The effect of mindfulness therapy through an android application on nurses' work stress: A literature review

Introduction: Several studies have shown that nurses have high levels of work stress. Work stress can be overcome with therapy, especially mindfulness therapy. The purpose of this literature review is to synthesize the literature on mindfulness therapy to reduce work stress for nurses. Objectives : The formulation of the problem in this study is how to influence mindfulness therapy through an android applicationon work stress


INTRODUCTION
PubMed and Scient Direct. The keywords used are different in each database. For Pubmed use "mindfulness" and "online" and "workload" or "work stress" or "occupational stress" and "nurse", meanwhile for scient direct use "mindfulness" and "online" or "app" and "workload" or "work stress" or "occupational stress" and "RCT". Results: The search results from various literature obtained 360 articles, then through a series of selections, 67 match the criteria. These articles are publications from 2018 -2023. but only 7 articles that are reviewed and in accordance with the research topic and 2 articles not available cannot be accessed, 1 article another language. There were 4 selected articles left for review. Conclusions: Nurses work have a high level of stress associated with a large workload. Work stress that is not handled properly can lead to social dysfunction and somatic disorders. Mindfulness-based stress reduction therapy is known effective in reducing the level of nurses anxiety, work fatigue, and work stress. Direct application or online is safe to give, because it does not have significant difference in effectiveness.
KEYWORD : mindfulness; online; workload; work stress; cccupational stress; nurse; app Article Info : Article submitted on February 14, 2023 Article revised on April 26, 2023 Article received on May 10, 2023 Stress is a condition in which a person is under pressure beyond his ability to adapt to it. This condition causes physiological changes such as disruption of the body's homeostatic system (1). Prolonged stress will affect health, well-being, and daily activities (2). One of the activities of nurses is providing nursing care to patients. High work stress causes nurses to be tired and lacking in providing services to patients (3). Lack of service to patients, rude attitude, and ignoring the needs of patients are i n c l u d e d i n a n e g a t i v e a t t i t u d e o r depersonalization in the aspect of work fatigue dimensions.
There are three dimensions of job burnout, namely emotional exhaustion, d e p e r s o n a l i z a t i o n , a n d p e r s o n a l accomplishment. Personal accomplishment is a negative evaluation of oneself. The inability to positively assess the surrounding conditions can increase emotional exhaustion which leads to the emergence of negative attitudes such as speaking in high intonation, demeaning patients, and ignoring the patient's needs (4). Therefore it is important to overcome work stress on nurses, because research shows that good service to patients affects patient satisfaction and compliance in treatment (5).
Work stress handling can be done in various ways according to the triggering factor.
Several studies have shown the effect of coping with stress on the ability to control work stress in nurses (6,7,8,9,10). Good stress coping can be trained with a psychological approach, one of which is using mindfulness techniques (11,12).
Mindfulness is a therapy that continues to be developed among medical personnel in the Pubmed use "mindfulness" and "online" and "workload" or "work stress" or "occupational stress" and "nurse", meanwhile for scient direct use "mindfulness" and "online" or "app" a n d following is a summary listed in Table 1.

DISCUSSION
Stress is an acute condition of a person experiencing pressure that exceeds his ability to cope with the pressure. Prolonged conditions of work stress will increase fatigue and decline in health. Work stress is experienced by many individuals who work in health services with high demands and responsibilities and busy working hours. One of them is for nurses working in the emergency room (18,19,20). In fatal conditions, work stress can lead to suicide in nurses (22,23).
In an effort to prevent work stress, it is necessary to know the factors that influence  Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being [14] Participant were 238 healthy employees from two large UK companies, RCT, mindfulness meditation practice app or a wait-list control condition.
The app offered 45 prerecorded 10-to 20-min guided audio meditation The intervention group reported significant improvement in well-being, distress, job strain, and perceptions of workplace social support compared to the control group. In addition, the intervention group had a marginally significant decrease in self-measured workday systolic blood pressure from preto post-intervention. Sustained positive effects in the intervention group were found for well-being and job strain at the 16-week follow-up assessment.
The main limitations of the trial are the lack of an active control condition, the short-term followup, and the reliance on selfadministered blood pressure readings. A second limitation is that participants were not tracked beyond several weeks postintervention were randomly divided into an intervention group (n = 52) and a no-treatment control group (n = 52). The intervention group received mindfulnessbased breathing and music therapy The data from the study showed that mindfulness-based breathing and music therapy decreased stress and workrelated strain (P < .05) and increased psychological wellbeing (P < .05). The control group showed no statistically significant changes on these measures (P > .05). The mindfulness-based breathing and music therapy practice reduced nurses' stress and work-related strain and increased psychological well-being during the COVID-19 pandemic.
the limitation of the study is that the long-term effects of mindfulness-based breathing and music therapy were not evaluated and the therapy was applied in a single session Mindfulness and music interventions in the workplace: assessment of sustained attention and working memory using a crowdsourcing approach [16] A total of 623 healthy volunteers from Danish companies participated in the study and were randomized into three groups, which consisted of a 30-day intervention of either mindfulness or music, or a non-Participants in the mindfulness group showed a significant improvement in the coefficient of sustained attention, working memory capacity and perceived stress (p? <? .001).
The music group showed a 38% decrease of self-perceived stress. The control group showed no difference from pre to post in the survey or cognitive outcome measures. Furthermore, there was a significant correlation between usage of the mindfulness and music app and elevated score on both the cognitive games and the perceived stress scale.
Size in each of the 3 groups was not entirely balanced. One criticism might be that participants in the mindfulness training condition simply experiencing a placebo effect because they knew they were in a mindfulness group and because of the general belief that mindfulness is beneficial.
The effect of mindfulness therapy through an android application on nurses' work stress: A literature review 110 need for an approach to using item response t h e o r y ( I RT ) i n i n t e r p r e t i n g t h e M B I measurement subscale (24).
In addition to the type of measuring instrument, researchers found various factors that cause work stress. The results of the article review that the author did there were 26 factors that caused work stress, 7 main factors that caused stress, namely workload (discussed 11 articles), gender (9 articles discussed), social support in the work environment (7 articles discussed), work fatigue (discussed in 9 articles), discussed 5 articles), anxiety due to fear of being exposed