Interventions to Reduce Perceived Stress Among Graduate Students: A Systematic Review With Implications for Evidence-Based Practice

Worldviews Evid Based Nurs. 2017 Dec;14(6):507-513. doi: 10.1111/wvn.12250. Epub 2017 Aug 10.


Background: Stress is a part of daily life for graduate students, including graduate nursing students. Contemporary graduate nursing students are facing unprecedented challenges to meet rigorous academic standards as they prepare for their advanced professional role to meet the demands of the nation's complex and ever-changing healthcare system. Empowering graduate nursing students to ease their perceived stress and minimize undesirable health effects may benefit their capacity to adapt and successfully manage perceived stress in their future healthcare role.

Aims: To conduct a systematic review to evaluate the existing evidence with the aim of identifying evidence-based self-care interventions for coping with perceived stress.

Methods: We conducted a systematic review, searching CINAHL Plus with Full Text, PsycINFO, and MEDLINE. Inclusion criteria included self-care, graduate students, perceived stress as measured by Perceived Stress Scale, quantitative analysis, conducted within the United States, English language, and peer reviewed. Two authors completed an asynchronous review of the articles, and one expert evidence-based practice mentor and one wellness expert conducted rigorous appraisal of the eight identified studies. Evidence was evaluated and synthesized, and recommendations for practice were determined.

Results: Eight studies meeting the criteria for this systematic review were critically appraised. The interventions varied from a stress management course to mind-body-stress-reduction (MBSR) techniques, such as yoga, breath work, meditation, and mindfulness. All studies measured the outcome of stress with the Perceived Stress Scale. Each study demonstrated a reduction in perceived stress postintervention.

Linking evidence to action: Most effective self-care MBSR interventions include (a) a didactic component, (b) a guided MBSR practice session, and (c) homework. Consideration should be given to a trained or certified MBSR instructor to teach the intervention.

Keywords: allied health; graduate students; interventions; nursing; perceived stress; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Education, Graduate / methods
  • Education, Graduate / standards
  • Humans
  • Perception
  • Psychometrics / instrumentation
  • Psychometrics / methods
  • Qualitative Research
  • Self-Management*
  • Stress, Psychological / etiology
  • Stress, Psychological / therapy*
  • Students / psychology*
  • Universities / organization & administration