Effectiveness of Acceptance and Commitment Therapy (ACT)–Based Intervention on Job Burnout and Quality of Care among Psychiatric Ward Nurses
Keywords:
Acceptance and Commitment Therapy, job burnout, psychiatric nursing, quality of care, psychological flexibilityAbstract
This study aimed to evaluate the effectiveness of a group-based Acceptance and Commitment Therapy (ACT) intervention in reducing job burnout among psychiatric ward nurses and improving the quality of nursing care as perceived by patients. A quasi-experimental pretest–posttest design with a control group was applied among 40 nurses working in the psychiatric ward of Farabi Hospital, Isfahan, Iran. After screening with the Maslach Burnout Inventory (MBI), nurses with burnout scores above average were purposively selected and randomly assigned to the intervention (n = 20) and control (n = 20) groups. The intervention group participated in eight 90-minute ACT sessions based on the standardized protocol (Hayes et al., 2012). Patient-perceived quality of care was measured using the Caring Behaviors Inventory (CBI), with five patients evaluating each nurse at baseline, immediate posttest, and one-month follow-up (total n = 200). Data were analyzed using analysis of covariance (ANCOVA), paired t-tests, and effect size (Cohen’s d). ACT significantly reduced total burnout scores in the intervention group compared to controls (pretest M = 65.3 ± 8.5 to immediate posttest M = 48.7 ± 7.9; p < .001; Cohen’s d = 1.85). Emotional exhaustion showed the largest reduction (d = 2.50), followed by depersonalization (d = 2.00) and reduced personal accomplishment (p = .002; d = 0.60). In the control group, no meaningful changes occurred (p > .05). Patient-reported care quality improved significantly in all dimensions in the intervention group, including technical skill, communication, empathy, and responsiveness (p < .001; d ranging from 1.65 to 1.90), with improvements sustained at one-month follow-up. Group-based ACT effectively alleviates burnout and enhances patient-perceived care quality among psychiatric nurses. This approach is practical, sustainable, and beneficial for improving both staff well-being and service delivery in mental health settings.
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Copyright (c) 2024 Fariba Khakzar (Corresponding Author); Maryam Faghih (Author)
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