The Development of a Cognitive Flexibility and Inhibition Control Recovery Program on Coping in Patients with Stress at Koh Chan Hospital, Chonburi Province

Abstract

Stress is a significant mental health problem that adversely affects quality of life, particularly in Koh Chan District, Chonburi Province, where the prevalence of stress-related conditions is continuously rising. This research and development study aimed to: 1) examine the situation of patients with stress-related conditions at Koh Chan Hospital, Chonburi Province; 2) develop a rehabilitation program integrating cognitive flexibility and behavioral inhibition for problem coping; and 3) evaluate the effectiveness of the developed program among patients experiencing stress. The study was conducted in a three-phase research and development (R&D) design. Phase I examined the stress situation among working-age individuals (25–59 years) using questionnaires and in-depth interviews. Phase II involved developing a rehabilitation program by integrating cognitive rehabilitation and self-regulation concepts with local healthcare personnel. Phase III implemented and tested the program over six weeks with 30 patients diagnosed with stress. Instruments included: 1) the cognitive flexibility and behavioral inhibition program, 2) the Suanprung Stress Test-20 (SPST-20), 3) the Resilience Quotient (RQ), and 4) a cognitive flexibility assessment. Data were analyzed using descriptive statistics, paired t-tests, and content analysis.

Results: Phase I, most participants were female (mean age = 38 ± 9.67 years), with high levels of stress (Mean = 52.04, S.D. = 14.02) and low resilience (Mean = 51.89, S.D. = 11.99). Phase II developed an eight-component rehabilitation program to enhance problem-solving skills. Phase III showed significant reductions in stress (Mean = 40.57, S.D. = 9.29) and improvements in resilience, cognitive flexibility, and behavioral inhibition (Mean = 53.60, 73.13, 39.87, respectively; p < .001), affirming the program’s effectiveness and its potential for broader application within community mental health services.