The Association of a Mindfulness-Based Stress Reduction Nursing Model With Quality of Life in Patients With Chronic Tonsillitis Complicated by Anxiety Disorder: A Retrospective Study

Abstract

Background: To examine the association between a mindfulness-based stress reduction (MBSR) nursing model and changes in quality of life in patients with chronic tonsillitis complicated by anxiety disorder.

Methods: This retrospective study analyzed propensity score-matched data from 110 patients (55 per group) with chronic tonsillitis and comorbid anxiety disorder treated at Yingshang County People’s Hospital from February 2023 to October 2025. Based on nursing records, patients received either routine nursing or the MBSR nursing model. Pharyngeal symptom scores, Generalized Anxiety Disorder-7 (GAD-7) scores, Mindful Attention Awareness Scale (MAAS) scores, Hamilton Anxiety (HAMA) Scale scores, Pittsburgh Sleep Quality Index (PSQI) scores, and World Health Organization Quality of Life Brief Version (WHOQOL-BREF) scores were extracted and compared. Polysomnography parameters were also analyzed. Exploratory encephalofluctuogram (EFG) data are presented in the Supplementary Material.

Results: Post-nursing, both groups showed significantly lower scores for all eight pharyngeal symptoms and lower GAD-7, HAMA, and PSQI scores and higher MAAS scores compared to pre-nursing values (p < 0.05). The MBSR group demonstrated significantly lower pharyngeal symptom scores, lower GAD-7, HAMA, and PSQI scores, and higher MAAS scores than the routine nursing group (p < 0.05), along with significantly higher scores across all WHOQOL-BREF domains (p < 0.05). Polysomnography revealed significantly shorter sleep latency, fewer microarousals, and a higher proportion of rapid eye movement sleep in the MBSR group (p < 0.05). Exploratory EFG observations are presented in the Supplementary Material. 

Conclusions: In this retrospective analysis, the MBSR nursing model was associated with lower anxiety levels, higher mindful attention awareness, better sleep quality, and better overall quality of life in patients with chronic tonsillitis complicated by anxiety disorder. Exploratory EFG observations are hypothesis-generating only and require validation with established methods. These findings warrant further investigation in prospective studies.