Nurse-Led Intervention (Riddikulus) to Reduce Anxiety in University Students (RNI)

The Riddikulus Nursing Intervention: A Brief, Nurse-Led Intervention to Reduce Student Anxiety in a Randomized Controlled Study

This randomized controlled trial investigates the effectiveness of the Riddikulus Nursing Intervention, a brief, low-cost, nurse-led strategy designed to reduce anxiety levels in university students. The intervention uses metaphor-based reflection and creative emotional flexibility techniques in a single-session format. A total of 36 participants were randomly assigned to intervention and control groups. Anxiety levels were measured using the Visual Analog Scale (VAS) and the Beck Anxiety Inventory (BAI) before and after the intervention. The study aims to evaluate whether this innovative, easily applicable approach can significantly reduce short-term perceived anxiety in young adults.

Study Overview

• Status: Completed
• Conditions: Anxiety; Nurse-led Supportive Care; Nursing Interventions
• Intervention / Treatment: Behavioral: Ridikullus Nursing İntervention

Detailed Description

This study investigates the effectiveness of a novel, low-cost, nurse-led psychological intervention called the Riddikulus Nursing Intervention, designed to reduce anxiety levels in university students with moderate anxiety. The intervention was inspired by a metaphorical coping scene from the Harry Potter film series and structured as a single-session, creative, and non-pharmacological approach. During the intervention, participants were asked to generate personal metaphors related to their anxiety and were guided in restructuring these metaphors into less distressing, humorous, or soothing mental images. The process was facilitated by an academic mentor trained in therapeutic communication.

The study was conducted at the School of Foreign Languages of Ege University between December 2023 and June 2024. A total of 1100 students were invited, and 549 agreed to participate. Among students with moderate levels of anxiety, 36 participants were included and the study was completed with them. These participants were randomly assigned to intervention (n=17) and control (n=19) groups. Anxiety levels were assessed at three time points-pre-intervention, post-intervention, and follow-up-using the Visual Analog Scale (VAS) and the Beck Anxiety Inventory (BAI). Data analysis was performed with SPSS 25.0, and participant flow was reported using the CONSORT diagram.

The results revealed a statistically significant reduction in VAS anxiety scores within the intervention group, with a large effect size. However, no significant differences were observed in BAI scores between the groups over time. These findings suggest that the Riddikulus Intervention may be particularly effective in reducing short-term, perceived anxiety in young adults. Participants also reported subjective improvements in emotional state and metaphor transformation following the session.

This study highlights the feasibility and promise of brief, creative, nurse-led interventions for managing moderate anxiety in university settings. Further research with larger sample sizes, repeated sessions, digital delivery formats, and long-term follow-up assessments is recommended to validate and expand upon these findings.

• Study Type: Interventional
• Enrollment (Actual): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Izmir, Turkey (Türkiye), 35100
    • Ege University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Undergraduate student at the School of Foreign Languages, Ege University during the study period
• No history of repeating an academic year
• No hearing or visual impairments
• No prior psychiatric diagnosis
• Not currently undergoing psychiatric treatment or therapy
• A score between 16 and 25 on the Beck Anxiety Inventory (BAI), indicating moderate anxiety
• Voluntary participation with signed informed consent

Exclusion Criteria:

• Failure to attend the intervention session
• Withdrawal of voluntary consent at any time

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: control group; Participants in this group received no intervention. They completed the same outcome measures at the same time points as the intervention group, but did not receive any psychological or nursing-based session.
Experimental: Riddikulus Intervention Group; Participants in this group received a one-session, metaphor-based psychosocial nursing intervention. The intervention involved identifying anxiety-related personal metaphors and restructuring them into less distressing or humorous mental images under the guidance of a trained academic nurse.	Behavioral: Ridikullus Nursing İntervention; A one-session, nurse-led psychosocial intervention designed to reduce anxiety in university students. Participants identified personal metaphors related to their anxiety and were guided to reconstruct them into less distressing, humorous, or calming mental images. The intervention was delivered in a structured format by an academic nurse trained in therapeutic communication

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in anxiety level measured by Beck Anxiety Inventory (BAI)	The Beck Anxiety Inventory (BAI) was used to assess clinical anxiety symptoms. It is a 21-item self-report instrument, with higher total scores reflecting higher levels of anxiety. The Beck Anxiety Inventory (BAI) ranges from 0 to 63, with higher scores indicating greater levels of anxiety	Baseline, Immediately Post-Intervention, 4-Week Follow-Up
Change in anxiety level measured by Visual Analog Scale (VAS)	Anxiety was assessed using a 0-10 Visual Analog Scale (VAS), with higher scores indicating greater anxiety. Measurements were taken before the intervention, immediately after, and two weeks following the session. Lower scores reflect reduced levels of anxiety.	Baseline, Immediately Post-Intervention

Collaborators and Investigators

• Sponsor: Ege Miray Topcu

Study record dates

Study Major Dates

• Study Start (Actual): December 16, 2023
• Primary Completion (Actual): December 10, 2024
• Study Completion (Actual): December 29, 2024

Study Registration Dates

• First Submitted: July 4, 2025
• First Submitted That Met QC Criteria: July 4, 2025
• First Posted (Actual): July 15, 2025

Study Record Updates

• Last Update Posted (Estimated): September 23, 2025
• Last Update Submitted That Met QC Criteria: September 17, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Anxiety; brief intervention; University Students; Psychosocial Nursing Intervention
• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders
• Other Study ID Numbers: 23-2T/44; 1919B012205498 (Other Grant/Funding Number: TÜBİTAK)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data including age, gender, Beck Anxiety Inventory (BAI) scores, and Visual Analog Scale (VAS) scores collected at baseline, immediately post-intervention, and 4-week follow-up will be shared.
• IPD Sharing Time Frame: Upon publication of primary results
• IPD Sharing Access Criteria: Qualified researchers who provide a methodologically sound proposal may request access to de-identified individual participant data, the study protocol, and the statistical analysis plan. Data will be shared via secure institutional email after obtaining approval from the principal investigator and the ethics committee.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No