The Effect of an Art Therapy Program Applied To Nurses On Stress-Coping Skills: A Non-Randomized Controlled Trial

Ahu Çırlak; Buse Buket Şener; Dilan Gökdemir

doi:10.70479/thdd.1646901

Clinical Research

Hemşirelere Uygulanan Sanat Terapisi Programının Stresle Baş Etme Becerileri Üzerine Etkisi: Randomize Olmayan Kontrollü Bir Çalışma

Year 2025, Volume: 6 Issue: 1, 11 - 24, 19.05.2025

Ahu Çırlak , Buse Buket Şener , Dilan Gökdemir

https://doi.org/10.70479/thdd.1646901

Abstract

Amaç: Bu çalışmanın amacı, sanat terapisi programının hemşirelerin stresle başa çıkma becerileri üzerindeki etkisini incelemektir.
Gereç ve Yöntem: Çalışma, Eylül 2022 ile Ocak 2023 tarihleri arasında Türkiye'de özel bir hastanede çalışan hemşirelerle yürütülen randomize olmayan kontrollü bir araştırma olarak gerçekleştirilmiştir. Müdahale grubundaki hemşirelere 8 haftalık bir sanat terapisi programı (iki yüz yüze oturum, altı hafta motivasyon mesajı) uygulanırken, kontrol grubuna herhangi bir müdahale yapılmamıştır. Veriler ‘’Tanımlayıcı Bilgi Formu’’ ve ‘’Algılanan Stres Ölçeği’’ kullanılarak toplanmıştır.
Bulgular: Müdahale grubunun sanat terapisi programı öncesindeki ortalama ölçek puanı T0=25.58±8.75, program sonrasındaki ortalama ölçek puanı T1=23.80±6.28 ve programın bitiminden iki hafta sonraki ortalama ölçek puanı T2=22.48±7.42 olarak bulunmuştur. Müdahale ve kontrol gruplarında gruplar arasındaki fark (F=5.214, p=0.026) ve grup*zaman etkileşimi (F=7.485, p=0.001) istatistiksel olarak anlamlı bulunmuştur. Zaman içindeki fark (F=0.543, p=0.583) ise istatistiksel olarak anlamlı bulunmamıştır (p>0.05).
Sonuç: Sanat terapisi programının hemşirelerin stres algısını azaltmada etkili olduğu belirlenmiştir.

Keywords

Hemşirelik, sanat terapi, stresle baş etme

References

1. Abbing A, de Sonneville L, Baars E, Bourne D, Swaab H. Anxiety reduction through art therapy in women. Exploring stress regulation and executive functioning as underlying neurocognitive mechanisms. PLosOne. 2019;14(12):e0225200. https://doi.org/10.1371/journal.pone.0225200
2. Zhang MF, Wen YS, Liu WY, Peng LF, Wu XD, Liu, QW. Effectiveness of Mindfulness-based Therapy for Reducing Anxiety and Depression in Patients With Cancer: A Meta-analysis, Medicine. 2015; 94(45): e0897-0. https://doi.org/10.1097/md.0000000000000897
3. Karpaviciüte S, Macijauskiene J. The impact of arts activity on nursing staff well-being: an intervention in the workplace, Int J of Environ Res Public Health. 2016;13(4):435. https://doi.org/10.3390/ijerph13040435 4. Yin Y, Ko KS. The effect of group art therapy on acculturative and academic stress of Chinese graduate students in South Korea. Front Psychol. 2023;14:1179778. https://doi.org/10.3389%2Ffpsyg.2023.1179778
5. Ho AHY, Tan-Ho G, Ngo TA, Ong G, Chong PH, Dignadice D, Potash J. A novel mindful-compassion art-based therapy for reducing burnout and promoting resilience among healthcare workers: findings from a waitlist randomized control trial. Front Psychol. 2021;12:744443. https://doi.org/10.3389/fpsyg.2021.744443
6. Hsu MF, Wang C, Tzou SJ, Pan TC, Tang PL, (2021). Effects of zentangle art workplace health promotion activities on rural healthcare workers, Public Health.2021;196:217-222. https://doi.org/10.1016/j.puhe.2021.05.033
7. Altınçapa B, Kaya BYA, Eren, N. Inter-model disavurumcu grup sanat terapı̇sı̇nı̇n hemsı̇relı̇k son sınıf öğrencı̇lerı̇nı̇n stresle başa cikma duzeylerı̇ne etkı̇sı̇. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2018; 4(1):11-19. doi: 10.30934/kusbed.341762.
8. Patterson SL. The effect of emotional freedom technique on stress and anxiety in nursing students: A pilot study. Nurse Education Today. 2016;40:104-110. https://doi.org/10.1016/j.nedt.2016.02.003
9. Kline JA, VanRyzin K, Davis JC, Parra JA, Todd ML, Shaw LL, Haggard BR, Fisher MA, Pettit KL, Beck, AM. Randomized trial of therapy dogs versus deliberative coloring (art therapy) to reduce stress in emergency medicine providers, Acad Emerg Med. 2020;27(4):266-275. https://doi.org/10.1111/acem.13939
10. Deshmukh SR, Holmes J, Cardno A. Art therapy for people with dementia. Cochrane Database Syst Rev. 2018; 9(9):CD011073, https://doi.org/10.1002/14651858.cd011073.pub2
11. Tofthagen C, Hernandez DF, Mason TM, Buck HG, Kip KE. Complicated grief with post-traumatic stress disorder addressed with accelerated resolution therapy: case discussions, Omega, 2022;85(2):455-464, https://doi.org/10.1177/0030222820947241
12. Ploukou S, Panagopoulou E. Playing music improves well-being of oncology nurses. Appl Nurs Res. 2018;39:77-80. https://doi.org/10.1016/j.apnr.2017.11.007
13. Alwledat K, Al-Amer R, Mohammed Ali A, Abuzied Y, Khudeir FA, Alzahrani NS, Alshammari SR, Albashtawy M, Thananayagam T, Dehghan M. Creative art therapy for improving depression, anxiety, and stress in patients with stroke: a quasi-interventional study. Sage Open Nurse. 2023;9:1-10. https://doi.org/10.1177/23779608231160473
14. Aydin M, Kutlu FY. The effect of group art therapy on loneliness and hopelessness levels of older adults living alone: a randomized controlled study. Florence Nightingale J Nurse. 2021;29(3):271-284. https://doi.org/10.5152/fnjn.2021.20224
15. Ciasca EC, Ferreira RC, Santana CLA, Forlenza OV, Dos Santos GD, Brum PS, Nunes PV. Art therapy as an adjuvan treatment for depression in elderly women: a randomized controlled trial. Braz J Psychiatry, 2018;40(3):256-263. https://doi.org/10.1590/1516-4446-2017-2250
16. Dionigi A, Gremigni, PA. Combined intervention of art therapy and clown visits to reduce preoperative anxiety in children. J Clin Nurse. 2017;26(5-6):632-640. https://doi.org/10.1111/jocn.13578
17. Kang SJ, Kim HS, Baek KH. Effects of nature-based group art therapy programs on stress, self-esteem and changes in electroencephalogram (eeg) in non-disabled siblings of children with disabilities, Int J Environ Res Public Health. 2021;18(11):5912, https://doi.org/10.3390/ijerph18115912
18. Ozsavran M, Ayyildiz TK. The effect of mandala art therapy on the comfort and resilience levels of mothers who have children with special needs: A randomized controlled study, Child Care Health Development. 2023;1-14. https://doi.org/10.1111/cch.13110
19. Utas-Akhan L, Avci D, Basak I. Art Therapy as a Nursing Intervention for Individuals with Schizophrenia. J Psychosoc Nurs Ment Health Serv. 2024;62(5):29-38. https://doi.org/10.3928/02793695-20231025-02
20. Yu WC, Lin KH. Nursing experience using art therapy with parents facing the death of a newborn. Hu Li Za Zhi. 2021;68(4):96-102, https://doi.org/10.6224/jn.202108_68(4).12
21. Ağac M, Düzgün N, Demir S. Yoğun bakım hemsirelerinde intermodel dısavurumcu sanat terapisinin merhamet yorgunluğu ve öz şefkat düzeylerine etkisi: pilot bir çalışma. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2024;13(2):743-750. https://doi.org/10.37989/gumussagbil.1366946
22. Moss M, Edelblute A, Sinn H, Torres K, Forster J, Adams T, Morgan C, Henry M, Reed K. The effect of creative arts therapy on psychological distress in health care professionals. Am J Med, 2022;135(10):1255-1262. https://doi.org/10.1016/j.amjmed.2022.04.016
23. Vlohov D. Transparent reporting of evaluations with nonrandomized designs (TREND). J Urban Health. 2004;81(2):163-164. https://doi.org/10.1093/jurban/jth099
24. Harding G. (2016). The meaning of art-and art therapy, Lancet Psychiatry. 2016;3(11):1008. https://doi.org/10.1016/s2215-0366(16)30268-1
25. Eskin M, Harlak H, Demirkıran F, Dereboy C. Algılanan stres ölçeğinin Türkçeye uyarlanması: güvenirlik ve geçerlik analizi. New/Yeni Symposium Journal. 2013;51(3): 132-140.
26. World Medical Association (WMA). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2013; 310(20): 2191-2194. https://doi.org/10.1001/jama.2013.281053
27. Iguina MM, Kashan S. Art therapy. treasure island (FL):StatPearls Publishing, 2022. https://www.ncbi.nlm.nih.gov/books/NBK549771/
28. Matthew J, Mike L, Huang HC, Wang CH, Shih CY, Chen YC, Chiu HY. Effects of personalized music intervention on nurse burnout: A feasibility randomized controlled trial. Nurs Health Sci. 2022; 24(4):836-844. https://doi.org/10.1111/nhs.12984
29. Hu J, Zhang J, Hu L, Yu H, Xu J. Art therapy: a complementary treatment for mental disorders. Front Psychol, 2021;12:686005, https://doi.org/10.3389/fpsyg.2021.686005

The Effect of an Art Therapy Program Applied To Nurses On Stress-Coping Skills: A Non-Randomized Controlled Trial

Year 2025, Volume: 6 Issue: 1, 11 - 24, 19.05.2025

Ahu Çırlak , Buse Buket Şener , Dilan Gökdemir

https://doi.org/10.70479/thdd.1646901

Abstract

Aim: The aim of the study was to examine the effect of an art therapy program on nurses' coping skills with stress.
Material and Methods: The study was conducted as a non-randomized controlled trial with nurses working in a private hospital in Türkiye between September 2022 and January 2023. An 8-week (Two face-to-face sessions, six weeks of motivational messages) art therapy program was administered to the nurses in the intervention group, while the control group did not receive any intervention. The research data were collected with " Descriptive Information Form " and "Perceived Stress Scale".
Results: The mean scale score of the intervention group before the art therapy programme was T0=25.588.75 the mean scale score after the art therapy programme was T1=23.806.28 and two weeks after the end of the programme was T2= 22.487.42. The difference between groups (F=5.214, p=0.026) and group*time interaction (F=7.485, p=0.001) were statistically significant in the intervention and control groups. The difference between times (F=0.543, p=0.583) was not statistically significant (p>0.05).
Conclusion: It was found that the art therapy program was effective in reducing nurses' stress perceptions

Keywords

art therapy, nursing, stress-coping

Ethical Statement

Çalışmanın etik açıdan uygunluğuna karar verebilmek için Okan Üniversitesi Etik Komisyonuna başvurularak (28.08.2022 tarih ve 157 sayılı) onay alındı.

References

1. Abbing A, de Sonneville L, Baars E, Bourne D, Swaab H. Anxiety reduction through art therapy in women. Exploring stress regulation and executive functioning as underlying neurocognitive mechanisms. PLosOne. 2019;14(12):e0225200. https://doi.org/10.1371/journal.pone.0225200
2. Zhang MF, Wen YS, Liu WY, Peng LF, Wu XD, Liu, QW. Effectiveness of Mindfulness-based Therapy for Reducing Anxiety and Depression in Patients With Cancer: A Meta-analysis, Medicine. 2015; 94(45): e0897-0. https://doi.org/10.1097/md.0000000000000897
3. Karpaviciüte S, Macijauskiene J. The impact of arts activity on nursing staff well-being: an intervention in the workplace, Int J of Environ Res Public Health. 2016;13(4):435. https://doi.org/10.3390/ijerph13040435 4. Yin Y, Ko KS. The effect of group art therapy on acculturative and academic stress of Chinese graduate students in South Korea. Front Psychol. 2023;14:1179778. https://doi.org/10.3389%2Ffpsyg.2023.1179778
5. Ho AHY, Tan-Ho G, Ngo TA, Ong G, Chong PH, Dignadice D, Potash J. A novel mindful-compassion art-based therapy for reducing burnout and promoting resilience among healthcare workers: findings from a waitlist randomized control trial. Front Psychol. 2021;12:744443. https://doi.org/10.3389/fpsyg.2021.744443
6. Hsu MF, Wang C, Tzou SJ, Pan TC, Tang PL, (2021). Effects of zentangle art workplace health promotion activities on rural healthcare workers, Public Health.2021;196:217-222. https://doi.org/10.1016/j.puhe.2021.05.033
7. Altınçapa B, Kaya BYA, Eren, N. Inter-model disavurumcu grup sanat terapı̇sı̇nı̇n hemsı̇relı̇k son sınıf öğrencı̇lerı̇nı̇n stresle başa cikma duzeylerı̇ne etkı̇sı̇. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2018; 4(1):11-19. doi: 10.30934/kusbed.341762.
8. Patterson SL. The effect of emotional freedom technique on stress and anxiety in nursing students: A pilot study. Nurse Education Today. 2016;40:104-110. https://doi.org/10.1016/j.nedt.2016.02.003
9. Kline JA, VanRyzin K, Davis JC, Parra JA, Todd ML, Shaw LL, Haggard BR, Fisher MA, Pettit KL, Beck, AM. Randomized trial of therapy dogs versus deliberative coloring (art therapy) to reduce stress in emergency medicine providers, Acad Emerg Med. 2020;27(4):266-275. https://doi.org/10.1111/acem.13939
10. Deshmukh SR, Holmes J, Cardno A. Art therapy for people with dementia. Cochrane Database Syst Rev. 2018; 9(9):CD011073, https://doi.org/10.1002/14651858.cd011073.pub2
11. Tofthagen C, Hernandez DF, Mason TM, Buck HG, Kip KE. Complicated grief with post-traumatic stress disorder addressed with accelerated resolution therapy: case discussions, Omega, 2022;85(2):455-464, https://doi.org/10.1177/0030222820947241
12. Ploukou S, Panagopoulou E. Playing music improves well-being of oncology nurses. Appl Nurs Res. 2018;39:77-80. https://doi.org/10.1016/j.apnr.2017.11.007
13. Alwledat K, Al-Amer R, Mohammed Ali A, Abuzied Y, Khudeir FA, Alzahrani NS, Alshammari SR, Albashtawy M, Thananayagam T, Dehghan M. Creative art therapy for improving depression, anxiety, and stress in patients with stroke: a quasi-interventional study. Sage Open Nurse. 2023;9:1-10. https://doi.org/10.1177/23779608231160473
14. Aydin M, Kutlu FY. The effect of group art therapy on loneliness and hopelessness levels of older adults living alone: a randomized controlled study. Florence Nightingale J Nurse. 2021;29(3):271-284. https://doi.org/10.5152/fnjn.2021.20224
15. Ciasca EC, Ferreira RC, Santana CLA, Forlenza OV, Dos Santos GD, Brum PS, Nunes PV. Art therapy as an adjuvan treatment for depression in elderly women: a randomized controlled trial. Braz J Psychiatry, 2018;40(3):256-263. https://doi.org/10.1590/1516-4446-2017-2250
16. Dionigi A, Gremigni, PA. Combined intervention of art therapy and clown visits to reduce preoperative anxiety in children. J Clin Nurse. 2017;26(5-6):632-640. https://doi.org/10.1111/jocn.13578
17. Kang SJ, Kim HS, Baek KH. Effects of nature-based group art therapy programs on stress, self-esteem and changes in electroencephalogram (eeg) in non-disabled siblings of children with disabilities, Int J Environ Res Public Health. 2021;18(11):5912, https://doi.org/10.3390/ijerph18115912
18. Ozsavran M, Ayyildiz TK. The effect of mandala art therapy on the comfort and resilience levels of mothers who have children with special needs: A randomized controlled study, Child Care Health Development. 2023;1-14. https://doi.org/10.1111/cch.13110
19. Utas-Akhan L, Avci D, Basak I. Art Therapy as a Nursing Intervention for Individuals with Schizophrenia. J Psychosoc Nurs Ment Health Serv. 2024;62(5):29-38. https://doi.org/10.3928/02793695-20231025-02
20. Yu WC, Lin KH. Nursing experience using art therapy with parents facing the death of a newborn. Hu Li Za Zhi. 2021;68(4):96-102, https://doi.org/10.6224/jn.202108_68(4).12
21. Ağac M, Düzgün N, Demir S. Yoğun bakım hemsirelerinde intermodel dısavurumcu sanat terapisinin merhamet yorgunluğu ve öz şefkat düzeylerine etkisi: pilot bir çalışma. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2024;13(2):743-750. https://doi.org/10.37989/gumussagbil.1366946
22. Moss M, Edelblute A, Sinn H, Torres K, Forster J, Adams T, Morgan C, Henry M, Reed K. The effect of creative arts therapy on psychological distress in health care professionals. Am J Med, 2022;135(10):1255-1262. https://doi.org/10.1016/j.amjmed.2022.04.016
23. Vlohov D. Transparent reporting of evaluations with nonrandomized designs (TREND). J Urban Health. 2004;81(2):163-164. https://doi.org/10.1093/jurban/jth099
24. Harding G. (2016). The meaning of art-and art therapy, Lancet Psychiatry. 2016;3(11):1008. https://doi.org/10.1016/s2215-0366(16)30268-1
25. Eskin M, Harlak H, Demirkıran F, Dereboy C. Algılanan stres ölçeğinin Türkçeye uyarlanması: güvenirlik ve geçerlik analizi. New/Yeni Symposium Journal. 2013;51(3): 132-140.
26. World Medical Association (WMA). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2013; 310(20): 2191-2194. https://doi.org/10.1001/jama.2013.281053
27. Iguina MM, Kashan S. Art therapy. treasure island (FL):StatPearls Publishing, 2022. https://www.ncbi.nlm.nih.gov/books/NBK549771/
28. Matthew J, Mike L, Huang HC, Wang CH, Shih CY, Chen YC, Chiu HY. Effects of personalized music intervention on nurse burnout: A feasibility randomized controlled trial. Nurs Health Sci. 2022; 24(4):836-844. https://doi.org/10.1111/nhs.12984
29. Hu J, Zhang J, Hu L, Yu H, Xu J. Art therapy: a complementary treatment for mental disorders. Front Psychol, 2021;12:686005, https://doi.org/10.3389/fpsyg.2021.686005

There are 28 citations in total.

Details

Primary Language	English
Subjects	Nurse Education
Journal Section	Research Articles
Authors	Ahu Çırlak 0000-0002-0442-4893 Buse Buket Şener 0009-0003-2108-7328 Dilan Gökdemir 0009-0006-0065-1163
Early Pub Date	May 16, 2025
Publication Date	May 19, 2025
Submission Date	February 25, 2025
Acceptance Date	April 9, 2025
Published in Issue	Year 2025 Volume: 6 Issue: 1

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Vancouver	Çırlak A, Şener BB, Gökdemir D. The Effect of an Art Therapy Program Applied To Nurses On Stress-Coping Skills: A Non-Randomized Controlled Trial. JTNA. 2025;6(1):11-24.

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