Effectiveness of Neurofeedback-Assisted and Conventional 6-Week Web-Based Mindfulness Interventions on Mental Health of Chinese Nursing Students: Randomized Controlled Trial

BackgroundNursing 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 prom...

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Main Authors: Shu Jing, Zhenwei Dai, Xiaoyang Liu, Xuelin Yang, Jinglei Cheng, Tianming Chen, Zihang Feng, Xin Liu, Fenghe Dong, You Xin, Zhuoyan Han, Haiyan Hu, Xiaoyou Su, Chen Wang
Format: Article
Language:English
Published: JMIR Publications 2025-05-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2025/1/e71741
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author Shu Jing
Zhenwei Dai
Xiaoyang Liu
Xuelin Yang
Jinglei Cheng
Tianming Chen
Zihang Feng
Xin Liu
Fenghe Dong
You Xin
Zhuoyan Han
Haiyan Hu
Xiaoyou Su
Chen Wang
author_facet Shu Jing
Zhenwei Dai
Xiaoyang Liu
Xuelin Yang
Jinglei Cheng
Tianming Chen
Zihang Feng
Xin Liu
Fenghe Dong
You Xin
Zhuoyan Han
Haiyan Hu
Xiaoyou Su
Chen Wang
author_sort Shu Jing
collection DOAJ
description BackgroundNursing 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. ObjectiveThis 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. MethodsA 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. ResultsA 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. ConclusionsThis 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. Trial RegistrationChinese Clinical Trial Registry (ChiCTR) ChiCTR2400080314; https://www.chictr.org.cn/bin/project/edit?pid=211845
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spelling doaj-art-e729b800142e4e02b2f057446039238b2025-08-20T02:26:20ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-05-0127e7174110.2196/71741Effectiveness of Neurofeedback-Assisted and Conventional 6-Week Web-Based Mindfulness Interventions on Mental Health of Chinese Nursing Students: Randomized Controlled TrialShu Jinghttps://orcid.org/0009-0004-0299-5782Zhenwei Daihttps://orcid.org/0000-0002-7508-008XXiaoyang Liuhttps://orcid.org/0009-0005-2937-2881Xuelin Yanghttps://orcid.org/0009-0006-2316-1271Jinglei Chenghttps://orcid.org/0009-0006-3536-7138Tianming Chenhttps://orcid.org/0009-0009-8023-1119Zihang Fenghttps://orcid.org/0009-0000-8977-9804Xin Liuhttps://orcid.org/0000-0003-4382-8687Fenghe Donghttps://orcid.org/0009-0008-5669-5290You Xinhttps://orcid.org/0009-0008-3289-2417Zhuoyan Hanhttps://orcid.org/0009-0009-3749-5573Haiyan Huhttps://orcid.org/0009-0001-6447-5107Xiaoyou Suhttps://orcid.org/0000-0002-4216-2142Chen Wanghttps://orcid.org/0000-0001-7857-5435 BackgroundNursing 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. ObjectiveThis 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. MethodsA 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. ResultsA 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. ConclusionsThis 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. Trial RegistrationChinese Clinical Trial Registry (ChiCTR) ChiCTR2400080314; https://www.chictr.org.cn/bin/project/edit?pid=211845https://www.jmir.org/2025/1/e71741
spellingShingle Shu Jing
Zhenwei Dai
Xiaoyang Liu
Xuelin Yang
Jinglei Cheng
Tianming Chen
Zihang Feng
Xin Liu
Fenghe Dong
You Xin
Zhuoyan Han
Haiyan Hu
Xiaoyou Su
Chen Wang
Effectiveness of Neurofeedback-Assisted and Conventional 6-Week Web-Based Mindfulness Interventions on Mental Health of Chinese Nursing Students: Randomized Controlled Trial
Journal of Medical Internet Research
title Effectiveness of Neurofeedback-Assisted and Conventional 6-Week Web-Based Mindfulness Interventions on Mental Health of Chinese Nursing Students: Randomized Controlled Trial
title_full Effectiveness of Neurofeedback-Assisted and Conventional 6-Week Web-Based Mindfulness Interventions on Mental Health of Chinese Nursing Students: Randomized Controlled Trial
title_fullStr Effectiveness of Neurofeedback-Assisted and Conventional 6-Week Web-Based Mindfulness Interventions on Mental Health of Chinese Nursing Students: Randomized Controlled Trial
title_full_unstemmed Effectiveness of Neurofeedback-Assisted and Conventional 6-Week Web-Based Mindfulness Interventions on Mental Health of Chinese Nursing Students: Randomized Controlled Trial
title_short Effectiveness of Neurofeedback-Assisted and Conventional 6-Week Web-Based Mindfulness Interventions on Mental Health of Chinese Nursing Students: Randomized Controlled Trial
title_sort effectiveness of neurofeedback assisted and conventional 6 week web based mindfulness interventions on mental health of chinese nursing students randomized controlled trial
url https://www.jmir.org/2025/1/e71741
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