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Using a Nature-Based Mindfulness Intervention to Improve Mental Health in Nurse Anesthesia Students: A Pilot Study.

Allan Lovern, M. Watson, A. Hollis, Lindsay Quinlan, Yuhua Su

AANA journal April 1, 2026 DOI: 10.70278/aanaj/.0000001058 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Single-arm pilot pre-/posttest study Randomized Pilot study Qualitative Peer reviewed
Population Third-year resident registered nurse anesthetists (RRNAs) in the southeastern United States
Intervention Nature-based mindfulness intervention (NBMI)
Duration 8-week intervention, postintervention assessment
Measures DASS-21
Topics Meditation
Keywords Education
Key points Anxiety significantly decreased (P = .039) after the 8-week nature-based mindfulness intervention; stress and depression scores decreased but not significantly. Qualitative findings indicated improved mental clarity, emotional well-being, and peer connection.

Abstract

Resident registered nurse anesthetists (RRNAs) face high levels of depression, anxiety, and stress (DAS) due to the academic, clinical, and financial demands of graduate anesthesia education. Nature-based mindfulness, which integrates nature exposure with mindfulness practices, has shown promise in reducing psychological distress but remains underexplored among RRNAs. This single-arm pilot, pre-/posttest study evaluated the effectiveness of a nature-based mindfulness intervention (NBMI) on DAS in a cohort of third-year RRNAs in the southeastern United States. The 8-week intervention included guided nature walks, box breathing exercises, and gratitude journaling. Depression, anxiety, and stress were measured pre- and postintervention using DASS-21. Focus groups explored participants' experiences postintervention. Quantitative analysis revealed a statistically significant reduction in anxiety levels (P = .039). Stress and depression scores decreased but did not reach statistical significance. Qualitative findings reflected improved mental clarity, emotional well-being, and peer connection. Findings suggest that NBMI is an effective, feasible, low-cost strategy to enhance well-being in RRNAs. Larger, randomized studies are warranted to examine the broader applicability of NBMI in nurse anesthesia education.