Effects of a Course-Based Yoga Intervention on Perceived Stress and Mindfulness Among Nursing Students: A Quasi-Experimental Mixed-Methods Study

Background and

Objectives: Yoga has been proposed as a supportive intervention to enhance mindfulness and reduce stress among nursing students, but evidence from mixed-method studies remains limited. This study aimed to examine the effects of a 12-week course-based yoga intervention on mindfulness and perceived stress and to explore students’ experiences of practicing yoga.

Materials and Methods: A total of 42 second-year nursing students at a university in Istanbul, Türkiye, participated in a mixed-methods study, with 22 students enrolled in the elective Health and Yoga course constituting the intervention group and 20 students enrolled in another elective course constituting the control group. Group allocation was non-randomized and determined by students’ elective-course enrollment. The intervention group attended weekly 90 min yoga sessions for 12 weeks, delivered by a certified instructor (E-RYT 200). Quantitative outcomes were measured using the Mindful Attention Awareness Scale (MAAS) and Perceived Stress Scale (PSS), with baseline-adjusted ANCOVA and change score analyses performed to control for pre-test differences and gender. Effect sizes (partial η2) were reported, and 95% CIs were calculated for the mean differences in change scores. Qualitative data were collected via semi-structured interviews and analyzed thematically, integrating findings with quantitative results.

Results: Baseline-adjusted ANCOVA revealed greater improvements in mindfulness (F(1, 39) = 29.686, p < 0.001, partial η2 = 0.432) and perceived stress (F(1, 39) = 158.293, p < 0.001, partial η2 = 0.802) in the intervention group, controlling for baseline scores. Change score analyses confirmed these

Findings: mindfulness increased (MD = 10.68, 95% CI [6.62, 14.75], p < 0.001) and perceived stress decreased (MD = −11.40, 95% CI [−13.32, −9.48], p < 0.001) significantly more in the intervention group than controls. Qualitative findings complemented the quantitative results, indicating perceived physical (flexibility, posture, pain reduction), mental (positive emotions, awareness, emotion regulation), and social (motivation, interaction) benefits of yoga. Some participants reported hesitation in applying yoga in nursing practice due to cultural barriers.

Conclusions: The findings suggest that participating in a course-based yoga program may help improve mindfulness and support stress reduction among nursing students. Qualitative findings complemented the quantitative results by providing insight into students’ perceived physical, mental, and social experiences of yoga. Given the small, single-center, and self-selected sample, these findings should be interpreted cautiously. Larger, multicenter randomized studies with longer follow-up are needed to confirm these findings and assess their generalizability.