- Upon completion of the mindfulness learning experience, the learner will be able to identify three methods of mindfulness training.
- Upon completion of the mindfulness learning experience, the learner will be able to demonstrate and apply three methods of mindfulness training.
Research Question:
- Is there a statistically significant difference between self-perceived stress levels in undergraduate junior nursing students before and after participating in mindfulness education?
Theoretical Framework:
Dorothea Orem’s Self-Care Deficit
Background on Mindfulness in Healthcare:
Mindfulness is increasingly being utilized in healthcare settings to alleviate pain, decrease stress, and enhance quality of life for patients (Hardison & Roll, 2016). Currently, mindfulness training has not been fully integrated in the health and wellness education of health care providers, despite being the recommended coping tool for nurses (Hunter, 2016). Nurses are at a great risk of experiencing high degrees of stress leading to burnout and have difficulty coping (Adriaenssens, De Gucht & Maes, 2015). Approximately 20% of newly graduated nurses leave the profession within the first year as a result of not caring for their own “self-care deficit,” which necessitates education in nursing school about how to care for oneself (Blair, 2014).
Narrative of the Project:
In one undergraduate, junior nursing course, 107 nursing students were trained by a Koru mindfulness expert on the principles of mindfulness. Koru mindfulness is specifically mindfulness geared towards the college-aged population (The Center for Koru Mindfulness, 2017). The purpose of the quality improvement project was to examine whether incorporating mindfulness training within a nursing foundations curriculum to be beneficial or not. The students were provided a questionnaire created by the researchers, including comparing pre and post-intervention stress scores using a Likert scale and areas for student feedback to describe their stress. The nursing students stress were asked to rank their stress levels in a similar fashion to the 0-10 pain scale. Students were informed the questionnaires were anonymous and to answer honestly. The students were taught foundational principles of mindfulness and meditation. In addition, the nursing students practiced three mindfulness techniques: “whole body scan,” “labeling,” and “leaves in river.” The response rate for the survey was 80.3%.
Limitations:
One nursing class in one university in suburban Chicago utilized mindfulness training, thus limiting generalizability.
Conclusion:
On average, the 86 students reported their stress decreased by 36.4% after participating in the mindfulness intervention. Statistical power was achieved as the sample size of 86 exceeded the minimum sample size of 54 as determined by G*Power (Faul, Erdfelder, Lang, & Buchner, 2007). The descriptive data found that the average score pre-participation was 6.02 points (SD=2.21) and the post-participation score was 3.92 points (SD=2.10). No outliers were identified through the use of a box plot. Normality of data was identified using a Normal Q-Q Plot. The mindfulness training decreased nursing students’ perceived stress by 2.10 points (95% CI, 1.80 to 2.41). A matched-pairs t-test was utilized and found a statistically significant decrease in self-perceived stress levels after the undergraduate junior nursing students participated in mindfulness training t(85)=13.72, p=0.000, d=0.98. Participants appeared to have less stress after completing the mindfulness training exercises. In addition, the most common feedback received from students was: “I feel less stressed,” “I like it; it helped me out of a stressful state,” “It taught me how to focus on what I can control in my life,” and “I will focus on my breathing more in times of stress,” “Learned I need to be present in the now.”
Implications:
Stress can negatively impact nursing students’ academic performance and risk patient safety (Mills, Carter, Rudd, Claxton & O’Brien, 2016). As such, nursing students need to learn strategies for self-care during times of high stress. Mindfulness training offers the nursing students an easy way to care for their mind, body, and spirit with the goal of preventing negative consequences of stress. Mindfulness has a place in preparation of future nurses. While initial research utilizing the researcher’s tool demonstrates statistical significance, further reliability and validity testing are warranted and will be conducted using a group of junior nursing students at a different institution.