Coping group Cognitive coping strategies and the problem-solving method were used for coping training. The methods directed to alter the situation are called problem-focused coping methods, whereas the methods directed to alter the emotional and cognitive reactions to the situation are called emotion-focused coping methods (Onbas¸ıog˘lu 2004). In this study, these two methods were integrated into the stress-coping process and were executed based on the principles of adult education. Coping training had been given within a structured education programme framework. The group that received coping training consisted of two groups, each group consisting of 18 people. In the first week, the concept of stress was explained to the nurses, and coping methods used by the nurses in stressful conditions were discussed. In the second session, basic communication skills on the stress level were discussed. In the third session, cognitive coping methods were presented theoretically. In the fourth session, cognitive distortions found among nurses and methods for coping with these distortions were discussed. In the fifth session, the problem-solving method was theoretically explained to the nurses. In the sixth session, stressful situations that the nurses encounter were discussed and resolved by means of the problem- solving method. In the seventh session, problems that the nurses had difficulty coping with were discussed by utilizing the skills learned during the course of the programme.
Support group The objectives of the social support groups are the following: to provide support, information and a sense of belonging, and to create an environment where individuals share their experiences (Kurtz 1997).In the first session,expectations have to be clarified by explaining the nature of the group. It increases the effective- ness of the groups that the group leader is prepared on possible discussion subjects and that he/she moderates the group by means of structuring the group process (Lederberg 1998). Gibbs’ reflection model was used in the support groups in this study (Gibbs 1988). The steps of reflection are the following: description: describe as a matter of fact just what happened during your critical incident or chosen episode for reflection; feelings: what were you thinking and feeling at the time?; evaluation: list points or tell the story about what was good and what was bad about the experience; analysis: what sense can you make
out of the situation? what does it mean?; conclusion: what else could you have done? what should you perhaps not have done?; action plan: if it arose again,what would you do differently? how would you adapt your practice in the light of this new under- standing? In this study, the support group consisted of three groups, each group consisting of 12 people. The nurses talked about the most frequently encountered stressors in the workplace and expressed their feelings towards their jobs. At the beginning of each session, the nurses expressed their feelings related to difficult situations at the workplace. Then, a problem chosen by the nurses was attempted to be solved by using reflective cycle steps. Researchers provided information when needed. Possible solution methods were discussed in the groups, and the nurses were advised to use these methods in their daily lives. The nurses shared their difficult and favourable times and also exchanged recommendations with each other.
The control group The control group did not receive either intervention until after the final data collection. The control group completed the forms prior to, just after and 6 months after the intervention like the intervention groups. Because no statistically significant difference among the interventions was observed following the completion of the data collection, the control group has been put through the coping training because of its ease of application.
Data collection Data were collected between March and December 2007. All three groups completed the forms prior to, just after and 6 months after the intervention. Opaque envelopes were used every time data were collected from the nurses. Nurses were requested to fill these self-report questionnaires at home.
Demographic questionnaire This questionnaire includes factors that can affect burnout, such as age, work experience, level of education and the number of night shifts.
MBI The MBI was developed originally by Maslach & Jackson (1981). It was translated into Turkish, and its reliability was recalculated by Ergin (1992). The MBI is a tool that evaluated burnout three- dimensionally, with three subscales. The scale features the following three subscales: emotional exhaustion, depersonalization and personal accomplisment. High scores in emotional exhaustion and depersonalization subscales and low scores in personal accomplishment subscale indicate high levels of burnout (Maslach & Jackson 1981). In the MBI, the scores of each sub-scale are evaluated separately. The relation between the three dimensions of burnout is not shown with an overall score.Three different scores are calculated for each individual (Ergin 1992; Maslach & Jackson 1981).