Effects of nonpharmacological interventions on depressive symptoms and depression among nursing students: A systematic review and meta-analysis.

Abstract Objectives We aim to examine whether nonpharmacological interventions could effectively improve depressive symptoms and depression to provide more treatment options for nursing students. Methods PubMed, the Cochrane Library, EMBase, Web of Science, PsycINFO, and three Chinese electronic databases were comprehensively searched for papers that were published from January 1990 through March 2018. Quality assessment, sensitivity analysis and heterogeneity were performed. Results In our review, 13 controlled trials met the inclusion criteria. The meta-analysis indicated that the depressive symptoms and depression of nursing students in the intervention groups showed significantly moderate improvements compared with the control groups. Three subgroup analyses showed that mindfulness interventions and stress management programs were common and effective, short-term interventions were beneficial to depression, nonpharmacological interventions had great improvements for Asian nursing students and more rigorous researches on methodological quality are recommended. Conclusion Nonpharmacological interventions can serve as promising complementary and alternative approaches in reducing the depressive symptoms and depression of nursing students. Highlights • Nonpharmacological interventions had moderate positive effects on depressive symptoms and depression. • Mindfulness interventions and stress management programs were common and effective at improving depression. • A short-term (1-8 weeks) intervention length is recommended. • Nonpharmacological interventions have greater improvements for nursing students in Asia. • Nonpharmacological interventions can serve as promising complementary and alternative approaches in reducing depression. [ABSTRACT FROM AUTHOR]