The Effectiveness of Acceptance and Commitment Therapy in Reducing Moral Distress and Enhancing Cognitive Fusion in Nurses

Due to the nature of the nursing profession, confronting conflicting situations regarding values and facing moral dilemmas is inevitable. It can, in turn, interfere with cognitive function. Therefore, the current research was conducted with the purpose of determining the effectiveness of Acceptance and Commitment Therapy (ACT) in reducing moral distress and enhancing cognitive fusion in the nurses working at Imam Khomeini Hospital, Ilam.

The present study is a quasi-experimental research with a pre-test and post-test design and a comparison group. The statistical sample consisted of 40 nurses working at Imam Khomeini Hospital, Ilam in 2022, who were randomly assigned into intervention and comparison groups. Data collection was performed using the Moral Distress Scale Corley & et al (2001) and the Cognitive Fusion Questionnaire Gillanders & et al (2010). Eight 90-minute acceptance and commitment therapy training sessions were held weekly; however, the comparison group did not receive any intervention. The data were analyzed by SPSS 27 software using descriptive (frequency, percentage mean, standard deviation) and inferential (Chisquare, Independent T-test, Analysis of covariance) statistical tests. Ethical Considerations: The principles of research ethics were observed: explaining the research objectives to the participants, obtaining informed consent, maintaining privacy, data confidentiality, and providing the participants with the right to withdraw from the study at any stage of implementation.

The findings of MANCOVA indicated that Acceptance and Commitment Treatment has a significant effect on reducing moral distress and enhancing cognitive fusion in the nurses belonging to the intervention group compared to the comparison group in the post-test phase. (P<0.05).

Based on the findings of the present research, eight weeks’ acceptance and commitment group therapy turned out to be effective in reducing moral distress and enhancing cognitive fusion in nurses.