Comparing the Effect of Resilience Skills Training and Metacognitive Therapy on Job Stress in Nurses: An Experimental Study

Halimeh Hasani, Bahare Zarei, Zahra Danaei, Gholamhossein Mahmoudirad


Background: Nursing is one of the stressful professions. The work‑related stressful factors have affected the physical and mental health of nurses seriously. This study aimed to compare the effect of resilience skills training and metacognitive therapy on nurses’ job stress.

Materials and Methods: This experimental study was conducted on 54 nurses working in intensive care units and the emergency department of Valiasr Hospital, Birjand, Iran, in 2018. Selected participants were allocated via permuted block randomization into three groups: resilience skills training, metacognitive therapy, and control (n = 18 for each group). Both resilience and metacognitive therapy programs were held in eight sessions of 45‑mintraining classes twice a week. The control group received no intervention. The data were collected using a demographic characteristics form and the Expanded Nursing Stress Scale (ENSS) before, immediately after, and one month after the intervention. The data were analyzed using Chi‑square, Fisher’s exact test, Analysis of Variance (ANOVA), and repeated measures ANOVA in the Statistical Package for Social Science (SPSS) software.

Results: Job stress significantly decreased in both resilience (F2,51 = 123.5, p < 0.001) and metacognitive therapy (F2,51 = 29.2, p = 0.002) groups over time. However, this decrease was not significantly different between the two groups (p > 0.05). Also, the control group’s job stress mean score increased over time (F2,51 = 9.35, p < 0.001).

Conclusions: The findings suggest that both resilience skills training and metacognitive therapy can reduce the job stress of emergency and intensive care nurses. Therefore, it is recommended that both programs be taken into account by managers to reduce nurses’ job stress.


Metacognition, nurses, occupational stress, resilience, psychological


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