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. 2026 Jul 26;58(4):e70116. doi: 10.1111/jnu.70116

The Effect of a Mindfulness‐Based Stress Reduction (MBSR) Program on Quality of Life, Life Satisfaction, Sleep Quality, and Mental Well‐Being in Menopausal Women: A Randomized Controlled Trial

Ebru Solmaz 1,✉, Aslı Sis Çelik 2
PMCID: PMC13402339  PMID: 42503602

ABSTRACT

Introduction

Menopause affects nearly one‐third of women's lives and is associated with a wide range of physical and psychological symptoms—including sleep disturbances, mood fluctuations, and reduced quality of life—that represent a significant public health concern. While pharmacological treatments carry well‐documented risks, evidence‐based non‐pharmacological interventions such as Mindfulness‐Based Stress Reduction (MBSR) remain understudied in this population, particularly with respect to multiple psychosocial outcomes.

Purpose

This study aimed to evaluate the effects of a Mindfulness‐Based Stress Reduction (MBSR) program on quality of life, life satisfaction, sleep quality, and mental well‐being among menopausal women.

Design

A randomized controlled trial with a pretest–posttest control group design.

Methods

The study was conducted between February 28 and December 22, 2025, at a primary healthcare center in Türkiye. A total of 84 menopausal women were included (intervention: n = 43; control: n = 41). Data were collected using the Utian Quality of Life Scale, Riverside Life Satisfaction Scale, Pittsburgh Sleep Quality Index, and Warwick–Edinburgh Mental Well‐Being Scale. The intervention group participated in an 8‐week MBSR program, while the control group received no intervention. Data were analyzed using IBM SPSS Statistics (version 26.0).

Findings

Compared with the control group, participants in the MBSR group demonstrated significant improvements in quality of life, life satisfaction, and mental well‐being, along with significant reductions in sleep disturbances (p < 0.001). Within‐group analyses showed significant improvements across all outcomes in the intervention group (p < 0.001), whereas no significant changes were observed in the control group (p > 0.05).

Conclusions

The MBSR program was associated with improvements in psychosocial well‐being and sleep quality among menopausal women. These findings suggest that MBSR may be a beneficial non‐pharmacological approach for managing menopausal symptoms.

Keywords: menopause, mental health, mindfulness, nursing care, psychological, quality of life, sleep quality, stress reduction

1. Introduction

Recent increases in life expectancy have extended the duration women spend in the menopausal and postmenopausal period. According to the World Health Organization, global life expectancy in 2021 was 74 years for women, exceeding that of men (WHO 2021). In Türkiye, this difference is even more pronounced, with women having a life expectancy of 80.7 years (TSI 2025). Considering that the average age at menopause is approximately 51 years worldwide and 46–48 years in Türkiye (EMAS 2022; TSEM 2021), women are estimated to spend nearly one‐third of their lives in the menopausal and postmenopausal stages (WHO 2021; EMAS 2022; TSEM 2021). This demographic shift highlights menopause as not merely a biological transition, but a significant public health issue with long‐term implications for women's quality of life, psychological well‐being, and overall health (Bagga et al. 2025).

Menopause is associated with a wide range of physical and psychological symptoms resulting from the decline in ovarian hormone production, including vasomotor symptoms, genitourinary syndrome, sleep disturbances, and psychological distress (Ali et al. 2020; Chukur et al. 2022; Mili et al. 2021; Min et al. 2022). These symptoms often co‐occur and interact, leading to cumulative negative effects on women's daily functioning and quality of life. In particular, vasomotor symptoms and sleep disturbances contribute to sleep fragmentation, increased fatigue, and emotional distress, thereby further impairing quality of life (Ali et al. 2020). Evidence suggests that menopausal symptoms may persist for years in some women, resulting in sustained negative impacts on both quality of life and mental health (Baker et al. 2018; Belešová and Tóthová 2023).

Psychological problems are also highly prevalent during the menopausal period. Increased levels of anxiety, depressive symptoms, mood disturbances, and cognitive complaints are commonly reported (Aljumah et al. 2023; Grigolon et al. 2023; Thapa and Yang 2022; Zaouali and Slama 2023). Hormonal fluctuations may influence stress response systems and emotion regulation processes, leading to a decline in mental well‐being. Furthermore, pre‐existing psychological conditions may worsen during menopause, increasing psychological vulnerability and contributing to a greater symptom burden (Hildreth et al. 2018).

The management of menopausal symptoms requires a holistic approach that integrates both pharmacological and non‐pharmacological strategies (Hill et al. 2016; Mojtehedi et al. 2022). Although hormone replacement therapy is effective in alleviating vasomotor symptoms, its long‐term use is limited due to its association with an increased risk of breast cancer and cerebrovascular events (Hill et al. 2016; Rozenberg et al. 2020). Non‐hormonal pharmacological treatments, such as selective serotonin reuptake inhibitors and gabapentinoids, have also been reported to have limited effectiveness and are not considered first‐line options (Cheng et al. 2021; Madsen et al. 2023). These limitations highlight a growing need for safer, more sustainable, and holistic approaches to managing menopausal symptoms. Accordingly, interest in non‐pharmacological interventions has increased in recent years (Madsen et al. 2023; McGuire and Anderson 2019).

Among non‐pharmacological approaches, exercise, yoga, aromatherapy, and dietary modifications are commonly used, while mindfulness, acupuncture, and herbal interventions are also frequently preferred (Chen et al. 2019; Dąbrowska‐Galas et al. 2019; Martínez‐Rodríguez et al. 2022; Mojtehedi et al. 2022). Among these, Mindfulness‐Based Stress Reduction (MBSR) has emerged as a prominent intervention in recent years for managing menopausal symptoms. Developed by John Kabat‐Zinn, MBSR consists of structured practices including breathing meditation, body scanning, yoga, and sitting meditation (Kabat‐Zinn 2013; Sood et al. 2019). MBSR has been shown to regulate stress responses, improve emotional regulation, and enhance individuals' ability to cope with symptoms (Creswell 2017; Kabat‐Zinn 2013; Sood et al. 2019).

MBSR has been reported to reduce stress, anxiety, and depressive symptoms while improving sleep quality, quality of life, and psychological resilience (Anderson 2021; Ghawadra et al. 2019; Sakki et al. 2022). These effects are explained by the regulation of the hypothalamic–pituitary–adrenal (HPA) axis, reduced cortisol levels, and improved autonomic nervous system balance (Creswell 2017; Pascoe et al. 2017). In addition, mindfulness practices have been shown to increase prefrontal cortex activity, decrease amygdala reactivity, and reduce inflammatory markers (Bower and Irwin 2016; Garland et al. 2015). These neurobiological and physiological mechanisms provide a strong rationale for the use of MBSR in managing common menopausal symptoms such as sleep disturbances, vasomotor symptoms, and mood fluctuations (Abatemarco et al. 2021; Zhou et al. 2025).

From a nursing perspective, MBSR represents a structured psychosocial intervention that aligns with a holistic approach to women's health care. Nurses, who maintain continuous contact with women, are in a key position to support menopausal women in recognizing their symptoms, developing coping strategies, and improving their quality of life (Anderson 2021; Woods and Rockman 2021). However, existing literature on MBSR in menopausal women has largely focused on limited symptom domains, and randomized controlled studies evaluating multiple outcomes—such as quality of life, life satisfaction, sleep quality, and mental well‐being—remain scarce (Aydın and Budak 2023; Chen et al. 2021; Huang et al. 2023). This gap highlights the need for comprehensive, evidence‐based interventions addressing the multidimensional nature of menopausal symptoms.

Accordingly, this study aims to evaluate the effects of a Mindfulness‐Based Stress Reduction program on quality of life, life satisfaction, sleep quality, and mental well‐being in menopausal women using a holistic approach.

The study hypotheses were as follows:

Hypothesis 1

MBSR has a positive effect on quality of life among menopausal women.

Hypothesis 2

MBSR has a positive effect on life satisfaction among menopausal women.

Hypothesis 3

MBSR has an improving effect on sleep quality among menopausal women.

Hypothesis 4

MBSR has a positive effect on mental well‐being among menopausal women.

2. Methods

2.1. Study Design

This study employed a pretest–posttest randomized controlled trial (RCT) design with an intervention and control group. The study was designed and reported in accordance with the Consolidated Standards of Reporting Trials (CONSORT) guidelines. This framework was selected to rigorously evaluate the effects of a structured Mindfulness‐Based Stress Reduction (MBSR) program on quality of life, life satisfaction, sleep quality, and mental well‐being in menopausal women. The pretest–posttest design allowed for the assessment of within‐group changes over time, while the inclusion of a control group enabled between‐group comparisons to isolate the effects of the intervention. Trial Registration: This study was registered at ClinicalTrials.gov with the identifier NCT06892509.

2.2. Setting and Participants

The study was conducted between February 28 and December 22, 2025, at a family health center in Türkiye. Participants were recruited from women attending the Family Health Center on weekdays until the predetermined sample size was reached. Women presenting for routine examinations, follow‐up visits, or other health‐related reasons were assessed for eligibility.

2.3. Inclusion Criteria

Women who agreed to participate were able to read and write in Turkish, had no diagnosed psychiatric disorder, were aged between 45 and 64 years, had experienced at least 12 months of amenorrhea, were not using any complementary and alternative medicine methods, and had a Pittsburgh Sleep Quality Index (PSQI) score greater than 5 were included in the study. The upper age limit was set at 64 years, as both the United Nations and the Turkish Ministry of Health define individuals aged 65 years and older as elderly or older persons (United Nations 2019; Türkiye Cumhuriyeti. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü 2023). Since this study focused specifically on menopausal women in middle adulthood, women aged 65 years and older were excluded.

2.4. Exclusion Criteria

Women who were using antidepressants, antihistamines, benzodiazepines, hypnotics, or narcotic drugs attended less than 80% of the MBSR sessions or initiated the use of complementary and alternative medicine methods during the study period were excluded.

2.5. Sample Size Calculation

A power analysis was conducted using GPower 3.1.9.4 to determine the required sample size. The calculation was based on the between‐group difference in the total score of the Menopause‐Specific Quality of Life Scale (MENQOL) reported in a previous randomized controlled trial examining mindfulness‐based interventions in menopausal women (John et al. 2022). Based on an effect size of 0.80 (John et al. 2022), a significance level of 0.05, and 95% power, a minimum of 35 participants per group was required. Considering potential attrition, the sample size was increased, and a total of 90 women were enrolled in the study (intervention group: n = 45; control group: n = 45).

2.6. Randomization and Blinding

Those who met the inclusion criteria were informed about the study and provided written informed consent. Participants' names and contact information were recorded to establish the sampling list. Participants were randomly assigned to the intervention and control groups using a computer‐generated simple randomization sequence via the Randomizer.org website. Numbers ranging from 1 to 90 were randomly allocated into two groups, and participants were assigned according to the order of their names on the list.

Due to the nature of the intervention, neither participants nor researchers were blinded. However, outcome assessment and data analysis were conducted using a single‐blind design. After data collection, datasets were coded as “Group X” and “Group Y” and analyzed by an independent statistician who was blinded to group allocation.

During the study, two participants from the intervention group withdrew due to personal reasons (bereavement and relocation), and four participants in the control group declined to continue after allocation. As a result, the study was completed with 84 participants (intervention group: n = 43; control group: n = 41). Participant flow throughout the study is presented in the CONSORT flow diagram (Figure 1).

FIGURE 1.

FIGURE 1

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CONSORT flow diagram of participant recruitment, allocation, follow‐up, and analysis. PSQI = Pittsburgh Sleep Quality Index. Participants were excluded if their PSQI score was ≤ 5 (indicative of good sleep quality). Two participants in the intervention group withdrew for personal reasons (bereavement and relocation); four participants in the control group declined to continue after allocation.

2.7. Intervention

Participants in the intervention group received a structured Mindfulness‐Based Stress Reduction (MBSR) program based on the original model developed by Kabat‐Zinn. The program consisted of weekly group sessions conducted over 8 weeks. The intervention was delivered by researchers who had completed internationally accredited MBSR training. All sessions were conducted face‐to‐face in a group format, with each session lasting approximately 90–120 min and following a standardized MBSR curriculum. The weekly structure and content of the program are presented in Table S1.

The 8‐week duration was selected based on evidence demonstrating its effectiveness in regulating stress and improving psychological well‐being (Ahmad et al. 2020; Gotink et al. 2016). The program included both formal mindfulness practices—such as breathing awareness, body scan, sitting meditation, and mindful movement—as well as informal practices integrated into daily activities.

A progressive structure was used to develop participants' mindfulness skills, advancing from basic awareness practices to more complex strategies related to emotional regulation and stress management. Each session included guided mindfulness practices, reflection on home practice, and structured group discussions.

Participants were provided with a structured educational booklet developed by the research team based on the literature, including information on menopause, mindfulness principles, session content, and home practice instructions. The booklet was used as supportive material throughout the intervention (File S2). Home practice was a core component of the intervention, and participants were encouraged to engage in regular practice. In line with traditional MBSR programs, one session was conducted as an extended intensive practice. The final session focused on consolidating acquired skills and supporting the sustainable integration of mindfulness practices into daily life. Participants' feedback regarding the intervention was collected after program completion and is presented as Table S3.

2.8. Intervention Environment

All MBSR sessions were conducted face‐to‐face in a quiet, closed, and distraction‐free environment. This setting supported participants' focus on mindfulness practices and facilitated active engagement in the intervention. The sessions were organized to promote group interaction, and appropriate physical conditions were provided to ensure participants' comfort and safety during the practices. Guided meditations and instructional components were delivered using appropriate audiovisual materials. The overall environment was arranged to support participant comfort and optimal engagement throughout the intervention.

2.9. Research Team

The research team consisted of two female researchers. The first author, who had completed an internationally accredited training and certification program in Mindfulness‐Based Stress Reduction (MBSR), delivered the intervention sessions. The second author, certified in mindfulness‐based practices and an expert in women's health nursing, provided scientific supervision and guidance throughout the study. The intervention sessions were conducted by the first author, while the second author contributed to the planning of the intervention, development of the scientific framework, and monitoring of the implementation process. Data collection was carried out in accordance with ethical and methodological principles, and data analysis and interpretation were performed collaboratively by both authors. There was no academic, administrative, or hierarchical relationship between the researchers and the participants. Participants were informed about the researchers' professional roles and their qualifications related to the intervention.

2.10. Data Collection Instruments

Data were collected using a Participant Information Form, the Utian Quality of Life Scale, the Riverside Life Satisfaction Scale, the Pittsburgh Sleep Quality Index (PSQI), and the Warwick–Edinburgh Mental Well‐Being Scale (WEMWBS).

The Participant Information Form was developed by the researchers based on the literature and consisted of 14 items assessing participants' sociodemographic characteristics (age, education level, occupation, economic status, marital status, family type, body mass index, chronic disease status, smoking and alcohol use) and menopause‐related characteristics (duration and type of menopause) (Aydın and Budak 2023; Şener Çetin et al. 2024).

The Utian Quality of Life Scale (UQOL) was developed by Utian et al. (2002) to assess quality of life in menopausal women. The Turkish validity and reliability study was conducted by Abay and Kaplan (2016). The scale consists of 23 items and is rated on a five‐point Likert scale. Higher scores indicate better quality of life. In the Turkish validation study, the Cronbach's alpha coefficient was reported as 0.88. In the present study, the Cronbach's alpha coefficient was 0.72 at pre‐test and 0.74 at post‐test.

The Riverside Life Satisfaction Scale (RLSS) was developed by Margolis et al. (2019) to assess individuals' life satisfaction. The Turkish validity and reliability study was conducted by Alıcı and Seçim (2020). The scale consists of six items and is rated on a seven‐point Likert scale, with higher scores indicating greater life satisfaction.

In the Turkish validation study, the Cronbach's alpha coefficient was reported as 0.77. In the present study, the Cronbach's alpha coefficient was 0.71 at pre‐test and 0.72 at post‐test.

The Pittsburgh Sleep Quality Index (PSQI) was developed by Buysse et al. (1989) to assess sleep quality and sleep disturbances over the past month. The Turkish validity and reliability study was conducted by Ağargün et al. (1996). The scale consists of seven components, and the global score reflects overall sleep quality. In the Turkish validation study, the Cronbach's alpha coefficient was reported as 0.80. In the present study, the Cronbach's alpha coefficient was 0.74 at pre‐test and 0.75 at post‐test.

The Warwick–Edinburgh Mental Well‐Being Scale (WEMWBS) was developed by Tennant et al. (2007) to assess mental well‐being. The Turkish validity and reliability study was conducted by Keldal (2015). The scale consists of 14 items and is rated on a five‐point Likert scale, with higher scores indicating greater mental well‐being.

In the original study, the Cronbach's alpha coefficient was reported as 0.89. In the present study, the Cronbach's alpha coefficient was 0.79 at pre‐test and 0.78 at post‐test.

2.11. Data Analysis

Data were analyzed using SPSS for Windows version 27.0. Descriptive statistics were presented as frequencies, percentages, minimum–maximum values, means, and standard deviations.

Normality of the data was assessed using skewness and kurtosis coefficients, with values within ±2 indicating normal distribution (Büyüköztürk et al. 2014). Normality test results for all continuous variables are presented in Tables 2 and 3. All primary outcome measure scores were normally distributed in both groups; therefore, independent samples t‐tests and paired samples t‐tests were used for between‐group and within‐group comparisons, respectively. For non‐normally distributed variables (height and BMI), the Mann–Whitney U test was applied. The Chi‐square test was used to compare sociodemographic characteristics between groups.

TABLE 2.

Normality test results for continuous variables.

Variable n Skewness Kurtosis Distribution
Statistic SE Statistic SE
Age 84 0.639 0.263 −0.192 0.520 Normal
Number of children 84 0.669 0.263 0.728 0.520 Normal
Weight 84 0.005 0.263 −0.223 0.520 Normal
Height a 84 −1.274 0.263 3.775 0.520 Non‐normal
BMI a 84 1.104 0.263 2.251 0.520 Non‐normal
Age at menopause 84 0.501 0.263 −0.010 0.520 Normal
Utian Quality of Life Scale (pre‐test) 84 −0.106 0.263 −0.380 0.520 Normal
Utian Quality of Life Scale (post‐test) 84 −0.440 0.263 −0.282 0.520 Normal
Riverside Life Satisfaction Scale (pre‐test) 84 −0.386 0.263 −0.353 0.520 Normal
Riverside Life Satisfaction Scale (post‐test) 84 −0.135 0.263 0.197 0.520 Normal
Pittsburgh Sleep Quality Index (pre‐test) 84 0.180 0.263 −1.549 0.520 Normal
Pittsburgh Sleep Quality Index (post‐test) 84 −0.025 0.263 −1.059 0.520 Normal
WEMWBS (pre‐test) 84 −0.347 0.263 −0.143 0.520 Normal
WEMWBS (post‐test) 84 −0.015 0.263 −0.789 0.520 Normal
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Note: Normality was assessed using skewness and kurtosis coefficients. Values within ±2 indicate normal distribution (Büyüköztürk et al. 2014).

Abbreviations: BMI, body mass index; SE, standard error; WEMWBS, Warwick–Edinburgh Mental Well‐Being Scale.

a

Variables with non‐normal distribution; Mann–Whitney U test was applied for between‐group comparisons.

TABLE 3.

Normality test results for outcome variables by group.

Intervention group (n = 43) n Skewness Kurtosis Distribution
Statistic SE Statistic SE
Utian Quality of Life Scale (pre‐test) 43 0.228 0.361 −0.868 0.709 Normal
Utian Quality of Life Scale (post‐test) 43 0.223 0.361 −1.171 0.709 Normal
Riverside Life Satisfaction Scale (pre‐test) 43 −0.466 0.361 −0.453 0.709 Normal
Riverside Life Satisfaction Scale (post‐test) 43 −0.219 0.361 0.838 0.709 Normal
Pittsburgh Sleep Quality Index (pre‐test) 43 0.377 0.361 −1.391 0.709 Normal
Pittsburgh Sleep Quality Index (post‐test) 43 0.566 0.361 −0.439 0.709 Normal
WEMWBS (pre‐test) 43 −0.513 0.361 0.220 0.709 Normal
WEMWBS (post‐test) 43 −0.346 0.361 −0.584 0.709 Normal
Control group (n = 41) n Skewness Kurtosis Distribution
Statistic SE Statistic SE
Utian Quality of Life Scale (pre‐test) 41 −0.351 0.369 −0.062 0.724 Normal
Utian Quality of Life Scale (post‐test) 41 0.176 0.369 0.399 0.724 Normal
Riverside Life Satisfaction Scale (pre‐test) 41 −0.317 0.369 −0.136 0.724 Normal
Riverside Life Satisfaction Scale (post‐test) 41 −0.089 0.369 0.209 0.724 Normal
Pittsburgh Sleep Quality Index (pre‐test) 41 −0.036 0.369 −1.658 0.724 Normal
Pittsburgh Sleep Quality Index (post‐test) 41 −0.377 0.369 0.163 0.724 Normal
WEMWBS (pre‐test) 41 −0.154 0.369 −0.746 0.724 Normal
WEMWBS (post‐test) 41 −0.111 0.369 −0.863 0.724 Normal
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Note: Normality was assessed using skewness and kurtosis coefficients. Values within ±2 indicate normal distribution (Büyüköztürk et al. 2014). All outcome measure scores were normally distributed within both groups; therefore, independent samples t‐tests and paired samples t‐tests were used for between‐group and within‐group comparisons, respectively.

Abbreviations: SE, standard error; WEMWBS, Warwick–Edinburgh Mental Well‐Being Scale.

For normally distributed data, independent samples t‐tests were used to compare differences between groups, and paired samples t‐tests were used for within‐group comparisons. For non‐normally distributed data, the Mann–Whitney U test and Wilcoxon signed‐rank test were applied for between‐group and within‐group comparisons, respectively.

Statistical significance was set at p < 0.05. Internal consistency of the scales was evaluated using Cronbach's alpha coefficients.

2.12. Ethical Considerations

Ethical approval for the study was obtained from the Atatürk University Non‐Interventional Clinical Research Ethics Committee on February 28, 2025, with meeting number 2 and decision number 43. Institutional permission was also obtained from the Ağrı Provincial Health Directorate Scientific Research Permission Commission with decision number 148. The study protocol was registered on ClinicalTrials.gov with the identifier NCT06892509.

The study was conducted in accordance with the Declaration of Helsinki. Written and verbal informed consent was obtained from all participants prior to data collection. Participation was voluntary, and participants were informed of their right to withdraw at any time without any consequences.

Participant confidentiality was ensured, and data were stored securely with access limited to the research team. After data collection, the intervention was offered to participants in the control group upon request.

Permissions for the use of the measurement instruments were obtained from the respective authors.

3. Results

The sociodemographic and menopause‐related characteristics of the participants are presented in Table 1. It was found that there was no statistically significant difference between the intervention and control groups in terms of education level, employment status, family type, presence of chronic disease, smoking, and alcohol use (p > 0.05). All participants reported no alcohol use and natural menopause.

TABLE 1.

Baseline sociodemographic and clinical characteristics of women in the intervention and control groups.

Variables Intervention Control Significance
n % n %
Education level
Primary school 33 76.7 31 75.6
Middle school 7 16.3 5 12.2 χ 2 = 1.349, p = 0.718
High school 1 2.3 3 7.3
University 2 4.7 2 4.9
Employment status
Employed 11 25.6 13 31.7 χ 2 = 0.386, p = 0.534
Unemployed 32 74.4 28 68.3
Marital status
Married 43 100 41 100 —
Family type
Nuclear 25 58.1 23 56.1 χ 2 = 0.036, p = 0.850
Extended 18 41.9 18 43.9
Chronic disease
Yes 25 58.1 29 70.7 χ 2 = 1.449, p = 0.229
No 18 41.9 12 29.3
Smoking status
Yes 15 34.9 18 43.9 χ 2 = 0.716, p = 0.398
No 28 65.1 23 56.1
Alcohol use
Yes — — — — —
No 43 100 41 100
Type of menopause
Natural 43 100 41 100 —
Other — — — —
Perception of menopause
Positive 21 48.8 19 46.3 χ 2 = 0.052, p = 0.819
Negative 22 51.2 22 53.7
Continuous variables Intervention Control
n Mean SD n Mean
Age 43 49.53 2.73 41 50.66 3.42
Number of children 43 4.86 1.93 41 4.80 1.82
BMI 43 32.79 7.46 41 31.95 7.22
Age at menopause 43 47.42 2.93 41 48.39 3.11
Duration of menopause (years) 43 2.11 1.76 41 2.26 1.84
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Note: Categorical variables were analyzed using the chi‐square test. Continuous variables were analyzed using the independent samples t‐test.

Abbreviations: BMI, body mass index; SD, standard deviation.

The mean age was 50.66 ± 3.42 years in the control group and 49.53 ± 2.73 years in the intervention group, and it was found that there was no significant difference between the groups (p > 0.05). Similarly, it was found that there was no statistically significant difference between the groups in terms of number of children, body mass index, and age at menopause (p > 0.05).

The normality test results for continuous variables are presented in Table 2. Skewness and kurtosis values indicated that most continuous variables were normally distributed; however, height and BMI showed a non‐normal distribution. Accordingly, the Mann–Whitney U test was used for between‐group comparisons of these variables.

The normality test results for outcome variables by group are presented in Table 3. All outcome measure scores were normally distributed within both the intervention and control groups. Therefore, independent samples t‐tests and paired samples t‐tests were used for between‐group and within‐group comparisons, respectively.

There was no statistically significant difference in pre‐test Utian Quality of Life Scale scores between the intervention and control groups (p > 0.05) (Table 4). In contrast, post‐test scores were significantly higher in the intervention group compared to the control group (p < 0.05). Within the intervention group, a significant increase in quality of life scores was observed from pre‐test to post‐test (p < 0.05; Cohen's d = 1.68). In the control group, no statistically significant change was observed between pre‐test and post‐test scores (p > 0.05; Cohen's d = 0.28).

TABLE 4.

Comparison of pre‐ and post‐test Utian Quality of Life Scale scores between and within groups.

Scale Time Intervention (n = 43) Control (n = 41) t p
Mean (SD) Mean (SD)
Utian Quality of Life Pre‐test Mean 67.53 68.00 t = −0.248 0.805
SD 7.94 9.25
Post‐test Mean 81.81 69.95 t = 8.399 < 0.001
SD 4.79 7.74
Within‐group t/p t* = −11.023 t* = −1.793 — —
p < 0.001 p = 0.081
Effect size (Cohen's d) −1.681 −0.280 — —
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Note: t = independent samples t‐test; t* = paired samples t‐test. Bold values indicate statistically significant results (p < 0.05).

There was no statistically significant difference in pre‐test Riverside Life Satisfaction Scale scores between the intervention and control groups (p > 0.05) (Table 5). Post‐test scores were significantly higher in the intervention group compared to the control group (p < 0.05).

TABLE 5.

Comparison of pre‐ and post‐test Riverside Life Satisfaction Scale scores between and within groups.

Scale Time Intervention (n = 43) Control (n = 41) t p
Mean (SD) Mean (SD)
Riverside life satisfaction Pre‐test Mean 23.84 23.20 t = 0.473 0.638
SD 6.13 6.32
Post‐test Mean 29.07 24.85 t = 3.828 < 0.001
SD 5.01 5.08
Within‐group t/p t* = −4.627 t* = −1.404 — —
p < 0.001 p = 0.168
Effect size (Cohen's d) −0.706 −0.219 — —
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Note: t = independent samples t‐test; t* = paired samples t‐test. Bold values indicate statistically significant results (p < 0.05).

Within the intervention group, a significant increase in life satisfaction scores was observed from pre‐test to post‐test (p < 0.05; Cohen's d = 0.71). In the control group, no statistically significant change was observed between pre‐test and post‐test scores (p > 0.05; Cohen's d = 0.22).

There was no statistically significant difference in pre‐test Pittsburgh Sleep Quality Index (PSQI) scores between the intervention and control groups (p > 0.05) (Table 6). Post‐test scores were significantly lower in the intervention group compared to the control group (p < 0.05). Within the intervention group, a significant decrease in PSQI scores was observed from pre‐test to post‐test (p < 0.05; Cohen's d = 1.33). In the control group, no statistically significant change was observed between pre‐test and post‐test scores (p > 0.05; Cohen's d = 0.23).

TABLE 6.

Comparison of pre‐ and post‐test Pittsburgh Sleep Quality Index (PSQI) scores between and within groups.

Scale Time Intervention (n = 43) Control (n = 41) t p
Mean (SD) Mean (SD)
Pittsburgh Sleep Quality Index (PSQI) Pre‐test Mean 10.07 10.54 t = −1.185 0.239
SD 1.70 1.91
Post‐test Mean 6.30 11.27 t = −9.532 < 0.001
SD 2.49 2.27
Within‐group t/p t* = 8.687 t* = −1.442 — —
p < 0.001 p = 0.157
Effect size (Cohen's d) 1.325 −0.225 — —
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Note: t = independent samples t‐test; t* = paired samples t‐test. Bold values indicate statistically significant results (p < 0.05).

There was no statistically significant difference in pre‐test Warwick–Edinburgh Mental Well‐Being Scale (WEMWBS) scores between the intervention and control groups (p > 0.05) (Table 7). Post‐test scores were significantly higher in the intervention group compared to the control group (p < 0.05). Within the intervention group, a significant increase in mental well‐being scores was observed from pre‐test to post‐test (p < 0.05; Cohen's d = 1.48). In the control group, no statistically significant change was observed between pre‐test and post‐test scores (p > 0.05; Cohen's d = 0.09).

TABLE 7.

Comparison of Pre‐ and Post‐Test Warwick–Edinburgh Mental Well‐Being Scale (WEMWBS) scores between and within groups.

Scale Time Intervention (n = 43) Control (n = 41) t p
Mean (SD) Mean (SD)
Warwick–Edinburgh Mental Well‐Being Scale (WEMWBS) Pre‐test Mean 38.93 41.24 t = −1.325 0.189
SD 8.15 7.85
Post‐test Mean 53.14 40.41 t = 8.696 < 0.001
SD 6.97 6.41
Within‐group t/p t* = −9.673 t* = 0.577 — —
p < 0.001 p = 0.567
Effect size (Cohen's d) −1.475 0.090 — —
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Note: t = independent samples t‐test; t* = paired samples t‐test. Bold values indicate statistically significant results (p < 0.05).

A regression analysis was conducted to examine the effect of the MBSR program on quality of life, life satisfaction, sleep quality, and mental well‐being among menopausal women (Table 8). The results indicated that the MBSR program was a statistically significant predictor of Utian Quality of Life, Riverside Life Satisfaction, Pittsburgh Sleep Quality, and Warwick–Edinburgh Mental Well‐Being Scale scores (p < 0.05). The MBSR program was positively associated with Utian Quality of Life (β = 0.727), Riverside Life Satisfaction (β = 0.843), and Warwick–Edinburgh Mental Well‐Being (β = 0.764) scores. A significant negative association was observed with Pittsburgh Sleep Quality scores (β = −2.086).

TABLE 8.

Regression analysis examining the effect of the MBSR Program on outcome variables.

Variables B SE Wald p Odds ratio 95% CI lower 95% CI upper
Utian Quality of Life −0.319 0.071 20.304 < 0.001 0.727 0.633 0.835
Constant 24.363 5.451 19.975 < 0.001 38.089 — —
Riverside Life Satisfaction −0.171 0.052 10.883 0.001 0.843 0.761 0.933
Constant 4.574 1.422 10.353 0.001 96.962 — —
Pittsburgh Sleep Quality Index 0.735 0.147 24.941 < 0.001 2.086 1.563 2.785
Constant −6.581 1.375 22.901 < 0.001 0.001 — —
Warwick–Edinburgh Mental Well‐Being −0.269 0.057 22.535 < 0.001 0.764 0.684 0.854
Constant 12.505 2.652 22.239 < 0.001 269.345 — —
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Note: Binary logistic regression analysis was performed. Bold values indicate statistically significant results (p < 0.05).

Abbreviations: B, unstandardized regression coefficient; CI, confidence interval; SE, standard error.

4. Discussion

This randomized controlled trial evaluated the effects of an eight‐week Mindfulness‐Based Stress Reduction (MBSR) program on quality of life, life satisfaction, sleep quality, and mental well‐being in menopausal women. The findings demonstrated that the MBSR program was associated with significant improvements across all four outcome domains compared to the control group (p < 0.05), with effect sizes ranging from moderate to large. These results support the growing body of evidence suggesting that MBSR may serve as an effective non‐pharmacological approach for managing the multidimensional challenges associated with menopause and contribute to the limited but expanding literature on comprehensive well‐being interventions in this population.

The MBSR program was associated with a significant improvement in quality of life among menopausal women, as reflected by the substantially higher post‐test scores in the intervention group and a large effect size (Cohen's d = 1.68). These findings are consistent with prior research demonstrating the potential of mindfulness‐based interventions to reduce psychological symptoms and enhance quality of life during menopause. Liu et al. (2023) reported that mindfulness‐based interventions reduce anxiety and depression while improving quality of life, and Koca et al. (2024) similarly found that MBSR was associated with reduced menopausal symptoms and improved quality of life. Studies conducted in Turkish populations have further demonstrated that MBSR may reduce menopausal symptoms and improve quality of life in postmenopausal women (Şener Çetin et al. 2024; Şener and Taşhan 2021). A meta‐analysis by Chen et al. (2021) also indicated that mindfulness‐based interventions are associated with significant improvements in overall quality of life. The observed improvements may be attributed to mechanisms such as the regulation of stress responses, reduction of ruminative thinking, and the development of a more accepting relationship with distressing experiences (Thomas et al. 2020). Menopause‐related hormonal changes, sleep disturbances, vasomotor symptoms, and mood fluctuations are well‐documented contributors to reduced quality of life (Humeniuk et al. 2019; Kling et al. 2024), and MBSR may contribute to improvements in this domain by modulating symptom perception and individuals' responses to these symptoms.

Consistent with its effects on quality of life, the MBSR program was also associated with significant improvements in life satisfaction, as evidenced by higher post‐test scores in the intervention group and a moderate effect size (Cohen's d = 0.71). Life satisfaction reflects the cognitive‐evaluative dimension of subjective well‐being and is inherently influenced by a broad range of social, economic, familial, and health‐related factors, which may account for the comparatively smaller effect size relative to other outcomes. Previous studies have similarly reported that mindfulness‐based approaches may contribute to life satisfaction by reducing emotional distress and enhancing coping capacity (Shorey et al. 2020; Wong et al. 2018). Koca et al. (2024) reported that MBSR was associated with improvements in life satisfaction, and Shorey et al. (2020) highlighted that mind–body interventions may improve menopausal symptoms and, consequently, life satisfaction. Possible mechanisms underlying these improvements include increased awareness of stress‐related thought patterns, development of non‐judgmental acceptance, and enhanced self‐compassion (Terikani et al. 2025; Yazdani Aliabadi et al. 2021), which may collectively mitigate the negative impact of menopausal symptoms on life satisfaction and contribute to more positive overall life evaluations.

The MBSR program was associated with a significant reduction in Pittsburgh Sleep Quality Index scores in the intervention group, indicating improved sleep quality, along with a large effect size (Cohen's d = 1.33). Sleep disturbances are among the most frequently reported and distressing symptoms during menopause, and addressing them is critical to improving overall well‐being. These findings are broadly consistent with previous studies indicating that mindfulness‐based interventions may improve sleep quality during menopause (Darehzereshki et al. 2022; Lin et al. 2022; Şener Çetin et al. 2024), as well as with meta‐analytic evidence supporting the role of mind–body interventions in this domain (Arar and Erbi̇l 2022; Xu et al. 2024). Importantly, the findings of the present study also align with those of Javadzade et al. (2025), who reported that an 8‐week MBSR program significantly reduced depression and physical problems, including sleep‐related difficulties, in depressed elderly individuals in a randomized controlled trial. Although that study was conducted in an elderly population with clinical depression rather than menopausal women, the shared mechanisms—namely reductions in stress, anxiety, and hyperarousal, as well as decreased pre‐sleep rumination (Shabani et al. 2022)—suggest that MBSR may exert its beneficial effects on sleep through common psychological pathways across diverse populations. Furthermore, increased parasympathetic activity and enhanced relaxation responses associated with mindfulness practice may facilitate sleep initiation and continuity (Fan et al. 2025), further supporting the potential of MBSR as a supportive approach for managing sleep‐related difficulties during menopause.

The MBSR program was also associated with significant improvements in mental well‐being, as reflected by substantially higher post‐test scores in the intervention group and a large effect size (Cohen's d = 1.48). This finding is consistent with recent evidence indicating that mindfulness‐based interventions may improve well‐being outcomes by reducing stress, anxiety, and depressive symptoms during menopause (Amin et al. 2025; Darehzereshki et al. 2022; Zarvekanloo et al. 2023). The observed improvements in mental well‐being may be explained by enhanced awareness of automatic stress responses, reduced reactivity, and increased self‐compassion associated with MBSR (Amin et al. 2025; Wong et al. 2018). These processes may help women manage emotional fluctuations more effectively during menopause, contributing to a broader sense of psychological resilience. However, some reviews have noted that the effects of mindfulness‐based interventions on anxiety and depression may vary depending on contextual factors such as menopausal stage, intervention characteristics, duration, and adherence (Kuck and Hogervorst 2024), which highlights the importance of tailoring such interventions to the specific needs and characteristics of the target population.

The regression analysis further indicated that the MBSR program was a significant predictor of all four outcome variables (p < 0.05), suggesting a multidimensional and coherent pattern of effects across the well‐being domains examined. This finding is consistent with the theoretical framework of MBSR, which integrates mindfulness practice, emotional regulation, and stress coping processes into a unified intervention model (Amin et al. 2025; Aydın and Budak 2023; Kumar et al. 2025). The associations observed with sleep quality in the regression analysis may be further explained by mechanisms related to autonomic nervous system regulation and enhanced physiological relaxation responses (Chang et al. 2023). Taken together, the regression findings reinforce the interpretation that the observed improvements across outcomes reflect a genuine multidimensional effect of the MBSR program rather than isolated or incidental changes, and support the utility of MBSR as a holistic, evidence‐based intervention for menopausal women.

5. Conclusion

This study evaluated the effects of an eight‐week Mindfulness‐Based Stress Reduction (MBSR) program on quality of life, life satisfaction, sleep quality, and mental well‐being in menopausal women. The findings suggest that the MBSR program was associated with significant improvements across these outcomes.

Following the intervention, increases in quality of life, life satisfaction, and mental well‐being, as well as reductions in sleep‐related problems, were observed in the intervention group. These results indicate that MBSR may contribute to positive changes in multiple well‐being domains during menopause.

MBSR may therefore be considered a supportive and feasible approach within nursing care for menopausal women. These findings support the potential integration of MBSR into nursing practice as a complementary approach for menopausal care.

6. Clinical and Practical Implications

The findings of the present study suggest that integrating mindfulness‐based stress reduction programs into nursing care may support the reduction of stress and improvement of quality of life, sleep quality, and mental well‐being in menopausal women.

Providing structured training for nurses working in primary care settings, such as family health centers, community health centers, and women's health clinics, and implementing group‐based mindfulness programs through these professionals may enhance the scope and accessibility of care for menopausal women.

In addition, the development and dissemination of web‐based, mobile‐supported, or online MBSR programs may offer a feasible alternative, particularly in settings with limited access to healthcare services.

The findings suggest that MBSR may serve as a feasible, low‐cost, and holistic psychoeducational intervention within nursing care for menopausal women. Its association with concurrent improvements across interrelated domains such as quality of life, sleep, and mental well‐being indicates that MBSR may be integrated into clinical practice and community‐based interventions.

7. Implications for Education

Integrating mindfulness‐based nursing interventions into undergraduate and graduate nursing curricula may contribute to the development of stress management, self‐awareness, and therapeutic communication skills among future nurses. In this context, incorporating structured mindfulness practices into both theoretical courses and clinical skills training, along with brief and targeted sessions, may support the educational process.

Furthermore, aligning mindfulness‐based practices with the NANDA, NIC, and NOC classifications may facilitate the systematic integration of these approaches into the nursing process.

8. Implications for Future Research

Future studies should examine the long‐term effects of mindfulness‐based interventions across different stages of menopause (perimenopausal and postmenopausal periods) to better understand the sustainability of these interventions. Randomized controlled trials comparing MBSR with other psychosocial interventions, such as laughter yoga or cognitive behavioral therapy, may help clarify which approaches are more effective for specific outcomes.

In addition, qualitative studies exploring women's experiences, perceptions, and motivations regarding mindfulness‐based practices may provide deeper insights and support the adaptation of interventions to better meet women's needs.

9. Strengths and Limitations

The findings of this study should be interpreted in light of several limitations. All measurement tools were self‐reported, which may introduce response bias due to reliance on participants' subjective evaluations. However, such instruments are widely used to assess subjective experiences in menopausal women.

The study evaluated the effects of the MBSR program only over an eight‐week period, and no long‐term follow‐up was conducted. Therefore, the sustainability of the observed effects could not be determined. In addition, only women experiencing natural menopause were included, limiting the generalizability of the findings to those undergoing surgical menopause.

Due to the nature of the intervention, blinding of participants and researchers was not feasible. However, to minimize potential bias, the datasets were coded and analyzed by an independent statistician using a single‐blind approach.

Despite these limitations, the study has several strengths. It is one of the few randomized controlled studies evaluating the effects of an MBSR program on quality of life, life satisfaction, sleep quality, and mental well‐being in menopausal women. The inclusion of multiple well‐being outcomes allowed for a comprehensive evaluation of the intervention.

Furthermore, face‐to‐face data collection may have supported participant engagement and enhanced data quality. The findings may contribute to the growing body of literature on mindfulness‐based interventions in menopausal populations.

Funding

This study was supported by Atatürk University Scientific Research Projects Coordination Unit (Project No: 2025/14822).

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Table S1: Weekly structure, session content, and home practice components of the mindfulness‐based stress reduction (MBSR) program.

JNU-58-0-s001.docx (10.1MB, docx)

File S2: Mindfulness‐Based Stress Reduction (MBSR) Program Handbook for Women in the Menopausal Period.

JNU-58-0-s003.docx (1MB, docx)

Table S3: Thematic findings on participant experiences following the mindfulness‐based stress reduction (MBSR) program.

JNU-58-0-s002.docx (17KB, docx)

Acknowledgments

This study was conducted as part of a doctoral dissertation. Use of Artificial Intelligence: Artificial intelligence (ChatGPT, OpenAI) was used for language editing and refinement. All content was critically reviewed and approved by the authors.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Table S1: Weekly structure, session content, and home practice components of the mindfulness‐based stress reduction (MBSR) program.

JNU-58-0-s001.docx (10.1MB, docx)

File S2: Mindfulness‐Based Stress Reduction (MBSR) Program Handbook for Women in the Menopausal Period.

JNU-58-0-s003.docx (1MB, docx)

Table S3: Thematic findings on participant experiences following the mindfulness‐based stress reduction (MBSR) program.

JNU-58-0-s002.docx (17KB, docx)

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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