Effect of a mindfulness-based stress reduction program forcaregivers of individuals with chronic mental illness oncognitive control and flexibility , psychological well-beingand self-compassion

ABSTRACT EFFECT OF A MINDFULNESS-BASED STRESS REDUCTION PROGRAM FOR CAREGIVERS OF INDIVIDUALS WITH CHRONIC MENTAL ILLNESS ON COGNITIVE CONTROL AND FLEXIBILITY , PSYCHOLOGICAL WELL-BEING AND SELF-COMPASSION Uslu Ö. Aydın Adnan Menderes University Institute of Health Sciences Mental Health and Psychiatric Nursing, Doctorate Thesis, Aydın, 2024. Objective: In this study, the effects of a Mindfulness-Based Stress Reduction program administered to primary caregivers of individuals with chronic mental illnesses registered at a community mental health center were examined in terms of cognitive control and flexibility, psychological well-being, and self-compassion. Material and Methods: The study employed a mixed methods design, combining both qualitative and quantitative research approaches, specifically utilizing an exploratory sequential design. The research was conducted with caregivers of individuals with chronic mental illnesses at the Community Mental Health Center of Fehime Faik Kocagöz State Hospital in Söke District, Aydın Province, between December 2023 and February 2025. To inform the development of the Mindfulness-Based Stress Reduction program, qualitative data were collected through face-to-face interviews with 20 primary caregivers, selected using maximum variation sampling. Content analysis was employed for the evaluation of the qualitative data, and the analysis was carried out using the MAXQDA 2020 software. The sample for the quantitative phase consisted of 60 caregivers (30 in the experimental group and 30 in the control group), selected through randomization. Data were collected using a Demographic Information Form, the Cognitive Control and Flexibility Questionnaire, the Psychological Well-Being Scale, and the Self-Compassion Scale–Short Form. In addition to descriptive statistics, the Kolmogorov-Smirnov test, Chi-square test, Mann-Whitney U test, ANOVA, Friedman test, Bonferroni test, Fisher's exact Chi-square test, and independent samples t-test were used for data analysis. Results: Based on the data obtained from interviews with caregivers during the qualitative phase of the study, four themes were identified: "sources of information about the illness," "attitudes toward the patient," "challenges experienced," and "coping behaviors". In the quantitative phase, the mean scores of cognitive control and flexibility at the post-test and three-month follow-up of the experimental group caregivers were found to be statistically significantly higher compared to those of the control group caregivers (p < 0.05). Similarly, the mean psychological well-being scores of the experimental group caregivers at both the post-test and three-month follow-up were significantly higher than those of the control group (p < 0.05). Additionally, the mean self-compassion scores of the experimental group caregivers at the post-test and three-month follow-up were statistically significantly higher than those of the control group caregivers (p < 0.05). Conclusion: This study demonstrated that the Mindfulness-Based Stress Reduction program administered to caregivers significantly enhanced their levels of cognitive control and flexibility, psychological well-being, and self-compassion. It is recommended that mental health institutions—especially community mental health centers, as well as public and private sector organizations providing mental health services—regularly implement resilience-building and psychological well-being support programs, such as mindfulness-based stress reduction, for both caregivers and patients. Keywords: Mindfulness, Caregivers, Cognitive control and flexibility, Psychological well-being, Self-compassion