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A Positive Psychology: Intervention in Nursing

The following consultant report is a description of the design of a positive psychology intervention that was developed to be used in the nursing profession to improve well-being. To recap to develop this intervention, there was a need highlighted in nursing to formulate a program that would build resilience and increase well-being in the face of a future of increasing stress and challenges. It was suggested that cultivating optimism, building mastery and personal control to influence outcomes, improve self-esteem and increase social support and build resilience skills would be the areas to develop an educational and coaching program to support these outcomes for success. Also it was suggested to include the underlying structure of appreciative inquiry to navigate the change process until knew behaviours were imbedded and continued.

The strategy before implementation to the broader nursing workforce is to run a pilot study in a busy surgical ward in a public hospital environment. This strategy was chosen to implement the program, collect the data and evaluate the results of the initiative and fine-tune any changes necessary for success. A table of how the PPI would be managed was developed with time-lines and indications of when data would be collected over the period of the project. Please refer to this table as an overview Appendix 1.

Research into the outcomes of two Positive Psychology interventions (PPI) was discussed in a study by Miller & Duncan (2015) and showed when to collect data and how to analyse findings. They used a control group with similar characteristics for validity and comparisons of results (Miller and Duncan 2015). Broderick & Metz (2009 Cited in Waters, 2001) used a control group of students to compare a mindfulness meditation curriculum and the effects on Math’s and English scores. By comparison to the control group and the group of students in the Mindfulness study the result was increase performance scores over a twelve month period. The control group displayed none of these results so added to the validity of the results. Reviewing these findings and in many other research papers sited it was decided a control group was important to this PPI. The control group chosen would be a surgical ward with similar specialty and environment.

Other studies for example Judkins, Arris & Keener (2005) used only Hardiness and Perceived stress scale to determine evaluation of its program. This program in fact looked at graduate nurse education to measure success of increasing hardiness while students completed their nursing administration course (Judkins, Arris & Keener, 2005). Considering this PPI developed for nurses was measuring Resilience and Well-Being it was decided that these to scaling systems should be part of the measurement to determine effectiveness. The Wagner & Young Resilience Scale (1993) was a tool used to determine the degree of resilience in a person. It uses the 7-point likert scale, which has been validated by Symonds (cited in Matell, & Jacoby, 1971:658) as being the most sensitive to reliability when used primarily to assess attitudes (Gliem, Gliem, 2003:82). The Subjective Happiness Scale (Lyubomirsky, 2007:33) was the other scale chosen for the measurement of this PPI and also uses a 7-point likert scale. The above scaling systems were chosen as resilience and well-being were the desired outcomes of this PPI.

It was also a common theme seen in the research of interventions that assessments where made pre-test, post-test with 6 month and 18 month follow-up as seen in Waters (2011) a school-based PPI cultivating hope in students and the benefits of testing at 6 and 18 month intervals after the intervention showed the benefits were maintained. They also used a control group in this PPI to compare and validate results (Water, 2011).

The methods used in this PPI have been a combination of qualitative data using discussion with staff during appreciative inquiry sessions, feedback from coaching and the one-day workshops. The quantitative data is for the purpose of seeing the number of staff involved and how many finished the PPI program and also when collating the data for the Resilience and Happiness scales. Although the questions asked in the scaling systems would be seen to be qualitative in design, by using a Likert Scale this can measure results in a quantitative form. Collection of all results would be compiled and statistically analysed and compared to the control group. Collecting different types of data would give varying views of this PPI and hopefully some hard evidence of the effectiveness of this program enough to warrant a larger scale intervention in the future. These finding would be published in a journal article and also delivered in a report to the staff involved in the study and the facility that the program was held. Discussion would continue with stakeholders and decisions of what needs to be developed further and the scope of this program determined.

Reference List

Gliem, J.A Gliem, R.R 2003, ‘Midwest Research to Practice Conference in Adult Continuing and Community Education’, The Ohio State University, Columbus, OH, October 8-10

Judkins, S Arris, L Keener, E 2005, ‘Program Evaluation in Graduate Nursing Education: Hardiness as a Predictor of Success Among Nursing Administration Students’, Journal of Professional Nursing, Vol 21, No5 pp 314-321.

Lyubomirsky, S 2010, ‘The How of Happiness: A practical Guide to Getting the Life You Want’, Piatkus, London.

Matell, M,S Jacoby, J ‘Educational & Psychological Measurement’ 31:657 DOI:10.1177|001316447103100307 Accessed 29/6/16

Wagnild, G.M Young, H.M 1993, ‘Development and Psychometric Evaluation of the Resilience Scale’, Journal of Nursing Measurement, Vol. 1, No. 2 pp. 165-178.

Miller, R.W Duncan, E 2007, ‘A pilot randomised controlled trial comparing two positive psychology interventions for their capacity to increase subjective wellbeing’, Counselling Psychology Review, Vol, 30, No.3 pp:36-45.

Waters, L 2011, ‘A review of school-based positive psychology interventions’, The Australian Educational and Development Psychologist, 28(2), 75-90.

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