The feasibility of a 4-week online Compassionate Mindful Resilience (CMR) intervention for pre-registration nursing and midwifery students

It is recommended to include integrated interventions that foster stress management and mental health awareness, instead of relying solely on brief, ad-hoc sessions or supplementary materials (Kinman et al., 2020).<br><br>Study Aim and Objectives<br>The aim of this study was to determine the feasibility and acceptability of a pilot randomised controlled trial (RCT) of the CMR intervention for pre-registration nursing and midwifery students studying at Queen’s University Belfast (QUB).

Overall, three objectives of the study were developed. These include:<br>I. To determine the acceptability of the CMR intervention for pre-registration nursing and midwifery students<br>II. To explore the suitability of the chosen outcome measures.<br>III.

To assess the feasibility of conducting a definitive RCT by testing trial procedures<br>including recruitment, retention, intervention adherence rates for a fully powered RCT.<br><br>Methodology<br>A parallel convergent mixed-methods design, consisting of two components: a pilot RCT and a qualitative process evaluation. Overall, the study was based in one geographical location: Queen’s University Belfast, in Northern Ireland.

The pilot RCT was delivered online using Microsoft Teams (MST). A formal sample size calculation is not warranted in feasibility studies (Clifton, et al., 2017) and was based on previous feasibility literature. Thus, the target sample was 60 participants.

Participants were recruited using a four-phase recruitment strategy that combined posters, emails, social media advertisements, and online and in-person face-to-face information<br>sessions. Participants were randomly assigned using simple randomisation. To reduce bias, simple randomisation was conducted by a person unaffiliated with the research.

Four clinical outcome measures were collected at three time points: Pre, Post (Week 4), and six-week follow-up (Week 10). Clinical outcome measures. included: The Resilience Scale, the Five-Facet Mindfulness Questionnaire, the Generalised Anxiety Disorder Assessment, and the Self-Compassion Scale. The process evaluation involved semi-structured interviews with 17 participants, 13 CMR participants and 4 waiting-list control participants.

Interviews were transcribed verbatim and thematically analysed using Braun and Clarke's (2006) 6-phase thematic analysis framework. Both stages were conducted separately and given equal weight for the final analysis. Findings from the pilot RCT and process evaluation were compared, contrasted, and merged to provide a comprehensive interpretation of the intervention's feasibility.<br><br>Results<br>The CMR intervention was acceptable to nursing and midwifery students, with moderate engagement and feasible online delivery.

While retention rates met progression criteria, recruitment reached only 78% of the target and lacked diversity, limiting generalisability. Outcome measures were feasible, though some inconsistencies in completion were noted. Although the study supports progression to a definitive RCT, significant limitations, including incomplete recruitment, restricted sample diversity, potential facilitator effects, and high intervention costs,<br>should be addressed before advancing to a fully powered trial.<br><br><i>Thesis is embargoed until 31 July 2027.

Please note some sections of this thesis are permanently redacted due to copyright restrictions.</i>