Mindfulness-based stress reduction for psychological distress among nurses: A systematic review.
03 July 2019
Ghawadra SF, Abdullah KL, Choo WY, Phang CK
Abstract
Aims and objectives
To explore the studies that used interventions based on the Mindfulness-Based Stress Reduction (MBSR) for decreasing psychological distress among nurses.
Background
Because of the demanding nature of their work, nurses often have significantly high levels of stress, anxiety and depression. MBSR has been reported to be an effective intervention to decrease psychological distress.
Design
Systematic review.
Methods
The databases included were Science Direct, PubMed, EBSCO host, Springer Link and Web of Science from 2002 to 2018. Interventional studies published in English that used MBSR among nurses to reduce their psychological distress were retrieved for review. The PRISMA guideline was used in this systematic review. The included studies were assessed for quality using “The Quality Assessment Tool For Quantitative Studies (QATFQS).”
Results
Nine studies were found to be eligible and included in this review. Many benefits, including reduced stress, anxiety, depression, burnout and better job satisfaction, were reported in these studies.
Conclusion
The adapted/brief versions of MBSR seem promising for reducing psychological distress in nurses. Future research should include randomised controlled trials with a larger sample size and follow-up studies. There should also be a focus on creative and effective ways of delivering MBSR to nurses.
Relevance to clinical practice
The results of this review are substantial for supporting the use of MBSR for nurses’ psychological well-being.
Reference
- Abbott, R. A., Whear, R., Rodgers, L. R., Bethel, A., Thompson Coon, J., Kuyken, W., Dickens, C. (2014). Effectiveness of mindfulness-based stress reduction and mindfulness-based cognitive therapy in vascular disease: A systematic review and meta-analysis of randomized controlled trials. Journal of Psychosomatic Research, 76, 341–351. https://doi.org/10.1016/j.jpsychores.2014.02.012
- Amin, N., Quek, K. F., Oxley, J. A., Noah, R., & Nordin, R. (2018). Emotional distress as a predictor of work-related musculoskeletal disorders in Malaysian nursing professionals. The International Journal of Occupational and Environmental Medicine, 9, 1169–1178.
- Ando, M., Natsume, T., Kukihara, H., Shibata, H., & Ito, S. (2011). Efficacy of mindfulness-based meditation therapy on the sense of coherence and mental health of nurses. Health, 3(2), 118–122. https://doi.org/10.4236/health.2011.32022
- Armijo-Olivo, S., Stiles, C. R., Hagen, N. A., Biondo, P. D., & Cummings, G. G. (2012). Assessment of study quality for systematic reviews: A comparison of the Cochrane Collaboration risk of bias tool and the effective public health practice project quality assessment tool. Journal of Evaluation in Clinical Practice, 18, 12–18. https://doi.org/10.1111/j.1365-2753.2010.01516.x
- Bazarko, D., Cate, R. A., Azocar, F., & Kreitzer, M. J. (2013). The impact of an innovative mindfulness-based stress reduction program on the health and well-being of nurses employed in a corporate setting. Journal of Workplace Behavioral Health, 28, 107–133. https://doi.org/10.1080/15555240.2013.779518
- Bell, M. L., Kenward, M. G., Fairclough, D. L., & Horton, N. J. (2013). Differential dropout and bias in randomized controlled trials: When it matters and when it may not. BMJ, 346, e8668. https://doi.org/10.1136/bmj.e8668
- Bergen-Cico, D., Possemato, K., & Cheon, S. (2013). Examining the efficacy of a brief mindfulness-based stress reduction program on psychological health. Journal of American College Health, 61, 348–360. https://doi.org/10.1080/07448481.2013.813853
- Burch, V. (2008). Living well with pain and illness: The mindful way to free yourself from suffering. Piatkus.
- Byrne, S. (2017). The development and evaluation of a mindfulness-based intervention for incarcerated young men. University of Glasgow.
- Cheung, T., & Yip, P. (2015). Depression, anxiety and symptoms of stress among Hong Kong nurses: A cross-sectional study. International Journal of Environmental Research and Public Health, 12, 11072–11100. https://doi.org/10.3390/ijerph120911072
- Chou, L. P., Li, C. Y., & Hu, S. C. (2014). Job stress and burnout in hospital employees: Comparisons of different medical professions in a regional hospital in Taiwan. BMJ Open, 4(2), e004185. https://doi.org/10.1136/bmjopen-2013-004185
- Deeks, J. J., Higgins, J. P. T., & Altman, G. D. (2008). Analysing data and undertaking meta-analyses. In Cochrane handbook for systematic reviews of interventions. John Wiley & Sons.
- dos Santos, T. M., Kozasa, E. H., Carmagnani, I. S., Tanaka, L. H., Lacerda, S. S., & Nogueira-Martins, L. A. (2016). Positive effects of a stress reduction program based on mindfulness meditation in Brazilian nursing professionals. Explore, 12, 90–99.
- Duarte, J., & Pinto-Gouveia, J. (2016). Effectiveness of a mindfulness-based intervention on oncology nurses’ burnout and compassion fatigue symptoms. International Journal of Nursing Studies, 64, 98–107. https://doi.org/10.1016/j.ijnurstu.2016.10.002
- Duarte, J., & Pinto-Gouveia, J. (2017). Mindfulness, self-compassion and psychological inflexibility mediate the effects of a mindfulness-based intervention in oncology nurses. Journal of Contextual Behavioral Science, 6(2), 125–133. https://doi.org/10.1016/j.jcbs.2017.03.002
- Fish, J., Brimson, J., & Lynch, S. (2016). Mindfulness interventions delivered by technology without facilitator involvement: What research exists and what are the clinical outcomes? Mindfulness, 7, 1011–1023. https://doi.org/10.1007/s12671-016-0548-2
- Foureur, M., Besley, K., Burton, G., Yu, N., & Crisp, J. (2013). Enhancing the resilience of nurses and midwives: Pilot of a mindfulness-based program. Contemporary Nurse, 45, 114–125. https://doi.org/10.5172/conu.2013.45.1.114
- Gilmartin, H., Goyal, A., Hamati, M. C., Mann, J., Saint, S., & Chopra, V. (2017). Brief mindfulness practices for healthcare providers: A systematic literature review. American Journal of Medicine, 130, 1219.e1211–1219.e1217.
- Golshiri, P., Pourabdian, S., Najimi, A., Zadeh, M. H., & Hasheminia, J. (2012). A comparison of salivary immunoglobulin A between nurses working in emergency wards and hospital clerks. Journal of Isfahan Medical School, 30, 1–8.
- Guillaumie, L., Boiral, O., & Champagne, J. (2017). A mixed-methods systematic review of the effects of mindfulness on nurses. Journal of Advanced Nursing, 73, 1017–1034. https://doi.org/10.1111/jan.13176
- Halm, M. (2017). The role of mindfulness in enhancing self-care for nurses. American Journal of Critical Care, 26, 344–348. https://doi.org/10.4037/ajcc2017589
- Haslinda, A., & Tyng, C. L. T. (2016). Job stress and coping mechanisms among nursing staff in a Malaysian private hospital. International Journal of Academic Research in Business and Social Sciences, 6, 471–487.
- Heckenberg, R. A., Hale, M. W., Kent, S., & Wright, B. J. (2019). An online mindfulness-based program is effective in improving affect, optimism and immunity. Physiology & Behavior, 199, 20–27. https://doi.org/10.1016/j.physbeh.2018.11.001
- Hee, K. L., Pathmawati, S., Norsiah, R., & Phang, C. K. (2014). The effects of mindfulness training program on reducing stress among nurses in critical care units. Australian Journal of Advanced Nursing, 31, 22–31.
- Jain, S., Shapiro, S., Swanick, S., Roesch, S., Mills, P., Bell, I., & Schwartz, G. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training. Annals of Behavioral Medicine, 33, 11–21. https://doi.org/10.1207/s15324796abm3301_2
- Janusek, L. W., Tell, D., & Mathews, H. L. (2019). Mindfulness-based stress reduction provides psychological benefit and restores immune function in breast cancer patients. Brain, Behavior, and Immunity. https://doi.org/10.1016/j.bbi.2019.04.012
- Kabat-Zinn, J. (1990). Full catastrophe living. Dell Publishing.
- Kabat-Zinn, J. (2013). Full catastrophe living. Bantam Dell.
- Keng, S. L., Phang, C. K., & Oei, T. P. S. (2015). Effects of a brief mindfulness-based intervention among medical students in Malaysia. International Journal of Cognitive Therapy, 8, 335–350. https://doi.org/10.1521/ijct.2015.8.4.335
- Lengacher, C. A., Reich, R. R., Paterson, C. L., et al. (2019). Effects of mindfulness-based stress reduction for breast cancer survivors. Biological Research for Nursing, 21, 39–49. https://doi.org/10.1177/1099800418789777
- MacGill, M. (2016). What is a randomized controlled trial in medical research? Medical News Today. http://www.medicalnewstoday.com/articles/280574.php
- Mackenzie, C. S., Poulin, P. A., & Seidman-Carlson, R. (2006). A brief mindfulness-based stress reduction intervention for nurses. Applied Nursing Research, 19, 105–109. https://doi.org/10.1016/j.apnr.2005.08.002
- McCloskey, S., & Taggart, L. (2010). Occupational stress among children’s palliative care nurses. International Journal of Palliative Nursing, 16, 233–240.
- McConville, J., McAleer, R., & Hahne, A. (2017). Mindfulness training for health profession students: A systematic review. Explore, 13, 26–45.
- Mealer, M., Burnham, E. L., Goode, C. J., Rothbaum, B., & Moss, M. (2009). PTSD and burnout in nurses. Depression and Anxiety, 26, 1118–1126. https://doi.org/10.1002/da.20631
- Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). PRISMA statement. PLOS Medicine, 6, e1000097.
- Niles, B. L., Vujanovic, A. A., Silberbogen, A. K., Seligowski, A. V., & Potter, C. M. (2012). Changes in mindfulness following telehealth intervention. Mindfulness, 4, 301–310. https://doi.org/10.1007/s12671-012-0130-5
- Phang, C. K., Chiang, K. C., Ng, L. O., Keng, S. L., & Oei, T. P. S. (2016). Mindfulness-based cognitive therapy for stress reduction among medical students. Mindfulness, 7, 189–197. https://doi.org/10.1007/s12671-015-0399-2
- Phang, C. K., Keng, S. L., & Chiang, K. C. (2014). Mindful-S.T.O.P.: Mindfulness made easy for stress reduction. Education in Medicine Journal, 6, e48.
- Phang, C. K., Mukhtar, F., Ibrahim, N., Keng, S. L., & Mohd Sidik, S. (2015). Mindful-Gym program for stress management among medical students. Advances in Health Sciences Education, 20, 1115–1134. https://doi.org/10.1007/s10459-015-9591-3
- Pipe, T. B., Bortz, J. J., Dueck, A., et al. (2009). Nurse leader mindfulness meditation program. Journal of Nursing Administration, 39, 130–137. https://doi.org/10.1097/NNA.0b013e31819894a0
- Regehr, C., Glancy, D., & Pitts, A. (2013). Stress reduction in university students: Review and meta-analysis. Journal of Affective Disorders, 148, 1–11. https://doi.org/10.1016/j.jad.2012.11.026
- Segal, W. J., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression. Guilford Press.
- Serpa, J. G., Taylor, S. L., & Tillisch, K. (2014). MBSR reduces anxiety and depression in veterans. Medical Care, 52, S19–S24.
- Slade, E. P., & Becker, K. D. (2014). Economic projections of preventive interventions. Prevention Science, 15, 807–817. https://doi.org/10.1007/s11121-013-0445-z
- Smith, S. A. (2014). Mindfulness-based stress reduction for nurses’ coping with stress. International Journal of Nursing Knowledge, 25, 119–130. https://doi.org/10.1111/2047-3095.12025
- Thomas, B. H., Ciliska, D., Dobbins, M., & Micucci, S. (2004). Systematic review process for public health nursing. Worldviews on Evidence-Based Nursing, 1, 176–184. https://doi.org/10.1111/j.1524-475X.2004.04006.x
- Thomas, C. D., Dobbins, M., & Micucci, S. (1998). Quality assessment tool for quantitative studies. Effective Public Health Practice Project.
- Weare, K. (2013). Mindfulness in children and young people. Journal of Children’s Services, 8, 141–153.
- Winterstein, A. G., & Kimberlin, C. L. (2008). Validity and reliability of research instruments. American Journal of Health-System Pharmacy, 65, 2276–2284. https://doi.org/10.2146/ajhp070364
- Wylde, C. M., Mahrer, N. E., Meyer, M. L., & Gold, J. I. (2017). Mindfulness for novice pediatric nurses. Journal of Pediatric Nursing, 36, 205–212. https://doi.org/10.1016/j.pedn.2017.06.008
- Yeboah, M. A., Ansong, M. O., Antwi, H. A., Yiranbon, E., Anyan, F., & Gyebil, F. (2014). Workplace stress among healthcare professionals in Ghana. International Journal of Business and Social Science, 5, 140–151.
Cite
Ghawadra SF, Abdullah KL, Choo WY, Phang CK. Mindfulness-based stress reduction for psychological distress among nurses: A systematic review. J Clin Nurs. 2019;28:3747–3758. https://doi.org/10.1111/jocn.14987


