Comparison of the Effectiveness of Group Anger Management Training Based on Cognitive Reconstructing and Mindfulness Based Stress Reduction (MBSR) on Mental Fatigue, Perceived Stress, and Emotion Regulation in Nurses in Urmia
Subject Areas : Educational PsychologyNazila Aghbolaghi 1 , alinaghi aghdasi 2 , Hossein Rostami 3 , Ahad Ahangar 4
1 - Ph. D. Student in Educational Psychology, Islamic Azad University, Tabriz Branch, Tabriz. Iran.
2 - Assistant Professor, Department of Psychology, Islamic Azad University, Tabriz Branch, Tabriz. Iran. *.
3 - 1-Research Center for Cognitive &Behavioral Sciences in Police; Directorate of Health, Rescue&Treatment, Police Headquarter, Tehran, Iran.
2-NAJA Institute of Law Enforcement Sciences and Social Studies, Tehran, Iran.
4 - Assistant Professor, Department of Psychology, Islamic Azad University, Shabestar Branch, Shabestar, Iran.
Keywords: emotion regulation, perceived stress, anger management, mindfulness, Mental Fatigue,
Abstract :
This study intended to compare the effectiveness of group training of anger management based on cognitive reconstructing and mindfulness based stress reduction (MBSR) on mental fatigue, perceived stress, and emotion regulation in nurses. The research method was quasi-experimental with pre-, and post-test design and a control group, statistical population included all the nurses of Shafa hospital in Urmia (n=85), among them 45 people were selected through on-hand method and were randomly assigned in two experimental and one control groups (each group 15 people). The research instruments included mental fatigue scale (Feron & Tidel), perceived stress scale (Cohen), and emotions questionnaire (Watson) and anger management based on cognitive reconstructing and MBSR packages. Data analysis was done by one-way analysis of covariance with SPSS software. The findings indicated that MBSR was more effective than anger management based on cognitive reconstructing regarding decreased perceived stress. No significant difference was observed regarding the effectiveness of two methods on both variables of mental fatigue and emotion regulation (in sig level of 0.05). In conclusion, participating in anger management training sessions based on cognitive restructuring and MBSR makes nurses familiar with their feelings, emotions and thoughts and can control their negative emotions, thereby experiencing lower levels of perceived stress and mental fatigue.
باباپور، جلیل؛ زینالی، شیرین؛ عظیمی، فاطمه؛ چاووشی، سید هادی. (1398). اثر بخشی درمان شناختی رفتاری بر کیفیت زندگی، اضطراب و خستگی روانی پرستاران بخش سرطان: یک مطالعه کارآزمایی بالینی، آموزش پرستاری. ۸ (۴)، ۳۲-۲۶.
بادله شموشکی، محمدتقی؛ صالحی یانسری، هاجر و صادقی، الهه. (1399). تأثیر آموزش استرس‌زدایی مبتنی بر ذهن‌آگاهی در کاهش استرس شغلی پرستاران. نشریه روان پرستاری، 8(6)، 53-61.
بخشی پور، عباس و دژکام، محمود. (1384). تحلیل عاملی تأییدی مقیاس عاطفه مثبت و منفی. مجلة روانشناسی، 9(4 پیاپی 36)، 351-365.
زارعی، سلمان. (1399). نقش واسطه‌ای نشانگان افسردگی و اضطراب در رابطه بین استرس ادراک شده و استفاده آسیب‌زا از تلفن همراه در بین دانشجویان پرستاری. نشریه آموزش پرستاری، 9(3)، 10-20.
زاهدی راد، زهره؛ رضاخانی، سیمین‌دخت و وکیلی، پریوش. (1399). مقایسه اثربخشی شناخت درمانی مبتنی بر ذهن‌آگاهی و روش کاهش استرس مبتنی بر ذهن‌آگاهی بر استرس پرستاران شاغل در بیمارستان‌های روانپزشکی. نشریه پژوهش پرستاری، 15(5)، 85-100.
زائری، سمیه؛ نیسی، عبدالکاظم؛ و خواجه، نجمه. (1399). آموزش مدیریت استرس به شیوة شناختی رفتاری بر توانمندسازی روانشناختی و ابعاد فرسودگی شغلی در کارکنان. سلامت کار ایران، 17(48)، 1-12.
فدایی وطن، زهرا؛ استکی، مهناز؛ قنبری پناه، افسانه؛ و کوچک انتظار، رویا. (1398). مقایسه اثربخشی شناخت درمانی مبتنی بر ذهن‌آگاهی و آموزش بازسازی شناختی بر خودکارآمدی اجتماعی و عاطفی دانش‌آموزان با مشکلات یادگیری. فصلنامه روانشناسی افراد استثنایی، 9(35)، 169-192.
Armstong, J., & Tume, L. N. (2020). Mindfulness-based interventions to reduce stress and burnout in nurses: an integrative review, British Journal of Mental Health Nursing, http://usir.salford.ac.uk/id/eprint/62218/
Asikhia, O. A. (2014). Effect of cognitive restructuring on the reduction of mathematics anxiety among senior secondary school students in Ogun State, Nigeria. International Journal of Education and Research, 2(2):1–20.
Babakova L.V. (2017). Daily hassles and life satisfaction in the context of coping behavior in aging. Ph. D. dissertation. Saint-Petersburg State University, [In Russian].
Babapour kheirodain, J., Esmaeilpour, K., & Saeedi dehgani, S. (2015). The role of perfectionism in predicting the feeling of cognitive, physical, and social fatigue. Journal of psychology, 74, 163-174. [In Persian].
Badeleh Shamooshaki, M. T., Salehi yansari, H., & Sadeqi, E. (2021). The effectiveness of mindfulness-based stress reduction on nurses' job stress. Iranian Journal of Psychiatric Nursing, 8(6): 53-61, URL: http://ijpn.ir/article-1-1666-fa.html [In Persian].
Bakhshipour, A., & Dezshkam, M. (2005). Confirmatory factor analysis of positive and negative affection scale. Journal of psychology, 9(4-36): 351-365 [In Persian].
Bardwell, W.A., Ancoli-Israel, S. (2008). Breast Cancer and Fatigue. Sleep Med Clin, 3(1): 61-71. Doi: 10.1016/j.jsmc.2007.10.011 pmid: 18769530
Blaxton, J. M., & Bergeman, C. S. (2017). A process-oriented perspective examining the relationships among daily coping, stress, and affect. Personality and Individual Difference, 104: 357-361. https://doi.org/10.1016/j.paid.2016.08.041.
Bowns, C. N., & Marlatt, G. A. (2011). Mindfulness-based relapse prevention for addictive behaviors: a clinician’s guide. New York: Guilford press.
Coholic, D., Eys, M., & Lougheed, S. (2012). Investigating the effectiveness of an arts-based and mindfulness based group program for the improvement of resilience in children in need. Journal of Child and Family Studies, 21(5): 833-844. https:// doi.org/10.1007/s10826-011-9544-2
Fadayi vatan, Z., Estaki, M., Ganbari panah, A., & Kuchak entezar, R. (2019). Comparing the effectiveness of MBCT and cognitive restructuring training on social and affective self-efficacy in the students with learning difficulties. Journal of Exceptional people psychology, 9(35): 169-192 [In Persian].
Farahani, M., & Ebadie Zare, S. (2018). Effectiveness of Cognitive-Behavioral Anger Management Training on Aggression and Job Satisfaction on Nurses Working in Psychiatric Hospital. Zahedan J Res Med Sci. In Press (In Press): e55348. doi: 10.5812/zjrms.55348.
Freeston, M., Tiplady, A., Mawn, L., Bottesi, G., & Thwaites, S. (2020). Towards a model of uncertainty distress in the context of coronavirus (COVID-19). Cogn. Behav. Ther. 13: e31. doi: 10.1017/S1754470X2000029X
Friedberg, R. D., & McClure, J. M. (2015). Clinical practice of cognitive therapy with children and adolescents: The nuts and bolts. Guilford Publications.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment, 26(1): 41-54.
Gross, J. J., & Thompson, R. A. (2007). Emotion regulation: Conceptual foundations. In JJ. Gross (Ed.), Handbook of emotion regulation. New York: Guilford Press, 3-24.
Hofer, M., Burkhard, L., & Allemand, M. (2015). Age differences in emotion regulation during a distressing film scene. J. Media Psychol. 27, 47–52. doi: 10.1027/1864-1105/a000134
Kang, L., Li, Y., Hu, S., Chen, M., Yang, C., & Yang, B.X. (2020). The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. The Lancet Psychiatry, 7(3): e14. [DOI:10.1016/S2215-0366(20)30047-X].
Khalili, R., Nir, M.S., Ebadi, A., Tavallai, A., & Habibi, M. (2017). Validity and reliability of the Cohen 10-item Perceived Stress Scale in patients with chronic headache: In Persian version. Asian Journal of Psychiatry, 26: 136-40. DOI:10.1016/j.ajp.2017.01.010.
Kranke, D., Weiss, E.L., Gin, J., Der-Martirosian, C., Brown, J.L.C., & Saia, R. (2017). A culture of compassionate bad asses: A qualitative study of combat veterans engaging in peer-led disaster relief and utilizing cognitive restructuring to mitigate mental health stigma. Best Practices in Mental Health: An International Journal, 13(1): 20–33.
Lim, J., Leow, Z., Ong, J. C., Pang, L.-S., & Lim, E. (2020). The Effects of Online Group Mindfulness Training on Stress and Sleep Quality during the COVID-19 Pandemic in Singapore: A Retrospective Equivalence Trial (SSRN Scholarly Paper ID 3629960). Social Science Research Network. doi: 10.2139/ssrn.3629960.
McVeigh, C., Ace, L., Ski, C.F., Carswell, C., Burton, S., Rej, S., & Noble, H. (2021). Mindfulness-Based Interventions for Undergraduate Nursing Students in a University Setting: A Narrative Review. Healthcare, 9, 1493. https:// doi.org/10.3390/healthcare9111493.
Muecke, S. (2005). Effects of rotating night shifts: Literature review. J Adv Nurs, 50(4): 433-9.
Parola, V., Coelho, A., Neves, H., Bernardes, R.A., Sousa, J.P., & Catela, N. (2022). Burnout and Nursing Care: A Concept Paper. Nurs. Rep.12, 464-471. https://doi.org/10.3390/nursrep12030044
Petko, D. J., (2017). Mindfulness-based Stress Reduction (MBSR) in Reducing Stress in Nursing Students: An Integrative Review and Toolkit, Doctor of Nursing Practice (DNP) Projects. 126. Retrieved from https://scholarworks.umass.edu/nursing_dnp_capstone/126
Rettie, H., & Daniels, J. (2020). Coping and tolerance of uncertainty: predictors and mediators of mental health during the COVID-19 pandemic. Am. Psychol. 76, 427–437. Doi: 10.1037/amp0000710
Richard, Y., Tazi, N., Frydecka, D., Hamid, M. S., & A. A., Moustafa, (2022). A systematic review of neural, cognitive, and clinical studies of anger and aggression, Springer, https://doi.org/10.1007/s12144-022-03143-6
Riediger, M., & Luong, G. (2015). From adolescence to old age: developmental perspectives on the extended process model of emotion regulation. Psychol. Inq. 26, 99–107.
Rielly, P. M., & Shopshire, M. S., (2019). Anger Management for Substance Use Disorder and Mental Health Clients a Cognitive–Behavioral Therapy Manual, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Substance Abuse and Mental Health Services Administration.
Röcke, C., Brose, A., & Kuppens, P. (2018). “Emotion dynamics in older age,” in Emotion Regulation: A Matter of Time, Part II: Development of Emotion Regulation as a Dynamic, Real-Time Process, eds P. M. Cole and T. Hollenstein (New York, NY: Routhledge), 179–207.
Santiago Calder, M., (2021). Emotional Resilience and Emotion Regulation: Examining Preference for Reappraisal or Distraction for Stressors of Differing Intensity, https://www.researchgate.net/publication/356603588.
Scheibe, S., Sheoppes, G., and Staudinger, U. M. (2015). Distract or rappraise? Age-related differences in emotion-regulation choice. Emotion 15, 677–681. doi: 10.1037/a0039246
Strizhitskaya, O., Petrash, M., Savenysheva S., Murtazina I., & Golovey L. (2019). PERCEIVED STRESS AND PSYCHOLOGICAL WELL-BEING THE ROLE OF THE EMOTIONAL STABILITY, The Annual International Conference on Cognitive – Social, and Behavioural Sciences, https://dx.doi.org/10.15405/epsbs.2019.02.02.18
Teasdale, J.T., Segal, Z.V., Williams, J.M.G., Ridgeway, V.A., Soulsby, J.M., & Lau, M.A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4): 615-23.
Yoder, E.A. (2010). Compassion fatigue in nurses. Appl Nurs Res, 23(4): 191-7. doi: 10.1016/j.apnr.2008.09.003.pmid: 21035028.
Yun, K., & Yoo, Y-S. (2021). Effects of the Anger Management Program for Nurses. Asian Nursing Research, https://doi.org/10.1016/j.anr.2021.07.004.
Zaeri, S., Neasi, A., & Khaje, N. (2020). The effectiveness of stress management training on psychological empowerment and job burnout. ioh, 17(1): 610-621, URL: http://ioh.iums.ac.ir/article-1-2565-fa.html. [In Persian].
Zahedirad, Z., Rezakhani, S., & Vakili, P. (2020). Comparison effectiveness of Mindfulness-Based Cognitive therapy and Mindfulness-Based Stress Reduction method on Stress among Nurses in Psychiatric Hospital. Iranian Journal of Nursing Research, 15(5): 84-98, URL: http://ijnr.ir/article-1-2403-fa.html. [In Persian].
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_||_باباپور، جلیل؛ زینالی، شیرین؛ عظیمی، فاطمه؛ چاووشی، سید هادی. (1398). اثر بخشی درمان شناختی رفتاری بر کیفیت زندگی، اضطراب و خستگی روانی پرستاران بخش سرطان: یک مطالعه کارآزمایی بالینی، آموزش پرستاری. ۸ (۴)، ۳۲-۲۶.
بادله شموشکی، محمدتقی؛ صالحی یانسری، هاجر و صادقی، الهه. (1399). تأثیر آموزش استرس‌زدایی مبتنی بر ذهن‌آگاهی در کاهش استرس شغلی پرستاران. نشریه روان پرستاری، 8(6)، 53-61.
بخشی پور، عباس و دژکام، محمود. (1384). تحلیل عاملی تأییدی مقیاس عاطفه مثبت و منفی. مجلة روانشناسی، 9(4 پیاپی 36)، 351-365.
زارعی، سلمان. (1399). نقش واسطه‌ای نشانگان افسردگی و اضطراب در رابطه بین استرس ادراک شده و استفاده آسیب‌زا از تلفن همراه در بین دانشجویان پرستاری. نشریه آموزش پرستاری، 9(3)، 10-20.
زاهدی راد، زهره؛ رضاخانی، سیمین‌دخت و وکیلی، پریوش. (1399). مقایسه اثربخشی شناخت درمانی مبتنی بر ذهن‌آگاهی و روش کاهش استرس مبتنی بر ذهن‌آگاهی بر استرس پرستاران شاغل در بیمارستان‌های روانپزشکی. نشریه پژوهش پرستاری، 15(5)، 85-100.
زائری، سمیه؛ نیسی، عبدالکاظم؛ و خواجه، نجمه. (1399). آموزش مدیریت استرس به شیوة شناختی رفتاری بر توانمندسازی روانشناختی و ابعاد فرسودگی شغلی در کارکنان. سلامت کار ایران، 17(48)، 1-12.
فدایی وطن، زهرا؛ استکی، مهناز؛ قنبری پناه، افسانه؛ و کوچک انتظار، رویا. (1398). مقایسه اثربخشی شناخت درمانی مبتنی بر ذهن‌آگاهی و آموزش بازسازی شناختی بر خودکارآمدی اجتماعی و عاطفی دانش‌آموزان با مشکلات یادگیری. فصلنامه روانشناسی افراد استثنایی، 9(35)، 169-192.
Armstong, J., & Tume, L. N. (2020). Mindfulness-based interventions to reduce stress and burnout in nurses: an integrative review, British Journal of Mental Health Nursing, http://usir.salford.ac.uk/id/eprint/62218/
Asikhia, O. A. (2014). Effect of cognitive restructuring on the reduction of mathematics anxiety among senior secondary school students in Ogun State, Nigeria. International Journal of Education and Research, 2(2):1–20.
Babakova L.V. (2017). Daily hassles and life satisfaction in the context of coping behavior in aging. Ph. D. dissertation. Saint-Petersburg State University, [In Russian].
Babapour kheirodain, J., Esmaeilpour, K., & Saeedi dehgani, S. (2015). The role of perfectionism in predicting the feeling of cognitive, physical, and social fatigue. Journal of psychology, 74, 163-174. [In Persian].
Badeleh Shamooshaki, M. T., Salehi yansari, H., & Sadeqi, E. (2021). The effectiveness of mindfulness-based stress reduction on nurses' job stress. Iranian Journal of Psychiatric Nursing, 8(6): 53-61, URL: http://ijpn.ir/article-1-1666-fa.html [In Persian].
Bakhshipour, A., & Dezshkam, M. (2005). Confirmatory factor analysis of positive and negative affection scale. Journal of psychology, 9(4-36): 351-365 [In Persian].
Bardwell, W.A., Ancoli-Israel, S. (2008). Breast Cancer and Fatigue. Sleep Med Clin, 3(1): 61-71. Doi: 10.1016/j.jsmc.2007.10.011 pmid: 18769530
Blaxton, J. M., & Bergeman, C. S. (2017). A process-oriented perspective examining the relationships among daily coping, stress, and affect. Personality and Individual Difference, 104: 357-361. https://doi.org/10.1016/j.paid.2016.08.041.
Bowns, C. N., & Marlatt, G. A. (2011). Mindfulness-based relapse prevention for addictive behaviors: a clinician’s guide. New York: Guilford press.
Coholic, D., Eys, M., & Lougheed, S. (2012). Investigating the effectiveness of an arts-based and mindfulness based group program for the improvement of resilience in children in need. Journal of Child and Family Studies, 21(5): 833-844. https:// doi.org/10.1007/s10826-011-9544-2
Fadayi vatan, Z., Estaki, M., Ganbari panah, A., & Kuchak entezar, R. (2019). Comparing the effectiveness of MBCT and cognitive restructuring training on social and affective self-efficacy in the students with learning difficulties. Journal of Exceptional people psychology, 9(35): 169-192 [In Persian].
Farahani, M., & Ebadie Zare, S. (2018). Effectiveness of Cognitive-Behavioral Anger Management Training on Aggression and Job Satisfaction on Nurses Working in Psychiatric Hospital. Zahedan J Res Med Sci. In Press (In Press): e55348. doi: 10.5812/zjrms.55348.
Freeston, M., Tiplady, A., Mawn, L., Bottesi, G., & Thwaites, S. (2020). Towards a model of uncertainty distress in the context of coronavirus (COVID-19). Cogn. Behav. Ther. 13: e31. doi: 10.1017/S1754470X2000029X
Friedberg, R. D., & McClure, J. M. (2015). Clinical practice of cognitive therapy with children and adolescents: The nuts and bolts. Guilford Publications.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment, 26(1): 41-54.
Gross, J. J., & Thompson, R. A. (2007). Emotion regulation: Conceptual foundations. In JJ. Gross (Ed.), Handbook of emotion regulation. New York: Guilford Press, 3-24.
Hofer, M., Burkhard, L., & Allemand, M. (2015). Age differences in emotion regulation during a distressing film scene. J. Media Psychol. 27, 47–52. doi: 10.1027/1864-1105/a000134
Kang, L., Li, Y., Hu, S., Chen, M., Yang, C., & Yang, B.X. (2020). The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. The Lancet Psychiatry, 7(3): e14. [DOI:10.1016/S2215-0366(20)30047-X].
Khalili, R., Nir, M.S., Ebadi, A., Tavallai, A., & Habibi, M. (2017). Validity and reliability of the Cohen 10-item Perceived Stress Scale in patients with chronic headache: In Persian version. Asian Journal of Psychiatry, 26: 136-40. DOI:10.1016/j.ajp.2017.01.010.
Kranke, D., Weiss, E.L., Gin, J., Der-Martirosian, C., Brown, J.L.C., & Saia, R. (2017). A culture of compassionate bad asses: A qualitative study of combat veterans engaging in peer-led disaster relief and utilizing cognitive restructuring to mitigate mental health stigma. Best Practices in Mental Health: An International Journal, 13(1): 20–33.
Lim, J., Leow, Z., Ong, J. C., Pang, L.-S., & Lim, E. (2020). The Effects of Online Group Mindfulness Training on Stress and Sleep Quality during the COVID-19 Pandemic in Singapore: A Retrospective Equivalence Trial (SSRN Scholarly Paper ID 3629960). Social Science Research Network. doi: 10.2139/ssrn.3629960.
McVeigh, C., Ace, L., Ski, C.F., Carswell, C., Burton, S., Rej, S., & Noble, H. (2021). Mindfulness-Based Interventions for Undergraduate Nursing Students in a University Setting: A Narrative Review. Healthcare, 9, 1493. https:// doi.org/10.3390/healthcare9111493.
Muecke, S. (2005). Effects of rotating night shifts: Literature review. J Adv Nurs, 50(4): 433-9.
Parola, V., Coelho, A., Neves, H., Bernardes, R.A., Sousa, J.P., & Catela, N. (2022). Burnout and Nursing Care: A Concept Paper. Nurs. Rep.12, 464-471. https://doi.org/10.3390/nursrep12030044
Petko, D. J., (2017). Mindfulness-based Stress Reduction (MBSR) in Reducing Stress in Nursing Students: An Integrative Review and Toolkit, Doctor of Nursing Practice (DNP) Projects. 126. Retrieved from https://scholarworks.umass.edu/nursing_dnp_capstone/126
Rettie, H., & Daniels, J. (2020). Coping and tolerance of uncertainty: predictors and mediators of mental health during the COVID-19 pandemic. Am. Psychol. 76, 427–437. Doi: 10.1037/amp0000710
Richard, Y., Tazi, N., Frydecka, D., Hamid, M. S., & A. A., Moustafa, (2022). A systematic review of neural, cognitive, and clinical studies of anger and aggression, Springer, https://doi.org/10.1007/s12144-022-03143-6
Riediger, M., & Luong, G. (2015). From adolescence to old age: developmental perspectives on the extended process model of emotion regulation. Psychol. Inq. 26, 99–107.
Rielly, P. M., & Shopshire, M. S., (2019). Anger Management for Substance Use Disorder and Mental Health Clients a Cognitive–Behavioral Therapy Manual, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Substance Abuse and Mental Health Services Administration.
Röcke, C., Brose, A., & Kuppens, P. (2018). “Emotion dynamics in older age,” in Emotion Regulation: A Matter of Time, Part II: Development of Emotion Regulation as a Dynamic, Real-Time Process, eds P. M. Cole and T. Hollenstein (New York, NY: Routhledge), 179–207.
Santiago Calder, M., (2021). Emotional Resilience and Emotion Regulation: Examining Preference for Reappraisal or Distraction for Stressors of Differing Intensity, https://www.researchgate.net/publication/356603588.
Scheibe, S., Sheoppes, G., and Staudinger, U. M. (2015). Distract or rappraise? Age-related differences in emotion-regulation choice. Emotion 15, 677–681. doi: 10.1037/a0039246
Strizhitskaya, O., Petrash, M., Savenysheva S., Murtazina I., & Golovey L. (2019). PERCEIVED STRESS AND PSYCHOLOGICAL WELL-BEING THE ROLE OF THE EMOTIONAL STABILITY, The Annual International Conference on Cognitive – Social, and Behavioural Sciences, https://dx.doi.org/10.15405/epsbs.2019.02.02.18
Teasdale, J.T., Segal, Z.V., Williams, J.M.G., Ridgeway, V.A., Soulsby, J.M., & Lau, M.A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4): 615-23.
Yoder, E.A. (2010). Compassion fatigue in nurses. Appl Nurs Res, 23(4): 191-7. doi: 10.1016/j.apnr.2008.09.003.pmid: 21035028.
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