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.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |