Mindfulness Centered Stress Reduction for Graduate Nursing Students: A Randomized Controlled TrialKaren Hande, DNP, ANP-BC | Carrie Plummer, PhD, ANP-BC | Jennifer Doersam, MS | Mary Dietrich, PhD

Background Nursing students experience high levels of stress1,2,3 While certain levels of stress can be beneficial in promoting learning and motivation, high levels and/or extended periods can prove detrimental to mental and physical health1,2,3 Growing evidence Mindfulness Centered Stress Reduction (MCSR) is effective in reducing stress and improving quality of life1,2,3

Statement of the Problem A search of the literature revealed no published studies examining stress levels of graduate nursing students. Stress management strategies benefit physical and mental well-being.1,2,3

Purpose Statement To examine the effect of Mindfulness Centered Stress Reduction training on nursing students’ self-reported levels of perceived stress, mindfulness, and quality of life.

Methods Inclusion Criteria • Enrolled in accelerated MSN

program (2015-2016)• At least 18 years of age• Able to speak and

understand English• Able to complete online study

questionnaires

Intervention Group (n = 47) • Attended weekly, 1.5 hour

MCSR training X 20 weeks• Completed demographic

survey and four questionnaires at weeks 0, 10, 20, and 32

Control Group (n = 93)• Completed demographic survey and 4

questionnaires at weeks 0, 10, 20, and 32 .• Incentivized with $5.00 gift card for each set of

questionnaires.

 Data Collection Instruments• Demographics• Perceived Stress Scale - 10• Cognitive and Affective Mindfulness Survey-

Revised • World Health Organization Quality of Life – BREF

Intervention Twenty 1.5-hour weekly sessions of MCSR training. The evidence-based mindfulness curriculum modules focused on Mindfulness of Body, Emotions, Mind, and Experience.

Limitations Lack of incentive: Intervention group was not incentivized to participate in surveys.

Faculty variability: Instructors received identical

curriculum training; however, content delivery was not routinely monitored.

Discussion • Results support literature that graduate nursing

students identify interpersonal, academic, and financial stressors.

• No significant demographic differences noted.• MBSR correlated with increase in overall mindfulness at

week 20, as reflected in the summative CAMS-R score.• Intervention group showed a significant difference at

week 20 in the CAMS-R subscales of Present Focus Results

Demographics (N = 94)Characteristic Control (N=58) Intervention (N=36)

Median [IQR] Median [IQR]

Age 23.0 [22-26] 23.0 [22-27]

Gender

Male 3 (5.2) 4 (11.1)

Female 55 (94.8) 32 (88.9)

Race*

Multiple Races 4 (7.0) 1 (2.8)

White 47 (82.5) 32 (88.9)

African American or Black 1 (1.8) 1 (2.8)

Asian 5 (8.8) 2 (5.6)

Ethnicity*

Not Hispanic or Latino 55 (96.5) 34 (94.4)

Hispanic or Latino 2 (3.5) 2 (5.6)

Relationship Status*

Single 25 (43.9) 12 (33.3)

In a Relationship 24 (42.1) 15 (41.7)

Married 7 (12.3) 7 (19.4)

Partnered 1 (1.8) 2 (5.6)

Current Employment Status

Full Time 1 (1.7) 1 (2.8)

Part Time 9 (15.5) 3 (8.3)

PRN 7 (12.1) 3 (8.3)

Not Employed 41 (70.7) 29 (80.6)

Children Living at Home

None 55 (94.8) 34 (94.4)

1 1 (1.7) 1 (2.8)

2 ≥ 2 (3.4) 1 (2.8)

Primary Caregiver for Adult

No 57 (98.3) 36 (100.0)

Yes 1 (1.7) 0 (0.0)

*N=93; Control N=57

and Awareness. There was no significant difference on the CAMS-R subscale for Attention.

• Attrition in the control and intervention groups from week 0 to 32.

• Neither the PSS-10 or WHO QOL-BREF indicated significant changes from week 0 to 32.

• The intervention group showed a statistically significant increase in the CAMS-R Acceptance subscale. However, interpretation of this finding is limited due to a statistically significant difference at Week 0.

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