Evidence-Based Research on Stress Management and Mindfulness Program for Nursing Students

This article presents evidence-based research on the effectiveness of stress management and mindfulness program for reducing stress among nursing students. It includes a pilot project conducted in Australia and highlights the positive impact of the intervention on stress reduction.

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EVIDENCE-BASED REASERCH
EVIDENCE-BASED RESEARCH
Name of the Student:
Name of the University:
Author note:
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EVIDENCE-BASED REASERCH
The undergraduate student population are suffering from high level of stress and psychological health issue that
is increasing day by day due in order to achieve excellence in their profession. The three primary articles used in
this critical appraisal will summarise the intervention that can be used to overcome the stress issue and
psychological health issue.
Hintz, Frazier & Meredith (2015) highlighted the concept of theory-based online intervention to improve the
health condition of the student by appropriate stress management technique (Kim et al., 2016). The
undergraduate students were included in the investigation and two different pilot test was conducted to clarify
and confirm if the intervention suggested is effective in controlling the stress and psychological health issue
among the students. The intervention had four different modules that was taken by the participants randomly.
Different scores were extracted from the trial on the basis of helpfulness and the stress logs. Each participants
submitted their feedback on the basis on which the efficacy of the internet based intervention was assessed and
identified that will reduce the stress and psychological issue among the undergraduate student.
Van der Riet et al., (2015) conducted a seven week pilot project that focused on the impact of mindfulness
program and stress management for reducing stress level among the nursing and midwifery students. The stress
management program was conducted in the regional university in Australia. Total of 14 participants were
included in the program studying in their first year graduation in nursing and midwifery students. Descriptive
qualitative design was used by the researcher in this study to identify the impact of the program followed by a
semi-structured group interview (Ratanasiripong et al., 2015). Thematic analysis was performed for generating
notes and transcript extracted from the interview of the participants. Ten participants showed a positive impact of
the program by reducing the negative cognitions and increasing concentration, thought clarity and sleep. Hence,
mindfulness program exhibited positive result in reducing the stress of undergraduate nursing and midwifery
students in Australia.
He et al., (2018) conducted this study to examine the conjecturers of mental well-being in the nursing students
within regional university of Australia. The researchers identified that stress has a negative effect on the
psychological well-being of the student whereas internal factors like resilience, self-efficacy and mindfulness
will exhibit a positive impact on the nursing student (Shearer et al., 2016). The researcher used a cross- sectional
descriptive analytical model accompanied by convenience sampling method where the nursing and midwifery
students participated in the study. Six types of validation scale was used to assess the students administered by
the online survey to further the factors affecting the mental well-being of the students. The younger students had
lower stress level as compared to the older students and hence required a specific curriculum that will support
positive strategy of stress management.
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EVIDENCE-BASED REASERCH
All the above mentioned three articles highlight the concept of stress-management among students who have to
deal with their study, work and family in the demanding and complex environment. The findings extracted from
the articles focused on different intervention strategy that will reduce the stress and psychological issue among
the students. Significant study was conducted with different students and regression analysis was done to identify
the result of the participated population in improving their stress and mental well-being. Hence, development of
effective curriculum by the university will help the students to reduce stress associated with mindfulness program
and online intervention program (Zimmaro et al., 2016). This program will assist the students in improving their
psychological condition and reducing the burden of stress they face in their everyday life. If the above mentioned
intervention is successfully used by the students it will help them to improve their stress level and reduce any
psychological illness they are facing in their life.
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EVIDENCE-BASED REASERCH
References
He, F. X., Turnbull, B., Kirshbaum, M. N., Phillips, B., & Klainin-Yobas, P. (2018). Assessing stress, protective
factors and psychological well-being among undergraduate nursing students. Nurse education today, 68,
4-12.
Hintz, S., Frazier, P. A., & Meredith, L. (2015). Evaluating an online stress management intervention for college
students. Journal of counseling psychology, 62(2), 137.
Kim, S., Lee, H., Kim, H., Noh, D., & Lee, H. (2016). Effects of an integrated stress management program
(ISMP) for psychologically distressed students: A randomized controlled trial. Perspectives in
psychiatric care, 52(3), 178-185.
Ratanasiripong, P., Park, J. F., Ratanasiripong, N., & Kathalae, D. (2015). Stress and anxiety management in
nursing students: Biofeedback and mindfulness meditation. Journal of Nursing Education, 54(9), 520-
524.
Shearer, A., Hunt, M., Chowdhury, M., & Nicol, L. (2016). Effects of a brief mindfulness meditation
intervention on student stress and heart rate variability. International Journal of Stress Management,
23(2), 232.
van der Riet, P., Rossiter, R., Kirby, D., Dluzewska, T., & Harmon, C. (2015). Piloting a stress management and
mindfulness program for undergraduate nursing students: Student feedback and lessons learned. Nurse
Education Today, 35(1), 44-49.
Zimmaro, L. A., Salmon, P., Naidu, H., Rowe, J., Phillips, K., Rebholz, W. N., ... & Jablonski, M. E. (2016).
Association of dispositional mindfulness with stress, cortisol, and well-being among university
undergraduate students. Mindfulness, 7(4), 874-885.
Word Count: 630
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EVIDENCE-BASED REASERCH
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EVIDENCE-BASED REASERCH
Citatio
n
(Articl
e 1)
Hintz, S., Frazier, P. A., & Meredith, L. (2015). Evaluating an online stress management
intervention for college students. Journal of counseling psychology, 62(2), 137.
https://www.researchgate.net/profile/Liza_Meredith/publication/
260873300_Evaluating_an_Online_Stress_Management_Intervention_for_Colle
ge_Students/links/545ae18d0cf2c46f66438cd5.pdf
Study
Purpos
e:
Was the
purpose
Stated
clearly?
Yes
No
The primary goal of this study is to evaluate the effectiveness and feasibility of the theory-based
online intervention program that will improve the stress management technique within the
undergraduate students.
There are many challenges faced by the students during their life that result in stress and mental
illness, which further develop into anxiety and depression. Hence, technology based intervention is
considered as a solution to manage the stress related problem in the students.
LITERA
TUR
E
Was
relevant
backgrou
nd
literature
reviewed
?
Yes
No
The study stated that undergraduate students suffer from stress and mental issue but failed to
provide a justification on why this is a major concern among students that require attention and
appropriate
Intervention strategy for stress-management. Very little research was conducted on high stress
level and psychological illness of the student. Articles were used for recommending the online-
based intervention strategy to reduce stress among students but no articles directed towards the
cause that lead to stress and mental issue among the target population. Adequate research was
conducted on the effectiveness of the internet-based intervention in reducing stress and mental
illness in the nursing students.
DESIG
N
Was the
design
clear
Yes
Qualitative study design was used in this study to identify the benefit of internet-based
intervention in improving stress-management.
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EVIDENCE-BASED REASERCH
No
Were the
methods
and
procedur
es
described
in detail?
Yes
No
Were the
participa
nts
described
in
adequate
detail?
Yes
No
Were the
data
analysis
procedur
es
described
?
Yes
No
The students studying in the psychological course were included in the procedure and they were
screened by tool known as perceived control over stressful; events scale (PCOSES). No exclusion
or inclusion criteria was used. An online survey was conducted where the participants were
divided in groups and accordingly the result was analysed. Different scales were used as a tool to
assess the stress level of the students:
 Pest control
 The Depression Anxiety Stress scale
 The perceived Stress scale
 Intervention feedback
The participants were not described in detail as they were randomly selected and assessed under
different scale.
The data analysis procedure used in this study was online survey and internet based procedures.
RESUL
TS
Were the
Results
Reported
The result stated that internet based intervention has an increased impact on stress management of
the student. The participants who were involved in the intervention experienced reduction in their
stress, depression, indication of anxiety. This intervention directly targeted college students who
were under greater stress and included them in the intervention trail. Positive response was
extracted from them hence making this result promising and establish a strong basis for future
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EVIDENCE-BASED REASERCH
Clearly?
Yes
No
stress management using internet-based intervention program.
CONCL
USION
S AND
IMPLIC
ATION
S
Conclusi
ons were
appropria
te given
the study
methods,
results
and
literature
Yes
No
Were any
limitation
s
identified
?
Yes
No
Practical
applicatio
ns or
clinical
implicati
The study concludes that online intervention technique was better and exhibited positive result as
compared to face to face intervention. The participants from psychology background who were
included in the study exhibited positive result in effective stress-management.
The limitation of the study was that it only focused on the female and white participants that
limited the result findings. The second limitation was that the study included psychology student
who participated for credit points. The last limitation was that the outcomes was assessed using
self-report method but as this study involved future implication more objective measures was
required for assessment.
The intervention was used to reduce the stress level in the students and overcome any psychology
related issue in the student, Internet-based intervention program was used in the study.
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EVIDENCE-BASED REASERCH
ons
Yes
No
Releva
nce of
the
article
The article was relatively easy to understand and read and it included online intervention
technique. The current generation students are more involved in online world and spend their time
in internet hence, this intervention would be attractive for the students to reduce their stress level.
The article could connect with the student. It was also easy to understand the effectiveness of the
research.
Score
total
/10
Citatio
n
(Articl
e 2)
Van der Riet, P., Rossiter, R., Kirby, D., Dluzewska, T., & Harmon, C. (2015). Piloting a stress
management and mindfulness program for undergraduate nursing students: Student feedback and
lessons learned. Nurse Education Today, 35(1), 44-49.
https://www.sciencedirect.com/science/article/pii/S0260691714001877
Study
Purpos
e:
Was the
purpose
Stated
clearly?
Yes
No
The primary aim of the study was to conduct a seven-week stress management and mindfulness
program for reducing stress of the nursing and midwifery student in Australia. Pilot project was
conducted to achieve the objective of the study.
LITERA
TUR
E
Was
relevant
backgrou
nd
Proper background and literature review was conducted in the study that focused on the factors
leading to stress among the student population in which low socio-economic condition was the
primary cause associate with low self-care and capability to cope up in the stressful condition.
Appropriate literature review was conducted on the intervention that is used to reduce the stress
level in the student using mindfulness program. 4 literature were reviewed for describing the
background of the mindfulness program in reducing stress level in the student. Literature review
was also conducted to identify the positive impact of the intervention (mindfulness) such as
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EVIDENCE-BASED REASERCH
literature
reviewed
?
Yes
No
enhanced immune response, regulated blood pressure and reduction in cortisol level. The research
findings were also supported by extensive literature review.
DESIG
N
Was the
Design
clear
Yes
No
Were the
Methods
And
Procedur
es
described
In detail?
Yes
No
Were the
participa
nts
described
in
adequate
detail?
Yes
No
Were the
The study design used in the article was descriptive qualitative design where a 60 minutes focused
group interview was performed for data collection.
A semi-structured group interview method was used in this article to collect the information on the
intervention used to reduce stress among nursing student.
The participants were the first year nursing and midwifery students, who were interested in
participating in the study. The study excluded second and third year student. Total 14 students
were included in the study out of which 10 students completed the investigation and successfully
participated in the group interview.
Thematic analysis method was used for data analysis that includes selecting variables or themes
and later coding them into different categories. Two different researcher were involved in thematic
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EVIDENCE-BASED REASERCH
data
analysis
procedur
es
described
?
Yes
No
analysis and identified two different themes and clarified by cross-checking the identified theme
from present transcript.
RESUL
TS
Were the
Results
Reported
Clearly?
Yes
No
The result was not very clearly stated as the findings were majorly highlighted in the study and a
proper concise result was missing from the article.
CONCL
USIONS
AND
IMPLIC
ATIONS
Conclusi
ons were
appropria
te given
the study
methods,
results
and
The study concluded that mindfulness program was effective in reducing the stress among the
nursing and midwifery students with a positive impact on stress reduction and enhanced self-
ability in both professional and personal setting. The students involved in the study gave a positive
feedback on the benefits of using mindfulness program and enhancing their thought clarity by
reducing negative cognitions.
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EVIDENCE-BASED REASERCH
literature
Yes
No
Were any
limitation
s
identified
?
Yes
No
Practical
applicatio
ns or
clinical
implicati
ons were
addressed
Yes
No
The limitation identified by the researcher was that the pilot study used in this article was not
validated and hence the result cannot be generalised in other setting. Other limitation in the study
highlighted was small sample size, irregular attendance and female participants. The last limitation
was the use of qualitative data on reporting the impact the program in stress management as mixed
method data was more favoured.
The transcript was analysed and it yielded three main themes that includes attending to self,
attending to program and attending to others. These three themes helped the participants to use the
mindfulness program as the intervention in reducing stress level.
Relevanc
e of the
article
The article was very easy and directly related to the causes that leads to stress in nursing and
midwifery students in Australia. The article consisted of all required parts and clearly stated the
methodology, findings and limitation of the intervention. The advantage of using mindfulness
program was also clearly stated in the article hence, making the article relevant and easy to
understand.
Score
total
/10
Citatio
n
(Articl
He, F. X., Turnbull, B., Kirshbaum, M. N., Phillips, B., & Klainin-Yobas, P. (2018). Assessing
stress, protective factors and psychological well-being among undergraduate nursing students.
Nurse education today, 68, 4-12.
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EVIDENCE-BASED REASERCH
e 3) https://www.sciencedirect.com/science/article/pii/S0260691718302053
Study
Purpos
e:
Was the
purpose
Stated
clearly?
Yes
No
The primary purpose of the study is to inspect the conjecturers of mental well-being in the nursing
student population in Australia.
LITERA
TUR
E
Was
relevant
backgrou
nd
literature
reviewed
?
Yes
No
Extensive literature review was performed on the causes that leads to psychological distress
among the nursing student like lack of financial and interpersonal help leading to anxiety. From
the literature review predictors of mental illness was identified that includes mood, alcohol, drugs,
eating and anxiety disorder. Sufficient literature review was performed with aim to study the
predictors of stress and different tools to improve the stress-management in the nursing student.
Appropriate literature review was done on the mindfulness program used as an intervention to
reduce the stress level in the student.
DESIG
N
Was the
Design
clear
Yes
No
A cross-sectional descriptive predictive research design was used in this study where preliminary
analysis was done and factors were also analysed highlighting three primary factors such as family
support, other associated support and friends support.
Questionnaire method was used in this study were the participated students had to fill the
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EVIDENCE-BASED REASERCH
Were the
methods
and
procedur
es
described
in detail?
Yes
No
Were the
participa
nts
described
in
adequate
detail?
Yes
No
Were the
data
analysis
procedur
es
described
?
Yes
No
information sheet and answer the question to complete the survey. Informed consent was also use
in this method and they participated using electronic survey.
Convenience sampling method was used in the study and the participants were included from the
Australian regional university. The participants were mature in age and were not immediate school
leavers. Both inclusion and exclusion method was used in this study and the students from
bachelor of nursing program were invited to participate in the study.
The online questionnaire filled by the participants were transferred to IBM SPSS software.
Descriptive analysis method was used that includes standard deviation, means and frequencies.
Pearson’s correlation analysis, multiple linear regression and probability plot was also conducted
to identify the result of reduced stress-management using mindfulness program.
RESUL
TS
Were the
results
Total 1760 students participated in the study in which 657 responses was received. 119 response
was incomplete and hence was discarded from the study. Total 538 response was furthered used in
the study and involved in data analysis with 37% response rate. Different predictors were
identified that resulted in stress among the nursing student.
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EVIDENCE-BASED REASERCH
reported
clearly?
Yes
No
CONCL
USIONS
AND
IMPLIC
ATIONS
Conclusi
ons were
appropria
te given
the study
methods,
results
and
literature
Yes
No
Were any
limitation
identified
?
Yes
No
Practical
applicatio
ns or
clinical
implicati
The study concludes that the students required specific curriculum that will promote a positive
coping approaches that will help them to reduce their stress level. The new students will have an
opportunity to be pre-prepared in order to involve with demanding, ever-changing and complex
environment.
The primary limitation identified was that only undergraduate student was involved in this study
with a lower rate of response. The second limitation was that esult was self-reported hence the
possibility was high that the student would have reported wrong rather than actual situation
reflection. The last limitation was that cross-sectional approach was used rather than longitudinal
design that would have provided a better understanding of the mental situation of the student.
The research finding extracted from the study exhibited that mindfulness program had a positive
impact on the student providing psychological resilience and social support. The development of
curriculum in the university will help the new graduates to be better prepared in dealing with the
critical and complex environment.
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EVIDENCE-BASED REASERCH
ons were
addressed
Yes
No
Relevanc
e of the
article
The article was easy to understand and interpret the psychological condition of the students and
the factors that result in stress among the students. The methodology used in the article was very
simple and easy to understand and the research finding was also elaborated in a precise manner.
The aim of the study was clearly stated and explained that was easy to understand and analyse.
Score
total
/10
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