Volume 29, Issue 2 (Spring 2021)                   Avicenna J Nurs Midwifery Care 2021, 29(2): 126-136 | Back to browse issues page

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Talebi M. The Effectiveness of Mindfulness-Based Cognitive Therapy on Anxiety, Happiness and Mindfulness in Nurses. Avicenna J Nurs Midwifery Care 2021; 29 (2) :126-136
URL: http://nmj.umsha.ac.ir/article-1-2215-en.html
Assistant Professor, Department of Psychology, Rah-e Danesh Babol Institute of Higher Education, Mazandaran, Iran , maryam.talebi68@yahoo.com
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The results of the present study showed that cognitive therapy based on mindfulness has increased awareness in the behavioral characteristics of the experimental group in the post-test stage. It seems that cognitive therapy based on mindfulness has a positive effect on increasing happiness and mindfulness in nurses.

Extended Abstract:   (1253 Views)

Psychological health is recognized as an important source of adaptation to workplace problems. Nursing is one of the professions that plays an important role in providing health care services in all countries. It is worth mentioning that the existence of psychological health for nurses is effective in improving their professional performance in patient care. The nature of nursing is such that it relates to a combination of maps through technical activities, professional skills, human relations, and empathy. Vargens et al. (2013) in a study found that nurses are one of the occupational groups that are aware of psychological problems and excitement, sadness, fatigue and anxiety are common problems in this group (14).
One of the approaches that plays an important role in increasing the psychological capacity of individuals is teachings and interventions based on mindfulness (18).
The aim of this study was to evaluate the effectiveness of mindfulness-based cognitive therapy on the level of anxiety, happiness and mindfulness in nurses.


Materials and Methods

The research method was experimental with pre- and post-test design with control group. According to Cohen's table (1986) (for the effect size of 0.40 and the first type error of 0.05 and the statistical power of 0.80), the minimum sample size required for each group was 25 people and the researcher considered 30 people for each group. Therefore, sixty nurses in Babol were randomly divided into experimental and control groups (thirty each). Mindfulness, Attention, and Awareness Scale (MAAS), Happiness Libomirsky (SHS), and Spielberger (STAAI-X) were performed before and after treatment. Participants in the experimental group were trained in groups for 8 sessions of 90 minutes. Multivariate analysis of covariance was used to analyze the data.



Considering the demographic characteristics of the samples, 80% of the experimental group and 73% of the control group were female. In the experimental and control groups, 57% and 60% of the subjects were married, respectively. In terms of education level, 90% of the experimental group and 83% of the control group had a bachelor's degree and other participants had a master's degree. Not to mention the mean age of the experimental group (M = 33.81, SD = 7.24) and the control group (M = 32.27, SD = 6.42) were evaluated. The mean of mindfulness and happiness for both groups increased in the post-test phase, which is higher in the experimental group; also, the results of analysis of covariance for anxiety showed that meditation has no significant effect on anxiety (F(1,6)= 5.92, P=0.217) but has significantly increased happiness in the experimental group (F (1,6)=6.85, P=0.011).


At the end of the intervention, the mindfulness and happiness of the nurses present in the meditation period were significantly higher compared to the beginning. In addition, the anxiety of the meditation group was reduced and this decrease, although not statistically significant, was considered significant compared to the change in the anxiety of the control group; because the anxiety of this group had increased during treatment. Also, the mindfulness of the meditation group was more increased compared with the control group. These findings were consistent with previous research suggesting an increase in mindfulness and happiness following participation in mindfulness-based intervention programs (18-20). Another study in 2019 also showed that both mindfulness and love-kindness meditation improve emotional well-being (24).
Previous studies have shown that programs with formal meditation and home exercises contribute more to nurses' stress than brief mindfulness exercises and their informal repetition (22, 27). The only multivariate predictors of greater mindfulness and less perceived stress were the number of days spent meditating each week. In addition, other studies have shown that the duration of the meditation experience is associated with higher levels of mindfulness and, in turn, with increased well-being (26).
It should be noted that specific interventions or special forms of meditation may not be sufficient to teach one aspect of the practice, and may teach several aspects, such as cultivating concentration and mindfulness while creating compassion, love, kindness, and wisdom. Mindfulness and mindfulness exercises are not separate experiences; rather, they are part of a whole (7). Therefore, one method cannot be sufficient to measure the results of the meditation experience. Separating these various exercises and components to measure the effects of treatment is not an easy task.
Although no definite cause-and-effect relationship can be found, the evidence from this study suggests that the meditation period is associated with improved mindfulness and increased nurses' happiness.
In explaining the results, it can be said that mindfulness training teaches people how to create the conditions for improving negative emotions by strategies of satisfying emotional needs and directing information processing resources towards neutral goals, such as breathing or sense of the moment. Therefore, re-applying attention to this method prevents the increase or continuation of anxiety and makes faulty processing cycles less accessible (21). Because during the mindfulness training, attention is drawn from unread thoughts to voluntary concentration, in the face of different situations, one can prevent the secondary processing of thoughts and bodily and emotional sensations that are aroused during unpleasant emotions in the hospital environment (16).
Explaining the effect of mindfulness-based cognitive therapy on reducing anxiety, this method teaches people to observe their thoughts and feelings without judgment and to see them as simple mental events that come and go, rather than as part of Consider themselves or a reflection of reality. This kind of attitude towards cognitions related to problems prevents the intensification of negative thoughts in the workplace (25). Thus, mindfulness techniques enable people to interpret and deduce most of the events that took place well and to stabilize their reactions and feelings. Mindfulness is a type of cognitive therapy that reduces dysfunctional attitudes by changing the content of thoughts (28). In the mindfulness of events, the pros and cons of thoughts are not eliminated or answered; rather, it emphasizes the resistance of individuals to negative thoughts, which is done with a distinct mind and with more attention and concentration (30).
With this treatment, the individual's thoughts are experienced as mental events and the focus and attention on breathing is used as a tool for living in the present. Thus, through these techniques, individuals can stop the cycle of thoughts that lead to undesirable consequences, distance themselves from negative thoughts, and experience greater happiness by increasing flexibility (23, 32). In the treatment of mindfulness, the technique of attention training helps to gain awareness and flexible control over negative thoughts. During flexible control, the patient is taught to pay attention to their disturbing inner thoughts or feelings as noise (29). Therefore, nurses increase their job productivity in the workplace by reducing stress related to the hospital environment.



The results of the present study showed that cognitive therapy based on mindfulness has increased awareness in the behavioral characteristics of the experimental group in the post-test stage. It seems that cognitive therapy based on mindfulness has a positive effect on increasing happiness and mindfulness in nurses.



This study has been approved by the Research Ethics Committee of Babol University with the code 600761137. Due to special issues and regulations and the need for confidentiality of the individual status of individuals, it was not possible to record meetings or photograph the meetings. The author would like to thank the Vice Chancellor for Research at the University of Babol and all the nurses who assisted carrying out this research.

Conflicts of Interest

The authors declared no connflict of interest.


Type of Study: Original Research | Subject: Nursing
Received: 2020/07/23 | Accepted: 2020/09/6 | Published: 2020/11/28

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