Mindfulness alleviates stress and anxiety among nursing staff, study confirms

A study by scientists at three Brazilian institutions reported in the journal Archives of Psychiatric Nursing found that practicing mindfulness helped nurses manage their levels of anxiety and stress. The authors mined databases for past research on the topic, selected 14 studies conducted in seven countries, and carried out a systematic review and analysis of these studies.

They opted for a methodology known as meta-analysis, a statistical technique used to combine evidence provided by multiple studies in order to reach more precise and reliable conclusions, which in this case was that mindfulness reduced anxiety and stress to a statistically significant extent.

The search was conducted in October 2022, encompassing seven databases including Web of Science and Scopus. The scientists retrieved 861 articles, and after careful screening selected 14 for systematic review: three were on studies conducted in Australia, two in the United States, one in Portugal, two in China, two in Brazil, three in Malaysia, and one in Taiwan. Thirteen articles were subjected to meta-analysis. All except a study of health workers at a long-term care institution were conducted in hospitals.

Ten of the studies focused on nurses. The other four involved nurses and nursing technicians; nurses, nursing technicians and auxiliary nurses; certified nursing assistants only; and nursing technicians only. The sum total of participants in all 14 studies resulted in a sample of 818 professionals for systematic review.

"The number of robust studies on sickness among nursing staff and their growing use of mindfulness practices was significant, and we realized how important it was to explore the use of this kind of intervention to manage anxiety in the group, combining the two previous research lines," said Karen de Oliveira Santana, first author of the article. She trained as a specialist in mental health and psychiatry at the University of São Paulo's Medical School (FM-USP) and is currently researching for a master's degree at its nursing school (EE-USP).

Mindfulness practitioners direct their attention to the present moment, observing feelings, thoughts and sensory experiences without judging them or reacting automatically, she explained. They use meditation, breathing exercises, and various techniques to enhance self-awareness.

"It helps you pause between stimulus and response so that you think before acting. Conscious breathing and meditation promote physical and mental relaxation, alleviating anxiety and stress so that you can be more aware of your needs," she said.

The article is also signed by several EE-USP colleagues of hers: faculty members Caroline Figueira Pereira and Divane de Vargas, graduate Manuela Silva Ramos, and master's candidate Roni Robson da Silva. The other two co-authors are Maria Neyrian de Fátima Fernandes, a professor in the Department of Nursing at the Federal University of Maranhão (UFMA), and Edilaine Cristina da Silva Gherardi-Donato, a professor at the Ribeirão Preto Nursing School (EERP-USP) with a Ph.D. in Psychiatric Nursing from the same institution.

The use of mindfulness techniques by nursing staff must not diminish the importance of improving their work conditions, according to Santana. "It's possible to manage symptoms of anxiety and stress, but their causes must also be tackled," she said, citing long hours, constant exposure to disease, lack of professional prestige and low pay, all of which heighten the risk of falling sick.

"Because a majority are women, nursing staff also suffer from gender inequity. As if stressful work conditions weren't enough, many also have to cope with housework and other domestic tasks culturally assigned to women. Burnout is increasingly frequent as a result," she said.

The World Health Organization (WHO) report "Depression and Other Common Mental Disorders: Global Health Estimates" finds that Brazil has the largest number of people who suffer from anxiety as a proportion of the population (9.3%). "Improving the nursing staff's quality of life also means improving the quality of care provided," Santana said.