Benefits of mindfulness-based interventions on stress and anxiety among undergraduate nursing students: A systematic review and meta-analysis.

AIM/OBJECTIVE: To systematically assess the effectiveness of mindfulness-based interventions (MBIs) in reducing psychological stress and anxiety among undergraduate nursing students, and to explore possible moderators of intervention outcomes. BACKGROUND: Nursing students are exposed to high levels of psychological stress and anxiety, which can impact their well-being and academic success. MBIs have been proposed as promising strategies for alleviating these challenges, yet evidence across studies remains inconsistent. DESIGN: A systematic review and meta-analysis of controlled trials conducted according to PRISMA guidelines. METHODS: A systematic search was conducted in PubMed, Scopus, and Web of Science for studies published up to October 3, 2025. Eligible studies included controlled trials with undergraduate nursing students, comparing MBIs to control groups, and reporting validated measures of stress and/or anxiety. Data were pooled using a random-effects meta-analysis. Subgroup, meta-regression, and leave-one-out sensitivity analyses were conducted. Risk of bias was assessed using the Cochrane RoB 2 tool. RESULTS: Eleven studies were included for stress and eight for anxiety outcomes. Pooled results indicated moderate-to-large immediate post-intervention reductions in stress (SMD = -0.95, 95% CI: -1.52 to -0.39) and anxiety (SMD = -1.14, 95% CI: -1.85 to -0.43), though both estimates were accompanied by very high heterogeneity (I2 = 92.2% and 92.7%, respectively). Sensitivity analyses confirmed no single study drove the pooled estimates. Greater benefits were observed in programs lasting five weeks or longer and among participants aged 20 years or older. Given the reliance on unblinded self-reported measures, results should be interpreted with caution. CONCLUSIONS: MBIs appear to produce meaningful immediate reductions in stress and anxiety among undergraduate nursing students, particularly with longer programs and older participants. However, very high heterogeneity and limited follow-up data mean findings should be regarded as indicative of a promising direction of effect rather than a definitive estimate of benefit. More rigorous trials with longer follow-up and objective outcome measures are needed.