Mindful Coloring to Reduce Nurses' Stress

Coloring as a Brief Mindfulness-based Intervention for Stress Reduction Among Nurses

The purpose of this study was to investigate whether nurses who did mindful coloring for at least five working days during a 10-day period experienced stress reduction afterwards.

Study Overview

• Status: Completed
• Conditions: Stress (Psychology); Burn Out (Psychology)
• Intervention / Treatment: Behavioral: Coloring as a brief mindfulness-based intervention

Detailed Description

Enrolled participants who met inclusion criteria (full-time clinical nurses working for at least five days during a specified 10-day period) were randomized in 1:1 ratio to the coloring or control groups. A third party did the allocation sequence and concealment. After giving informed consent, participants completed the baseline questionnaire and the coloring group watched an instructional video on mindful coloring. The coloring group were asked to color for any length of time on at least five working days during a 10-day period (period A) while the control group were asked to do it on a subsequent 10-day (period B). The post-intervention questionnaire was completed by both groups at the end of period A. The study was completed after period B.

• Study Type: Interventional
• Enrollment (Actual): 79
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hong Kong
  • Shatin
    • Hong Kong, Shatin, Hong Kong, 852
      • Prince of Wales Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Full time clinical nurses working under the Hospital Authority who would be working for at least 5 days during a specified 10-day study period.

Exclusion Criteria:

-

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Coloring; This group did mindful coloring for at least 5 days or at least 100 minutes in total during a 10-day period	Behavioral: Coloring as a brief mindfulness-based intervention; Participants watched an instructional video on mindful coloring at the beginning of the intervention and colored mindfully for at least 5 days or 100 minutes in total during a 10-day period. The intervention included a coloring booklet that contained mandala patterns for coloring.
No Intervention: Wait-list control; This group did not do mindful coloring at all during a 10-day period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in perceived stress	Scores of 0-40 measured by the Perceived Stress Scale. A positive outcome is indicated by a lower post-intervention score.	Time point 1: pre-intervention. Time point 2: post-intervention (10 days)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in mental well-being	Scores of 7-35 measured by the short Warwick-Edinburgh Mental Well-being Scale. A positive outcome is indicated by a higher post-intervention score.	Time point 1: pre-intervention. Time point 2: post-intervention (10 days)
Change in burnout	Three subscales (each with a separate score) assessing three facets of burnout including Emotional Exhaustion (scores 0-54), Depersonalisation (scores 0-30) and Personal Accomplishment (scores 0-48) measured by the Maslach Burnout Inventory - Human Services Survey for medical personnel. Burnout is represented by a combination of high emotional exhaustion and depersonalization scores, together with a low personal accomplishment score. Positive outcomes are indicated by a lower score in Emotional Exhaustion and Depersonalisation, and a higher score in Personal Accomplishment.	Time point 1: pre-intervention. Time point 2: post-intervention (10 days)
Change in trait mindfulness	Scores of 24-120 measured by the Five Facets Mindfulness Questionnaire - short form. A positive outcome is indicated by a higher post-intervention score.	Time point 1: pre-intervention. Time point 2: post-intervention (10 days)

Collaborators and Investigators

• Sponsor: Chinese University of Hong Kong
• Collaborators: City University of Hong Kong
• Investigators: Principal Investigator: Shuk Yan Janet Fong, MSocSc, Chinese University of Hong Kong

Publications and helpful links

General Publications

• Fong JSY, Hui ANN, Ho KM, Chan AKM, Lee A. Brief mindful coloring for stress reduction in nurses working in a Hong Kong hospital during COVID-19 pandemic: A randomized controlled trial. Medicine (Baltimore). 2022 Oct 28;101(43):e31253. doi: 10.1097/MD.0000000000031253.

Study record dates

Study Major Dates

• Study Start (Actual): December 7, 2020
• Primary Completion (Actual): January 12, 2021
• Study Completion (Actual): January 12, 2021

Study Registration Dates

• First Submitted: June 6, 2021
• First Submitted That Met QC Criteria: June 23, 2021
• First Posted (Actual): June 28, 2021

Study Record Updates

• Last Update Posted (Actual): June 30, 2021
• Last Update Submitted That Met QC Criteria: June 25, 2021
• Last Verified: June 1, 2021

More Information

Terms related to this study

• Keywords: mindfulness; nurses; coloring; brief mindfulness-based intervention; mental well-being
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological; Burnout, Psychological
• Other Study ID Numbers: SBRE-20-162

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No
• IPD Plan Description: Participants were ensured confidentiality in this study.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No