Nursing students’ mindfulness and emotional regulation: an integrative review

Costa, Daiana Alves Vendramel da; Costa, Cássia Janne Nonato da; Kogien, Moisés; Gimenez, Larissa Bessani Hidalgo; Gherardi-Donato, Edilaine Cristina da Silva; Pedrão, Luiz Jorge

doi:10.1590/0034-7167-2023-0466

Daiana Alves Vendramel da Costa Corresponding author Daiana Alves Vendramel da Costa E-mail: daivendramel@gmail.com

study/research conception or design

data analysis and/or interpretation

Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil

https://orcid.org/0000-0003-2304-1393

Cássia Janne Nonato da Costa

data analysis and/or interpretation

Universidade Federal de Mato Grosso. Cuiabá, Mato Grosso, Brazil

https://orcid.org/0000-0001-9507-0789

Moisés Kogien

data analysis and/or interpretation

final review with critical and intellectual participation in the manuscript

Universidade Federal de Mato Grosso. Cuiabá, Mato Grosso, Brazil

https://orcid.org/0000-0003-4591-6648

Larissa Bessani Hidalgo Gimenez

data analysis and/or interpretation

Universidade Federal de Mato Grosso. Cuiabá, Mato Grosso, Brazil

https://orcid.org/0000-0002-3262-0023

Edilaine Cristina da Silva Gherardi-Donato

final review with critical and intellectual participation in the manuscript

Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil

https://orcid.org/0000-0001-7475-6650

Luiz Jorge Pedrão

study/research conception or design

final review with critical and intellectual participation in the manuscript

Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil

https://orcid.org/0000-0002-0321-0455

Corresponding author
Daiana Alves Vendramel da Costa E-mail: daivendramel@gmail.com

EDITOR IN CHIEF

Antonio José de Almeida Filho

ASSOCIATE EDITOR

Rosane Cardoso

Database	Search strategies
PubMed	(“Atenção plena” OR “Consciência Plena” OR “Mindfulness” OR “Atención Plena” OR “Consciência” OR “Meditação” OR “Meditation” OR “Meditación”) AND (“Regulação Emocional” OR “Emotional Regulation” OR “Regulación Emocional” OR “Desregulação Emocional” OR “Emotional Dysregulation” OR “Desregulación Emocional” OR “Autorregulação Emocional” OR “Emotional Self-Regulation” OR “Autorregulación Emocional” OR “Regulação da Emoção” OR “Emotion Regulation”) AND (“Estudantes” OR “Alunos” OR “Students” OR “Estudiantes” OR “Alumno” OR “Estudantes Universitários” OR “College Students” OR “Estudantes de Graduação” OR “Graduations Students” OR “Estudiantes Graduado” OR “Graduando” OR “Graduating” OR “Graduarse” OR “Estudantes de Enfermagem” OR “Students Nursing” OR “Estudiantes de Enfermería”)
CINAHL	(“Mindfulness” OR “Meditation”) AND (“Emotional Regulation” OR “Emotion Regulation” OR “Emotional Dysregulation” OR “Emotional Self-Regulation”) AND (“Students” OR “College Students” OR “Graduations Students” OR “Graduating” OR “Students Nursing”)
Scopus	“Mindfulness” OR “Meditation” AND “Emotional Regulation” OR “Emotion Regulation” OR “Emotional Dysregulation” OR “Emotional Self-Regulation” AND “Students” OR “College Students” OR “Graduations Students” OR “Graduating” OR “Students Nursing”
Web of Science	All=(((“Mindfulness” OR “Meditation”) AND (“Emotional Regulation” OR “Emotion Regulation” OR “Emotional Dysregulation” OR “Emotional Self-Regulation”) AND (“Students” OR “College Students” OR “Graduations Students” OR “Graduating” OR “Students Nursing”)))

Author, years, country	Objective	Design/number of participants	Main results and conclusion
Dubert et al., 2016(²⁶26 Dubert CJ, Schumacher AM, Locker L, Gutierrez AP, Barnes VA. Mindfulness and Emotion Regulation among Nursing Students: investigating the mediation effect of working memory capacity. Mindfulness. 2016;7:1061-70. https://doi.org/10.1007/s12671-016-0544-6 https://doi.org/10.1007/s12671-016-0544-... ) (USA)	Examine the relationship between mindfulness and emotional regulation in nursing students as well as the potential mediating role of working memory capacity in this relationship.	Cross-sectional n=85	There was a significant but relatively small positive correlation between dispositional mindfulness and emotional regulation (reappraisal). These results suggest that dispositional mindfulness has a direct effect on the use of reappraisal as an emotional regulation strategy and working memory capacity.
Chow et al., 2020(²⁷27 Chow KM, Tang FWK, Tang WPY, Leung AWY. Resilience-building module for undergraduate nursing students: a mixed-methods evaluation. Nurse Educ Pract. 2020;49:102912. https://doi.org/10.1016/j.nepr.2020.102912 https://doi.org/10.1016/j.nepr.2020.1029... ) (China)	Develop a resilience building module and assess the effect of applying this module on the results of resilience, well-being and mindfulness in a sample of nursing students.	Sequential explanatory n=195	The second workshop of the module introduced approaches to stress management, with a particular focus on the use of mindfulness-based practices. Univariate and multivariate regression analyzes showed that dispositional mindfulness presented significant positive correlations with resilience. Only dispositional mindfulness remained significantly associated with resilience, indicating that this variable is a relevant independent predictor of resilience. Notably, the data above suggest that the level of dispositional mindfulness independently predicted resilience in this sample. Further research is recommended to explore the effects of a more intensive treatment program with a stronger focus on mindfulness and the inclusion of more activities in smaller groups.
Salvarani et al., 2020(²⁸28 Salvarani V, Ardenghi S, Rampoldi G, Bani M, Cannata P, Ausili D, et al. Predictors of psychological distress amongst nursing students: a multicenter cross-sectional study. Nurse Educ Pract. 2020;44. https://doi.org/10.1016/j.nepr.2020.102758 https://doi.org/10.1016/j.nepr.2020.1027... ) (Italy)	Assess psychological distress in a sample of Italian nursing students and explore its relationship with sociodemographic and psychological factors, specifically dispositional mindfulness, difficulties in emotional regulation and empathy.	Cross-sectional n=622	Regarding the dimensions of dispositional mindfulness that predict the psychological performance of nursing students, participants with higher levels of describing (p = 0.016), acting with awareness (p < 0.001), non-judgment (p < 0.001) and not reactivity (p < 0.001) had lower levels of psychological distress. These results suggest that the inclusion of mindfulness-based interventions may be beneficial in protecting nursing students from stress.
Lee and Jang, 2021(²⁹29 Lee M, Jang KS. Mediating Effects of Emotion Regulation between Socio-Cognitive Mindfulness and Achievement Emotions in Nursing Students. Healthcare (Basel). 2021;21(9):1238. https://doi.org/10.3390/healthcare9091238 https://doi.org/10.3390/healthcare909123... ) (South Korea)	Investigate the relationships between socio-cognitive mindfulness, emotional regulation, and positive and negative emotions of achievement among nursing students.	Cross-sectional n=459	Sociocognitive mindfulness correlated positively with reappraisal and negatively with suppression. Furthermore, reappraisal mediated the link between sociocognitive mindfulness and positive emotions, and suppression mediated the link between sociocognitive mindfulness and negative emotions. These findings suggest that sociocognitive mindfulness may be effective in regulating emotions among nursing students, improving reappraisal and reducing suppression.
Costa et al., 2022(³⁰30 Costa DAV, Kogien M, Hartwig SV, Ferreira GE, Guimarães MKOR, Ribeiro MRR. Dispositional mindfulness, emotional regulation and perceived stress among nursing students. Rev Esc Enferm USP. 2022;56. https://doi.org/10.1590/1980-220X-REEUSP-2022-0086en https://doi.org/10.1590/1980-220X-REEUSP... ) (Brazil)	Investigate the correlation between dispositional mindfulness, emotional regulation and perceived stress and verify factors associated with dispositional mindfulness in nursing students.	Cross-sectional n=335	Moderate mean scores for dispositional mindfulness, emotional regulation and perceived stress were identified. There was no significant correlation between dispositional mindfulness, general emotional regulation score and perceived stress, with this first variable being weakly correlated with the emotional regulation dimension of emotion suppression. Thus, the results indicate a relationship between dispositional mindfulness only with the dimension of emotional regulation and suppression of emotions.
Noroozie and Mohebbi-Dehnavi, 2022(³¹31 Noroozi M, Mohebbi-Dehnavi Z. Comparison of the effect of two educational methods based on mindfulness and cognitive emotion strategies on psychological well-being and anxiety of eighth-semester midwifery students before the final clinical trial. J Educ Health Promot. 2022;28(11):295. https://doi.org/10.4103/jehp.jehp_1427_21 https://doi.org/10.4103/jehp.jehp_1427_2... ) (Iran)	Investigate and compare the effect of two educational methods based on mindfulness and cognitive emotional regulation strategies on the psychological well-being and anxiety of nursing and midwifery students.	Quasi-experimental Pre- and post-test n=30	The results of this study showed that mindfulness-based and cognitive emotional regulation training can reduce anxiety scores and increase psychological well-being scores in nursing and midwifery students before the comprehensive examination. Therefore, it is recommended to consider educational programs based on mindfulness practices and cognitive emotional regulation to promote the mental health and academic/professional success of this group of students.

	Dubert et al., 2016(²⁶26 Dubert CJ, Schumacher AM, Locker L, Gutierrez AP, Barnes VA. Mindfulness and Emotion Regulation among Nursing Students: investigating the mediation effect of working memory capacity. Mindfulness. 2016;7:1061-70. https://doi.org/10.1007/s12671-016-0544-6 https://doi.org/10.1007/s12671-016-0544-... )	Chow et al., 2020(²⁷27 Chow KM, Tang FWK, Tang WPY, Leung AWY. Resilience-building module for undergraduate nursing students: a mixed-methods evaluation. Nurse Educ Pract. 2020;49:102912. https://doi.org/10.1016/j.nepr.2020.102912 https://doi.org/10.1016/j.nepr.2020.1029... )	Salvarani et al., 2020(²⁸28 Salvarani V, Ardenghi S, Rampoldi G, Bani M, Cannata P, Ausili D, et al. Predictors of psychological distress amongst nursing students: a multicenter cross-sectional study. Nurse Educ Pract. 2020;44. https://doi.org/10.1016/j.nepr.2020.102758 https://doi.org/10.1016/j.nepr.2020.1027... )	Lee and Jang, 2021(²⁹29 Lee M, Jang KS. Mediating Effects of Emotion Regulation between Socio-Cognitive Mindfulness and Achievement Emotions in Nursing Students. Healthcare (Basel). 2021;21(9):1238. https://doi.org/10.3390/healthcare9091238 https://doi.org/10.3390/healthcare909123... )	Costa et al., 2022(³⁰30 Costa DAV, Kogien M, Hartwig SV, Ferreira GE, Guimarães MKOR, Ribeiro MRR. Dispositional mindfulness, emotional regulation and perceived stress among nursing students. Rev Esc Enferm USP. 2022;56. https://doi.org/10.1590/1980-220X-REEUSP-2022-0086en https://doi.org/10.1590/1980-220X-REEUSP... )	Noroozie and Mohebbi-Dehnavi, 2022(³¹31 Noroozi M, Mohebbi-Dehnavi Z. Comparison of the effect of two educational methods based on mindfulness and cognitive emotion strategies on psychological well-being and anxiety of eighth-semester midwifery students before the final clinical trial. J Educ Health Promot. 2022;28(11):295. https://doi.org/10.4103/jehp.jehp_1427_21 https://doi.org/10.4103/jehp.jehp_1427_2... )
Was the objective clear?	Y	Y	Y	Y	Y	Y
Was a review of relevant literature carried out on this topic?	Y	Y	Y	Y	Y	Y
Describe the design	CST	QES	CST	CST	CST	CST
Sample described in detail	Y	Y	Y	Y	Y	Y
Justification for sample size presented	Y	Y	Y	Y	Y	Y
Reliable outcome measures	Y	Y	Y	Y	Y	Y
Valid outcome measures	Y	Y	Y	Y	Y	Y
Intervention described in detail	NA	S	NA	NA	NA	Y
Contamination was avoided	NA	N	NA	NA	NA	N
Simultaneous intervention was avoided	NA	S	NA	NA	NA	Y
Results reported in terms of statistical significance	Y	Y	Y	Y	Y	Y
Adequate analysis methods	Y	Y	Y	Y	Y	Y
Clinical importance was reported	Y	Y	Y	Y	Y	Y
Report of participants who abandoned the study	NA	Y	NA	NA	NA	N
Conclusions consistent with the methods and results obtained	Y	Y	Y	Y	Y	Y

[1] Corresponding author
Daiana Alves Vendramel da Costa E-mail: daivendramel@gmail.com

Brasil

Brasil

Nursing students’ mindfulness and emotional regulation: an integrative review

Mindfulnessy regulación emocional de estudiantes de enfermería: revisión integradora

ABSTRACT

Objective:

Methods:

Results:

Conclusion: