A MINDFULNESS BASED APPROACH TO STUDENT SELF CARE Brenda G Kucirka PhD, PMHCNS-BC, CNE Assistant Professor Widener University Chester, PA
Disclosure: The speaker has no conflicts of interest No sponsorship or commercial support was received
Learning Objectives: 1. Explore strategies to support nursing student wellbeing. 2. Discuss strategies and considerations to support adherence to research protocols. 3. Examine the benefits of MBSR and cognitive behavioral interventions in nursing education.
Problem Stress is the top impediment to academic performance and wellbeing. (National College Health Association, 2015) Nursing students report: Increased anxiety & stress Inability to shut down at night Sleep deprivation and fatigue (Mills, Krouse, Schwartz & Klein, (2017)
Literature Review Unmanaged stress leads to increased student attrition and negative physical & psychological consequences (Hensel & Laux, 2014; Ratanasiripong, Park, Ratanasiripong, & Kathalae, 2015). MBSR and cognitive behavioral interventions increase student wellbeing and decrease anxiety & stress (Regehr, Glancy & Pitts, 2013; van der Riet, Rossiter, Kirby, Dluzewska, & Harmon, 2015).
Purpose of study To determine if an 8 week mindfulness based stress reduction (MBSR) intervention and journaling would decrease stress, improve sleep and positively impact wellbeing among junior level nursing students
Methods & Design Mixed methods Pilot study Pretest-posttest control group design
Hypothesis: A MBSR intervention and journaling will improve wellbeing among nursing students.
Sample N= 9 junior level nursing students Ethnicity : 1 African American 1 Asian 5 Caucasian 2 Mixed race Gender: 9 females
Data Collection University IRB & Dean approval After consent, students were randomly assigned to control and experimental groups.
Instruments Student Nurse Stress Index (SNSI) WHO-5 Wellbeing Index Lifestyle questionnaire Demographic form
Experimental Group Protocol: 8 Week Mindfulness Based Intervention Nightly 5 minute journaling using brain dump technique Nightly 12 minute body scan meditation Source: UCLA Mindful Awareness Research Center http://marc.ucla.edu/mindful-meditations
Descriptive Statistics N = 9 Min. Max. Mean Std Error Age 20 26 21.11.69 Pre test WHO 9.00 17.00 13.89.82 Post test WHO Pre test SNSI Post test SNSI 6.00 20.00 13.67 1.44 52.00 87.00 65.78 3.45 58.00 90.00 69.44 3.68
Paired T- Test Results Control n = 5 Pre test Mean Post test Mean WHO-5 14.60 11.20 SNSI 67.60 69.00 Experimental Pre test Post test n = 4 Mean Mean WHO-5 13.00 16.75 SNSI 63.50 70.00
Comparison of Groups Equality of Sig (2 tailed) means Pre WHO-5 t =.37 p =.96 Post WHO-5 t =-2.4 p =.046 * Pre SNSI t =.57 p =.59 Post SNSI t =-1.3 p =.90 *Post WHO-5 results were significant
Quantitative Findings Students in the experimental group experienced improved wellbeing. Control group wellbeing decreased. Perceived stress increased for both groups
Qualitative Findings/Themes Academic stress overload Relationship strain Feeling overwhelmed with no life Anxiety and sadness Sleep deprivation viewed as the norm Clinical pressures
Qualitative Findings/Themes Those who consistently completed the protocol reported improved sleep and ability to relax at night. Several students apologized in their journal for inconsistency in maintaining the protocol.
Considerations Timing Academic schedule Historical factors related to stress throughout the curriculum
Considerations Meet with the experimental group weekly to practice mindfulness as a group. Weekly check in with students to foster buy in for the protocol and consistency in MBSR practice.
Future Research Proactive strategies & approaches for building coping skills and self-care Longitudinal research of a stress inoculation strategy to identify crucial points for intervention & early signs of students at risk.
?QUESTIONS? You can't stop the waves, but you can learn to surf. ~ Jon Kabat-Zinn
References A "BRAIN DUMP" MAY HELP YOU SLEEP BETTER. (2013). USA Today Magazine, 141(2815), 16. American College Health Association. (2015). American College Health Association National College Health Assessment Spring 2015 Reference Group Executive Summary. Retrieved from http://www.achancha.org/docs/achancha_ Reference_Group_ExecutiveSummary_Spring20 15.pdf
References Chernomas, W.M. & Shapiro, C. (2013). Stress, anxiety and depression among undergraduate nursing students. International Journal of Nursing Education Scholarship. 10(1), 255-266. Hensel, D. & Laux, M. (2014). Longitudinal study of stress, self care, and professional identity among nursing students. Nurse Educator, 39, 227-231. doi:10.1097/nne.0000000000000057
References Mills, S., Krouse, A., Schwartz, R., & Klein, J. (2017). Curriculum revision: Student stress and lessons learned. Manuscript accepted for publication. Ratanasiripong, P., Park, J. F., Ratanasiripong, N., & Kathalae, D. (2015). Stress and anxiety management in nursing students: Biofeedback and mindfulness meditation. Journal of Nursing Education, 54(9), 520-524. doi:10.3928/01484834-20150814-07
References Regehr, C., Glancy, D., & Pitts, A. (2013). Interventions to reduce stress in university students: A review and meta-analysis. Journal of Affective Disorders, 148(1), 1-11. doi:10.1016/j.jad.2012.11.026 van der Riet, P., Rossiter, R., Kirby, D., Dluzewska, T., & Harmon, C. (2015). Piloting a stress management and mindfulness program for undergraduate nursing students: Student feedback and lessons learned. Nurse Education Today, 35(1), 44-49. doi:10.1016/j.nedt.2014.05.003