The Benefits of Mindfulness Meditation on Trait Mindfulness, Perceived Stress, Cortisol, and C-Reactive Protein in Nursing Students: A Randomized Controlled Trial

Hossam N Alhawatmeh, Mohammad Rababa, Mahmoud Alfaqih, Raya Albataineh, Issa Hweidi, Awwad Abu Awwad, Hossam N Alhawatmeh, Mohammad Rababa, Mahmoud Alfaqih, Raya Albataineh, Issa Hweidi, Awwad Abu Awwad

Abstract

Purpose: Mindfulness meditation was used to reduce stress and its responses such as cortisol and C-reactive protein (CRP) among healthy and ill individuals in various cultures, but its effect has not yet been studied among nursing students, experiencing tremendous stress. The objective of this study was to examine the effects of mindfulness meditation on trait mindfulness, perceived stress, serum cortisol, and serum C-reactive proteins (CRP) in nursing students.

Patients and methods: Using a two-arm, randomized, parallel study (conducted in a large university in Jordan, 108 nursing students were randomly assigned to experimental group receiving five 30-minute weekly sessions of mindfulness meditation and control group sitting quiet during the experimental sessions. Trait mindfulness, perceived stress, serum cortisol, and CRP were measured at baseline and end of the intervention.

Results: Using one-way MANOVA and post-hoc comparisons, the results showed that mindfulness meditation was significantly effective in decreasing serum cortisol levels and perceived stress. The mindfulness meditation also decreased CRP and increased trait mindfulness although the results did not reach statistically significant levels.

Conclusion: These findings underscore the need for serious consideration of mindfulness meditation in nursing colleges to improve stress and raise immunity in this vulnerable population.

Trial registration: Mindfulness Meditation for Nursing Students: clinicaltrials.gov, identifier: NCT05099224.

Keywords: C-reactive proteins; cortisol; meditation; mindfulness; nursing students; stress.

Conflict of interest statement

The authors declare no conflicts of interest in this work. The funder (Jordan University of Science and Technology) had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

© 2022 Alhawatmeh et al.

Figures

Figure 1
Figure 1
Study flow diagram for the study participants.

References

    1. Foster K, Roche M, Giandinoto JA, et al. Mental health matters: a cross-sectional study of mental health nurses’ health-related quality of life and work-related stressors. Int J Ment Health Nurs. 2021;30(3):624–634. doi:10.1111/inm.12823
    1. Al-Zayyat AS, Al-Gamal E. Perceived stress and coping strategies among Jordanian nursing students during clinical practice in psychiatric/mental health courses. Int J Ment Health Nurs. 2014;23(4):326–335. doi:10.1111/inm.12054
    1. Labrague LJ, McEnroe–Petitte DM, Santos DL, et al. Examining stress perceptions and coping strategies among Saudi nursing students: a systematic review. Nurse Educ Today. 2018;65:192–200. doi:10.1016/j.nedt.2018.03.012
    1. Chaabane S, Chaabna K, Bhagat S, 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):1–7. doi:10.1186/s13643-021-01691-9
    1. Kinlein SA, Karatsoreos IN. The hypothalamic-pituitary-adrenal axis as a substrate for stress resilience: interactions with the circadian clock. Front Neuroendocrinol. 2020;56:100819. doi:10.1016/j.yfrne.2019.100819
    1. Hannibal KE, Bishop MD. Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys Ther. 2014;94(12):1816–1825. doi:10.2522/ptj.20130597
    1. Cruz-Topete D, Cidlowski JA. One hormone, two actions: anti-and pro-inflammatory effects of glucocorticoids. Neuroimmunomodulation. 2015;22:20–32. doi:10.1159/000362724
    1. Saul AN, Oberyszyn TM, Daugherty C, et al. Chronic stress and susceptibility to skin cancer. J Natl Cancer Inst. 2005;97(23):1760–1767. doi:10.1093/jnci/dji401
    1. Mizoguchi K, Ishige A, Aburada M, Tabira T. Chronic stress attenuates glucocorticoid negative feedback: involvement of the prefrontal cortex and hippocampus. Neuroscience. 2003;119(3):887–897. doi:10.1016/S0306-4522(03)00105-2
    1. Knight EL, Jiang Y, Rodriguez-Stanley J, et al. Perceived stress is linked to heightened biomarkers of inflammation via diurnal cortisol in a national sample of adults. Brain Behav Immun. 2021;93:206–213. doi:10.1016/j.bbi.2021.01.015
    1. Markozannes G, Koutsioumpa C, Cividini S, et al. Global assessment of C-reactive protein and health-related outcomes: an umbrella review of evidence from observational studies and Mendelian randomization studies. Eur J Epidemiol. 2021;36(1):11–36. doi:10.1007/s10654-020-00681-w
    1. Khader YS, Alsadi AA. Smoking habits among university students in {: prevalence and associated factors. East Mediterr Health J. 2008;14(4):897–904.
    1. Khater W, Akhu-Zaheya L, Shaban I. Sources of stress and coping behaviours in clinical practice among baccalaureate nursing students. Int J Humanit Soc Sci. 2014;4(6):194–202.
    1. Amanvermez Y, Rahmadiana M, Karyotaki E, et al. Stress management interventions for college students: a systematic review and meta-analysis. Clin Psychol. 2020. doi:10.1111/cpsp.12342
    1. Yanyu J, Xi Y, Huiqi T, et al. Meditation-based interventions might be helpful for coping with the Coronavirus disease 2019 (COVID-19). OSF Preprints. 2020. doi:10.31219/
    1. Zhang D, Lee EKP, Mak ECW, et al. Mindfulness-based interventions: an overall review. Br Med Bull. 2021;138(1):41–57. doi:10.1093/bmb/ldab005
    1. Virgili M. Mindfulness-based interventions reduce psychological distress in working adults: a meta-analysis of intervention studies. Mindfulness. 2015;6(2):326–337. doi:10.1007/s12671-013-0264-0
    1. De Vibe M, Solhaug I, Tyssen R, et al. Mindfulness training for stress management: a randomised controlled study of medical and psychology students. BMC Med Educ. 2013;13(1):107. doi:10.1186/1472-6920-13-107
    1. Garland E, Gaylord S, Park J. The role of mindfulness in positive reappraisal. Explore. 2009;5(1):37–44. doi:10.1016/j.explore.2008.10.001
    1. Kabat-Zinn J. Mindfulness-based interventions in context: past, present, and future. Clin Psychol Sci Pract. 2003;10(2):144–156. doi:10.1093/clipsy/bpg016
    1. Lahtinen O, Aaltonen J, Kaakinen J, et al. The effects of app-based mindfulness practice on the well-being of university students and staff. Curr Psychol. 2021. doi:10.1007/s12144-021-01762-z
    1. De Sousa GM, de Lima-araújo GL, de Araújo DB, et al. Brief mindfulness-based training and mindfulness trait attenuate psychological stress in university students: a randomized controlled trial. BMC Psychol. 2021;9(1):1–4. doi:10.1186/s40359-021-00520-x
    1. Lazarus RS, Folkman S. Stress, Appraisal, and Coping. New York, USA: Springer publishing company; 1984.
    1. Pascoe MC, de Manincor M, Tseberja J, et al. Psychobiological mechanisms underlying the mood benefits of meditation: a narrative review. ComprPsychoneuroendocrinology. 2021;6:100037. doi:10.1016/j.cpnec.2021.100037
    1. Galante J, Dufour G, Vainre M, et al. A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial. Lancet Public Health. 2018;3(2):e72–e81. doi:10.1016/S2468-2667(17)30231-1
    1. Chiodelli R, Mello LTN, Jesus SN, et al. Effects of a brief mindfulness-based intervention on emotional regulation and levels of mindfulness in senior students. Psicol Reflex Crit. 2018;31:21. doi:10.1186/s41155-018-0099-7
    1. Sanada K, Montero-Marin J, Alda Diez M, et al. Effects of mindfulness-based interventions on salivary cortisol in healthy adults: a meta-analytical review. Front Physiol. 2016;7:471. doi:10.3389/fphys.2016.00471
    1. Stevens BS, Royal KD, Ferris K, et al. Effect of a mindfulness exercise on stress in veterinary students performing surgery. Vet Surg. 2019;48(3):360–366. doi:10.1111/vsu.13169
    1. Tang YY, Tang R, Jiang C, et al. Short-term meditation intervention improves self-regulation and academic performance. J Child Adolesc Behav. 2014;2:4. doi:10.4172/2375-4494.1000154
    1. Parsons EM, Dreyer-Oren SE, Magee JC, et al. Evaluating the indirect efects of trait mindfulness facets on state tripartite components through state rumination and state experiential avoidance. J Nerv Ment Dis. 2019;207(6):440–4450. doi:10.1097/NMD.0000000000000993
    1. Heckenberg RA, Eddy P, Kent S, et al. Do workplace-based mindfulness meditation programs improve physiological indices of stress? A systematic review and meta-analysis. J Psychosom Res. 2018;114:62–71. doi:10.1016/j.jpsychores.2018.09.010
    1. Bottaccioli AG, Bottaccioli F, Carosella A, Cofini V, Muzi P, Bologna M. Psychoneuroendocrinoimmunology-based meditation (PNEIMED) training reduces salivary cortisol under basal and stressful conditions in healthy university students: results of a randomized controlled study. Explore. 2020;16(3):189–198. doi:10.1016/j.explore.2019.10.006
    1. Rayan A, Ahmad M. The psychometric properties of the mindful attention awareness scale among Arab parents of children with autism spectrum disorder. Arch Psychiatr Nurs. 2018;32(3):444–448. doi:10.1016/j.apnu.2018.01.001
    1. Almadi T, Cathers I, Mansour AM, et al. An Arabic version of the perceived stress scale: translation and validation study. Int J Nurs Stud. 2012;49(1):84–89. doi:10.1016/j.ijnurstu.2011.07.012
    1. Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol. 2003;84(4):822. doi:10.1037/0022-3514.84.4.822
    1. Cohen S, Kamarck T, Mermelstein RA. Global measure of perceived stress. J Health Soc Behav. 1983;24:385–396. doi:10.2307/2136404
    1. Levine A, Zagoory-Sharon O, Feldman R, et al. Measuring cortisol in human psychobiological studies. Physiol Behav. 2007;90(1):43–53. doi:10.1016/j.physbeh.2006.08.025
    1. Fetzer SJ. Reducing venipuncture and intravenous insertion pain with eutectic mixture of local anesthetic: a meta-analysis. Nurs Res. 2002;51(2):119–124. doi:10.1097/00006199-200203000-00008
    1. Smith JC. Relaxation, Meditation, & Mindfulness: A Mental Health Practitioner’s Guide to New and Traditional Approaches. New York, USA: Springer Publishing Company; 2005.
    1. Rausch SM, Gramling SE, Auerbach SM. Effects of a single session of large-group meditation and progressive muscle relaxation training on stress reduction, reactivity, and recovery. Int J Stress Manag. 2006;13(3):273–290. doi:10.1037/1072-5245.13.3.273
    1. Kiken LG, Garland EL, Bluth K, et al. From a state to a trait: trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness. Pers Individ Dif. 2015;81:41–46. doi:10.1016/j.paid.2014.12.044
    1. Bruno VHT, Catarucci FM, Habimorad PH, et al. Evaluation of inflammatory markers in the practice of meditation in students of medicine: controlled clinical trial. Psicosom Psiquiatr. 2017;esp:10. ID: biblio-946959.
    1. Cohen ZP, Cosgrove KT, Akeman E, et al. The effect of a mindfulness-based stress intervention on neurobiological and symptom measures in adolescents with early life stress: a randomized feasibility study. BMC Complement Med Ther. 2021;21(1):1–4. doi:10.1186/s12906-021-03295-1
    1. Turner L, Galante J, Vainre M, et al. Immune dysregulation among students exposed to exam stress and its mitigation by mindfulness training: findings from an exploratory randomised trial. Sci Rep. 2020;10(1):5812. doi:10.1038/s41598-020-62274-7
    1. Eisendrath SJ, Gillung E, Hartzler A, et al. Mindfulness-based cognitive therapy associated with decreases in C-reactive protein in major depressive disorder: a pilot study. J Altern Complement Integr Med. 2016;2:010.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir