A mixed-methods systematic review of the effects of mindfulness on nurses

Abstract

Aim: To review the effects of mindfulness-based interventions on Registered Nurses and nursing students.

Background: Work-related stress among nurses is estimated to be the biggest occupational health problem after musculoskeletal disorders.

Design: A mixed-method systematic review incorporating quantitative and qualitative data was conducted.

Data sources: Studies on the effects of mindfulness-based interventions for nurses and nursing students published between 1980 and 2014 were identified through a systematic search in electronic databases: Medline, Embase, PsycINFO, Cochrane Library and Cinahl.

Review methods: Data analysis was conducted based on the framework of Thomas and Harden (2004).

Results: A total of 32 studies, including 17 controlled designs, 11 pre-post designs and four qualitative designs were reviewed. Meta-analysis suggests that mindfulness-based interventions may be effective in significantly reducing state anxiety and depression at posttreatment and state anxiety and trait anxiety at follow-up. Qualitative studies and uncontrolled studies shed light on benefits overlooked in RCTs, including improvements in the well-being of individuals (e.g. inner state of calmness, awareness and enthusiasm) and improved performance at work (better communication with colleagues and patients, higher sensitivity to patients' experiences, clearer analysis of complex situations and emotional regulation in stressful contexts).

Conclusions: Mindfulness appeared to improve nurses' mental health significantly. It could be used in worksite health promotion programmes. Only a few studies have explored the impact of mindfulness on nurses' professional behaviours and their relationships with patients and colleagues. Future research should further explore the long-term impacts of mindfulness on performance and well-being at work using sound methodological designs.

Keywords: anxiety; depression; health promotion; mindfulness; nurses; nursing students; occupational health; psychological stress; systematic review.