Nursing students' trait mindfulness and psychological stress: A correlation and mediation analysis

The influence of hatha yoga on stress, anxiety, and suppression: A randomized controlled trial

Engaging in yoga may mitigate stress and anxiety in individuals while potentially enhancing one's capacity to manage distractions. Our research aimed to explore the relation between these two outcomes: Can an eight-week yoga program foster distraction suppression, thereby reducing stress and discomfort? To answer this question, we used Hatha Yoga, the most commonly practiced form of yoga. We tested if the intervention improved participants' ability to suppress distractions and selectively decrease self-reported stress and stress reactivity. In Addition, we investigated whether such an intervention would increase participants' mindfulness. Our study included 98 healthy yoga novices between 18 and 40 years who were randomly assigned to either an experimental or a waitlist condition, with each participant completing pre- and post-intervention assessments, including questionnaires, as well as electrophysiological and behavioral measures. After eight weeks of yoga practice, significant reductions in self-reported stress and stress reactivity levels, as well as increased mindfulness, were observed among those participating in the intervention relative to those in the waitlist control group. There were, however, no significant changes in state or trait anxiety due to the intervention. Changes in stress measures could not be explained by changes in participants' ability to suppress distractors, which was not affected by the intervention. Overall, our findings suggest that regular participation in Hatha Yoga can improve mental health outcomes without impacting cognitive functioning directly related to distractor suppression. CLINICAL TRIAL REGISTRATION NUMBER: NCT05232422.

Improving stress management, anxiety, and mental well-being in medical students through an online Mindfulness-Based Intervention: a randomized study

Pressures and responsibilities of medical school put a strain on medical student's personal wellbeing, leading among all to high rates of anxiety, emotional discomfort and stress. In this work we evaluated the effectiveness of a comprehensive Mindfulness-Based Intervention (MBI) in reducing this load. The intervention comprised 10 twice-a-week Integral Meditation classes, dietary advice, and brief yoga sessions. We performed a randomized trial on two cohort of medical students from Italian universities: 239 in cohort 1 (106 treated and 133 controls), and 123 in cohort 2 (68 treated and 55 control) for a total sample of 362 students. Nine questionnaires for evaluating the effectiveness of our intervention on stress (PSS), state anxiety (STAIX-1), well-being (WEMWBS), mind-wandering (MW-S), overall distress (PANAS), emotion regulation (DERS), resilience (RS-14), and attentional control (ACS-C and ACS-D) were collected both pre and post intervention. Linear mixed effect models were run on the whole sample showing that, after multiple testing correction, our intervention was effective in reducing perceived stress (β = - 2.57 [- 4.02; - 1.12], p = 0.004), improving mental well-being (β = 2.82 [1.02; 4.63], p = 0.008) and emotional regulation (β = - 8.24 [- 12.98; - 3.51], p = 0.004), resilience (β = 3.79 [1.32; 6.26], p = 0.008), reducing the tendency to wander with the mind (β = - 0.70 [- 0.99; - 0.39], p = 0.0001), ameliorating the ability to maintain attention (AC-S (β = - 0.23 [- 0.44; - 0.02], p = 0.04) and AC-D (β = - 0.19 [- 0.36; - 0.01], p = 0.04)), and the overall distress (β = 1.84 [0.45; 3.23], p = 0.02).

Mindfulness meditation intervention improves the mindfulness awareness level of nurses' second victims to enhance their psychological support

Introduction

The medical staff involved in adverse events, referred to as second victims, usually suffer second victim syndrome endangering their health. Still, there are few organizational support projects in this area in China.

Objective

To explore the effect of mindfulness meditation on the level and needs of organizational support, and mindfulness awareness among nurses as second victims.

Methods

Forty-six nurses from a comprehensive tertiary hospital in Wuhan, China were selected to participate in the study. This study was conducted using a convenience sampling method for eight weeks of mindfulness meditation intervention. The Second Victim Experience and Support Tool and Mindfulness Attention Awareness Scale were used to assessing the need for support and mindfulness awareness of nurses prior to intervention, during the fourth and eighth weeks of intervention, and at the conclusion of the intervention course.

Results

The difference between the scores measured before the intervention, in the fourth week, and in the eighth week of intervention showed that the need for the second victim support from work-related organizations was significant (F  =  34.513, p  =  .000); there was no significant difference in the scores related to the need for nonwork-related support of the second victim in the participating nurses (F  =  1.373, p = .257); the scores of the level of mindfulness awareness were (64.85  ±  11.41), (68.63  ±  11.33), and (71.20  ±  8.41), a significant difference (F = 18.848; p = .000) was found in terms of before and after the intervention; nurses' second victim support needs gradually shifted from evasion to confronting problems appropriately.

Conclusion

Mindfulness meditation intervention is applicable to the second victim population of nurses. It is an effective way to support second victim nurses and can effectively improve their level of mindfulness and awareness.

Mindfulness for stress and anxiety management in nursing students in a clinical simulation: A quasi-experimental study

AIM

To determine the efficacy of an online mindfulness intervention in reducing anxiety and stress levels in nursing students during clinical simulations.

BACKGROUND

Clinical simulation as a learning strategy has many benefits but the high levels of stress and anxiety it produces in participants can compromise learning, motivation or performance.

DESIGN

A quasi-experimental study with a non-equivalent control group design is presented. Forty-two undergraduate nursing students from a natural group were divided into: an experimental group (n = 21) and a control group (n = 21).

METHODS

Before conducting a clinical simulation, the experimental group followed a 10-day intensive online mindfulness intervention. All students received the same information and training. Instruments used were: Self-administered Analogue Stress Scale, State-Trait Anxiety Inventory and Five Facet Mindfulness Questionnaire. In addition, physiological data (blood pressure and heart rate) were collected at baseline, pre-briefing and debriefing.

RESULTS

Physiological variables increased in the prebriefing phase but remained statistically significantly lower in the experimental group (diastolic blood pressure p = .032 and heart rate p = .048). Levels of stress (p = .029) and anxiety (p = .016) were also managed better. Both groups in the debriefing session showed a statistically significant decrease in the different physiological variables, stress and anxiety. No changes in mindfulness were observed.

CONCLUSIONS

The clinical simulation is indicated to generate stress and anxiety in nursing students. Therefore, measures must be adopted to control it. The intensive online mindfulness intervention proposed in this study reduced physiological parameters, stress and anxiety in the clinical simulation.

Dispositional mindfulness, emotional regulation and perceived stress among nursing students

OBJECTIVE

To investigate the correlation between dispositional mindfulness, emotional regulation and perceived stress and to verify factors associated with dispositional mindfulness among nursing students.

METHOD

A correlational, cross-sectional study with public undergraduate students. The following instruments were used: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire and Perceived Stress Scale. Analyzes were performed using t tests, Pearson's correlation and multiple linear regression.

RESULTS

The study included 330 students. There was no correlation between dispositional mindfulness and general emotional regulation score and/or perceived stress and a weak correlation with the emotional regulation dimension emotional suppression. Being in psychological treatment and psychoactive substance use were associated with decreased dispositional mindfulness. Age, sufficient sleep hours and emotional suppression were associated with an increase in this variable.

CONCLUSION

There was a relationship between dispositional mindfulness only with emotional suppression, in addition to the connection of this variable with the perception of sufficient sleep hours, age, use of alcohol or psychoactive substances, undergoing psychological/psychiatric follow-up and emotional suppression.

Mindfulness as a Protective Factor Against Depression, Anxiety and Psychological Distress During the COVID-19 Pandemic: Emotion Regulation and Insomnia Symptoms as Mediators

Objectives

Research has linked mindfulness to improved mental health, yet the mechanisms underlying this relationship are not well understood. This study explored the mediating role of emotion regulation strategies and sleep in the relationship between mindfulness and symptoms of depression, anxiety and psychological distress during the COVID-19 pandemic.

Methods

As detailed in this study’s pre-registration (osf.io/k9qtw), a cross-sectional research design was used to investigate the impact of mindfulness on mental health and the mediating role of emotion regulation strategies (i.e., cognitive reappraisal, rumination and suppression) and insomnia. A total of 493 participants from the general population answered an online survey and were included in the final analysis. The online survey consisted of the short form of the Five-Facets Mindfulness Questionnaire (FFMQ-SF), the Impact of Event Scale-revised (IES-R), the Generalised Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-8), the Emotion Regulation Questionnaire (ERQ), the short form of the Rumination Response Scale (RSS-SF), and the Insomnia Severity Index (ISI).

Results

Structural equation modelling revealed that mindfulness was related to lower symptoms of depression, anxiety and psychological distress, both directly and indirectly. Mindfulness was negatively associated with rumination and insomnia. As hypothesised, models revealed that the associations between mindfulness and depression, anxiety and psychological distress were significantly mediated by its negative associations with rumination and insomnia. Our findings also demonstrated that rumination was related to increased insomnia symptoms, which in turn was associated with increased mental health problems, indicating a mediated mediation. Mindfulness was also positively associated with cognitive reappraisal and negatively associated with suppression, which were, respectively, negatively and positively associated with depressive symptoms, and thus functioned as specific mediators of the association between mindfulness and depression.

Conclusion

Our findings suggest that rumination and insomnia operate transdiagnostically as interrelated mediators of the effects of mindfulness on mental health, whereas cognitive reappraisal and suppression function as specific mediators for depression. These insights emphasise the importance of targeting emotion regulation and sleep in mindfulness interventions for improving mental health. Limitations and implications for practice are discussed.

Health-related behaviors, self-rated health, and predictors of stress and well-being in nursing students

BACKGROUND

Nursing students are at increased risk for the consequences of stress on wellbeing. Little is known about nursing students' health promoting behaviors and how these relate to health, stress, and well-being.

PURPOSE

The purpose was to describe perceived stress and measures of well-being (self-compassion, happiness, and life satisfaction) along with self-reported health promoting behaviors and health status in order to identify factors that could affect stress and well-being in nursing students.

METHODS

A multi-site team employed cross-sectional research methods to explore well-being, stress, and potential physical and emotional health-relevant factors in undergraduate nursing students. Baccalaureate Nursing students from three nursing programs in North Texas participated in a web-based survey. Undergraduate students (n = 417) reported being junior or senior level in a traditional (74.1%) or an alternative nursing training program (on-line, fast-track, or weekend nursing program; 24.9%) in the fall of 2019. Recruitment fliers went to a total of 2264 potential participants via university e-mail. Consenting students completed online surveys collecting demographic and health related factors as well as measures of well-being and stress.

RESULTS

More than half (56.6%) of students reported worsening health since starting nursing school. Exercise and meditation were related to higher measures of well-being and lower stress, but this relationship diminished in the multivariate model when considering individual demographic and health related factors. Our multivariate model suggests that self-rated health status remains a main potential predictor of reduced stress and improved well-being.

CONCLUSIONS

Self-reported health factors are related to wellbeing in nursing students. Targeted interventions to improve well-being among nursing students may be necessary and would fit with national recommendations for nursing education programs. Resiliency skills training with mindfulness practices may help nursing students reduce stress, improve overall well-being, and equip students to avoid burnout and stress-related illness once in the workforce.

The Relationship Between Mindfulness and Conflict Resolution Styles Among Nurse Managers: A Cross-Sectional Study

INTRODUCTION

Mindfulness might help nurse managers in dealing with conflicts. However, the relationship between mindfulness and conflict resolution styles were still not clearly understood.

OBJECTIVE

To identify the relationship between mindfulness and conflict resolution and to predict the conflict resolution styles of nurse managers through mindfulness.

METHODS

A descriptive correlational cross-sectional design was employed. A convenience sample of 197 nurse managers was recruited from five public and two university hospitals. Data about nurse managers' mindfulness and conflict management styles were collected through self-reported scales. The data was collected between January and March 2020.

RESULTS

Mindfulness was significantly associated with integrating (r = 0.31, p < .001) and obliging (r = 0.14, p = .045) conflict resolution styles. Mindfulness was able to uniquely predict using the integrating conflict resolution style (χ² = 4.65, p = .031).

CONCLUSIONS

Mindfulness is uniquely related to integrating conflict resolution among nurse managers. The findings encourage stakeholders in health care organizations to develop training programs to improve managers' conflict resolution skills and to invest in managers' mindfulness.

Atenção plena disposicional, regulação emocional e estresse percebido em estudantes de enfermagem

RESUMO Objetivo: Investigar a correlação entre atenção plena disposicional, regulação emocional e estresse percebido e verificar fatores associados à atenção plena disposicional em estudantes de enfermagem. Método: Estudo correlacional, transversal, com estudantes de universidade pública. Foram utilizados os instrumentos: Mindful Attention Awareness Scale, Emotional Regulation Questionnaire e Perceived Stress Scale. Análises foram realizadas por meio de testes t, correlação de Pearson e regressão linear múltipla. Resultados: Participaram 330 estudantes. Identificou-se ausência de correlação entre a atenção plena disposicional e escore geral de regulação emocional e/ou estresse percebido e correlação fraca com a dimensão de regulação emocional supressão das emoções. Estar em tratamento psicológico e uso de substância psicoativas se associou à diminuição da atenção plena disposicional. Já idade, suficiência de horas de sono e supressão emocional se associaram ao aumento desta variável. Conclusão Houve relação entre a atenção plena disposicional apenas com a supressão das emoções, além de ligação desta variável com percepção de horas suficientes de sono, idade, uso de álcool ou substâncias psicoativas, estar em acompanhamento psicológico/psiquiátrico e supressão emocional.

The influence of socio-demographic factors on stress and coping strategies among undergraduate nursing students

BACKGROUND

Nursing students may experience high levels of stress during academic study, which may affect their physical and mental health. Continued severe stress may lead to attrition from a program, particularly if utilised coping strategies are not appropriate or effective. In addition, some socio-demographic factors can influence an individual's perceived stress level and choice of coping strategies.

AIM

To determine if socio-demographic factors have an impact on perceived stress and preferred coping strategies of students enrolled in undergraduate nursing studies.

DESIGN

Descriptive correlational cross-sectional study design.

METHODS

Self-report questionnaires including a demographic questionnaire, Perceived Stress Scale, and Coping Strategy Inventory were utilised. A convenience cross-sectional sample of second- and third-year undergraduate nursing students (N = 377) were surveyed. Independent samples t-test, One-way ANOVA and multiple regression analysis were used to analyse data. Voluntary consent was obtained.

FINDINGS

A moderate of proportion of participants (60%) were International students. The majority (n = 270, 71.6%) of participants had moderate stress levels. Engagement coping strategies (M = 56.33, SD = 10.27) were preferred over disengagement coping strategies (M = 46.29, SD = 11.36) for managing stress. Independent associations were identified for 'gender', 'age', 'marital status', 'country of birth', 'residential status' and 'language spoken' with stress and utilisation of preferred coping strategies.

CONCLUSION

This study has determined that a significant number of students currently enrolled in an undergraduate nursing course may be experiencing a moderate amount of stress. Furthermore, participants' demographic factors may have influenced perceived stress and utilisation of coping strategies. Diversity in background may be contributing to additional stress for some students, who may have migrated alone, without family and support networks. Future research may evaluate strategies to reduce stress for undergraduate nursing students. Students for whom English was second language may require specific support to enhance their educational experience.

Mindfulness, emotional intelligence and occupational burnout in intensive care nurses: A mediating effect model

AIM(S)

To construct structural equation models to test the mediating role of emotional intelligence in the relationship between mindfulness and occupational burnout.

BACKGROUND

Reports assessing the relationships among mindfulness, emotional intelligence and burnout, specifically in ICU nurses, are scarce.

METHODS

This was a descriptive, correlational, cross-sectional research design with 883 ICU nurses enrolled by convenience sampling from 29 ICUs in seven tertiary hospitals in urban areas of Chengdu, China. Mediation analysis was performed by structural equation modelling. Indirect effects were evaluated through bootstrapping.

RESULTS

The associations among mindfulness, emotional intelligence, emotional exhaustion, depersonalization and personal accomplishment were all significant (p < .001). In the mediation models, emotional intelligence partially mediates the relationships between mindfulness and emotional exhaustion (indirect effect 0.118, p = .006; direct effect -0.374, p = .010; total effect -0.492, p = .011) and between mindfulness and depersonalization (indirect effect -0.182, p = .006; direct effect -0.452, p = .015; total effect -0.633, p = .018). Emotional intelligence plays a total mediating role between mindfulness and personal accomplishment (indirect effect 0.293, p = .004; direct effect 0.119, p = .053).

CONCLUSIONS

The results suggest that nursing manager could implement mindfulness training to improve occupational burnout in ICU nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers could help create a more favourable working environment by providing mindfulness training. Such mindfulness training could help improve nursing quality, reduce errors and ensure patient safety, possibly improving patient prognosis and probably satisfaction.

Moderating Effect of Mindfulness on the Influence of Stress on Depression According to the Level of Stress among University Students in South Korea

Stress and depression are representative of the mental health problems of university students worldwide. This cross-sectional study explored the moderating effect of mindfulness on the influence of stress on depression according to the degree of life stress. The participants were 738 university students in years 2–4 in five 4-year universities in South Korea. Depression was positively correlated with stress and negatively with mindfulness at a statistically significant level. In multiple regression analysis, stress was found to have an effect by increasing depression, and mindfulness by relieving depression. In the moderated multiple regression analysis, mindfulness had a moderating effect on the impact of stress on depression only in low-stress groups, showing that the interaction of stress with mindfulness was significantly negative (β = −0.11, t = −2.52, p = 0.012) and the inclusion of this interaction significantly increased the explanatory power for depression variation (F change 6.36, p = 0.012) in the full model. In conclusion, we suggest considering stress levels in the development of mindfulness-based intervention strategies to effectively manage the depression of university students.