This study aimed to investigate the effect of psychoeducation on rumination and cognitive flexibility in elderly individuals residing in nursing homes. Cognitive Behavioral Therapy (CBT)-based psychoeducation has recently been applied to multiple specific groups around the world and in our country. In general, executive functioning skills and, more specifically, cognitive flexibility appear to be important for the ability to use certain CBT techniques; however, considering that these skills naturally decline with age, further research is needed. It is anticipated that the results of this study will contribute to applications in the field of psychiatric nursing.
Be 65 years of age or older,
Be willing to participate in the study,
Not have hearing or vision problems that would prevent understanding the training to be provided,
Have communication and comprehension skills,
Having any hearing or vision problems.
Having physical, neurological, or psychological health problems that could disrupt group harmony and integrity.
Having an illness or problem that could prevent them from responding to the measurement tools used in the study.
Having a Standardized Mini Mental Test score below 25.
Parallel
Cognitive Behavioral Approach-Based Psychoeducation Program
BehavioralIntervention Group: Cognitive Behavioral Approach-Based Psychoeducation Program Participants will receive a cognitive-behavioral psychoeducation program designed to improve cognitive flexibility and reduce rumination. The sessions include structured activities, discussions, and exercises based on cognitive-behavioral principles. Pre-test assessments will be conducted before group allocation. Control Group: No intervention will be provided during the study period. Participants will complete pre-test assessments administered by an independent evaluator. After the study concludes, control group participants will be offered the opportunity to participate in the psychoeducation program if they wish.
Cognitive Flexibility Inventory
The inventory was adapted into Turkish. The five-point Likert-type inventory consists of two subscales, "alternatives" and "control," and 20 items. The "alternatives" subscale consists of statements regarding the possibility of finding alternative solutions to difficult situations or alternative explanations for life circumstances and human behavior. The "control" subscale consists of statements about the controllability of difficult situations. The lowest possible score on the inventory is 20, and the highest possible score is 100. Items 2, 4, 7, 9, 11, and 17 of the scale are reverse-coded. High scores on the inventory indicate high cognitive flexibility. In the Turkish version of the inventory, the Cronbach's alfa coefficient (Cronbach's alpha) was calculated as .90 for the entire inventory, .90 for the alternatives subscale, and .84 for the control subscale.
Self-Critical Rumination Scale
The scale was adapted into Turkish. The scale is a unidimensional scale with a 4-point Likert scale (1 = Never, 2 = Somewhat, 3 = Mostly, 4 = Completely). The scale's fit indices were found to be chi-square/degrees of freedom (x²/df) = 3, Root Mean Square Error of Approximation (RMSEA) = .08, Tucker-Lewis Index (TLI) = .93, Comparative Fit Index (CFI) = .94, and Standardized Root Mean Square Residual (SRMR) = .04. In criterion-related validity, the correlation between the Ruminative Responses Scale short form (RRS) and the RRS was found to be r = .73, with the obsessive thinking subscale r = .73 and the deep thinking subscale r = .68. The internal consistency coefficient of the scale was Cronbach's alfa coefficient (Cronbach's alpha) = .89, and the test-retest reliability coefficient, measured five weeks apart, was .83.
Standardized Mini Mental Test (SMMT)
A standardized version of the test was created, taking into account sociocultural differences in our country. This test consists of five subcategories-orientation, memory, attention and calculation, recall, and language-and 11 items. It is scored out of a total of 30 points, with each correct answer earning one point. The lowest possible score is 0, and the highest possible score is 30. A score between 0 and 12 indicates severe cognitive impairment, a score between 13 and 22 indicates moderate cognitive impairment, a score between 23 and 24 indicates early-stage cognitive impairment, and a score between 25 and 30 indicates no cognitive impairment.
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