title: A mixed-methods systematic review of the effects of mindfulness on nurses.
abstract: OBJECTIVE
  To review the effects of mindfulness-based interventions on Registered Nurses and nursing students.
  
  
  BACKGROUND
  Work-related stress among nurses is estimated to be the biggest occupational health problem after musculoskeletal disorders.
  
  
  METHODS
  A mixed-method systematic review incorporating quantitative and qualitative data was conducted.
  
  
  METHODS
  Studies on the effects of mindfulness-based interventions for nurses and nursing students published between 1980 and 2014 were identified through a systematic search in electronic databases: Medline, Embase, PsycINFO, Cochrane Library and Cinahl.
  
  
  METHODS
  Data analysis was conducted based on the framework of Thomas and Harden (2004).
  
  
  RESULTS
  A total of 32 studies, including 17 controlled designs, 11 pre-post designs and four qualitative designs were reviewed. Meta-analysis suggests that mindfulness-based interventions may be effective in significantly reducing state anxiety and depression at posttreatment and state anxiety and trait anxiety at follow-up. Qualitative studies and uncontrolled studies shed light on benefits overlooked in RCTs, including improvements in the well-being of individuals (e.g. inner state of calmness, awareness and enthusiasm) and improved performance at work (better communication with colleagues and patients, higher sensitivity to patients' experiences, clearer analysis of complex situations and emotional regulation in stressful contexts).
  
  
  CONCLUSIONS
  Mindfulness appeared to improve nurses' mental health significantly. It could be used in worksite health promotion programmes. Only a few studies have explored the impact of mindfulness on nurses' professional behaviours and their relationships with patients and colleagues. Future research should further explore the long-term impacts of mindfulness on performance and well-being at work using sound methodological designs.
authors.affiliation: Faculty of Nursing, Université Laval, Centre de Recherche du CHU de Québec, Québec, Québec, Canada.
authors.forename: Laurence
authors.identifier: http://orcid.org/0000-0003-1138-8285
authors.initials: L
authors.lastname: Guillaumie
authors.affiliation: Faculty of Administration, Université Laval, Québec, Québec, Canada.
authors.forename: Olivier
authors.initials: O
authors.lastname: Boiral
authors.affiliation: Faculty of Nursing, Université Laval, Québec, Québec, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Champagne
mesh_terms: D001007:Anxiety / Q000517:prevention & control; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003863:Depression / Q000517:prevention & control; D006801:Humans; D007588:Job Satisfaction; D008603:Mental Health; D064866:Mindfulness / Q000379:methods*; D009726:Nurses / Q000523:psychology*; D009784:Occupational Diseases / Q000517:prevention & control*; D011364:Professional Practice; D016032:Randomized Controlled Trials as Topic; D012649:Self Concept; D020377:Self Efficacy; D013315:Stress, Psychological / Q000517:prevention & control*
keywords: anxiety; depression; health promotion; mindfulness; nurses; nursing students; occupational health; psychological stress; systematic review