Effects of a messaging app-enabled compassion training program on nursing students’ well-being: a randomized controlled trial

Nursing students experience elevated levels of stress and mental health challenges, highlighting the need for accessible and scalable interventions to support their well-being. This study aimed to evaluate the effects of a messaging app-enabled compassion training program on self-compassion, mindfulness, perceived stress, and psychological well-being among nursing students. A two-arm, parallel-group randomized controlled trial was conducted with 96 nursing students in Guangzhou, China. Participants were randomly assigned to either an intervention group, which received an 8-week compassion training program via the messaging app WeChat, or a wait-list control group. The program was structured into three phases and included weekly psychoeducation, mindfulness/meditation practices, reflective diary writing, and emotional support. Outcomes were assessed at baseline, immediately post-intervention, and at a 2-month follow-up using validated Chinese versions of the Mindful Attention Awareness Scale, Self-Compassion Scale–Short Form, Perceived Stress Scale, and Psychological Well-being Scale. Eighty-five participants completed the study (88.5% retention rate; 43/48 intervention, 42/48 wait-list control). The sample was predominantly female (91.8%), with a mean age of 19.04 ± 1.01 years. Omnibus analyses showed no significant time-by-group interactions for any outcome. In exploratory simple-effects analyses, the intervention group showed within-group increases in self-compassion from baseline to post-intervention ( t = − 2.396, p = 0.021) and follow-up ( t = − 3.277, p = 0.002); reduced perceived stress at post-intervention ( t = 2.609, p = 0.013); and improved psychological well-being at follow-up ( t = − 2.117, p = 0.040). Mindfulness was higher in the intervention group than in the wait-list control group at post-intervention ( t = 2.579, p = 0.012). This WeChat-enabled compassion training program showed strong retention and promising exploratory signals for improving self-compassion, mindfulness, perceived stress, and psychological well-being among nursing students. This scalable approach may offer a practical and accessible strategy for integrating well-being support into nursing education, with potential applications across healthcare education contexts. The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2400081056) on 21 February 2024 ( https://www.chictr.org.cn/showproj.html?proj=215944 ). Participant recruitment was initiated after university ethics approval and institutional approval from the participating site had been obtained. The registration process was initiated during the early phase of study commencement; however, formal registration approval was granted after enrollment had commenced, owing to the registry’s administrative review process and requests for supplementary documentation.