation for nurses and nursing students: An integrated literature review. Nurse Educ Tuday. 2018;65(1):201-211. DOI: 10.1016/j.nedt.2018.03.018.
• Van Kuiken D, Bradley J, Harland B, O’Brien King M. Calming and focusing: Students’ perceptions of short classroom strategies for fostering presence. J. Holist. Nurs. 2017; 35(2):165-174. DOI: 10.1177/089.801.0116646644.
• Burger KG, Lockhart JS. Meditation’s effect on attentional efficiency, stress, and mindfulness characteristics of nursing students. J. Nurs. Educ. 2017;56(7):430-434. DOI:10.3928/01484.834.20170619-08.
• Marthiensen R, Sedgwick M, Crowder R. Effects of a brief mindfulness intervention on after-degree nursing student stress. J. Nurs. Educ. 2019;58(3):165-168. DOI:10.3928/01484.834.20190221-07.
• Jayawardene WP, Lohrmann DK, Erbe RG, Torabi MR. Effects of preventive online mindfulness interventions on stress and mindfulness: A metaanalysis of randomized controlled trials. Preventive Medicine Reports 2017;5:150-159. DOI: 10.1016/jpmedr.2016.11.013
• Garmaise-Yee JS, LeBlanc RG. Reducing Stress and increasing mindfulness in nursing students: An online mindfulness intervention study. Nurs Educ Perspect. 2021;12. DOI:10.1097/01.NEP.000.000.0000000887.
• Guillaumie L, Boiral O, Champagne J. A mixed-methods systematic review of the effects of mindfulness on nurses. J Adv Nurs. 2017;73(5):1017-1034. DOI: 10.1111/jan.13176.
• Koren ME. Mindfulness interventions for nursing students: Application of modelling and role modelling theory. Int. J. Caring Sci. 2017;10(3):1710-1716. Accessed [10 May 2021]. http://www.internationaljournalofcaringsciences.org/docs/67_koren_pilot_10-3.pdf
• Karaca A, Sisman NY. Effects of a stress management training program with mindfulness-based stress reduction. J. Nurs. Educ. 2019;58(5):273-280. DOI:10.3928/01484.834.20190422-05.
• Firth AM, Cavallini I, Sütterlin S, Lugo RG. Mindfulness and self-efficacy in pain perception, stress and academic performance: The influence of mindfulness on cognitive processes. Psychol. Res. Behav. Manag. 2019;12:565574. DOI: 10.2147/PRBM.S206666.
• Sanko J, McKay M, Rogers S. Exploring the impact of mindfulness meditation training in pre-licensure and post graduate nurses. Nurse Educ Tuday 2016;45:142-147. DOI:10.1016/j.nedt.2016.07.006.