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. 2023 May 12;2023(5):CD002892. doi: 10.1002/14651858.CD002892.pub6

Ghawadra 2020.

Study characteristics
Methods Study design: randomised controlled trial
Study grouping: parallel group
Participants Baseline characteristics
Mindfulness‐based training

  • Age <25, 26‐30, > 31 (n(%)): 42 (49%), 19 (47%), 42 (65%)

  • Sex (N (% female)): 112 (53%)

  • Sample size: 118

  • Years of experience < 5, 6‐10, > 11 (n(%)): 57 (50%), 31 (47%), 30 (70%)


Control (no intervention)

  • Age < 25, 26‐30, > 31 (n(%)): 44 (51%), 20 (53%), 23 (35%)

  • Sex (N (% female)): 101 (47%)

  • Sample size: 106

  • Years of experience < 5, 6‐10, > 11 (n(%)): 58 (50%), 35 (53%), 13 (30%)


Overall

  • Age < 25, 26‐30, > 31 (n(%)): NR

  • Sex (N (% female)): NR

  • Sample size: 224

  • Years of experience < 5, 6‐10, > 11 (n(%)): NR


Included criteria: nurses who work in wards who had mild to moderate levels of stress and depression (according to DASS‐21) in an earlier cross‐sectional survey.
Excluded criteria: nurses who work in the outpatient clinic, or nursing managers, due to the different types of patient care, roles and responsibilities. Nurses who have a history of mental illness (n = 3) were excluded in the first study. The nurses who had severe and extremely severe levels of SAD (according to DASS‐21). They were advised to seek professional help at the psychiatric/psychology clinic in the hospital.
Pretreatment: reported socio‐demographic baseline characteristics of participants randomised to the intervention group were similar to socio‐demographic baseline characteristics of participants randomized to the control group
Compliance rate: the drop‐out rate was high, especially for the website intervention (48.3%).
Response rate: it seems that all eligible participants actually participated
Type of healthcare worker: nurses
Interventions Intervention characteristics
Mindfulness‐based training

  • Type of the intervention: Intervention type 1 ‐ to focus one's attention on the experience of stress

  • Description of the intervention: The MBT intervention in this study was MINDFULGym, consisted of ABC of stress, introduction to mindfulness, mindful body stretching, mindful breathing, NOW‐ing the present moment, paying attention to wellness, loving kindness practice

  • The number of sessions: NR

  • Duration of each session on average: 2 hours workshop, 4 weeks of self‐practice

  • Duration of the entire intervention: 4 weeks

  • Duration of the entire intervention short vs long: short

  • Intervention deliverer: Author

  • Intervention form: Individual and group


Control (no intervention)

  • Type of the intervention: NA

  • Description of the intervention: NA

  • The number of sessions: NA

  • Duration of each session on average: NA

  • Duration of the entire intervention: NA

  • Duration of the entire intervention short vs long: NA

  • Intervention deliverer: NA

  • Intervention form: NA
Outcomes DASS ‐ Depression

  • Outcome type: ContinuousOutcome


DASS ‐ Anxiety

  • Outcome type: ContinuousOutcome


DASS ‐ stress

  • Outcome type: ContinuousOutcome
Identification Sponsorship source: NR
Country: Malaysia
Setting: Hospital
Comments: NR
Authors name: Sajed Faisal Ghawadra
Institution: Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysi
Email: katlim@um.edu.my
Address: Khatijah Lim Abdullah, Department of Nursing Science, Faculty of Medicine, University of Malaya, 506030 Kuala Lumpur, Malaysia and Fakultas Keperawatan Universitas Airlangga, Surabaya, Indonesia
Time period: NR
Notes Not able to include in analysis due to missing data. 
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Quote: "The participants were randomly assigned to the intervention and control groups using stratified blocked randomization."
Sequence generation process insufficiently described.
Allocation concealment (selection bias) Unclear risk Unable to judge whether participants and/or investigators could possibly foresee assignment
Blinding of participants and personnel (performance bias)
All outcomes High risk Participants were not blinded
Blinding of outcome assessment (detection bias)
All outcomes High risk Participants were not blinded whereas outcomes are self‐reported
Incomplete outcome data (attrition bias)
All outcomes Low risk 25 of the 249 (11%) participants were not analysed. Reasons provided. Not mentioned whether lost to follow‐up was at random however loss to follow‐up is below our pre‐defined cut‐off point.
Selective reporting (reporting bias) Unclear risk Trial registration, nor did we find one online
Other bias Low risk Low compliance but the per protocol analysis did not differ from the intention to treat analysis. Per‐protocol (PP) analysis was performed for (n = 136) participants who completed all the intervention (workshop and website), and for those who completed the three‐point questionnaires; the intervention and control group in PP analysis were n = 37 and 99, respectively. The results of the PP using GEE were similar to ITT, which strengthens the validity of the results