Jing Shu, Dai Zhenwei, Liu Xiaoyang, Yang Xuelin, Cheng Jinglei, Chen Tianming, Feng Zihang, Liu Xin, Dong Fenghe, Xin You, Han Zhuoyan, Hu Haiyan, Su Xiaoyou, Wang Chen
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Peking University Sixth Hospital, Peking University, Beijing, China.
J Med Internet Res. 2025 May 23;27:e71741. doi: 10.2196/71741.
Nursing students experience disproportionately high rates of mental health challenges, underscoring the urgent need for innovative, scalable interventions. Web-based mindfulness programs, and more recently, neurofeedback-enhanced approaches, present potentially promising avenues for addressing this critical issue.
This study aimed to explore the effectiveness of the neurofeedback-assisted online mindfulness intervention (NAOM) and the conventional online mindfulness intervention (COM) in reducing mental health symptoms among Chinese nursing students.
A 3-armed randomized controlled trial was conducted among 147 nursing students in Beijing, China, using a 6-week web-based mindfulness program. Participants received NAOM, COM, or general mental health education across 6 weeks. Electroencephalogram and validated tools such as the Patient Health Questionnaire and the Generalized Anxiety Disorder Questionnaire were used to primarily assess symptoms of depression and anxiety at baseline, immediately after the intervention, and at 1 and 3 months after the intervention. Generalized estimating equations were used to evaluate the effects of intervention and time.
A total of 155 participants enrolled in the study, and 147 finished all assessments. Significant reductions in the symptoms of depression, anxiety, and fatigue were observed in the NAOM (mean difference [MD]=-3.330, Cohen d=0.926, P<.001; MD=-3.468, Cohen d=1.091, P<.001; MD=-2.620, Cohen d=0.743, P<.001, respectively) and the COM (MD=-1.875, Cohen d=0.490, P=.03; MD=-1.750, Cohen d=0.486, P=.02; MD=-2.229, Cohen d=0.629, P=.01, respectively) groups compared with the control group at postintervention assessment. Moreover, the NAOM group showed significantly better effects than the COM group in alleviating depressive symptoms (MD=-1.455; Cohen d=0.492; P=.04) and anxiety symptoms (MD=-1.718; Cohen d=0.670; P=.04) and improving the level of mindfulness (MD=-3.765; Cohen d=1.245; P<.001) at the postintervention assessment. However, no significant difference except for the anxiety symptoms was observed across the 3 groups at the 1- and 3-month follow-ups.
This 6-week web-based mindfulness intervention, both conventional and neurofeedback-assisted, effectively alleviated mental health problems in the short term among nursing students. The addition of neurofeedback demonstrated greater short-term benefits; however, but these effects were not sustained over the long term. Future research should focus on long-term interventions using a more robust methodological approach.
Chinese Clinical Trial Registry (ChiCTR) ChiCTR2400080314; https://www.chictr.org.cn/bin/project/edit?pid=211845.
护理专业学生面临心理健康挑战的比例异常高，这凸显了对创新、可扩展干预措施的迫切需求。基于网络的正念训练项目，以及最近的神经反馈强化方法，为解决这一关键问题提供了潜在的有效途径。
本研究旨在探讨神经反馈辅助在线正念干预（NAOM）和传统在线正念干预（COM）对减轻中国护理专业学生心理健康症状的效果。
在中国北京的147名护理专业学生中进行了一项三臂随机对照试验，采用为期6周的基于网络的正念训练项目。参与者在6周内接受NAOM、COM或一般心理健康教育。使用脑电图以及诸如患者健康问卷和广泛性焦虑症问卷等经过验证的工具，主要在基线、干预后立即以及干预后1个月和3个月评估抑郁和焦虑症状。使用广义估计方程来评估干预和时间的效果。
共有155名参与者纳入研究，147名完成了所有评估。在干预后评估中，与对照组相比，NAOM组（平均差值[MD]=-3.330，科恩d=0.926，P<0.001；MD=-3.468，科恩d=1.091，P<0.001；MD=-2.620，科恩d=0.743，P<0.001）和COM组（MD=-1.875，科恩d=0.490，P=0.03；MD=-1.750，科恩d=0.486，P=0.02；MD=-2.229，科恩d=0.629，P=0.01）的抑郁、焦虑和疲劳症状均有显著减轻。此外，在干预后评估中，NAOM组在减轻抑郁症状（MD=-1.455；科恩d=0.492；P=0.04）和焦虑症状（MD=-1.718；科恩d=0.670；P=0.04）以及提高正念水平（MD=-3.765；科恩d=1.245；P<0.001）方面显示出比COM组更好的效果。然而，在1个月和3个月的随访中，除焦虑症状外，三组之间未观察到显著差异。
这项为期6周的基于网络的正念干预，无论是传统的还是神经反馈辅助的，在短期内都有效减轻了护理专业学生的心理健康问题。添加神经反馈显示出更大的短期益处；然而，这些效果在长期内并未持续。未来的研究应聚焦于采用更稳健方法的长期干预。
中国临床试验注册中心（ChiCTR）ChiCTR2400080314；https://www.chictr.org.cn/bin/project/edit?pid=211845
