Impact of mindfulness-based interventions on stress, anxiety and depression among nursing students: A systematic review and meta-analysis.

AIM: This updated systematic review and meta-analysis aimed to evaluate the effectiveness of mindfulness-based interventions (MBIs) in reducing stress, anxiety, depression and improving mindfulness among nursing students.

BACKGROUND

Nursing students often experience significant psychological distress due to the demanding academic and clinical environments of nursing education. MBIs have been increasingly used to reduce distress and enhance well-being. However, the strength and certainty of the available evidence remain variable, warranting an updated synthesis.

DESIGN

Systematic review and meta-analysis.

METHODS

Following PRISMA 2020 guidelines, five databases were searched up to September 2025 for randomized controlled trials (RCTs) on MBIs in nursing students. Two reviewers independently extracted data and assessed risk of bias using RoB2. Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using Stata 17.0 software. Subgroup, sensitivity and meta-regression analyses explored heterogeneity. Evidence certainty was assessed using the GRADE approach.

RESULTS

Eighteen RCTs were included. MBIs were associated with reductions in anxiety (SMD = -0.49), depression (SMD = -0.43), stress (SMD = -0.54) and with an improvement in mindfulness (SMD = 0.40). Subgroup analyses showed no significant differences between face-to-face and online delivery modes across outcomes. A significant stage-based difference was observed for stress, with larger pooled effects in clinical-phase students.

CONCLUSIONS

This meta-analysis provides moderate certainty evidence suggesting that MBIs are associated with improvements in psychological well-being among nursing students. However, given methodological limitations, further well-designed RCTs with longer follow-up are needed to strengthen the evidence base.