The effectiveness of mindfulness-based nursing management intervention programme on compassion fatigue, resilience, and social support among oncology nurses: a randomised controlled trial with mediating role of physiological biomarkers.
Muhammad Sohaib, Yue Liqing
BMC Nursing April 18, 2026 DOI: 10.1186/s12912-026-04648-2 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 100 |
| Population | Oncology nurses at a single hospital |
| Intervention | Mindfulness-based resilience intervention |
| Duration | 8-week intervention, outcomes measured at baseline and weeks 1, 3, 8, and 12 |
| Topics | Meditation |
| Keywords | Resilience Social support Randomised controlled trial Compassion fatigue Nursing leadership Oncology nursing Mindfulness-based intervention Wearable stress monitoring Cortisol biomarker Physiological mediation |
| Key findings | A management-led, eight-week mindfulness-based resilience programme reduced compassion fatigue, increased resilience and perceived social support, and lowered serum cortisol and smartwatch-derived stress among oncology nurses compared with standard institutional training. Cortisol partially mediated the association between social support and psychological outcomes. The authors argue that resilience training integrated into nursing leadership is a viable response to high-stress clinical settings and should be adopted more widely and evaluated further. |
Abstract
Background: Oncology nurses face long-term emotional pressures that contribute to compassion fatigue, decreased resilience, and a lack of social support. The number of interventions integrated into clinic workflows or directed by nursing management is modest. This study examined a mindfulness-based resilience intervention offered by nursing leadership.
Methods: In a single-blind, parallel-group randomised controlled trial done in a single hospital, 100 oncology nurses were randomly allocated (1:1) to either mindfulness-based intervention (eight weeks) or standard institutional training. Randomisation was conducted using a computer-generated allocation sequence. Because of the intervention nature, group assignment was known to the participants, yet outcome assessors and data analysts were not allocated. The mindfulness-based programme in the intervention group commenced immediately after the baseline assessment, whereas the institutional training in the control group was undertaken during the same period. Compassion fatigue, resilience, and perceived social support were the primary outcomes, measured at baseline and at weeks 1, 3, 8, and 12. Serum cortisol levels and indicators provided by smartwatches were used to assess physiological stress. Pathways of biomarkers were analysed through mediation analysis. All analyses were carried out on an intention-to-treat basis.
Findings: The management-led mindfulness programme resulted in a significant decrease in compassion fatigue markers, enhanced resilience, and increased perceived social support among participating nurses. General Linear Model repeated-measures analysis revealed significant time × group effects across psychological and physiological outcomes (Pillai’s Trace = 0.95–0.99, p < 0.001), with marked reductions in serum cortisol and smartwatch-derived stress. Cortisol partially mediated the association between social support and psychological outcomes (indirect effect = 0.12, 95% CI 0.03–0.22), and structural equation modelling confirmed this pathway with excellent fit indices (CFI = 0.998; RMSEA = 0.034). The programme was well tolerated, with no adverse events reported.
Results: Oncology nurses’ psychological and physiological well-being improves with a management-led mindfulness intervention. Resilience training integrated into nursing leadership is a viable solution to the high-stress conditions in clinical settings. It should be adopted more generally and evaluated in the future. CLINICAL TRIAL NUMBER: Not applicable.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 8
- Effects of a mindfulness-based interventions on stress, burnout in nurses: a systematic review and meta-analysis Frontiers in Psychiatry August 3, 2023
- Effectiveness of mindfulness-based interventions on burnout, resilience and sleep quality among nurses: a systematic review and meta-analysis of randomized controlled trials. BMC Nursing July 1, 2025
- Long-term effectiveness of the Mindful Self-Compassion programme compared to a Mindfulness-Based Stress Reduction intervention: a quasi-randomised controlled trial involving regular mindfulness practice for 1 year. Frontiers in Psychology 2025
- Mindfulness-based stress reduction training supplemented with physiological signals from smartwatch improves mindfulness and reduces stress, but not anxiety and depression. PLoS One 2025
- How mindfulness-based training improves stress-related health: a selective review of randomized clinical trials comparing psychological mechanisms of action. Frontiers in Endocrinology August 4, 2025
and 3 more in the library