Mental Health Promotion Through Nursing Interventions Focused on Anxiety, Sleep and Well-Being: A Scoping Review

Authors: Silva Louise Constancia de Melo Alves, Dutra Samia Valeria Ozorio, Ferreira Barbara Fernandes, Rojas Yenifer Lizeth Gañan, Dos Santos Kauanny Vitoria Gurgel, de Silva Carlos Jordão Assis, Silva Hylarina Maria Montenegro Diniz, Ribeiro Kátia Regina Barros, Dantas Daniele Vieira, Dantas Rodrigo Assis NevesJournal: International journal of mental health nursingPublished: April 1, 2026DOI: 10.1111/inm.70254

Strong EvidenceSystematic Review

Anxiety Insomnia

In Plain Language: anxiety, explained

Anxiety is more prevalent than other mental disorders and maintains a bidirectional relationship with sleep disturbances, negatively affecting well-being and overall mental health. This scenario underscores the need to strengthen and qualify nursing practice in addressing these outcomes. This study aimed to map how nursing has developed care for adults and older people through interventions related to anxiety, sleep quality and well-being. A scoping review was conducted in accordance with the PRISMA-ScR checklist. Searches were performed between November and December 2025 across 11 data sources: CINAHL, Cochrane Library, LILACS, MEDLINE/PubMed, SciELO, Scopus, EBSCO Open Dissertations, Web of Science, CAPES Catalogue of Theses and Dissertations, ScienceDirect and Google Scholar, in addition to reference list screening. Sixty-four studies were included. Although the search covered the period from 2010 to 2025, eligible publications were identified between 2011 and 2025, predominantly clinical trials conducted in Iran and Turkey. Thirty-one occurrences of interventions were identified, representing different modes of application of a smaller set of nursing-implementable strategies targeting anxiety, sleep and well-being. Integrative and complementary therapies predominated, including aromatherapy, music therapy, reflexology, acupressure, therapeutic touch, massage, relaxation techniques, Reiki and yoga. Other interventions comprised spiritual support, environmental adjustments (lighting, noise, temperature control), guided imagery, group counselling and self-care programmes, reinforcing nursing's holistic approach. Sleep quality was the most investigated outcome, mainly through environmental control during hospitalisation. However, considering sleep, well-being and anxiety, multicentre studies, further investigation into spirituality and the nursing process and research prioritising well-being and anxiety disorders as primary outcomes are still needed.

Key Findings: what this systematic review found about anxiety

✓Anxiety is more prevalent than other mental disorders and maintains a bidirectional relationship with sleep disturbances, negatively affecting overall well-being and mental health.
✓A scoping review of 64 studies from 2011-2025 identified nursing interventions focused on anxiety, sleep quality, and well-being in adults and older people across 11 major databases.
✓Current evidence indicates a need to strengthen and qualify nursing practice in developing and implementing interventions that address the interconnected outcomes of anxiety, sleep disturbances, and mental well-being.

What This Means for You

Reflexology is among the most researched nursing-led therapies for anxiety and sleep problems, though the overall evidence quality varies—talk with your healthcare provider about whether it's appropriate for your specific situation.

What This Means for Practitioners

This review identifies reflexology as a recognized nursing intervention for mental health outcomes; consider documenting outcomes systematically to contribute to the evidence base in your practice.

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Anxiety: common questions

What does this study say about anxiety?

What did this study find?

Anxiety is more prevalent than other mental disorders and maintains a bidirectional relationship with sleep disturbances, negatively affecting overall well-being and mental health. A scoping review of 64 studies from 2011-2025 identified nursing interventions focused on anxiety, sleep quality, and well-being in adults and older people across 11 major databases. Current evidence indicates a need to strengthen and qualify nursing practice in developing and implementing interventions that address the interconnected outcomes of anxiety, sleep disturbances, and mental well-being.

How strong is this evidence?

This is a systematic review and we rate its evidence strong. It was published in International journal of mental health nursing. This study is indexed here for context; it did not test reflexology itself.