Anxiety, Burnout Syndrome, Psychological Stress, Anxiety, and Depression Associated With Academic Pressure
Conditions
Keywords
Mental Health Promotion, Nursing Students
Brief summary
The primary purpose of this randomized controlled trial is to evaluate the efficacy of a 12-week gamified blended mindfulness intervention in reducing academic burnout, perceived stress, and anxiety among first-year nursing students. Nursing students frequently face high academic and clinical demands that deplete their psychological resources, leading to high levels of stress and emotional exhaustion during their training. While mindfulness interventions can mitigate these negative effects, adherence to standard digital programs often remains a challenge. To address this, the study investigates the impact of incorporating gamification elements into a mindfulness program. Participants are randomly assigned to one of three groups: a minimal-treatment control group, a standard blended mindfulness group, or a gamified blended mindfulness group. The intervention spans 12 weeks and consists of 24 guided meditation sessions (16 online and 8 in-person). The central hypothesis is that the gamified architecture will act as a behavioral reinforcement mechanism, improving student adherence to the program. Consequently, researchers hypothesize that participants in the gamified group will exhibit significantly lower post-intervention levels of emotional exhaustion, perceived stress, and anxiety compared to those in both the standard mindfulness intervention and the control group.
Interventions
BEHAVIORALPsychoeducation and Free App Recommendation
Participants receive baseline information regarding the definition and health effects of meditation, alongside advice on how to independently practice it using free sessions available on a mobile application.
BEHAVIORALStandard Blended Mindfulness Program
A 12-week program consisting of 24 guided meditation sessions (16 online and 8 in-person). Sessions are led by a mindfulness expert, last between 15 and 30 minutes, and focus on breathing techniques and guided meditation practices.
BEHAVIORALGamified Blended Mindfulness Program
A 12-week, 24-session blended mindfulness program (15-30 minutes per session) integrated with gamification elements. Participants earn one point per completed session to enter a draw for a premium nursing training app subscription. The system also provides weekly automated score updates and a final anonymized leaderboard.
Sponsors
Universidad de Granada
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Enrolled as a first-year undergraduate nursing student at the Ceuta Campus of the University of Granada (Spain). * Aged 18 years or older. * Voluntarily provide informed consent prior to participation.
Exclusion criteria
* Pre-existing clinical diagnosis of anxiety or depressive disorders. * Current use of prescribed psychotropic medications (concurrent psychopharmacological treatment).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Academic Burnout: Emotional Exhaustion | Baseline (T0) and immediately following the 12-week intervention period (T1). | Assessed using the Emotional Exhaustion subscale of the Maslach Burnout Inventory-Student Survey (MBI-SS). This subscale consists of 5 items rated on a 7-point frequency scale ranging from 0 (never) to 6 (daily). Higher scores indicate higher levels of emotional exhaustion. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Academic Burnout: Cynicism | Baseline (T0) and immediately following the 12-week intervention period (T1). | Assessed using the Cynicism subscale of the Maslach Burnout Inventory-Student Survey (MBI-SS). It consists of 4 items rated on a 7-point scale (0 = never to 6 = daily). Higher scores indicate higher levels of cynicism toward studies. |
| Academic Burnout: Academic Efficacy | Baseline (T0) and immediately following the 12-week intervention period (T1). | ssessed using the Academic Efficacy subscale of the Maslach Burnout Inventory-Student Survey (MBI-SS). It consists of 6 items rated on a 7-point scale (0 = never to 6 = daily). Higher scores indicate higher levels of academic efficacy (considered a protective factor against burnout). |
| Perceived Stress | Baseline (T0) and immediately following the 12-week intervention period (T1). | Assessed using the 10-item Perceived Stress Scale (PSS). Higher total scores indicate higher levels of perceived stress. |
| Anxiety | Baseline (T0) and immediately following the 12-week intervention period (T1). | Assessed using the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS). This subscale consists of 7 items, each scored from 0 to 3, with subscale totals ranging from 0 to 21. Higher scores indicate higher levels of anxiety symptomatology. |
| Depression | Baseline (T0) and immediately following the 12-week intervention period (T1). | Assessed using the depression subscale of the Hospital Anxiety and Depression Scale (HADS). This subscale consists of 7 items, each scored from 0 to 3, with subscale totals ranging from 0 to 21. Higher scores indicate higher levels of depressive symptomatology. |
| Student Engagement | Baseline (T0) and immediately following the 12-week intervention period (T1). | Evaluated using the 9-item short version of the Utrecht Work Engagement Scale for Students (UWES-9). All items use a 0-6 frequency scale. Higher scores indicate higher levels of academic work engagement. |
| Dispositional Mindfulness | Baseline (T0) and immediately following the 12-week intervention period (T1). | Measured by the Mindful Attention Awareness Scale (MAAS). This is a 15-item instrument designed to assess core characteristics of dispositional mindfulness, specifically open awareness and attention to the present moment. Higher scores denote greater mindfulness. |
Countries
Spain
Outcome results
None listed