The association between mindfulness and health promotion in undergraduate nursing students: A serial multiple mediator analysis

Abstract

Aim This study was conducted to examine the association between mindfulness and health promotion among undergraduate nursing students and explore the mediation effect of certain factors (perceived stress, depressive symptoms, self‐care agency, and impulsivity) on this relationship. Design Cross‐sectional quantitative design. Methods A total of 195 undergraduate nursing students from a public university in Jordan participated in this study. A demographic questionnaire was used in addition to using well‐established, validated tools to measure health promotion, mindfulness, perceived stress, depressive symptoms, impulsivity, and self‐care agency. Data were collected between March and November 2018. Data were analysed using PROCESS macros. Results The direct association between mindfulness and health promotion was positive but not statistically significant. Simple mediation analysis showed that perceived stress is the only statistically significant mediator (effect = 0.03; 95% CI: LL = 0.008, UL = 0.057). The serial multiple mediator analyses revealed that three combinations of the mediators made the mindfulness effect on health promotion statistically significant; perceived stress and self‐care agency (effect = −0.01, 95% CI: LL = −0.022, UL = −0.01); depressive symptoms and self‐care agency (effect = 0.016, 95% CI: LL = 0.006, UL = 0.03); and perceived stress with depressive symptoms and self‐care agency (effect = 0.006, 95% CI: LL = 0.002, UL = 0.013). Conclusions The results of this study add to the literature evidence concerning the mediation role of perceived stress, depressive symptoms, and self‐care agency on the relationship between mindfulness and health promotion among nursing students. Impact This study examined the complex relationship between mindfulness and health promotion. There is a mediation effect of nursing students’ perceived stress, depressive symptoms, and self‐care agency on the relationship between mindfulness and health promotion. Researchers interested in designing mindfulness‐based interventions to optimize health promotion of nursing students could benefit from the findings of this study.