Relationships among Training, Mindfulness, and Workplace Injuries among Nurse Aides Working in Long-Term Care Settings

  • William H. O’BrienEmail author
  • Kristin A. Horan
  • Sonia R. Singh
  • Mary M. Moeller
  • Rachel S. Wasson
  • Steve M. Jex
  • Russell A. Matthews
  • Clare L. Barratt
Original Research Article


Nursing aides working in long-term care settings experience high rates of injury, musculoskeletal symptoms, and exposure to resident aggression. Some of these injuries and exposure to aggression may be related to trait mindfulness. The aim of this study was to examine the relationships between trait mindfulness, job training, injury, sources of injury, and musculoskeletal symptoms among nursing aides working in long-term care residential settings. Nursing aides working in long-term care settings across Ohio, USA (n = 152) were recruited for the study. Measures of sociodemographic characteristics, job tenure, job training, mindfulness, work injuries, sources of injuries, and musculoskeletal symptoms were obtained. Correlational analyses demonstrated that higher levels of mindfulness and training were associated with lower levels of injury and musculoskeletal symptoms. They were also significantly inversely associated with the following injury sources: lifting/repositioning resident, bumping/hitting equipment, and resident aggression. Results of hierarchical linear regressions indicated that mindfulness was a significant and unique predictor of injuries, exposure to the most common sources of injury, and musculoskeletal symptoms. Specifically, nursing aides with higher levels of mindfulness were less likely to report experiencing injuries, exposure to the most common sources of injury, and musculoskeletal symptoms. Given that mindfulness can be trained and modified, adding mindfulness training to nursing aide educational programs could potentially help reduce risk for injury among this vulnerable population of workers. Further research exploring the potential benefit of mindfulness training could address this possibility.


Nursing aides Mindfulness Training Work injuries Occupation-related musculoskeletal symptoms 



This project was funded by the Ohio Bureau of Workers Compensation Occupational Safety and Health Research Program.

Compliance with Ethical Standards

Conflict of Interest

The authors whose names are listed above certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest, in the subject matter or materials discussed in this manuscript.

On behalf of all authors, the corresponding author states that there is no conflict of interest.


  1. Ahola, K., Salminen, S., Toppinen-Tanner, S., Koskinen, A., & Väänänen, A. (2013). Occupational burnout and severe injuries: An eight-year prospective cohort study among Finnish forest industry workers. Journal of Occupational Health, 55(6), 450.CrossRefGoogle Scholar
  2. Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., Walsh, E., Duggan, D., & Williams, J. M. G. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342.CrossRefGoogle Scholar
  3. Baddely, A. L. (2018). Exploring working memory: Selected works of Alan Baddely. London: Routledge.CrossRefGoogle Scholar
  4. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822.CrossRefGoogle Scholar
  5. Bureau of Labor Statistics. (2014). Employer-reported workplace injuries and illnesses – 2013. Retrived December 17, 2018 from
  6. Chen, Y., Yang, X., Wang, L., & Zhang, X. (2013). A randomized controlled trial of the effects of brief mindfulness meditation on anxiety symptoms and systolic blood pressure in Chinese nursing students. Nurse Education Today, 33(10), 1166–1172.CrossRefGoogle Scholar
  7. Chiros, C., & O’Brien, W. H. (2011). Acceptance, Appraisals, and Migraine Headache. Journal of Behavioral Medicine, 34, 307–320.CrossRefGoogle Scholar
  8. Cohen-Katz, J., Wiley, S., Capuano, T., Baker, D., & Shapiro, S. (2005). The effects of mindfulness-based stress reduction on nurse stress and burnout, part II: A quantitative and qualitative study. Holistic Nursing Practice, 19, 26–35.CrossRefGoogle Scholar
  9. Coy, W. B., O'Brien, W. H., Tabaczynsky, T., Northern, J., & Carels, R. (2011). The influence of evaluation anxiety on working memory: The role of cognitive interference. Journal of Applied Cognitive Psychology., 25, 823–832.CrossRefGoogle Scholar
  10. Desbordes, G., Gard, T., Hoge, E., Holzel, B., Kerr, C., Lazar, S., Olendzki, A., & Yago, D. (2015). Moving beyond mindfulness: Defining equanimity as an outcome measure in meditation and contemplative research. Mindfulness, 6, 356–372.CrossRefGoogle Scholar
  11. Ditto, B., Eclache, M., & Goldman, N. (2006). Short-term autonomic and cardiovascular effects of mindfulness body scan meditation. Annals of Behavioral Medicine, 32, 227–234.CrossRefGoogle Scholar
  12. Esposito, M. D., & Postle, B. (2015). The cognitive neuroscience of working memory. Annual Review of Psychology, 66, 115–142.CrossRefGoogle Scholar
  13. Fogarty, F. A., Lu, L. M., Sollers, J. J., Krivoschekov, S. G., Booth, R. J., & Consedine, N. S. (2015). Why it pays to be mindful: Trait mindfulness predicts physiological recovery from emotional stress and greater differentiation among negative emotions. Mindfulness, 6, 175–185.CrossRefGoogle Scholar
  14. Frewen, P., Evans, E. M., Karaj, N., Dozois, D. J., & Partridge, K. (2008). Letting go: Mindfulness and negative automatic thinking. Cognitive Therapy and Research, 32, 758–774.CrossRefGoogle Scholar
  15. Haynes, S. N., O’Brien, W. H., & Keawe'aimoku Kaholokula, J. (2011). Behavioral assessment and functional analysis. Hoboken: Wiley.Google Scholar
  16. Khatutsky, G., Wiener, J., Anderson, W., & Porell, F. (2012). Work-related injuries among certified nursing assistants in nursing homes. RTI Press publication No. RR-0017-1204. Research Triangle Park, NC: RTI Press.Google Scholar
  17. Krygier, J. R., Heathers, J. A. J., Shahrestani, S., Abbott, M., Gross, J. J., & Kemp, A. H. (2013). Mindfulness meditation, well-being, and heart rate variability: A preliminary investigation into the impact of intensive Vipassana meditation. International Journal of Psychophysiology, 89, 305–313.CrossRefGoogle Scholar
  18. Kuorinka, I., Jonsson, B., Kilbom, A., Vinterberg, H., Biering-Sorensen, F., Andersson, G., & Jorgensen, K. (1987). Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms. Applied Ergonomics, 18, 233–237.CrossRefGoogle Scholar
  19. MacKenzie, C., Poulin, P., & Seidman-Carlosn, R. (2006). A brief mindfulness-based stress reduction intervention for nurses and nurse aides. Applied Nursing Research, 19, 105–109.CrossRefGoogle Scholar
  20. Moore, A., & Malinowski, P. (2009). Meditation, mindfulness, and cognitive flexibility. Consciousness and Cognition, 18, 176–186.CrossRefGoogle Scholar
  21. O’Brien, W. H., & Carhart, V. (2011). Functional analysis in behavioral medicine settings. European Journal of Psychological Assessment, 27, 4–16.CrossRefGoogle Scholar
  22. O’Brien, W. H., Goetz, P., Morrison, W., Horan, K., & Watford, T. (2017). Job satisfaction among mental health workers. Associations with respiratory sinus reactivity to, and recovery from exposure to mental stress. Journal of Psychophysiology.
  23. Ohio Department of Health (2011). Nurse aide training and competency evaluation program: Standards and guidelines. Retrieved from
  24. Ostafin, B. D., & Kassman, K. T. (2012). Stepping out of history: Mindfulness improves insight problem solving. Consciousness and Cognition, 21, 1031–1036.CrossRefGoogle Scholar
  25. Pipe, T. B., Bortz, J. J., Dueck, A., Pendergast, D., Buchda, V., & Summers, J. (2009). Nurse leader mindfulness meditation program for stress management: A randomized controlled trial. Journal of Nursing Administration, 39(3), 130–137.CrossRefGoogle Scholar
  26. Quaglia, J. T., Braun, S. E., Freeman, S. P., McDaniel, M. A., & Brown, K. W. (2016). Meta-analytic evidence for the effects of mindfulness training on dimensions of self-reported dispositional mindfulness. Psychological Assessment, 28, 803–818.CrossRefGoogle Scholar
  27. Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3), 373–386.CrossRefGoogle Scholar
  28. Smith, R., Thayer, J. F., Khalsa, S. S., & Lande, R. D. (2017). The hierarchical basis of neurovisceral integration. Neuroscience and Biobehavioral Reviews, 75, 274–296.CrossRefGoogle Scholar
  29. Squillace, M., Remsberg, R., Bercovitz, A., & Rosenoff, E. (2007). An introduction to the National Nursing Assistant Survey. National Center for Health Statistics. Vital Health Statistics Series, 1(44), 1–54.Google Scholar
  30. Stanev, S., Bailer, J., Straker, J. K., Mehdizadeh, S., Park, R. M., & Li, H. (2012). Worker injuries and safety equipment in Ohio nursing homes. Journal of Gerontological Nursing, 38(6), 47–56. Scholar
  31. Zeidan, F., Johnson, S., Diamond, B., David, Z., & Goolkasian, P. (2010). Mindfulness meditation improves cognition: Evidence of brief mental training. Consciousness and Cognition, 19, 597–605.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • William H. O’Brien
    • 1
    Email author return OK on get
  • Kristin A. Horan
    • 2
  • Sonia R. Singh
    • 1
    • 3
  • Mary M. Moeller
    • 1
    • 3
  • Rachel S. Wasson
    • 1
    • 3
  • Steve M. Jex
    • 2
  • Russell A. Matthews
    • 4
  • Clare L. Barratt
    • 1
    • 3
  1. 1.Department of PsychologyBowling Green State UniversityBowling GreenUSA
  2. 2.Department of PsychologyUniversity of Central FloridaOrlandoUSA
  3. 3.Department of PsychologyBowling Green State UniversityBowling GreenUSA
  4. 4.Department of Management and MarketingUniversity of AlabamaTuscaloosaUSA

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