Effect of the mindfulness-based program on stress, anxiety and physiological changes among nurse aid students attending the 9 months course of nurse aid training in Myanmar
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20241806Keywords:
Mindfulness-based program, Stress, Anxiety, Serum cortisol, Nurse aid studentsAbstract
Background: Suffering under stress and anxiety was a big challenge for the majority of nurse aid students and it was requisite to pass the 9 months training without attrition to become a qualified nurse aid.
Methods: From 1st week of February to 4th week of May, 2023, 104 nurse aid training students (51 participants in intervention group and 53 participants in control group) from 7 tertiary hospitals in the Yangon Region were conducted by a quasi-experimental study. Data collection was done by asking questionnaire for stress and anxiety, and by collecting blood samples to test serum cortisol level. Data was analysed by using SPSS 23 and independent t-test, one-way repeated measures ANOVA and multiple linear regression with propensity score adjustment were applied.
Results: The mean changes (before- after- followed up) in the Perceived Stress Scale (PSS) and in the Generalized Disorder Scale (GAD) were significantly different between the intervention and control groups displaying a difference in difference mean change of 4.13 (2.41, 5.86) at p<0.001, 3.02 (95%CI: 1.05, 4.99) at p=0.003 and that of 2.45 (95% CI: 1.24, 3.66), p<0.001, 1.49 (95%CI: 0.16, 2.83) at p=029 respectively. Moreover, there was a significant decrease (before-after 8 week intervention) in the serum cortisol level between two groups showing a difference in difference mean change of 39.66 (95% CI: 4.97, 74.34), p=0.026.
Conclusions: This study might observe as supportive evidence of the mindfulness-based program to manage stress and anxiety among nurse aid students.
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References
Lwin PM. Job stress and burnout among hospital nurses in a city of Myanmar; 2015. Available at: https://www.semanticscholar.org/paper/JNURSES-INALwin/7b3a8838c623f153659ed55feb22f6ff70c9919. Accessed on 15 July 2022.
Lwin P, Rattanapan C, Laosee O. Nurses’ intention to remain employed in hospitals: Understanding the shortage in the context of Myanmar. International Journal of Nursing Practice. 2017;23:e12536.
Beddoe AE, Murphy SO. Does mindfulness decrease stress and foster empathy among nursing students? J Nurs Educ. 2004;43(7):305-12.
Spadaro KC, Hunker DF. Exploring The effects Of An online asynchronous mindfulness meditation intervention with nursing students On Stress, mood, And Cognition: A descriptive study. Nurse Education Today. 2016;39:163-9.
Alhawatmeh HN, Rababa M, Alfaqih M, Albataineh R, Hweidi I, Awwad AA. The Benefits of Mindfulness Meditation on Trait Mindfulness, Perceived Stress, Cortisol, and C-Reactive Protein in Nursing Students: A Randomized Controlled Trial. AMEP. 2022;13:47-58.
Champion L, Economides M, Chandler C. The efficacy of a brief app-based mindfulness intervention on psychosocial outcomes in healthy adults: A pilot randomised controlled trial. PLoS One. 2018;13(12):e0209482.
Hofmann SG, Sawyer AT, Witt AA, Oh D. The Effect of Mindfulness-Based Therapy on Anxiety and Depression: A Meta-Analytic Review. J Consult Clin Psychol. 2010;78(2):169-83.
Amundsen R, Riby LM, Hamilton C, Hope M, McGann D. Mindfulness in primary school children as a route to enhanced life satisfaction, positive outlook and effective emotion regulation. BMC Psychology. 2020;8(1):71.
Koncz A, Demetrovics Z, Takacs ZK. Meditation interventions efficiently reduce cortisol levels of at-risk samples: a meta-analysis. Health Psychology Review. 2021;15(1):56-84.
Braun SE, Dow A, Loughan A, Mladen S, Crawford M, Rybarczyk B, et al. Mindfulness training for healthcare professional students: A waitlist controlled pilot study on psychological and work-relevant outcomes. Complement Ther Med. 2020;51:102405.
Johnson N. The Impact of Mindfulness on Healthcare Provider Burnout During COVID-19. Mindfulness Studies Theses. Available from: https://digital commons.lesley.edu/mindfulness_theses/48. Accessed on 22 May 2021.
Kabat-Zinn J. Mindfulness-based interventions in context: Past, present, and future. Clin Psychol Sci Pract. 2003;10(2):144-56.
Balakrishnan P, Abraham D. Aerobic exercises: Types and its benefit for children. International Journal of Nursing Education and Research. 2021;9(1):120-2.
Norton KI, Norton L. Pre-exercise screening: guide to the Australian adult pre-exercise screening system. Exercise and Sport Science Australia, fitness Australia and Sports Medicine Australia. Flinders Univ. 2011.
Physical Fitness Dance Myanmar စည်းလုံးခြင်းသည်အင်အား credit-original. 2021. Available from: https://www.youtube.com/ watch?v=z5NrUwBb23Q. Accessed on 11 August 2022.
Bushman BA. Determining the I (Intensity) for a FITT-VP Aerobic Exercise Prescription. ACSM’s Health & Fitness Journal. 2014;18(3):4-7.
Cohen S, Kamarck T, Mermelstein R. A Global Measure of Perceived Stress. Journal of Health and Social Behavior. 1983;24(4):385-96.
She Z, Li D, Zhang W, Zhou N, Xi J, Ju K. Three Versions of the Perceived Stress Scale: Psychometric Evaluation in a Nationally Representative Sample of Chinese Adults during the COVID-19 Pandemic. Int J Environ Res Public Health. 2021;18(16):8312.
Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-7.
Tong X, An D, McGonigal A, Park SP, Zhou D. Validation of the Generalized Anxiety Disorder-7 (GAD-7) among Chinese people with epilepsy. Epilepsy research. 2016;1:31-6.
Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction With Life Scale. J Pers Assess. 1985;49(1):71-5.
Turkal M, Richardson LG, Cline T, Guimond ME. The effect of a mindfulness based stress reduction intervention on the perceived stress and burnout of RN students completing a doctor of nursing practice degree. JNEP. 2018;8(10):58.
Donato ECDSG, Quinhoneiro DCG, Gimenez LBH, Hernandes Siqueira LH, Serrano KVD, Zanetti ACG. Efetividade de uma intervenção baseada em Mindfulness para redução de estresse e melhora da qualidade de vida em estudantes de enfermagem. SMAD Rev Eletr Saúde Mental Álcool Drog. 2020;16(3):33-43.
Dodson J. The Effects of Mindfulness on Test Anxiety in Nursing Students. 2021. Available from: https://mospace.umsystem.edu/xmlui/handle/10355/83241. Accessed on 17 May 2022.
Franco H. Testing the impact of an online mindfulness program on prelicensure nursing students stress and anxiety. Nursing Forum. 2022;57(2):288-97.
Kang YS, Choi SY, Ryu E. The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. Nurse Education Today. 2009;29(5):538-43.
Chen Y, Yang X, Wang L, Zhang X. A randomized controlled trial of the effects of brief mindfulness meditation on anxiety symptoms and systolic blood pressure in Chinese nursing students. Nurse Education Today. 2013;33(10):1166-72.
Seidi P, Ahmad A. The effect of mindfulness-based stress reduction on the test anxiety of Students at the University of Garmian. Journal of Garmian University. 2018;5:465-74.
Kim SH, Schneider SM, Bevans M, Kravitz L, Mermier C, Qualls C, et al. PTSD Symptom Reduction With Mindfulness-Based Stretching and Deep Breathing Exercise: Randomized Controlled Clinical Trial of Efficacy. The Journal of Clinical Endocrinology & Metabolism. 2013;98(7):2984-92.
Turakitwanakan W, Mekseepralard C, Busarakumtragul P. Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai. 2013;96 Suppl 1:S90-5.
Mousavi E, Sadeghi-Bahmani D, Khazaie H, Brühl AB, Stanga Z, Brand S. The Effect of a Modified Mindfulness-Based Stress Reduction (MBSR) Program on Symptoms of Stress and Depression and on Saliva Cortisol and Serum Creatine Kinase among Male Wrestlers. Healthcare. 2023;11(11):1643.
Knezevic E, Nenic K, Milanovic V, Knezevic NN. The Role of Cortisol in Chronic Stress, Neurodegenerative Diseases, and Psychological Disorders. Cells. 2023;12(23):2726.
Yazdani M, Esmaeilzadeh M, Pahlavanzadeh S, Khaledi F. The effect of laughter Yoga on general health among nursing students. Iran J Nurs Midwifery Res. 2014;19(1):36-40.
Mathad MD, Pradhan B, Sasidharan RK. Effect of Yoga on Psychological Functioning of Nursing Students: A Randomized Wait List Control Trial. J Clin Diagn Res. 2017;11(5):KC01-5.
Chaabane S, Chaabna K, Bhagat S, Abraham A, Doraiswamy S, Mamtani R, et al. Perceived stress, stressors, and coping strategies among nursing students in the Middle East and North Africa: an overview of systematic reviews. Syst Rev. 2021;10(1):136.
Hilcove K, Marceau C, Thekdi P, Larkey L, Brewer MA, Jones K. Holistic Nursing in Practice: Mindfulness-Based Yoga as an Intervention to Manage Stress and Burnout. J Holist Nurs. 2021;39(1):29-42.
Stefanaki C, Bacopoulou F, Livadas S, Kandaraki A, Karachalios A, Chrousos GP, et al. Impact of a mindfulness stress management program on stress, anxiety, depression and quality of life in women with polycystic ovary syndrome: a randomized controlled trial. Stress. 2015;18(1):57-66.
