Absence of conflict of interest.
Citation
Highlights
- The study's objective was to examine the impact of a yoga and mindfulness intervention on health outcomes.
- The study used an interrupted time series design to compare reported stress levels of graduate nurses before and after participation in the intervention. Using online surveys with stress thermometers, the author conducted statistical analyses to compare differences in outcomes.
- The study found a significant relationship between program participation and decreased stress levels.
- The study receives a low causal evidence rating. This means we are not confident that the estimated effects are attributable to the yoga and mindfulness intervention; other factors are likely to have contributed.
Features of the Intervention
The study author developed a yoga and mindfulness intervention to address the burnout rate of newly licensed registered nurses. The intervention consisted of a yoga program led by a skilled instructor, scheduled at the start of the day's activities. Each session included a lesson on stress response and yoga principles, as well as breathing exercises and basic yoga poses. Participants received handouts with instructions for practicing at home and were encouraged to contact the instructor with questions. The sessions lasted approximately twenty minutes per month over a period of three months. The intervention was incorporated into an existing New Nurse Residency Program (NNRP) at a large southeastern academic health care center and was delivered via an online streaming platform.
Features of the Study
The study used an interrupted time series design to compare stress levels before and after participation in the intervention. The sample included 42 newly licensed registered nurses in their first 1-2 years of working in the field. The sample was primarily female (93%), White (64%), with an average age of 26.6 years. Data were obtained after each session using online surveys with stress thermometers. Pre-intervention stress levels were assessed using a retrospective stress thermometer. The surveys had a low response rate, with 20 participants completing the survey after session 1, 12 after session 2, and 14 after session 3. The author conducted statistical analyses to compare the changes in stress levels after each session.
Findings
Health and safety
The study found a significant relationship between the intervention and stress levels, with participants reporting reduced stress after each session.
Considerations for Interpreting the Findings
The author compared the outcomes of participants before and after they participated in each session of the intervention, using retrospective data for the pre-intervention outcome. For these types of designs, the authors must observe outcomes for multiple periods before the intervention to rule out the possibility that participants had increasing or decreasing trends in the outcomes examined before enrollment in the program. That is, if participants who had decreasing stress levels tended to enroll in the program, we would anticipate further decreases over time, even if they did not participate in the program. Without knowing the trends before program enrollment, we cannot rule this out.
Causal Evidence Rating
The quality of causal evidence presented in this study is low because the author did not account for trends in outcomes before the intervention. This means we are not confident that the estimated effects are attributable to the yoga and mindfulness intervention; other factors are likely to have contributed.