Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Anne L. Thatcher, Chairperson, DNP, MSW, APRN, PMHNP -BC, LMSW


Cathy Koetting, Committee Faculty Member, Ph.D., DNP, APRN, CPNP, PMHS, FNP-C


Amanda Finley, Committee Faculty Member, PhD, RN


Problem: Nursing graduate students are at increased risk of greater stress, anxiety, and depression (Hoying, 2020; Melnyk et al., 2020). Cognitive Behavioral Therapy is the gold standard in the treatment of anxiety and depression (Hoying et al., 2020; Melnyk et al., 2015; Melnyk et al., 2020). MINDSTRONG™, a CBT-based training program, has been proven in many studies to be effective in helping individuals prevent or cope with these issues (The Ohio State University College of Nursing, 2020).

Methods: This Quality Improvement (QI) project was a descriptive-observational, pre-post design. Sample and setting were nursing graduate students from a Midwestern, middle-sized urban, public university. Descriptive statistics and the Wilcoxon signed-rank tests were used to compare pre-and post-intervention results.

Results: The sample for this project consisted of six graduate nursing students. The results indicate no statistically significant difference in pre- post Perceived Stress Scale (PSS) and Generalized Anxiety Disorder-7 (GAD-7) scores, though results were clinically significant, with 83.3% (n = 5, N = 6) participants with improved stress and anxiety. There was a statistically significant difference in pre-post Patient Health Questionnaire-8 (PHQ-8) scores with a p = .043. Overall, 83.3% (n = 5) of participants had decreased depression symptoms with the two participants rated with ‘severe’ depression scores having the greatest improvement.

Discussion: Though the sample size was small, the results in this QI project are consistent with that of other studies on the MINDSTRONG™ program. This QI project supports the continued use of MINDSTRONG™ to improve the mental health of graduate nursing students.