Developing Resilience Through the Inner Arts Process in Nursing Students: A Pilot Study
DOI:
https://doi.org/10.60099/jtnmc.v39i04.269626Keywords:
inner arts, nursing students, resilienceAbstract
Introduction Developing resilience is essential for nursing students to cope with the challenges of their studies and future careers. Based on Anthroposophy principles, the inner arts process is a unique approach that can help foster resilience in nursing students.
Objectives 1) To compare the mean scores of resilience in nursing students before, after, and 3-month follow-up period; and 2) To compare subscales of resilience, including flexibility, sense of self-efficacy, ability to regulate emotion, optimism, and cognitive focus/maintaining attention under stress before, after, and 3-month follow-up period.
Design A quasi-experimental with one-group repeated measures design
Methodology The participants consisted of 23 first-year nursing students who volunteered to participate in resilience development through the inner arts process, including four sessions, each lasting seven hours, for a total of 28 hours. Data were collected using the 10-item Davidson Resilience Scale (CD-RISC10-Thai version) and reflection journals on Google Forms. Data were analyzed using descriptive statistics, One-way repeated measures ANOVA, and Bonferroni pairwise comparisons.
Results Most participants were females (95.7%), with an average age of 19.57 years (SD = 0.79). One-way ANOVA with repeated measures revealed that time had a statistically significant effect on overall resilience (F(2,44) = 5.815, p = .006, partial η² = .209). After the program, the overall resilience (M = 32.70, SD = 4.09) was significantly higher than before (M = 30.26, SD = 3.35; p = .006). Comparisons of resilience subscales revealed that flexibility at the 3-month follow-up (M = 3.44, SD = 0.55) was significantly higher than flexibility before (M = 2.91, SD = 0.65; p = .004). Flexibility after the program (M = 3.39, SD = 0.52) was also higher than before the program (p = .014). However, no statistically significant differences were found in the sense of self-efficacy, ability to regulate emotion, optimism, and cognitive focus/maintaining attention under stress.
Recommendation Developing resilience through the inner arts process can enhance the overall resilience of nursing students. This approach can be applied to promote resilience among nursing students. However, this study has limitations, and future research should be designed with more stringent controls.
Downloads
References
Vo TN, Chiu HY, Chuang YH, Huang HC. Prevalence of stress and anxiety among nursing students: a systematic review and meta-analysis. Nurse Educ. 2023;48(3): E90-5. https://doi.org/10.1097nne.0000000000001343 PMID: 36538669
Tosangwarn S, Juntarawiwat T. Stress, depression, coping strategies and resilience of nursing students at an institute in Northeast Thailand during the outbreak of the Covid-19 virus. The Journal of Psychiatric Nursing and Mental Health. 2023;37(3): 92-113. Available from: https://he02.tci-thaijo.org/index.php/JPNMH/article/view/262552/181865 (in Thai)
Labrague LJ. Umbrella Review: Stress Levels, Sources of Stress, and Coping Mechanisms among Student Nurses. Nurs Rep. 2024;14(1):362-375.
Arian M, Jamshidbeigi A, Kamali A, Dalir Z, Ali-Abadi T. The prevalence of burnout syndrome in nursing students: a systematic review and meta-analysis. Teach Learn Nurs. 2023;18(4):512-20. Available from: https://doi.org/10.1016/j.teln.2023.04.015
Connor KM, Davidson JRT. Development of a new resilience scale: The Connor Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2): 76-82. Available from: https://doi.org/10.1002/da.10113 PMID: 129641746
Grotberg E. A guide to promoting resilience in children: strengthening the human spirit. The Hague, Netherlands: Bernard van Leer Foundation; 1995.
Regev D, Cohen-Yatziv L. Effectiveness of art therapy with adult clients in 2018—What progress has been made? Front Psychol. 2018;9(1351):1-19. Available from: https://doi.org/10.3389%2Ffpsyg.2018.01531 PMID: 30210388
Steiner R. Art as spiritual activity: Rudolf Steiner›s contribution to the visual arts. Hudson, NY: Anthroposophic; 1998.
Jarunjawanaphet A, Chaisubunkhanok N, Plukpankhachee A. The Inner Art: a handbook and philosophy for child welfare professionals. Chiang Mai: Project to develop a prototype model of inner art instructors and develop the health of school-aged children; 2022. (in Thai)
Kongsuwan S, editor. Innerscape: When art changes “us” and the world with beauty. Bangkok: Thai Health Promotion Foundation; 2020. (in Thai)
Plukpankhachee A. The colorful beauty of life: artistic approaches to life foundation for children. Bangkok: 7 Arts Inner Place; 2021. (in Thai)
de Rijke V. Introduction: what has happened to the soul of art education? In: de Rijke V, editor. Art and soul: Rudolf Steiner, interdisciplinary art and education. Cham, Switzerland: Springer; 2019.
Stoltz T, Weger U. Piaget and Steiner: Science and art in the process of formation. RoSE. 2012;3(1): 134-145.
Khuniontrtong M, Chaiseana Dallas J, Hengudomsub P. The effect of group art therapy on resilience among youths with substance abuse. Journal of Nursing and Health Care. 2019;37(2):36-44. Available from: https://he01.tci-thaijo.org/index.php/jnat-ned/article/view/200582/140211 (in Thai)
Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H. Anthroposophic therapy for chronic depression: a four-year prospective cohort study. BMC Psychiatry. 2006;6:57. https://doi.org/10.1186/1471-244x-6-57 PMID: 17173663
Hamre HJ, Witt CM, Kienle GS, Glockmann A, Ziegler R, Willich SN, et al. Anthroposophic therapy for anxiety disorders: a two-year prospective cohort study in routine outpatient settings. Clinical Medicine Insights: Psychiatry. 2009;2:17-31.
Ayres AJ, Robbins J. Sensory integration and the child: understanding hidden sensory challenges. Los Angeles: Western Psychological Services; 2005.
Zarobe L, Bungay H. The role of arts activities in developing resilience and mental wellbeing in children and young people a rapid review of the literature. Perspect Public Health. 2017;137(6):337-47. Available from: https://doi.org/10.1177/1757913917712283 PMID: 2861310719
Chaisubannakanok N. Music, the sweetness of reverie dreams and inner balance. In: Kongsuwan S, editor. Innerscape: When art changes “us” and the world with beauty. Bangkok: Thai Health Promotion Foundation; 2020. p.45-73. (in Thai)
Plukpankhachee A. Art therapy, bringing balance back to the inside. In: Kongsuwan S, editor. Innerscape: when art changes “us” and the world with beauty. Bangkok: Thai Health Promotion Foundation; 2020. p.75-104. (in Thai)
Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91.
Cohen J. Statistical power analysis. Current Directions in Psychological Science. 1992;1(3):98-101. Available from: https://psycnet.apa.org/doi/10.1111/1467-8721.ep10768783
Campbell-Sills L, Stein MB. Psychometric analysis and refinement of the connor–davidson resilience scale (CD-RISC): validation of a 10-item measure of resilience. Journal of Traumatic Stress. 2007; 20(6):1019-28. Available from: https://doi.org/10.1002/jts.20271
Vongsirimas N, Thanoi W, Klainin-Yobas P. Evaluating psychometric properties of the Connor– Davidson Resilience Scale (10-Item CD-RISC) among university students in Thailand. J Nurs Sci. 2017;35(3):25-35. Available from: https://he02.tci-thaijo.org/index.php/ns/article/view/116086
Connor KM, Davidson JRT. Scoring and interpretation of the Connor-Davidson Resilience Scale (CD-RISC©); 2020. Availble from: https://www.cd-risc.com/contact.php
Southwick SM, Bonanno GA, Masten AS, Panter-Brick C, Yehuda R. Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol. 2014;5(1):25338. Available from: https://doi.org/10.3402%2Fejpt.v5.25338 PMID: 25317257
Amsrud KE, Lyberg A, Severinsson E. Development of resilience in nursing students: a systematic qualitative review and thematic synthesis. Nurse Educ Pract. 2019;41:102621. Availble from: https://doi.org/10.1016/j.nepr.2019.102621 PMID: 31726329
Jin X, Ye Y. Impact of fine arts education on psychological wellbeing of higher education students through moderating role of creativity and self-efficacy. Front Psychol. 2022;13:957578. Available from: https://doi.org/10.3389/fpsyg.2022.957578 PMID: 36017422
Martin L, Oepen R, Bauer K, Nottensteiner A, Mergheim K, Gruber H, et al. Creative arts interventions for stress management and prevention--a systematic review. Behav Sci (Basel). 2018;8(2):28. Available from: https://doi.org/10.3390%2Fbs8020028 PMID: 29470435
Sandmire DA, Rankin NE, Gorham SR, Eggleston DT, French CA, Lodge EE, et al. Psychological and autonomic effects of art making in college-aged students. Anxiety Stress Coping. 2016;29(5):561-9. Available from: https://doi.org/10.1080/10615806.2015.1076798 PMID: 26222010
Yeager DS, Dweck CS. Mindsets that promote resilience: when students believe that personal characteristics can be developed. Educat Psychol. 2012;47(4):302-14. Available from: https://doi.org/10.1080/00461520.2012.722805
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 The Journal of Thailand Nursing and Midwifery Council
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
