Analyzing the effect of theoretical mindfulness-nursing-education-programme on students’ stress, resilience, and heart rate variability: a quasi-experimental study

BACKGROUND: Stress adversely affects nursing students' well-being and clinical communication. This study examined the effects of a newly developed mindfulness-based nursing education programme (MINDNUEDU) on perceived stress, resilience, and heart rate variability (HRV) among nursing students. METHODS: A quasi-experimental, two-arm pre-post design was conducted at a university in Taiwan. Seventy nursing students were allocated to either an eight-week mindfulness intervention group (n = 36) or a standard curriculum control group (n = 34) based on academic scheduling constraints. Primary outcomes were perceived stress, measured using the Perceived Stress Scale, and resilience, measured using the Connor-Davidson Resilience Scale. Secondary outcomes included HRV indices (SDNN, RMSSD, and HF power), assessed within the intervention group. Adjusted between-group differences over time were analyzed using Generalized Estimating Equations, controlling for baseline values and year of study. RESULTS: After adjustment for baseline differences, significant Group × Time interactions were observed for perceived stress (p = .004) and resilience (p < .001), indicating greater improvements in the intervention group compared with controls. The mean increase in resilience exceeded the minimal clinically important difference. A significant dose-response relationship was also identified, with higher attendance linearly associated with greater reductions in stress (p = .003) and greater gains in resilience (p = .004). Within the intervention group, session-level analyses demonstrated acute post-session increases in parasympathetic-related HRV indices across several weeks. CONCLUSIONS: Participation in the MINDNUEDU programme was associated with reduced perceived stress and increased resilience among nursing students. While physiological findings reflected short-term autonomic changes during sessions rather than confirmed long-term trait adaptation, the results support the feasibility of integrating structured mindfulness training into nursing education. Randomized controlled trials with longitudinal follow-up are needed to confirm sustainability and causal effects.