Plain English Summary
Background and study aims
Nursing students are prone to high levels of stress. This can lead to poor physical and psychological health and result in low self-esteem and poorer academic performance. Students that are able to reduce their stress levels will be healthier, more productive and will be more successful in their academic and clinical studies. This, in turn, is likely to improve the quality of nursing care. The mindfulness-based stress reduction (MBSR) program is an eight-week workshop that teaches people a number of mindfulness techniques. It is known to significantly reduce stress levels, anxiety and depression. There have been several studies on MBSR that has been used to reduce stress levels in student nurses, but only with small groups of people, with no control group or tailored program. This study will assess how effective the program is at reducing stress and depression in Thai nursing students and whether it improves their self-esteem and mindfulness.
Who can participate?
Male and female nursing students, aged 18-20 years studying in the first and the second years of the Bachelor of nursing at the University of Phayao, Thailand.
What does the study involve?
127 participants are randomly assigned into one of two study groups. One group is split into three groups, all of which attend the MBSR program. The other group is the control. They do not take part in the MBSR program but have access to the mental health services from the Mental Health Counselling Centre at the university. All participants are asked to complete a baseline demographic questionnaire, collecting information on age, gender, year of study, educational background, religion, family status, financial status and any previous experiences of mindfulness practice. We also ask them to complete a series of questionnaires assessing stress, depression, self-esteem, mindfulness and use of health and counselling services. These questionnaires are collected at the beginning of the study and then at 8-weeks, 16-weeks and 32-weeks afterwards. We will also look at the participants academic grades, to investigate the impact of stress and stress management on their academic performance. Control participants will be offered the opportunity to receive a two-day intensive mindfulness workshop once the study is completed.
What are the possible benefits and risks of participants?
Benefits: Participants in the MBSR program are likely to benefit by learning to use mindfulness techniques to more effectively manage stress.
Risks: Some participants in the MBSR might experience discomfort including pain, numbness, cramping in the legs, and drowsiness.
Where is the study run from?
School of Nursing and Midwifery, Faculty of Health and Medicine, the University of Newcastle, Australia
When is the study starting and how long is it expected to run for?
From August 2013 to July 2014.
Who is funding the study?
The study is being conducted as PhD research within the School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Australia.
Who is the main contact?
Professor Michael Hazelton
Prof Michael Hazelton
School of Nursing and Midwifery
Faculty of Health and Medicine
The University of Newcastle
+61 2 4921 5695
Effects of mindfulness-based stress reduction (MBSR) on stress, depression, self-esteem and mindfulness in Thai nursing students: A randomised controlled trial
An eight week program of mindfulness-based stress reduction (MBSR) will reduce stress and depression and increase self-esteem and mindfulness in nursing students in Thailand.
The study has joint ethics approval from the following ethics committees:
1. Human Research Ethics Committee, The University of Newcastle (Australia), 24/04/2013; Ref. H-2012-0347
2. Ethical Committee on Human Rights Related to Research Involving Human Subjects, University of Phayao (Thailand), 08/08/2013; Ref. 56-02-04-0008
Randomised double blinded parallel group trial
Primary study design
Secondary study design
Randomised controlled trial
Quality of life
Patient information sheet
Not available in web format, please use the contact details below to request a participant information sheet
Stress and Depression
The intervention group received the MBSR program, whereas the control group were able to access existing mental health services on an as-needed basis. The MBSR program comprised of 8 weekly 2.5 hour group sessions and one full day (8 hours) silent practice, held in the 6th week of the program. The weekly sessions included a series of activities designed to develop mindfulness skills and practice. The MBSR intervention was delivered by a research team member trained in this form of psychosocial intervention.
Primary outcome measures
A series of questionnaires assessing stress, depression, self-esteem, mindfulness were administered at baseline, 8 weeks, 16 weeks and 32 weeks.
1. Stress was measured using the Perceived Stress Scale (PSS); scores ranged from 0 (never) to 4 (very often)
2. Depression was measured using the Centre for Epidemiology Studies-Depression Scale (CES-D); scores ranged from 0 (rarely or none) to 3 (most or all)
3. Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES), scores ranged from 1 (strongly disagree) to 4 (strongly agree)
4. Mindfulness was measured using the Mindful Attention Awareness Scale (MAAS), scores ranged from 0 (almost always) to 6 (almost never)
Secondary outcome measures
1. The utilisation of health and counselling services were measured using a specially designed Health and Counselling Service Utilisation Questionnaire, at baseline, 8 weeks, 16 weeks and 32 weeks
2. Difference in intervention and control group participants academic grades in the undergraduate nursing program was measured by accessing participants' academic records at the end of the academic period (semester) in which the research was conducted
Overall trial start date
Overall trial end date
Participant inclusion criteria
Female and male nursing students, aged 18-20 years and studying in the first and the second years of the Bachelor of Nursing at the University of Phayao, Thailand
Target number of participants
Participant exclusion criteria
Nursing students in the third and fourth years of the Bachelor of Nursing at the University of Phayao, Thailand
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
School of Nursing and Midwifery
The University of Newcastle Australia (Australia) - School of Nursing and Midwifery, the Faculty of Health and Medicine
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting