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High-risk units, including intensive care, oncology, and emergency services, are clinical environments characterized by rapid decision-making demands and heavy workloads, placing substantial emotional and physical strain on nurses and other healthcare professionals. These challenging working conditions may contribute to burnout, negatively influence clinical decision-making processes, and increase levels of existential anxiety. Frequent exposure to death and critical illness can intensify nurses' confrontation with themes such as meaning, responsibility, and psychological resilience within their professional roles.
Existential anxiety involves fundamental human concerns related to life, death, freedom, responsibility, and meaning, which may become more salient in high-risk healthcare settings. In recent years, mindfulness-based approaches have gained attention as effective interventions for supporting healthcare professionals. Mindfulness emphasizes present-moment awareness and a nonjudgmental attitude toward thoughts and emotions, and has been shown to help individuals cope with stress and emotional burden more adaptively.
This study aims to evaluate the effects of a mindfulness-based psychoeducation program on burnout, clinical decision-making, and existential anxiety among nurses working in high-risk units, including intensive care, oncology, and emergency services. The findings of this study are expected to contribute to the development of supportive interventions that may enhance nurses' psychological well-being, professional functioning, and the overall quality of patient care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mindfulness-Based Psychoeducation Program | Experimental | Participants receive a mindfulness-based psychoeducational program. |
|
| No Intervention | No Intervention | Participants receive no intervention during the study period. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mindfulness-Based Psychoeducational Program | Behavioral | The mindfulness-based psychoeducational program is a structured, group-based intervention designed for nurses working in high-risk hospital units. The program includes mindfulness practices, psychoeducational content, and experiential exercises aimed at enhancing awareness, emotional regulation, and adaptive coping with work-related psychological challenges. |
| Measure | Description | Time Frame |
|---|---|---|
| Burnout | Burnout Scale - Short Version: The scale was developed by Maslach and Pines (2005) to assess individuals' levels of burnout and was adapted into Turkish by Tümkaya et al. (2009), who conducted validity and reliability analyses. The Short Version of the Burnout Scale is a unidimensional instrument consisting of 10 items rated on a seven-point Likert scale (1 = never, 2 = almost never, 3 = rarely, 4 = sometimes, 5 = often, 6 = very often, 7 = always). Higher scores obtained from the scale indicate higher levels of burnout. In the Turkish adaptation study conducted by Tümkaya et al. (2009), the Cronbach's alpha coefficient was reported as 0.91 (Tümkaya, Sabahattin, & Çavuşoğlu, 2009). | 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical decision-making | Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM©) Scale: The NASC-CDM© was developed by White and adapted into Turkish by Bektaş et al. The 27-item, six-point Likert scale assesses self-confidence and anxiety separately in clinical decision-making. Both subscales include three dimensions: (1) using resources and listening fully to obtain information, (2) using available information to identify the problem, and (3) knowing and taking action. Higher scores on the self-confidence subscale indicate greater clinical decision-making confidence, whereas lower scores on the anxiety subscale indicate lower anxiety. Scores for each subscale range from 27 to 162. In the Turkish study, Cronbach's alpha was 0.97 (self-confidence) and 0.96 (anxiety). In the present study, alpha coefficients were 0.98 and 0.94, respectively. |
| Measure | Description | Time Frame |
|---|---|---|
| Existential anxiety | Existential Concerns Questionnaire (ECQ): The original form of the scale was developed by van Bruggen, Klooster, Westerhof, Vos, Kleine, Bohlmeijer, and Glas (2017), and it was adapted into Turkish by Ümmet, Ekşi, Özkapu, and Ekşi (2018). The ECQ consists of 22 items rated on a five-point Likert scale and includes three subscales: general existential anxiety (13 items), death anxiety (5 items), and avoidance (4 items). Total scores range from 22 to 110, with higher scores indicating higher levels of existential anxiety. In reliability analyses, the test-retest coefficients were reported as 0.81 for the general anxiety subscale, 0.73 for the death anxiety subscale, 0.69 for the avoidance subscale, and 0.87 for the total scale. Cronbach's alpha coefficients were 0.85 for general anxiety, 0.72 for death anxiety, 0.62 for avoidance, and 0.88 for the total scale (Ümmet et al., 2018). |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Düzce University Hospital | Düzce | Centre | 81000 | Turkey (Türkiye) |
Individual participant data will not be shared due to ethical considerations and the sensitive nature of psychological data collected from participants.
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| ID | Term |
|---|---|
| D000077062 | Burnout, Psychological |
| D002055 | Burnout, Professional |
| D001008 | Anxiety Disorders |
| ID | Term |
|---|---|
| D013315 | Stress, Psychological |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D000073397 | Occupational Stress |
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This study uses a parallel-group randomized design. Eligible participants are randomly assigned to either an intervention group receiving a mindfulness-based psychoeducational program or a control group receiving no intervention during the study period. Outcomes are assessed at baseline and post-intervention.
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|
| 12 weeks |
| 12 weeks |
| D009784 |
| Occupational Diseases |
| D001523 | Mental Disorders |