Analyzing the effect of theoretical mindfulness-nursing-education-programme on students’ stress, resilience, and heart rate variability: A quasi-experimental study

J T Tseng; Jo Wu

doi:10.1186/s12909-026-09176-w

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Analyzing the effect of theoretical mindfulness-nursing-education-programme on students’ stress, resilience, and heart rate variability: A quasi-experimental study

Journal article

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Analyzing the effect of theoretical mindfulness-nursing-education-programme on students’ stress, resilience, and heart rate variability: A quasi-experimental study

J T Tseng and Jo Wu

BMC Medical Education, Vol.Advanced access

18-May-2026

DOI: https://doi.org/10.1186/s12909-026-09176-w

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Abstract

mindfulness

mindfulness-based cognitive therapy

college

university nursing students

stress

resilience

quasi-experimental design

Background Stress adversely affects nursing students’ well-being and clinical communication. This study examined the effects of a newly developed mindfulness-based nursing education programme (MINDNUEDU) on perceived stress, resilience, and heart rate variability (HRV) among nursing students. Methods A quasi-experimental, two-arm pre–post design was conducted at a university in Taiwan. Seventy nursing students were allocated to either an eight-week mindfulness intervention group (n = 36) or a standard curriculum control group (n = 34) based on academic scheduling constraints. Primary outcomes were perceived stress, measured using the Perceived Stress Scale, and resilience, measured using the Connor–Davidson Resilience Scale. Secondary outcomes included HRV indices (SDNN, RMSSD, and HF power), assessed within the intervention group. Adjusted between-group differences over time were analyzed using Generalized Estimating Equations, controlling for baseline values and year of study. Results After adjustment for baseline differences, significant Group × Time interactions were observed for perceived stress (p = .004) and resilience (p < .001), indicating greater improvements in the intervention group compared with controls. The mean increase in resilience exceeded the minimal clinically important difference. A significant dose–response relationship was also identified, with higher attendance linearly associated with greater reductions in stress (p = .003) and greater gains in resilience (p = .004). Within the intervention group, session-level analyses demonstrated acute post-session increases in parasympathetic-related HRV indices across several weeks. Conclusions Participation in the MINDNUEDU programme was associated with reduced perceived stress and increased resilience among nursing students. While physiological findings reflected short-term autonomic changes during sessions rather than confirmed long-term trait adaptation, the results support the feasibility of integrating structured mindfulness training into nursing education. Randomized controlled trials with longitudinal follow-up are needed to confirm sustainability and causal effects.

Details

Title: Analyzing the effect of theoretical mindfulness-nursing-education-programme on students’ stress, resilience, and heart rate variability: A quasi-experimental study
Authors: J T Tseng - Chang Gung University of Science and Technology
Jo Wu (Corresponding Author) - University of the Sunshine Coast
Publication details: BMC Medical Education, Vol.Advanced access
Publisher: BioMed Central Ltd.
DOI: 10.1186/s12909-026-09176-w
ISSN: 1472-6920
Copyright note: This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Grant note: This study was supported by Ministry of Science and Technology (MOST 110-2511-H-255-009), Taiwan.
Organisation Unit: Healthy Ageing Research Cluster; School of Health - Nursing
Language: English
Record Identifier: 991223826502621
Output Type: Journal article

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