Title : Effectiveness of mindfulness interventions in reducing perceived stress among nurses and nursing students: A systematic review and meta-analysis
Abstract:
Nurses and nursing students contribute vital role in healthcare system, but often experience high level of stress prevalence 43%. Although, Mindfulness-Based Interventions (MBIs) have demonstrated effectiveness in reducing anxiety and depression, their impact on perceived stress, a key driver of burnout and reduced well-being among clinical nurses and nursing students remains less explored. This study synthesizes evidence on the effects of MBIs in mitigating perceived stress within this high-stress professional group, focusing on intervention delivery modes, settings, and methodological variations. We conducted a comprehensive search based on the Medical Subject Heading (MeSH) and relevant keywords in PubMed and Embase (inception-Fabruary, 2024), which identified studies evaluating the effects of mindfulness on perceived stress. Standardized Mean Differences (SMDs) were calculated using random-effects models. According to PRISMA guidelines, thirty six studies involving 2,201 participants were included and synthesized. We performed separate meta- analyses for one sample pre post designs and intervention control designs. Additionally, subgroup analyses examined variables including control type (active vs. non- active), intervention mode (instructor-led vs. self-directed), and intervention setting (workplace vs. non-workplace). We performed sensitivity analyses to evaluate the robustness of findings. Risk of bias assessed using the Cochrane Risk of Bias Assessment Tool for Non- Randomized Controlled Trails (ROBINS-I). Results demonstrated that mindfulness interventions significantly reduced perceived stress, with medium effects in one-sample pre-post studies (SMD = -0.54 [-0.77, -0.31]) and small effects in intervention-control studies (SMD= -0.21 [-0.37, -0.05]). Subgroup analyses indicated stronger effects for instructor-led interventions, workplace settings, and non-active controls groups. Sensitivity analyses confirmed the robustness of results, as no single study disproportionately influencing the pooled effect sizes. This meta-analysis confirms the effectiveness of MBIs in reducing perceived stress among clinical nurses and nursing students. Particularly, instructor-led and workplace-based interventions demonstrated effective. These findings highlight the potential of tailored MBIs to enhance stress management strategies, support mental health, and build resilience in clinical and educational nursing settings. The protocol of the systematic review/meta-analysis was preregistered in PROSPERO
