{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:38:29Z","timestamp":1753879109168,"version":"3.41.2"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,8,23]],"date-time":"2020-08-23T00:00:00Z","timestamp":1598140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Japan Journal Nursing Sci"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate whether the addition of a nurse\u2010led cognitive behavioral group therapy for recovery of self\u2010esteem (CBGTRS) program to usual care for individuals with mental disorders can improve clinical outcomes and reduce direct medical costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study employed single\u2010group pre\u2010post design, and recruited 51 community\u2010dwelling 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\u2010esteem, with other clinical outcomes and direct medical costs. The clinical outcomes were measured at pre\u2010intervention (T0), intervention midpoint (T1), immediate post\u2010intervention (T2), and 3\u2009months post\u2010intervention (T3). Direct medical costs were calculated for 3\u2009months pre\u2010intervention (A0), 3\u2009months post\u2010intervention (A1), between 4\u20136 months post\u2010intervention (A2), and between 7\u20139 months post\u2010intervention (A3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Self\u2010esteem scores were significantly improved from T0 to T2 and T3 (<jats:italic>p<\/jats:italic> = .009 and .006, respectively); within\u2010group effect sizes were .49 (small) for T0\u2010T2, and .51 (medium) for T0\u2010T3. Other secondary clinical outcomes for mood, cognitive bias, global functioning, and quality of life were also improved by T3 (all <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). 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) (<jats:italic>p<\/jats:italic> = .003 and .017, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results suggest that nurse\u2010led CBGTRS for mental disorders is a potentially effective approach in improving self\u2010esteem and other clinical outcomes, and in reducing direct medical costs. Further controlled studies that address the limitations of this study are required.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jjns.12371","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T04:09:22Z","timestamp":1598242162000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical and cost\u2010effectiveness of nurse\u2010led cognitive behavioral group therapy for recovery of self\u2010esteem among individuals with mental disorders: A single\u2010group pre\u2010post study"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3806-1285","authenticated-orcid":false,"given":"Hiroko","family":"Kunikata","sequence":"first","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences Kagawa Prefectural University of Health Sciences  Takamatsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4438-9746","authenticated-orcid":false,"given":"Naoki","family":"Yoshinaga","sequence":"additional","affiliation":[{"name":"School of Nursing, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kensuke","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Center for Next Generation of Community Health Chiba University Hospital  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Furushima","sequence":"additional","affiliation":[{"name":"Department of Drug Evaluation and Informatics Graduate School of Pharmaceutical Sciences, University of Shizuoka  Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,23]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_9_2_1","DOI":"10.3390\/brainsci9010012"},{"volume-title":"Quick reference to the diagnostic criteria from DSM\u2010iv\u2010TR","year":"2000","author":"American Psychiatric Association","key":"e_1_2_9_3_1"},{"key":"e_1_2_9_4_1","first-page":"102","article-title":"Evaluation of an integrated intensive cognitive behavioral therapy treatment within addiction care","volume":"17","author":"Bador K.","year":"2019","journal-title":"The Journal of Behavioral Health Services & Research"},{"volume-title":"The psychology of self\u2010esteem","year":"1969","author":"Branden N.","key":"e_1_2_9_5_1"},{"doi-asserted-by":"publisher","key":"e_1_2_9_6_1","DOI":"10.1176\/appi.ps.52.5.631"},{"volume-title":"Statistical power analysis for the behavioral sciences","year":"1988","author":"Cohen J.","key":"e_1_2_9_7_1"},{"doi-asserted-by":"publisher","key":"e_1_2_9_8_1","DOI":"10.1037\/h0099565"},{"volume-title":"Overcoming low self\u2010esteem self\u2010help course","year":"2006","author":"Fennell M. 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