This pilot study of baccalaureate nursing students explored the effects of an 8-week mindfulness-based stress reduction (MBSR) course on stress and empathy. The course was intended to provide students with tools to cope with personal and professional stress and to foster empathy through intrapersonal knowing. A convenience sample of 16 students participated in the course, used guided meditation audiotapes at home, and completed journal assignments. Stress and empathy were measured using paired sample t tests.
Participation in the intervention significantly reduced students’ anxiety (p > .05). Favorable trends were observed in a number of stress dimensions including attitude, time pressure, and total stress. Two dimensions of empathy—personal distress and fantasy—also demonstrated favorable downward trends. Regular home meditation was correlated with additional benefit. Participants reported using meditation in daily life and experiencing greater well-being and improved coping skills as a result of the program. Findings suggest that being mindful may also decrease tendencies to take on others’ negative emotions. Coping with stress and fostering the affective domain are important facets of nursing education that may be facilitated by mindfulness training.
- Alligood M.R. (1992). Empathy: The importance of recognizing two types. Journal of Psychosocial Nursing and Mental Health Services, 30(3), 14–17. LinkGoogle Scholar
- Astin J. (1997). Stress reduction through mindfulness meditation: Effects on psychological symptomology, sense of control, and spiritual experience. Psychotherapy and Psychosomatics, 66, 97–106.
10.1159/000289116Crossref MedlineGoogle Scholar
- Atkins M.W., Steitz J.A. (2000). The assessment of empathy: An evaluation of the interpersonal reactivity index. Retrieved March, 09, 2003, from Union University, Teacher Education Program Faculty Research Web site: http://www.uu.edu/union/academ/tep/research/atkins.htm Google Scholar
- Baillie L. (1996). A phenomenological study of the nature of empathy. Journal of Advanced Nursing, 24, 1300–1308.
10.1111/j.1365-2648.1996.tb01038.xCrossref MedlineGoogle Scholar
- Barrett-Lennard G.T. (1993). The phases and focus of empathy. British Journal of Medical Psychology, 66, 3–14.
10.1111/j.2044-8341.1993.tb01722.xCrossref MedlineGoogle Scholar
- Beck D., Hackett M.B., Srivastava R., McKim E., Rockwell B. (1997). Perceived level and sources of stress in baccalaureate nursing students. Journal of Nursing Education, 36, 180–186. LinkGoogle Scholar
- Bennett J.A. (1995). Methodological notes on empathy: Further considerations. Advances in Nursing Science, 18(1), 36–50.
10.1097/00012272-199509000-00005Crossref MedlineGoogle Scholar
- Carlson L.E., Ursuliak Z., Goodey E., Angen M., Speca M. (2001). The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up. Support Care Cancer, 9, 112–123.
10.1007/s005200000206Crossref MedlineGoogle Scholar
- Cutcliffe J.R., Cassedy P. (1999). The development of empathy in students on a short, skills based counseling course: A pilot study. Nurse Education Today, 19, 250–257.
10.1016/S0260-6917(99)80011-2Crossref MedlineGoogle Scholar
- Davis M.H. (1980). A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 10, 85. Google Scholar
- Davis M.H. (1983). The effects of dispositional empathy on emotional reactions and helping: A multidimensional approach. Journal of Personality, 51, 167–184.
- Derogatis L.R. (1987). The Derogatis stress profile (DPS): Qualifications of psychological stress. In (Eds.), Research paradigms in psychosomatic medicine (pp. 30–54). New York: Basel, Karger. Google Scholar
- Evans G.W., Wilt D.L., Alligood M.R., O’Neil M. (1998). Empathy: A study of two types. Issues in Mental Health Nursing, 19, 453–461.
10.1080/016128498248890Crossref MedlineGoogle Scholar
- Forsyth G.L. (1980). Analysis of the concept of empathy: Illustration of one approach. Advances in Nursing Science, 2(2), 33–42.
10.1097/00012272-198001000-00005Crossref MedlineGoogle Scholar
- Grossman S., Wheeler K. (1999). Integrating multidimensional stress management into a baccalaureate nursing curriculum. Nursing Connections, 12, 23–28. MedlineGoogle Scholar
- Heaman D. (1995). The quieting response (QR): A modality for reduction of psychophysiologic stress in nursing students. Journal of Nursing Education, 34, 5–10. LinkGoogle Scholar
- Hope-Stone L.D., Mills B.J. (2001). Developing empathy to improve patient care: A pilot study of cancer nurses. International Journal of Palliative Nursing, 7, 146–150.
10.12968/ijpn.2001.7.3.8913Crossref MedlineGoogle Scholar
- Jones M.C., Johnston D.W. (1997). Distress, stress and coping in first-year student nurses. Journal of Advanced Nursing, 26, 475–482.
10.1046/j.1365-2648.1997.t01-5-00999.xCrossref MedlineGoogle Scholar
- Jordan J.V. (2000). The role of mutual empathy in relational/cultural therapy. JCLP/In Session: Psychotherapy in Practice, 56, 1005–1016.
- Kabat-Zinn J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress. New York: Delacorte. Google Scholar
- Kabat-Zinn J., Wheeler E., Light T., Skillings A., Scharf M.J., Cropley T.G., 1998). Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to sever psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosomatic Medicine, 60, 625–632.
10.1097/00006842-199809000-00020( Crossref MedlineGoogle Scholar
- Kendrick P. (2000). Comparing the effects of stress and relationship style on student and practicing nurse anesthetists. American Association of Nurse Anesthetists Journal, 68, 115–122. Google Scholar
- Kornfield J. (1993). A path with heart: A guide through the perils and promises of spiritual life. New York: Bantam Doubleday Dell. Google Scholar
- Kornfield J. (1994). Buddha’s little instruction book. New York: Bantam. Google Scholar
- Kristeller J.L., Hallett C.B. (1999). An exploratory study of a meditation based intervention for binge eating disorder. Journal of Health Psychology, 4, 357–363.
10.1177/135910539900400305Crossref MedlineGoogle Scholar
- La Monica E.L., Wolf R.M., Madea A.R., Oberst M.T. (1987). Empathy and nursing outcomes. Scholarly Inquiry for Nursing Practice, 1, 197–213. MedlineGoogle Scholar
- Levenson R.W., Ruef A.M. (1992). Empathy: A physiological substrate. Journal of Personality and Social Psychology, 63, 234–246.
10.1037/0022-35126.96.36.199Crossref MedlineGoogle Scholar
- Levinson W., Roter D.L., Mullooly J.P., Dull V.T., Frankel R.M. (1997). Physician-patient communication: The relationship with malpractice claims among primary care physicians and surgeons. Journal of the American Medical Association, 277, 553–559.
- Mahat G. (1996). Stress and coping: First year Nepalese nursing students in clinical settings. Journal of Nursing Education, 35, 163–169. LinkGoogle Scholar
- Manderino M.A., Ganong L.H., Darnell K.F. (1988). Survey of stress management content in baccalaureate nursing curricula. Journal of Nursing Education, 27, 321–325. LinkGoogle Scholar
- Marcus E.R. (1999). Empathy, humanism, and the professionalization process of medical education. Academic Medicine, 74, 1211–1215.
10.1097/00001888-199911000-00014Crossref MedlineGoogle Scholar
- Meisenhelder J. (1987). Anxiety: A block to clinical learning. Nurse Educator, 12(6), 27–30.
10.1097/00006223-198712060-00009Crossref MedlineGoogle Scholar
- Miller J.J., Fletcher K., Kabat-Zinn J. (1995). Three-year follow-up and clinical implications of a mindfulness-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17, 192–200.
10.1016/0163-8343(95)00025-MCrossref MedlineGoogle Scholar
- Miller K., Stiff J., Ellis B.H. (1988). Communication and empathy as precursors to burnout among human service workers. Communication Monographs, 55, 250–265.
- Morse J.M., Bottorff J., Anderson G., O’Brien B., Solberg S. (1992). Beyond empathy: Expanding expressions of caring. Journal of Advanced Nursing, 17, 809–821.
10.1111/j.1365-2648.1992.tb02002.xCrossref MedlineGoogle Scholar
- Motowidlo S.J., Packard J.S., Manning M.R. (1986). Occupational stress: Its causes and consequences for job performance. Journal of Applied Psychology, 71, 618–629.
10.1037/0021-9010.71.4.618Crossref MedlineGoogle Scholar
- Olson J.K. (1995). Relationships between nurse-expressed empathy, patient-perceived empathy and patient distress. Image, 27, 317–322. Google Scholar
- Omdahl B.L., O’Donnell C. (1999). Emotional contagion, empathic concern and communicative responsiveness as variables affecting nurses’ stress and occupational commitment. Journal of Advanced Nursing, 29, 1351–1359.
10.1046/j.1365-2648.1999.01021.xCrossref MedlineGoogle Scholar
- Oswald P.A. (2002). The interactive effects of affective demeanor, cognitive processes, and perspective-taking focus on helping behavior. The Journal of Social Psychology, 142, 120–132.
10.1080/00224540209603890Crossref MedlineGoogle Scholar
- Oz F. (2001). Impact of training on empathic communication skills and tendency of nurses. Clinical Excellence for Nurse Practitioners, 5, 44–51. MedlineGoogle Scholar
- Redelmeier D.A., Molin J.P., Tibshirani R.J. (1995). A randomized trial of compassionate care for the homeless in an emergency department. Lancet, 345, 1131–1134.
10.1016/S0140-6736(95)90975-3Crossref MedlineGoogle Scholar
- Reibel D.K., Greeson J.M., Brainard G.C., Rosenzweig S. (2001). Mindfulness based stress reduction and health-related quality of life in a heterogeneous patient population. General Hospital Psychiatry, 23, 183–192.
10.1016/S0163-8343(01)00149-9Crossref MedlineGoogle Scholar
- Remen R.N. (1996). Kitchen table wisdom: Stories that heal. New York: Riverhead. Google Scholar
- Reynolds W.J., Presly A.S. (1988). A study of empathy in student nurses. Nurse Education Today, 8, 123–130.
10.1016/0260-6917(88)90029-9Crossref MedlineGoogle Scholar
- Roth B. (2001). Mindfulness-based stress reduction at the Yale School of Nursing. Yale Journal of Biology and Medicine, 74, 249–258. Google Scholar
- Santorelli S. (2000). Healthy self: Lessons on mindfulness in medicine. New York: Bell Tower. Google Scholar
- 2002). Mindfulness-based stress reduction professional training curriculum guide and supporting materials: Integrating mindfulness meditation into medicine and health care. Worcester, MA: University of Massachusetts Medical School. (Eds.). (Google Scholar
- Shapiro S.L., Schwartz G.E.R. (2000). Intentional systemic mindfulness: An integrative model for self-regulation and health. Advances in Mind-Body Medicine, 16, 128–134. MedlineGoogle Scholar
- Shapiro S.L., Schwartz G.E., Bonner G. (1998). Effects of mindfulness based stress reduction on medical and premedical students. Journal of Behavioral Medicine, 21, 581–599.
10.1023/A:1018700829825Crossref MedlineGoogle Scholar
- Teasdale J.D., Segal Z.V., Williams J.M.G., Ridgeway V.A., Soulsby J.M., Lau A. (2000). Prevention of relapse/recurrence in major depression of mindfulness-based cognitive therapy. Journal of Consulting Clinical Psychology, 68, 515–623.
10.1037/0022-006X.68.4.615Crossref MedlineGoogle Scholar
- U.S. Department of Health and Human Services. (2000). Healthy people 2010: Understanding and improving health (2nd ed.). Washington, DC: U.S. Government Printing Office. Google Scholar
- Watson J. (1996). Watson’s theory of transpersonal caring. In (Eds.), Blueprint for use of nursing models: Education, research, practice, and administration (pp. 141–184). New York: National League for Nursing Press. Google Scholar
- Wheeler K., Barrett E.M., Lahey E.A.M. (1996). A study of empathy as a nursing care outcome measure. International Journal of Psychiatric Nursing Research, 3, 281–289. Google Scholar
- Williams C.A. (1989). Empathy and burnout in male and female helping professions. Research in Nursing & Health, 12, 169–179.
10.1002/nur.4770120307Crossref MedlineGoogle Scholar
- Williams K.A., Kolar M.M., Reger B.E., Pearson J.C. (2001). Evaluation of a wellness-based mindfulness stress reduction intervention: A controlled trial. American Journal of Health Promotion, 15, 422–432.
10.4278/0890-1171-15.6.422Crossref MedlineGoogle Scholar
- Wiseman T. (1996). A concept analysis of empathy. Journal of Advanced Nursing, 23, 1162–1167.
10.1046/j.1365-2648.1996.12213.xCrossref MedlineGoogle Scholar
- Young L.E., Bruce A., Turner L., Linden W. (2001). Student nurse health promotion: Evaluation of a mindfulness-based stress reduction (MBSR) intervention. Canadian Nurse, 97 (6), 23–26. MedlineGoogle Scholar
- Zderad L. (1970). Empathic: From cliché to construct. In (Ed.), Proceedings of the third nursing theory conference, Kansas City (pp. 46–75). Kansas City, KS: University of Kansas Medical Center, Department of Nursing Education. Google Scholar