The effect of group bibliotherapy on the self-esteem of female students living in dormitory.

INTRODUCTION: Bibliotherapy is a supplement, simple, inexpensive and readily available method to treat the diseases that is performed with cooperation of librarians and psychologists or doctors. The aim of this study is the investigation of group bibliotherapy's effect on the self-esteem of the female students of Isfahan University of Medical Sciences Living in Dormitory in 2012.
MATERIALS AND METHODS: The present study is an interventional semi-experimental study with pre test and post test and control group. The statistical population of study consisted of 32 female students who reside in Isfahan University of Medical Sciences dormitories which control and case groups and the students were divided randomly between these two groups. Data was collected by Cooper Smith Self-esteem questionnaire scale (Cronbach's alpha: 0.85). Two groups were examined by the questionnaire in pre test. Case group received group bibliotherapy for 2 month (8 sessions of 2 hours), while the control group received no training at all. Then, 2 groups were assessed in post test after 1 month. Descriptive statistics (means and frequencies distribution) and inferential statistics (independent t- test, paired t- test and mann whitney) were used and data was analyzed by SPSS20 software.
RESULTS: The findings showed that group bibliotherapy had positive and significant effect on general, family, professional and total self esteem of female students living in dormitories, but it had no effect on their social self esteem.
CONCLUSION: Group bibliotherapy can increase female students' self-esteem levels. On the other hand, conducting these studies not only can improve mental health of people, but can also improve their reading habits.

RCT Entities:   Population Interventions Outcomes

INTRODUCTION

Since technological advancements and its effects on the human's health and his life quality, dealing with health and positive and negative effecting factors can help to partial uncertainties and complexities related to pathology, life style, mental, physical, social health promotion as well as recognition of threatening factors for psychological health in this era. Mental health issues are one the most important thing in students which influence in their education advancements,[1] Self-esteem is a mental issue for the students and one the most important factor in progress and education advancements.[2] The studies have shown that the students who have higher self-esteem are succeeding in their study and educations. They communicate better with others, have more participation in academic and non-academic communities and utilize more social and emotional adjustment.[3] The people who have low self-esteem damage themselves by inferiority complex and their constant and negative self-criticism are one of the usual ways for them. These people may encounter with emotions like sadness, anxiety, feeling shame and guilt, humility, disappointment and anger and may experience chronic courage less and disappointed in their life. Finally, low self-esteem may result in depression and suicide.[4] One of the theoretical patterns which justify the reasons for relinquish from study is a failure pattern of self-esteem and It is assumed that the failure in a university can decrease the student's self-esteem and vice versa.[5] There are several ways to increase the people's self-esteem, including Psychotherapy, referring to the counseling center and bibliotherapy.

Self-esteem is a preliminary human need. The successful life requires high self-esteem. Individual Decision-making power depend upon his/her self-esteem level; so it is very important and vital in humans life. People regardless of age, gender, cultural background and their profession, they need self-esteem because it affects all levels of life.[6] Self-esteem is a state which the person assumes himself as a competent person and face with life challenges such a successful way and he feels that life has worth to live more happily. According to Cooper Smith, self-esteem is self-evaluation and/or self-judgment about his/her values. There is an interaction between the person's self-esteem and ability to understand his abilities, in such a way that decreasing self-esteem causes weakness and inability, while increasing self-esteem can revive the feeling of power and valuable in the person.[7] Self-esteem is a source for struggling with stress effects and motivate for suicide.[8]

The studies have shown that the girls have low self-esteem.[910] One of the most important reasons in girl's low self-esteem results from the society and family attitude toward female (against males). In a traditional family, the girls never have equal opportunity for studying, profession and learning experience in compared with the boys and there have been more control upon them. In the past, the parents sent their sons to the masters for learning science at their childhood or if they had profession or experience, they learned know-how of it. At that time, the girls were limited to the house work and after entering those girls to the society, they couldn’t encounter with issues maturely and competently like boys. Although these customs fades as the time goes by, it has not eradicated. Entering the university is an important milestone in the each person's life. Today, however, girls more than boys enter the Iranian universities,[11] but still there are parents who are disagree with educate their daughters in other cities. Owing to the fact that the most girl students are resided in dormitories, they suddenly encounter with a new environment and have not their family support anymore. Staying away from family, independent living experience and related issues cause them to endure stress and heavy pressures and these factors may decrease their self-esteem. As mentioned before, there are many treatment methods to increase self-esteem which bibliotherapy is one of those ways.

Bibliotherapy is a method which is used for treatment by information specialists and with cooperation of psychologists and physicians. In this method, selected readings are used for clients and proposed to them in order to help them during treatment. These resources are offered to individuals and help them to resolve issues related to their health needs to gain new insights. By this, Bibliotherapy will effect on people's attitudes and change their behaviors. This method depends on librarians, because they are more able than others to recommend the most readable topics based of their experiences and profession. Meanwhile, Bibliotherapy should not only be regarded as an independent approach, but also a help and supplement method.[12] Biblotherapy's total aim is the individual and group guidance which includes personality development, emotional maturity and changing philosophy of life, and based on his awareness of internal dynamic process.[13] Bibliotherapy, as a therapy supplement is applied in medicine and clinical psychology to help people with emotional and mental problems and personal problems through targeted study.[14]

There have been conducted many studies about the effect of Bibliotherapy on illnesses and the result have showed that Bibliotherapy has positive influence on illnesses like depression, anxiety and the children aggressive. Below some of these studies are mentioned. According to Balouch Zera’atkar, Biblitherapy has effect on female students living in a dormitory. In other words, using this method reduces sadness, the feeling of failure, dissatisfaction, guilt feeling, self-dissatisfaction, self-blame, energy level and pessimism. This study has also showed that not only Bibliotherapy can improve the reading habits, but also with promotion of the society mental health, facilitates the achieving of mental health goal.[15] According to Jokar, Baghban and Ahmadi showed that cognitive consultation and Bibliotherapy individually has effect on depression symptoms reduction.[16] Also, Mazaheri, Baghban and Fatehizadeh made a conclusion that behavior methods and cognitive behavioral with group approach increase the student's self-esteem which living in dormitory and cognitive-behavioral training had more effective influence than behavioral training.[17] Saheb-alzamani and his colleagues showed that there are meaningful statistical differences between self-esteem mean scores and the firmness of female high school student's researchable units before and after training. Paired T Test shows that the Self-esteem and the firmness rate increased in both before and after training.[18]

Karacan and Yerin Guneri conducted the research “The effect of self-esteem enrichment bibliocounseling program on the self-esteem of sixth grade students”. The findings showed that there has been important increase in the case group self-esteem.[19] According to Muto, Hayes and Jefcoat, the students who receive acceptance and commitment therapy (ACP) and the self-help book in Japanese translation, utilize more mental health than others. These patterns repeated right after waiting list group received the mentioned books. The findings totally showed that ACP Bibliotherapy has improved the international Japanese student's flexibility and mental health.[20]

The studies conducted in Iran which were about the measurement of Bibliotherapy on illnesses, were based upon cases like depression, anxiety and children's aggression and there have not been conducted any study about the influence of Bibliotherapy on self-esteem yet and it is clear that the mentioned study is necessary to do. Hence, the aim of this study is to survey the effect of Group Bibliotherapy on the self-esteem of female students of Isfahan University of Medical Sciences living in dormitory in 2012. It is clear that the results can effect on the female students self-esteem and improve their mental health.

MATERIALS AND METHODS

The present study is an interventional semi-experimental study with pre test and post test and control group. Study population includes the female students of Isfahan University of Medical Sciences who were keen to participate in the study. The requisite condition for quitting the study was obtaining 4 out of 8 by a lie detector. According to the formula n = (Z1 + Z2)2 (2S2) / d2, at least 32 female students living in dormitory of Isfahan University of Medical Sciences in 2011-2012 were determined in both Case group and Control group. Firstly, a call was made for participating in the study and attending Bibliotherapy course in Isfahan University of Medical Sciences dormitories, then 200 enrolled students were selected by simple random sampling. The students were arranged based on the obtained test scores from low to high Sort by Cooper Smith and 64 people who obtained the lowest scores were placed in Case and Control groups. To unify the two groups, the arranged people were sorted into odd and even numbers.

Data was collected by Cooper Smith Self-esteem Inventory.[21] This inventory includes 58 questions which 8 of them are about Control questions. In total, the 50 provisions have divided into 4 subscales of General self-esteem, Social self-esteem (peers), Family self-esteem (parents) and Education self-esteem (job). The grading system was based on one-zero method. The minimum obtained scores may be zero and the maximum is 50. Seifi Gandomany quoted Zolfaghari that the inventory's validity equals 84% and the reliability of the inventory in which is based on the female students, are reported 85% through Cronbach's alpha method.[22]

To performing the study, firstly the inventory was completed by Case and Control groups. Next, a justification meeting was held for both groups and a book donated to them. Control group book was (Stop: Be serious about passing time wrote by Raheleh Samoei: the book is about Time Management) and Case group book was (Seven Day self-esteem wrote by Jenny Alexander: the book is about self-esteem). Then, 8 sessions of 2 hours about Bibliotherapy were held within 2 months for Case group according the programas. The way of boosting self-esteem was trained thorough group reading, question and answer and brainstorming to the Case group in the 8 sessions. After 2 training months and 1 month latency (totally 3 months from starting Bibliotherapy session) to study the Bibliotherapy effecting process, the inventory was completed and measured again by both groups.

RESULTS

In this study, the 32 female students who living in Isfahan University of Medical Sciences dormitories Kermani 1, Kermani 2, Milad and Seyyedol shohada, were placed in Case group and the other 32 students in Control group. 4 peoples from Case group refused to continue the study. 50% of Case group and 37.5% of Control group in Bachelor's degree, 50% of Case group and 46.9% of control group in Master's degree and 15.6% of Control group in Professional Doctorate were studying. Mann Whitney showed that the both groups hadn’t any meaningful differences with each other (P = 0.13).

The Table 1 shows the mean and the standard deviation of total self-esteem score in both groups before and after Bibliotherapy intervention process. As we can see, the mean score of total self-esteem had no meaningful difference between 2 groups before the invention (P = 0.53), but this score in Case group had a meaningful difference which was more than Control group (P = 0.005). Also, there was not any meaningful difference between total self-esteem score of Control group before and after the intervention (P = 0.08), while total self-esteem score of Case group after the intervention had meaningful progress than before it (P = 0.001) [Figure 1].

Table 1

The mean and standard deviation of total self-esteem scores before and after intervention (bibliotherapy) in control and case group

Figure 1

General self-esteem score in both control and casegroup

Table 2 shows the self-esteem mean score in 4 dimensins of General, Family, Social and Job. As can be seen, General self-esteem mean score has not meaningful differences between both groups before the intervention (P = 0.28), but the score in Case group had a meaningful progress after the intervention than control group (P < 0.05). General self-esteem mean score had not meaningful difference before and after the intervention in Control group (P = 0.06), while general self-esteem mean score of Case group had a meaningful progress after the intervention (P = 0.001).

Table 2

The mean and standard deviation of 4 dimension of self-esteem score before and after the intervention (bibliotherapy) in both control and case groups

According to the Table 2, the Family self-esteem mean score had no meaningful difference in both groups before the intervention (P = 0.37), but the score in Case group was more than Control group after the intervention (P < 0.05). The Family self-esteem mean score had no meaningful difference in Control group before and after the intervention (P = 0.18), while in the Case group, the Family self-esteem mean score after the intervention was more than the score before it (P < 0.005).

Table 2 shows that the social self-esteem mean score had not meaningful differences between two groups before the intervention (P = 0.75) and the score had no change after the intervention (P = 0.26). Social self-esteem mean score had no difference before and after the intervention in Control group (P = 0.73) and the condition in Case group was similar to the other group (P = 0.1).

According to the Table 2, the Job self-esteem mean score had no meaningful difference in both groups before the intervention (P = 0.8), but the score in Case group was more than Control group after the intervention (P = 0.05). The job self-esteem mean score had no meaningful difference in Control group before and after the intervention (P = 0.12), while in the Case group, the Job self-esteem mean score after the intervention was more than the score before it (P = 0.004).

DISCUSSION

The results of this study showed that the self-esteem mean score was similar in both groups before the Group Bibliotherapy intervention, but there was a meaningful difference between two groups after Group Bibliotherapy. These findings were consistent with Baghban and Fatehizade,[17] Moradi Shahre babak, Ghanbari Hashem abadi and Agha mohammadian Sherbaf,[23] Tourkashvand, Kermanshahi and Azad Fallah,[24] Ranjbar Kohan and Sajjadi nezhad,[25] Seyfi Gandomani, Shaghaghi and Kalantari Meybodi,[22] Moemeni Mahmoei, Teymoori and Rahman pour,[26] Forghani Toroghy and his colleagues,[27] Moradi and Rezaee Dehnavi,[28] Tabatabaee and Hosseinian,[29] Haghighi and his colleagues,[30] Saheb alzamani and his colleagues,[18] Jalali and Nazari,[31] Karakan and Yerin Gunery,[19] Lin and his colleagues,[32] Zhou and his colleagues[33] which they had proved that the different training ways would improve self-esteem and decrease other mental and psychological problems. But Dokanei-Fard's study[34] is non-aligned which report that the training has no effect on the students’ self-esteem.

The present study also showed that the group who received Bibliotherapy had meaningful difference in self-esteem in comparison with Control group. In other words, the Bibliotherapy effects on the participants’ self-esteem. This finding was consistent with Balouch Zera’at kar,[15] Jokar, Baghban and Ahmadi,[16] Riahinia,[35] Parirokh and Naseri,[36] Nokarizi and Alam zade,[37] Navvabi nezhad and Riahinia,[38] Banki, Amiri and As’adi,[39] Buwalda,[40] Nordin,[41] Karacan and Yerin Gunery,[19] Moto,[20] Jernelov[42] which they proved that the Bibliotherapy have effect on improving psychological problems.

In this study, self-esteem was calculated in 4 dimensions (General, Social, Family, and Job) and Total self-esteem, ultimately. But in other studies, the Total dimension was regarded and just Letafati Beris and Younesi[4] have dealt with all dimensions and the results have showed that the Cognitive-Behavior counseling will have effect on all 4 self-esteem dimensions. The present study findings (all dimensions except Social) are consistent with Letafati Beris and Younesi's[4] study but it is non-align with Social self-esteem.

CONCLUSION

Self-esteem regarded as an important index for mental health and its reduction can risk the mental health. This factor has an important role in people daily life, specially the students and their education performance. The present study showed that we can help the students who living in dormitories (also their special problems) to improve their self-esteem through the simple, inexpensive and available ways like Bibliotherapy.

Many people are cautious about facing with psychological problems and the way for solving them. Group Bibliotherapy sessions not only improve study habits between the students, but also proved them they are not the only people who have problems and the other surely have the similar difficulties and they are seeking for the solutions. Group partnership facilitates the people to the solving, receiving and coping with the problems.