Preventing Stress-Related Ill Health Among Future Nurses: Effects Over 3 Years

In 2011, a randomized controlled trial with a sample of 113 nursing students and a group intervention consisting of six 2-hr sessions based on acceptance and commitment training (ACT) to prevent symptoms of burnout was initiated. Measures included the process variables of mindful awareness and experiential avoidance and the outcome variables of perceived stress and burnout. The current study presents data from 1, 2, and 3 years post intervention, investigating the maintenance of the effects. The effects were analyzed using multilevel modeling, including data from six points of measurement (baseline to 3 years after the end of the intervention). In addition, the mediation of effects was investigated. An effect on mindful awareness was maintained during the years following the intervention as indicated by a statistically significant group-by-time interaction and between-groups differences up to 2 years after the intervention. The group-by-time interactions for experiential avoidance, perceived stress, and burnout did not reach statistical significance, but the between-groups difference for perceived stress at 1 year after the intervention was statistically significant, and the effect was mediated by change in experiential avoidance. This study provided new information about the long-term effects of an ACT intervention including mediation of effects, suggesting that more research should be directed toward investigating mechanisms of change of ACT interventions and how to design interventions that bring about effects that last over time.