The effect of mindfulness-based training on stress, anxiety, depression and job satisfaction among ward nurses: A randomized control trial

20 May 2020


Sajed Faisal Ghawadra, Khatijah Lim Abdullah, Wan Yuen Choo, Mahmoud Danaee, Cheng Kar Phang


Abstract

Aim

To assess the effect of a 4-week mindfulness-based training intervention on improving stress, anxiety, depression and job satisfaction among ward nurses.

Background

Previous literature showed that mindfulness-based training is useful for helping nurses cope with stress.

Method

Nurses who have mild to moderate levels of stress, anxiety and depression identified from a teaching hospital were invited to a randomized control trial. The intervention group had a 2-hr Mindfulness-Based Training workshop, followed by 4 weeks of guided self-practice Mindfulness-Based Training website. Both the intervention group (n = 118) and the control group (n = 106) were evaluated pre- and post-intervention, and 8 weeks later (follow-up) using the Depression, Anxiety, and Stress Scale-21, Job Satisfaction Scale and Mindful Attention Awareness Scale.

Results

There was a significant effect over time on stress, anxiety, depression and mindfulness level (p < .05). Regarding the difference between the groups and interaction between time and group, there was a significant effect for anxiety (p = .037 p = .008) and job satisfaction (p < .001, p = .40), respectively, with moderate effect size for anxiety reduction (.465) and small for job satisfaction increment (.221).

Conclusion

Mindfulness-Based Training is effective in improving anxiety and job satisfaction among nurses.


Reference

  1. Aggs, C., & Bambling, M. (2010). Teaching mindfulness to psychotherapists in clinical practice: The mindful therapy programme. Counselling and Psychotherapy Research, 10(4), 278–286. https://doi.org/10.1080/14733145.2010.485690
  2. Amin, A. A., Vankar, J. R., Nimbalkar, S. M., & Phatak, A. G. (2015). Perceived stress and professional quality of life in neonatal intensive care unit nurses in Gujarat, India. Indian Journal of Pediatrics, 82(11), 1001–1005. https://doi.org/10.1007/s12098-015-1794-3
  3. 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. International Journal of Occupational and Environmental Medicine, 9(2), 69–78. https://doi.org/10.15171/ijoem.2018.1158
  4. 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), 5. https://doi.org/10.4236/health.2011.32022
  5. Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181. https://doi.org/10.1037/1040-3590.10.2.176
  6. Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504
  7. 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(2), 107–133. https://doi.org/10.1080/15555240.2013.779518
  8. Bostanov, V., Ohlrogge, L., Britz, R., Hautzinger, M., & Kotchoubey, B. (2018). Measuring mindfulness: A psychophysiological approach. Frontiers in Human Neuroscience, 12, 249. https://doi.org/10.3389/fnhum.2018.00249
  9. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848. https://doi.org/10.1037/0022-3514.84.4.822
  10. Chaskalson, M. (2011). The mindful workplace: Developing resilient individuals and resonant organizations with MBSR. John Wiley & Sons.
  11. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
  12. Cohen-Katz, J., Wiley, S. D., Capuano, T., Baker, D. M., & Shapiro, S. (2005). The effects of mindfulness-based stress reduction on nurse stress and burnout, part II: A quantitative and qualitative study. Holistic Nursing Practice, 19(1), 26–35.
  13. Cook, R. J., & Sackett, D. L. (1995). The number needed to treat: A clinically useful measure of treatment effect. BMJ, 310(6977), 452. https://doi.org/10.1136/bmj.310.6977.452
  14. Cummings, S. R., Grady, D., & Hulley, S. B. (2013). Designing a randomized blinded trial. In S. B. Hulley et al. (Eds.), Designing clinical research (4th ed., pp. 137–150). Lippincott Williams & Wilkins.
  15. Dobie, A., Tucker, A., Ferrari, M., & Rogers, J. (2016). Preliminary evaluation of a brief mindfulness-based stress reduction intervention for mental health professionals. Australasian Psychiatry, 24(1), 42–45. https://doi.org/10.1177/1039856215618524
  16. 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(2), 90–99. https://doi.org/10.1016/j.explore.2015.12.005
  17. 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
  18. Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1. Behavior Research Methods, 41(4), 1149–1160. https://doi.org/10.3758/BRM.41.4.1149
  19. Fernández-Álvarez, J., Díaz-García, A., González-Robles, A., Baños, R., García-Palacios, A., & Botella, C. (2017). Dropping out of a transdiagnostic online intervention: A qualitative analysis of clients’ experiences. Internet Interventions, 10, 29–38. https://doi.org/10.1016/j.invent.2017.09.001
  20. Gärtner, F. R., Nieuwenhuijsen, K., van Dijk, F. J. H., & Sluiter, J. K. (2012). Impaired work functioning due to common mental disorders in nurses and allied health professionals. International Archives of Occupational and Environmental Health, 85, 125–138. https://doi.org/10.1007/s00420-011-0649-0
  21. Ghawadra, S. F., Abdullah, K. L., Choo, W. Y., & Phang, C. K. (2019a). Mindfulness-based stress reduction for psychological distress among nurses: A systematic review. Journal of Clinical Nursing, 28(21–22), 3747–3758. https://doi.org/10.1111/jocn.14987
  22. Ghawadra, S. F., Abdullah, K. L., Choo, W. Y., & Phang, C. K. (2019b). Psychological distress and its association with job satisfaction among nurses. Journal of Clinical Nursing, 28(21–22), 4087–4097. https://doi.org/10.1111/jocn.14993
  23. Guillaumie, L., Boiral, O., & Champagne, J. (2017). A mixed-methods systematic review of the effects of mindfulness on nurses. Journal of Advanced Nursing, 73(5), 1017–1034. https://doi.org/10.1111/jan.13176
  24. Gupta, S. K. (2011). Intention-to-treat concept: A review. Perspectives in Clinical Research, 2(3), 109–112. https://doi.org/10.4103/2229-3485.83221
  25. 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(5), 471–487.
  26. Hee, K. L., Pathmawati, S., Norsiah, R., & Phang, C. K. (2014). Effects of mindfulness training program on reducing stress and promoting well-being among nurses in critical care units. Australian Journal of Advanced Nursing, 31(3), 22–31.
  27. Hernán, M. A., & Hernández-Díaz, S. (2012). Beyond intention-to-treat in comparative effectiveness research. Clinical Trials, 9(1), 48–55. https://doi.org/10.1177/1740774511420743
  28. Jakobsen, J. C., Gluud, C., Wetterslev, J., & Winkel, P. (2017). Multiple imputation for missing data in randomized clinical trials. BMC Medical Research Methodology, 17, 162. https://doi.org/10.1186/s12874-017-0442-1
  29. Kabat-Zinn, J. (2013). Full catastrophe living. Bantam.
  30. Kuyken, W., Crane, R. S., & Williams, J. M. G. (2012). MBCT implementation resources. Universities of Bangor, Exeter and Oxford.
  31. Lenhard, W., & Lenhard, A. (2016). Calculation of effect sizes. https://www.psychometrica.de/effect_size.html
  32. Letvak, S., Ruhm, C., & Gupta, S. (2012). Nurses’ presenteeism and its effects. American Journal of Nursing, 112(2), 30–38.
  33. Lomas, T., Medina, J. C., Ivtzan, I., Rupprecht, S., & Eiroa-Orosa, F. J. (2019). Mindfulness-based interventions and healthcare professionals’ well-being: Meta-analysis. Mindfulness, 10(7), 1193–1216. https://doi.org/10.1007/s12671-018-1062-5
  34. Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales. Psychology Foundation of Australia.
  35. Mackenzie, C. S., Poulin, P. A., & Seidman-Carlson, R. (2006). Mindfulness-based stress reduction for nurses. Applied Nursing Research, 19(2), 105–109. https://doi.org/10.1016/j.apnr.2005.08.002
  36. Melville, K. M., Casey, L. M., & Kavanagh, D. J. (2010). Dropout from Internet-based treatment. British Journal of Clinical Psychology, 49(4), 455–471. https://doi.org/10.1348/014466509X472138
  37. Mohammed, W. A., Pappous, A., Muthumayandi, K., & Sharma, D. (2018). Mindfulness meditation and burnout in therapists. European Journal of Physiotherapy, 20(4), 213–224. https://doi.org/10.1080/21679169.2018.1452980
  38. Morledge, T. J., et al. (2013). Online mindfulness program feasibility. Annals of Behavioral Medicine, 46(2), 137–148. https://doi.org/10.1007/s12160-013-9490-x
  39. Morris, S. B. (2008). Estimating effect sizes from pretest-posttest designs. Organizational Research Methods, 11(2), 364–386.
  40. Musa, R., Fadzil, M. A., & Zain, Z. (2007). Validation of Malay DASS. ASEAN Journal of Psychiatry, 8(2), 82–89.
  41. Ng, S. (1993). Job satisfaction scale for nurses. New Zealand Journal of Psychology, 22, 87–91.
  42. Pflugeisen, B. M., et al. (2016). Mindfulness program for physicians. EXPLORE, 12(1), 50–54. https://doi.org/10.1016/j.explore.2015.10.005
  43. Phang, C. K., et al. (2015). Mindful-Gym RCT. Advances in Health Sciences Education, 20(5), 1115–1134. https://doi.org/10.1007/s10459-015-9591-3
  44. Pinson, L., & Gray, G. E. (2003). Number needed to treat. Psychiatric Services, 54(2), 145–154.
  45. Pipe, T. B., et al. (2009). Nurse mindfulness meditation program. Journal of Nursing Administration, 39(3), 130–137. https://doi.org/10.1097/NNA.0b013e31819894a0
  46. Reid, D., Farragher, J., & Ok, C. (2013). Mindfulness in occupational therapy. Occupational Therapy in Mental Health, 29(3), 279–292.
  47. Santorelli, S. (2014). MBSR standards of practice. University of Massachusetts Medical School.
  48. Schulz, K. F., Altman, D. G., & Moher, D. (2010). CONSORT statement. BMC Medicine, 8, 18. https://doi.org/10.1186/1741-7015-8-18
  49. Smith, S. A. (2014). Mindfulness-based stress reduction in nurses. International Journal of Nursing Knowledge, 25(2), 119–130. https://doi.org/10.1111/2047-3095.12025
  50. Spijkerman, M. P. J., Pots, W. T. M., & Bohlmeijer, E. T. (2016). Online mindfulness interventions meta-analysis. Clinical Psychology Review, 45, 102–114. https://doi.org/10.1016/j.cpr.2016.03.009
  51. Suni, M. S., Nirmala, V., & Sikkandar, S. (2017). Stress and job satisfaction among nurses. Asian Journal of Nursing Education & Research, 7(1), 31.
  52. Titov, N., et al. (2008). Internet-based CBT RCT. Australian and New Zealand Journal of Psychiatry, 42(12), 1030–1040. https://doi.org/10.1080/00048670802512107
  53. Trowbridge, K., & Lawson, L. M. (2016). Mindfulness in social work. Social Work in Health Care, 55(2), 101–124. https://doi.org/10.1080/00981389.2015.1094165
  54. UMMC. (2016). About UMMC. University Malaya Medical Centre.
  55. Wylde, C. M., et al. (2017). Smartphone mindfulness for nurses. Journal of Pediatric Nursing, 36, 205–212. https://doi.org/10.1016/j.pedn.2017.06.008
  56. Zainal, N., Nor-Aziyan, Y., & Subramaniam, P. (2015). MAAS psychometric properties in Malaysia. MJP Online Early, 24(1), 1–9.

Cite

Ghawadra SF, Lim Abdullah K, Choo WY, Danaee M, Phang CK. The effect of mindfulness-based training on stress, anxiety, depression and job satisfaction among ward nurses: A randomized control trial. J Nurs Manag. 2020;28:1088–1097. https://doi.org/10.1111/jonm.13049

COPY CITATION Copied!