Effectiveness of Virtual Mindfulness Combined With Brief Structured Breathing Training on Perceived Stress, Burnout, Sleep Quality, and Cognitive Function Among Rotating-Shift Nurses: A Randomized Controlled Trial

Inclusion Criteria

Inclusion Criteria: 1. Age between 20 and 65 years. 2. Able to understand spoken or written Mandarin or Taiwanese. 3. Employed full-time for at least 3 months with a signed employment contract. 4. Has worked rotating shifts (including day, evening, and/or night shifts) in the past 3 months. 5. Willing to participate and sign informed consent. 6. Registered nurse. 7. A perceived stress score greater than or equal to 50 based on a standardized scale. Exclusion Criteria: 1. Pregnant or breastfeeding individuals. 2. History of substance abuse (e.g., tobacco, illicit drugs). 3. Alcohol consumption ≥350 ml/week with alcohol content ≥3.5%. 4. Diagnosed or suspected autonomic nervous system disorders. 5. History of severe or unstable cardiovascular disease, cerebrovascular disease, cancer, or end-stage organ failure within the past 6 months. 6. Current diagnosis of psychiatric disorders (e.g., major depressive disorder, schizophrenia), or use of psychiatric or sleep medications (e.g., antidepressants, sedatives). 7. Reported discomfort (e.g., dizziness, nausea) when using virtual reality devices. 8. Engaged in other regular exercise programs, light therapy, or mind-body interventions during the study period. 9. Participating in other clinical trials simultaneously.