Comparing the Effectiveness of Lifestyle Education and Mindfulness-Based Stress Reduction on Self-Blame and Feelings of Shame in Female Students with Kidney and Urinary Tract Infections
Keywords:
lifestyle education, mindfulness-based stress reduction, self-blame, shame, urinary tract infection, female studentsAbstract
This study aimed to compare the effectiveness of lifestyle education and mindfulness-based stress reduction (MBSR) in reducing self-blame and feelings of shame among female students with kidney and urinary tract infections. This quasi-experimental study employed a pretest–posttest–follow-up design with two active intervention groups and one control group during the 2023–2024 academic year. The study population comprised female elementary school students aged 6–11 years in Sarpol-e Zahab, Kermanshah Province, Iran. Using multistage cluster sampling, 45 students with positive urine cultures were selected and allocated to lifestyle education, MBSR, and control groups, with 15 participants in each group. Both interventions consisted of eight group sessions. Self-blame was assessed using the Levels of Self-Criticism Scale, while shame was evaluated using the shame-related components of the Guilt and Shame Proneness Scale. Data were analyzed in SPSS version 26 using multivariate analysis of covariance, mixed repeated-measures analysis of variance, and Bonferroni-adjusted pairwise comparisons. After controlling for baseline scores, the overall multivariate group effect on the combined outcomes of self-blame and shame was significant (Wilks’ λ=0.384, F(4,78)=11.98, p<0.001). For self-blame, significant effects were found for time (F(1.74,73.18)=78.39, p<0.001, ηp²=0.651), time × group interaction (F(3.48,73.18)=13.74, p<0.001, ηp²=0.395), and between-group differences (F(2,42)=6.61, p=0.003, ηp²=0.239). For shame, the effects of time (F(2,84)=73.98, p<0.001, ηp²=0.638), time × group interaction (F(4,84)=14.21, p<0.001, ηp²=0.404), and group (F(2,42)=10.06, p<0.001, ηp²=0.324) were also significant. Bonferroni comparisons indicated that both active interventions produced significant reductions in self-blame and shame at posttest and follow-up compared with the control group, whereas no significant differences emerged between the two active interventions. Lifestyle education and MBSR appear to be effective and relatively durable interventions for reducing self-blame and shame among female students with kidney and urinary tract infections, with no statistically significant evidence supporting the superiority of either intervention.
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