The effect of gross' process model of emotion regulation integrated in musical rhythm interventions on student nurses' anger expressions and states

Introduction: Nursing students' anger regulation functionally has increasingly gained importance. It is known that cognitive behavioral approaches and music can be used as effective tools for young adults. It is important that the rhythm component of music be integrated with the Gross Model of Emotion Regulation, which analyzes the emotional regulation processes on a cognitive-behavioral basis, and new interventional tools be developed, which can be regularly and easily accessed in psychiatric nursing. The study results will shed light on future studies in terms of using the Gross Model, integrated in musical rhythm studies, to manage functional anger in student nurses. Aim: The study aims to determine the effect of the anger management program to be implemented by integrating the rhythm component of music with the Gross Model of Emotion Regulation on the anger expression and anger types of nursing students determined to be under risk through screenings. Materials and Methods: This single-blind randomized experimental research was conducted with three control groups. The study group consisted of third-grade students (N=67) who were enrolled in Ege University Faculty of Nursing and determined to have scores above average from The State-Trait Anger Expression Inventory (STAXI). The study data were collected from 38 students who met the inclusion criteria. They were collected with pre-post tests and follow-up measurements using STAXI and introductory information form developed in light of the literature. The Gross Model of Emotion Regulation intervention program, integrated with musical rhythms, was completed in five sessions after pilot study. The sessions in the musical rhythms were carried out in company with a specialist. The data were analyzed using one-way and two-way variance analyses (4x3 Factorial ANOVA). The statistical significance level was measured with p˂0.05, and effect size was measured with ε2. Ethical permissions were obtained to conduct the study. Results: Considering the effect of different intervention applications at different time periods on the STAXI scores, there were differences between groups in terms of Trait Anger (F(6-68): 22,639, p<0.05), Anger Control (F(6-68): 9,024, p˂0.05), Anger-Out (F(6-68): 15,865, p˂0.05) and Anger-In (F(6-68): 10,888, p˂0.05). The developed intervention program caused positive and effective changes in all dimensions of the anger. In further examinations, the changes were positive in the Trait Anger, Anger Control, and Anger-Out dimensions of the intervention group and in the Anger-In dimension of the cognitive behavioral control group where no rhythm was applied (p<0.05). The impact of the research was determined as strong and very strong in the group-time interaction. Conclusion: The interventions through the Gross Model of Emotion Regulation integrated with the rhythm component of music reduced the students' tendency to experience anger and inappropriate expression of anger more effectively than other methods. This tool has become the most effective intervention that has developed the anger management skills. Although the integrated interventions positively have reduced the Anger-In tendency, their impact has fallen behind the behavioral and cognitive interventions. Consequently, the results show that The Gross Model of Emotion Regulation interventions, integrated with musical rhythms can be effectively used in all dimensions of anger in the short and long term. This intervention tool proved to have a stronger effect than other similar intervention examples which is more preferable in terms of emotion intensity, control, and expression. The researchers and practitioners who aim to ensure the management of functional anger can design interventions that will ensure Gross Model based behavioral and cognitive reorganization, and develop rhythm applications that will ensure physical discharge.