Clinical and cost‐effectiveness of nurse‐led cognitive behavioral group therapy for recovery of self‐esteem among individuals with mental disorders: A single‐group pre‐post study. Issue 1 (23rd August 2020)

• Record Type: Journal Article
• Authors: Kunikata, Hiroko; Yoshinaga, Naoki; Yoshimura, Kensuke; Furushima, Daisuke
• Is Part Of: Japan journal of nursing science. Volume 18:Issue 1(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-08-23
• Subjects: cognitive behavioral therapy -- costs and cost analysis -- mental disorders -- nurse; Nursing -- Periodicals; Nursing -- East Asia -- Periodicals; 610.73
• DOI: 10.1111/jjns.12371
• Languages: English
• ISSNs: 1742-7932

Abstract

Abstract: Aim: To investigate whether the addition of a nurse‐led cognitive behavioral group therapy for recovery of self‐esteem (CBGTRS) program to usual care for individuals with mental disorders can improve clinical outcomes and reduce direct medical costs. Methods: This study employed single‐group pre‐post design, and recruited 51 community‐dwelling individuals with mental disorders. Participants received 12 weekly CBGTRS sessions by a nurse in addition to usual care. The primary outcome measure was the level of self‐esteem, with other clinical outcomes and direct medical costs. The clinical outcomes were measured at pre‐intervention (T0), intervention midpoint (T1), immediate post‐intervention (T2), and 3 months post‐intervention (T3). Direct medical costs were calculated for 3 months pre‐intervention (A0), 3 months post‐intervention (A1), between 4–6 months post‐intervention (A2), and between 7–9 months post‐intervention (A3). Results: Self‐esteem scores were significantly improved from T0 to T2 and T3 ( p = .009 and .006, respectively); within‐group effect sizes were .49 (small) for T0‐T2, and .51 (medium) for T0‐T3. Other secondary clinical outcomes for mood, cognitive bias, global functioning, and quality of life were also improved by T3 (all p < .05). The mean total direct medical costs were significantly reduced from A0 (49, 569.51 JPY) to A2 and A3 (21, 845.76 JPY and 25, 981.69 JPY, respectively) ( p = .003 and .017, respectively). Conclusions: The results suggest that nurse‐led CBGTRS for mental disorders is a potentially effective approach in improving self‐esteem and other clinical outcomes, and in reducing direct medical costs. Further controlled studies that address the limitations of this study are required.