This clinical trial will evaluate the effectivness of an Eastern Principles Acceptance and Commitment Therapy intervention (EPACT) relative to an estabished traditional Western-based Acceptance and Commitment Therapy intervention (ACT) and a no treatment control group. The participants for the study will be nurses and nursing aides (NNAs) who work in long-term care settings in the USA and Thailand. The primary dependent variables are work-related injuries, work stress and burnout, wellbeing, musculoskeletal symptoms, time off from work due to injury. High frequency heart rate variability will also be investigated as a predictor of responsiveness to the interventions. The study has three primary aims: 1. To compare the EPACT NNA intervention to an established traditional Western ACT NNA intervention and a no-treatment control group. 2. To identify predictors of ACT NNA and EPACT NNA responsiveness to the interventions and injury likelihood across time. 3. To assess EPACT NNA's feasibility and effectiveness across cultures. USA participants working in Ohio will be randomly assigned to one of three groups: EPACT NNA (n = 80), ACT NNA (n = 80), or a no treatment control group (n = 80). All participants will participate in an assessment session where study questnnaires are completed and a baseline high frequency HRV measurement is collected. Subsequent to the assessment, the EPACT NNA and ACT NNA participants will attend two 2.5 hour sessions spaced one week apart. The control group will have no further in-person meetings with the researchers. One-month after completing the intervention (4 weeks after the baseline assessment) a follow-up survey will be sent to participants for the first follow-up. Three months after baseline, the second follow-up survey will be sent to participants. The surveys assess demographic characteristics, organizational variables, work-related injuries, work stress, and well-being. A second RCT study will be conducted in Thailand comparing EPACT NNA (n = 40) to a no-treatment control group (n = 40) among nurses and nursing aides working in healthcare settings. The same outcome measures and procedures will be used. This research aims to develop a culturally-informed, evidence-based intervention that integrates both Western and Eastern mindfulness principles to address the high rates of work-related injuries among NNAs.
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Organizational and Work Characteristics Associated with Injury
Timeframe: Measured at baseline (pretreatment), 1 month, and 3 months
Exposure to Violence
Timeframe: Measured at baseline (pretreatment), 1 month, and 3 months
Work-related Injuries and Days Missed Due to Injury
Timeframe: Measured at baseline, 1 month, and 3 months
Musculoskeletal Symptoms
Timeframe: Measured at baseline (pretreatment), 1 month, and 3 months
Burnout
Timeframe: Measured at baseline (pretreatment), 1 month, and 3 months
Acceptance, present-moment awareness, self-as-context, defusion, values, and committed action
Timeframe: Measured at baseline (pretreatment), 1 month, and 3 months
Self-compassion and other compassion
Timeframe: Measured at baseline (pretreatment), 1 month, and 3 months
Ubiquity of suffering, impermanence, common humanity, nonattachment to self.
Timeframe: Measured at baseline (pretreatment), 1 month, and 3 months
High Frequency Heart Rate Variability (HF-HRV)
Timeframe: Measured at baseline (pretreatment), 1 month, and 3 months