| Background With the development of evidence-based medicine, evidence-based psychotherapy also gets the attention by Psychologists. Evidence-based psychotherapy contains three parts:the best available evidence provided by researchers, the clinical expertise of practitioners, and the patient’s characteristics, cultures and preferences. As it has many advantages, the solution-focused approach is conducting related researches. As we know, some question skills of the solution-focused approach come form the experience in cases. So it is important to prove that the questions can be used in different situations. For now, the researches which are about the best available evidence of the question skills is inadequate. We should study the effectiveness of specific question skill and the difference of the effectiveness between different skills.Objective In order to provide guidance and evidence for the application of Solution-Focused Approach in various areas, this study investigated the effects of exception questions/miracle questions in Solution-Focused Approach in nursing, and compared the different influence of different questions. Besides, the difference of effectiveness between two different exception questions had been compared.Methods 136 nurses were randomly divided into four groups(exception questions group, EQG, miracle questions group, MQG, problem-focused group, PFG and brief exception questions group, BEQG). If the score of Self-Rating Depression Scale (SDS) or Self-Rating Anxiety Scale (SAS) was above 50, and the score of the willingness to participate in research and solve the problem was below 5, the participate was taken out.First, the difference of the willingness to participate in research and solve the problem between four groups were compared. Second, we compared the instant effects (the change of emotion, confidence to solve problems and the perception of problem’s difficulty, and the help form the questions) and subsequent effects (the help from the questions after a week) between EQG, MQG and PFG, and the different influence of different questions for the participant in three groups. Third, comparing the difference of the above indicators between EQG and BEQG.Results (1) The effective sample of every group were 34(EQG),31 (MQG),31 (PFG) and 31(BEQG).There was no significant difference between four groups in aspect of the willingness to participate in research(K-W χ2=2.73, P>0.05) and solve the problem(K-W χ2=2.55, P>0.05). (2)For the EQG, there were significant differences before and after the questions on the confidence to solve problem(Z=-2.72, P<0.01), affects (Z=-4.26, P<0.01) and the perception of problem’s difficulty(Z=3.35, P<0.01). For the MQG, there was significant difference before and after the questions on the affects(Z=-3.18,P<0.01). And for the PFG, there were no significant differences. Comparing these three groups, there were significant differences between the three groups of the change before and after the questions on the aspects of confidence to solve problem(K-W χ2=9.68, P<0.05)and affects (K-W χ2=9.71, P<0.05). And there were significant differences between them on the aspects of the help from the questions immediately (K-W χ2=17.66, P<0.001) and the help from the questions after a week (K-W χ2=18.58, P<0.001). Furthermore, there was significant difference on the help from the questions immediately between MQG and EQG and PFG; there was significant difference on the help form the questions a week later between EQG and the other two groups. The participants also said that the exception questions can enhance the confidence to solve problems, the miracle questions can help people with clearer goals, and the problem-focused questions can not only reduce the confidence and emotions but also make goals more clear. (3) For the BEQG, there was significant difference before and after on the affects (Z=-3.0, P<0.01) and the other difference was not significant. The results of EQG have been shown. Comparing these two groups, there were significant differences between the three groups of the change before and after the questions on the aspects of affects(M-W U=306.0, P<0.01) and the perception of problem’s difficulty(M-W U=705.5, P<0.05).There were significant differences between them on the aspects of the help from the questions immediately (M-W U =307.0, P<0.05) and the help from the questions after a week (M-W U=244.0, P<0.01). Comparing the influence of different questions on participants found that a rough version of exception questions was worse than the full version exception questions on each side.Conclusion Exception questions can enhance the confidence to solve problems and promote the emotion, and explore resources and advantages to provide methods for solving problems. Miracle questions can help people make their goals more clear. However, in order to improve the effectiveness, the miracle questions may need to work with the exception questions. |
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