Calm in the Chaos: A Mixed-Methods Pilot Study Using a Mobile Mindfulness App to Manage Stress and Burnout Among Emergency Department Nurses.
Michelle Kober, Jennifer A Livingston, Christopher Barrick, Yu-Ping Chang
Journal of holistic nursing : official journal of the American Holistic Nurses' Association March 11, 2026 DOI: 10.1177/08980101261424557 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Explanatory sequential mixed-methods pilot study Qualitative Peer reviewed |
|---|---|
| Sample size | 11 |
| Population | Emergency department nurses |
| Duration | 4 weeks |
| Topics | Meditation |
| Keywords | Stress Burnout Mixed methods Holistic nursing Emergency department nurses Mobile app |
| Key points | Among 11 emergency department nurses, four weeks of Headspace app use was associated with significantly decreased perceived stress and significantly increased mindfulness and well-being, while burnout scores showed no significant change. Interview themes covered usability, personal impact, barriers to engagement, and recommendations for improvement. The authors conclude that mobile mindfulness is a feasible holistic, self-directed intervention aligned with holistic nursing values. |
Abstract
Background: Emergency department (ED) nurses are routinely exposed to high-stress clinical environments, increasing their risk for burnout and emotional exhaustion. In holistic nursing, self-care is viewed as a professional and ethical responsibility essential to delivering whole-person care. This pilot study, guided by the Integrative Nursing Framework, explored the use of a mobile mindfulness app as a holistic intervention to support nurse well-being.
Purpose: To explore how ED nurses experience and manage stress and burnout and to evaluate the effects of a mobile mindfulness app on these outcomes.
Methods: An explanatory sequential mixed-methods design was used. Eleven ED nurses used the Headspace app for 4 weeks and completed pre- and post-intervention surveys measuring perceived stress, burnout, mindfulness, and well-being. Nine participants also completed post-intervention interviews. Quantitative data were analyzed using Wilcoxon signed-rank tests; qualitative data were analyzed using thematic analysis.
Results: Perceived stress significantly decreased, while mindfulness and well-being significantly increased. Burnout scores showed no significant change. Themes included usability, personal impact, barriers to engagement, and recommendations for improvement.
Conclusions: This study demonstrates the feasibility of mobile mindfulness as a holistic, self-directed intervention that aligns with holistic nursing values and supports ED nurses' well-being in demanding care environments.
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 |