title: A randomized controlled pilot trial of acceptance and commitment training (ACT) for preventing stress-related ill health among future nurses.
abstract: BACKGROUND
  Levels of stress and burnout increase during nursing education. This development has consequences for nursing students' health, learning, competence, and interest in quality issues in health care.
  
  
  METHODS
  In a randomized controlled pilot trial with a sample of 113 nursing students the effect of an intervention using techniques from acceptance and commitment training (ACT) to prevent the development of stress and burnout was evaluated.
  
  
  METHODS
  The 6 × 2-hour program was compared to standard treatment (reflection seminars) post-intervention and at a three-month follow-up using longitudinal analysis of mean response profiles. Mechanisms of change were investigated using a baseline-post intervention two-mediator model.
  
  
  RESULTS
  The intervention resulted in increased mindful awareness and decreased experiential avoidance, as well as decreased perceived stress and burnout. Levels of mindful awareness and perceived stress were sustained at follow-up. The proposed mechanisms of change were partly supported by the data.
  
  
  CONCLUSIONS
  This study shows that techniques from ACT might have the potential to contribute to preventing the development of stress and burnout during nursing education. However, additional studies are needed to validate these results.
authors.affiliation: a Department of Clinical Neuroscience , Karolinska Institutet , Nobels väg 9, 171 77 Stockholm , Sweden.
authors.forename: Elin
authors.initials: E
authors.lastname: Frögéli
authors.affiliation: a Department of Clinical Neuroscience , Karolinska Institutet , Nobels väg 9, 171 77 Stockholm , Sweden.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Djordjevic
authors.affiliation: a Department of Clinical Neuroscience , Karolinska Institutet , Nobels väg 9, 171 77 Stockholm , Sweden.
authors.forename: Ann
authors.initials: A
authors.lastname: Rudman
authors.affiliation: a Department of Clinical Neuroscience , Karolinska Institutet , Nobels väg 9, 171 77 Stockholm , Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Livheim
authors.affiliation: a Department of Clinical Neuroscience , Karolinska Institutet , Nobels väg 9, 171 77 Stockholm , Sweden.
authors.forename: Petter
authors.initials: P
authors.lastname: Gustavsson
mesh_terms: D064869:Acceptance and Commitment Therapy; D017144:Focus Groups; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D010865:Pilot Projects; D013315:Stress, Psychological / Q000517:prevention & control*; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: acceptance and commitment therapy/training; behavior therapy; nursing students; prevention; randomized controlled trial; stress