A transactional analysis training program on cognitive flexibility and emotion regulation in undergraduate nursing students: an experimental study.

Background: One factor influencing mental health is cognitive flexibility and emotion regulation. Employing adaptive strategies positively impacts the development of appropriate responses to emotional situations. Nursing students, particularly during initial patient and family interactions, may experience high stress and anxiety, often accompanied by reduced cognitive flexibility and emotion regulation. Therefore, incorporating strategies to enhance these skills, such as transactional analysis (TA) training, into nursing curricula is essential. TA is one of the theories that has provided practical solutions in the field of interpersonal relationships, increasing self-concept, and adapting to existing conditions in the field of interpersonal issues. This study aimed to evaluate the effect of TA training on cognitive flexibility and emotion regulation in nursing students.

Methods: This experimental study was conducted with a pre-test and post-test design with intervention and control groups among employed 80 sixth-semester nursing students from Razi School of Nursing and Midwifery affiliated with Kerman University of Medical Sciencesin southeastern Iran. The participants were included in the study via a census method and were randomly assigned to either an intervention group (n = 40) or a control group (n = 40). The intervention group received four weeks of TA training, consisting of two 90-minute sessions per week. The control group received no intervention during this period. Both groups completed the Cognitive Flexibility Inventory and the Affective Style Questionnaire before and one month after the intervention.

Results: Results indicated no significant difference in pre-test cognitive flexibility scores between the intervention (100.4 ± 17.38) and control groups (102.07 ± 15.53; p = 0.065). However, post-test scores revealed a significant increase in cognitive flexibility in the intervention group (113.72 ± 10.73) compared to the control group (61 ± 16.85/101; p = 0.001). Additionally, the intervention group exhibited a significant increase in post-test emotion regulation score (67.85 ± 7.42) compared to pre-test scores (64.58 ± 10.55; p = 0.003). However, no significant difference in post-test emotion regulation scores was observed between the intervention and control groups (65.6 ± 10.64; p = 0.27).

Conclusion: The results of this study demonstrated the efficacy of TA programs in enhancing cognitive flexibility and emotion regulation among nursing students. It is recommended that this intervention be implemented in medical education, particularly for nursing students who frequently interact with patients and may experience increased stress, anxiety, and reduced cognitive flexibility and emotion regulation during initial patient encounters. TA as an educational method, can enhance self-awareness, interpersonal relationship, and emotional regulation among nursing and nursing students in clinical setting. It can also It can be used to improve the quality of professional interactions and clinical practice of nursing students, finally enhancing the quality of nursing care.