The influence of COVID-19 on the mental health of final-year nursing students: comparing the situation before and during the pandemic

The impact of the COVID-19 pandemic on the professional commitment of male nursing students in China: a descriptive comparative study

BACKGROUND

The social culture, gender stereotypes, and social status of nursing in China impact the professional commitment of male nursing students. Increasing the professional commitment of male nursing students is critical for alleviating the shortage of nurses and addressing the gender gap. The outbreak of the COVID-19 pandemic has caused widespread public concern about the nursing profession and may have changed people's perception of the profession, which in turn may have a positive impact on the professional commitment of male nursing students in China.

OBJECTIVE

This research aimed to assess how the COVID-19 pandemic affected the professional commitment of male nursing students in China and to analyze the impact of the COVID-19 pandemic on potential factors that might affect their professional commitment.

METHODS

A descriptive comparative study was conducted. This study involved total 368 male nursing students from five 4-year universities in Henan Province, China. 190 male nursing students were included before the COVID-19 pandemic (October to November 2019) and 178 were included after the COVID-19 pandemic (April to May 2023). The data, such as the sociodemographic characteristics and professional commitment of the two samples, were collected using a paper-and-pencil questionnaire. The research instruments used included the Professional Commitment Scale, the Multidimensional Scale of Perceived Social Support and the General Self-efficacy Scale. The data analysis employed χ2-tests, t-tests and hierarchical regression models.

RESULTS

The proportion of Chinese male nursing students who are interested in nursing and do not intend to leave the major has increased after the pandemic (65.17% vs. 29.47%, 61.80% vs. 39.47%, respectively). Male nursing students exhibited greater professional commitment (3.30 ± 0.63) after the pandemic compared to before the pandemic (2.77 ± 0.43). The various factors, such as grade, intend to leave the major, interest in nursing, social support, and general self-efficacy, were linked to professional commitment of male nursing students in China.

CONCLUSIONS

Male nursing students in China exhibited greater professional commitment after the pandemic. This phenomenon may be attributed to the public's increased recognition of the significance of nursing work during the pandemic, and the social status and image of nursing profession have been improved. Given the changes brought about by the COVID-19, strategies should be considered by nursing decision makers and schools to strengthen the professional commitment of male nursing students and increase the number of male nurses in the post-pandemic era.

Fostering Improved Mental and Spiritual Health of Nursing Students During COVID and Beyond

ABSTRACT

Nursing school is a highly stressful experience for most nursing students. The COVID-19 pandemic intensified stress levels for undergraduate students with serious impacts on mental health. Faculty acted to provide solutions such as debriefings and fostering safe places inside and outside of class where students could release negative emotions and develop positive coping skills. The integration of faith and the caring outreach by the faculty also strengthened students' emotional, mental, and spiritual health.

Navigating Perceived Stress: Experiences of Nursing Students Completing Internships during the COVID-19 Pandemic in Spain

Background: University students often experience psychological strains such as academic stress, particularly as they approach the transition into the workforce. This stress may have been heightened for nursing students who completed internships during the COVID-19 pandemic. This study aims to analyze the impact of the COVID-19 pandemic on the perceived stress levels of undergraduate nursing students. Methodology: A cross-sectional descriptive observational study was conducted using the Spanish version of the PSS-10 scale, a validated reduction of the English version PSS-14, to evaluate perceived stress. The responses are Likert-type with a total score range of 0 to 40. Questionnaires were distributed electronically to nursing students across all academic years who were engaged in clinical practice. Participation was voluntary. Results: The study included 487 students, the majority of whom were women (78.4%) with an average age of 23.51 years. Most participants were in their third and fourth years (67%). The mean perceived stress score was 20.65 (SD = 5.62) out of a possible 40, indicating moderate stress levels. Statistically significant differences in perceived stress were found between genders, with women reporting higher stress levels than men (Mann-Whitney U = 15,380.000; p < 0.001). Additionally, a significant correlation was observed between the overall perceived stress score and gender, as well as between specific items on the PSS-10 scale and gender, highlighting the importance of gender-specific stress management interventions. Conclusions: Nursing students reported moderate levels of perceived stress, with women experiencing higher stress levels than men. These findings highlight the need for targeted stress management interventions for nursing students, especially during health crises. Addressing gender-specific stressors and fostering a supportive educational environment will enhance students' well-being, academic success, and professional preparedness.

Anxiety in Nursing Students during the COVID-19 Pandemic: Systematic Review and Meta-Analysis

OBJECTIVES

To analyse the influence of the COVID-19 pandemic on the development of anxiety in nursing students and the factors involved.

DESIGN

A systematic review and meta-analysis.

DATA SOURCE

PubMed, CINAHL, Scopus and Web of Science.

BACKGROUND

Nursing students are at an increased risk of developing mental overload, due to the presence of many sources of stress during their academic training. Therefore, the COVID-19 pandemic has had an impact on the mental health of the general population, especially on healthcare workers and consequently on students undertaking placements in healthcare settings.

METHODS

A systematic review was conducted using PubMed, CINAHL, Scopus and Web of Science databases. A total of 24 articles were included in the review, and 20 articles were selected for the meta-analysis.

RESULTS

We found that the anxiety scores of nursing students during the COVID-19 pandemic were slightly higher (50%) than before the pandemic. The most influential risk factors for developing anxiety were academics, age, gender, having children, living in urban areas or with family, having an addiction to social networks, and having a fear of becoming infected with COVID-19. Resilience, spiritual support and feelings of happiness protected students against the risk of developing high levels of anxiety.

CONCLUSIONS

The COVID-19 pandemic has led to increased levels of anxiety in nursing students. Thirty-five percent of the meta-analytically analysed sample had elevated levels of anxiety.

From students to nurses under pressure: Nursing students' entry into employment during the first COVID-19 wave

AIMS AND OBJECTIVE

To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID-19 pandemic (May-June 2020).

BACKGROUND

As other healthcare professionals, nursing students who worked during the first COVID-19 wave suffered from dysfunctional mental health symptoms.

DESIGN

Sequential, mixed-method, multicentre study.

METHODS

The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi-structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting.

RESULTS

The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned.

CONCLUSION

The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members.

RELEVANCE TO CLINICAL PRACTICE

In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience.

Enlisting in the army in the Jewish Ultraorthodox community and the consequences for wellbeing

Israeli law requires citizens to enlist in the army at 18 years old. However, the Jewish Ultraorthodox community has a longstanding agreement with the state that members of this community will not have to enlist in the army, given its spiritual leaders' strong opposition. Still, there are young men who go against the communal norms and enlist. In the current study we investigated these young men and the contribution of their self-esteem (a personal resource), their sense of community (a communal resource), and the community members' attitudes toward them (societal conditional regard, both positive and negative, and stigma) to their wellbeing. The current study consisted of 153 participants between the ages of 20 and 55 (M = 29.64, SD = 6.89). A path analysis model indicated the protective role played by self-esteem and sense of community in participants' wellbeing, and the risk factor posed by societal conditional negative regard and stigma. Moreover, self-esteem was found to mediate between income and wellbeing, whereas sense of community was found to mediate between societal conditional negative regard and wellbeing, and between stigma and wellbeing. The discussion highlights the complexity of the protective role played by sense of community against the risk of experiencing societal conditional negative regard and stigma. It also addresses the importance of promoting intervention programs during the army service of these young men, with a focus on promoting their self-esteem and on the presence of a spiritual leadership that legitimizes working, serving in the army, and yet still being part of the community.

Prevalence and factors associated with academic burnout risk among nursing and midwifery students during the COVID-19 pandemic: A cross-sectional study

AIM

The aim of the study was to assess the prevalence of academic burnout (AB) and its associated factors among nursing and midwifery students during the COVID-19 pandemic.

DESIGN

A correlational cross-sectional study.

METHODS

An online survey was distributed from November to December 2020 to nursing and midwifery students in Belgium. The risk of AB was assessed using the MBI-SS Academic Burnout Inventory scale. Factors associated with AB were related to the personal life and level of education of the student and to the COVID-19 pandemic.

RESULTS

The prevalence of overall AB risk was 50.0% (95% CI 48.5-53.1). Factors significantly associated with higher risk of AB were having a child, having a job, the level of academic training, working overtime, insufficient personal protective equipment against viral contamination during the last internship, work overload due to the pandemic, personal proven or possible SARS-CoV-2 infection and having a relative who died related to COVID-19.

Academic burnout among undergraduate nursing students: A quantitative survey approach

BACKGROUND

Exposure of nursing students to constant work pressure, stress, and emotional turmoil during both clinical and theoretical sessions of nursing training often leads to academic burnout among them. The aim of the study was to determine the presence of academic burnout among undergraduate nursing students and the association of academic burnout with age, gender, year of nursing program, residence location, and relaxation technique practice.

MATERIALS AND METHODS

A descriptive survey design was used, and data were collected from 266 undergraduate nursing students from Udupi Taluka, South India. Baseline information was collected through a demographic proforma, and Oldenburg Burnout Inventory for Students was used for assessing academic burnout. A stratified proportionate sampling technique was used to select the study sample. The data were collected from April 2021 to May 2021. Descriptive and inferential statistics were used for the analysis by using Statistical Package for the Social Sciences (SPSS) version 16.

RESULTS

The study revealed that most of the participants had high levels of academic burnout (163, 61.7%), emotional exhaustion (165, 62%), and disengagement (173, 65%). Moreover, academic burnout was significantly associated with age (χ²= 8.669, P = 0.012) and relaxation technique practice (χ²= 9.263, P = 0.002). Additionally, disengagement was significantly associated with gender (χ²= 9.956, P = 0.002), residence location (χ²= 7.032, P = 0.027), and relaxation technique practice (χ²= 8.729, P = 0.003).

CONCLUSIONS

Based on the findings of the study, we recommend that the faculty and administrators of nursing institutes must incorporate strategies for the prevention or reduction of academic burnout in the nursing curriculum.

Psychological disorders among Spanish Nursing students three months after COVID-19 lockdown: A cross-sectional study

The COVID-19 pandemic had a notable impact on the psychological well-being of a large part of the population, putting them at risk of developing depressive symptoms, different levels of anxiety disorders, and posttraumatic stress disorder (PTSD). One group considered to be at high risk are Nursing students; they were affected as learning strategies changed and clinical practices were cancelled. This study attempts to assess the psychological impact COVID-19 pandemic had on Nursing students and to explore the sociodemographic differences that can be risk factors for mental health disturbance. The psychological impact was evaluated using the Impact of Event Scale-Revised (IES-R) and Hospital Anxiety and Depression Scale (HADS). The study took place 4 months after the state of alarm was declared over in Spain. From a total sample of 304 Nursing students, 26.7%, 39.8%, and 15.5% showed PTSD, anxiety, and depression symptoms, respectively. Severe levels of psychological impact have been associated with being a female, a smoker, and feeling fear and stress. Having a relative test positive has been linked to lower anxiety levels while being afraid or stressed to higher anxiety levels. Being a female, co-habit with friends and feeling stress have been associated with higher depression levels.

Nurses' self-esteem, self-compassion and psychological resilience during COVID-19 pandemic

AIM

This study aimed to identify self-esteem, self-compassion and psychological resilience among staff nurses during the COVID-19 pandemic in Qatar.

DESIGN

Descriptive cross-sectional survey design.

METHODS

The study was conducted on January 2022 (during the third wave in Qatar). Anonymous data were collected through an online survey using Microsoft forms from 300 nurses in 14 health facilities in Qatar. Socio-demographic information, Connor-Davidson Resilience Scale, Rosenberg Self-Esteem Scale and Self-Compassion Scale-Short Form were used to collect the data. Correlation, t-test and ANOVA analyses were conducted.

RESULTS

Participants expressed a high level of resilience, self-esteem and self-compassion. Resilience scores were positively and significantly correlated with self-esteem and self-compassion. The education level of nurses was a statistically significant contributing factor to self-esteem and resilience.

Mental Health Characteristics of Traditional and Accelerated Baccalaureate Prelicensure Nursing Students

BACKGROUND

Mental health issues in college students are increasing, and nursing students may experience higher stress and anxiety levels than other college students. Limited data differentiate mental health characteristics of traditional Bachelor of Science in Nursing (BSN) and accelerated Bachelor of Science in Nursing (ABSN) students.

METHOD

This descriptive mixed-methods study compared mental health characteristics between BSN (n = 21) and ABSN (n = 51) students.

RESULTS

Mild to moderate distress was identified with the Psychological Distress Profile, and moderate levels of stress were identified on the Perceived Stress Scale. No significant differences in scores were found between groups. More ABSN students reported mental health diagnoses than BSN students. Common reasons for stress included academic obligations, relationship challenges, and financial concerns.

CONCLUSION

Nursing students report experiencing psychological stress, although reasons may vary by cohorts. Further investigation and development of support programs for student mental health is warranted. [J Nurs Educ. 2023;62(2):105-108.].

The mental health impact of COVID-19 on pre-registration nursing students in Australia: Findings from a national cross-sectional study

AIM

The study aimed to measure and describe the mental health impact of COVID-19 on Australian pre-registration nursing students.

BACKGROUND

The COVID -19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID-19 on Australian pre-registration nursing students currently.

DESIGN

A cross-sectional study was conducted across 12 Australian universities.

METHODS

Using an anonymous, online survey students provided demographic data and self-reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID-19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale-Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS-21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20-188). All participating universities obtained reciprocal approval.

RESULTS

Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID-19. Close to half of students (n = 255, 49.4%) reported signs of post-traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID-19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID-19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors.

CONCLUSION

The COVID-19 pandemic has considerably impacted pre-registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce.

IMPACT STATEMENT

This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID-19. In this study, we found that students with a pre-existing mental health issue and final-year students were most affected. The changes to education in Australian universities related to COVID-19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce.

PATIENT OR PUBLIC INVOLVEMENT

The study was designed to explore the impact of COVID-19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants.

Final-Year Nursing Students' Experiences During the COVID-19 Pandemic: A Scoping Review

BACKGROUND

The transitional experience from final-year nursing students (FYNS) to newly graduated RNs (NGRN) challenges individuals' professional and personal identities. Multiple studies have documented the experiences of FYNS graduating in the pandemic, but no studies have synthesized the findings.

METHOD

This scoping review examined the barriers and facilitators FYNS experience as they transitioned to become NGRN during the coronavirus disease 2019 (COVID-19) pandemic. Databases were searched for relevant articles, and articles published in peer-reviewed journals between 2019 and 2021 that focused on the support of FYNS in clinical settings in North America, Europe, and Australia were included.

RESULTS

Three themes were identified: emotional turmoil and coping, clinical competence and readiness for practice, and teaching strategies.

CONCLUSION

This review revealed important insight on how the pandemic affected FYNS' transition to practice and identified gaps in the literature for future research. [J Nurs Educ. 2023;62(1):6-11.].

Clinical experiences of final-year nursing students during the COVID-19 pandemic: A systematic review and meta-synthesis

OBJECTIVES

This systematic review aimed to qualitatively synthesise existing literature to examine the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic and provide recommendations for the effective management of clinical placement of nursing students.

DESIGN

A qualitative systematic review was conducted and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

DATA SOURCES

Five electronic databases were searched and qualitative studies were included for analysis if they focussed on the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic.

REVIEW METHODS

Data synthesis was conducted by extracting all findings, developing categories, and producing synthesised findings.

RESULTS

Four synthesised findings were concluded: 1) facing the unknown and willingness to help, 2) challenging the clinical environment, 3) transition improving professional identity, and 4) finding ways out of the pandemic.

CONCLUSIONS

The transition of nursing students to clinical nursing practice during the pandemic is a personally and professionally challenging process, while nursing students try to adapt to the changing clinical environment and enhance their professional identity. Nursing managers and health policymakers should acknowledge the challenges encountered by nursing students during the pandemic and support the professional growth of future nursing teams by providing high-quality supervision.

Psychological Effect of the COVID-19 Pandemic on Nursing Students: Palestinian Perspective

Introduction

COVID-19 has had an important effect on nursing students, with some having their clinical practice cancelled or suspended and others suffering from the virus.

Objective

The purpose of this study was to assess the psychological status in terms of stress, anxiety, and depression of nursing students during COVID-19 pandemic.

Methods

The study was cross-sectional, carried out by a convenience sample of 320 participants of nursing students between May and June 2020. Data collection was performed by "Depression Anxiety Stress-21 Scale" (DASS-21).

Results

The results revealed that 78 (24.3%) of participants reported stress; 121 (37.8%) reported anxiety; and 72 (22.5%) reported depression. Also, grade and socioeconomic status had statistically significant effect on anxiety, stress, and depression. In addition, age had statistically significant effect on depression, place of residence had statistically significant effect on anxiety, and gender had statistically significant effect on stress.

Conclusion

The study confirmed an alarming number of nursing students who experienced anxiety, stress, and depression. This study serves as an evidence concerning nursing students' mental health issues as a consequence of the COVID-19 pandemic.

Developing a personalized self-care curriculum for graduate students in the health sciences

The purpose of this study was to evaluate the Pitt Personal Wellness Program, three 1-hour workshops that were integrated into the first-semester curriculum of five health sciences graduate programs. The workshops were designed as a personalized education approach to promote self-care and well-being. Of the 156 graduate students who participated in the Pitt Personal Wellness Program, 99 (65%) completed online questionnaires regarding stress and coping at three time points across a 14 week period: before the program, and after the second and third workshops. Graduate students reported significant decreases in perceived stress and number of stressful situations across the three time points. Students who reported a previous history of mental health counseling demonstrated steeper declines in perceived stress across Times 1 and 2, and reported significantly higher use of coping strategies across the three time points. Racially minoritized students and those reporting more financial struggles also reported significant declines in stress and number of stressors across Times 1 and 2. The Pitt Personal Wellness Program was acceptable to graduate students and a promising program for further dissemination and study.

The influence of emotional burnout and resilience on the psychological distress of nursing students during the COVID-19 pandemic

The aim of this study was to measure and analyse the association of emotional burnout and resilience with the psychological distress of students who finished their nursing studies after the peak of the COVID-19 pandemic. The mental health of nursing students was affected during the pandemic, and resilience seems to counteract the negative effects. This is a cross-sectional study. The data (quantitative) were gathered at the beginning of the second term of the academic year 2020/2021. The study was carried out in the Spanish university context. Self-reported measures were gathered using three one-dimensional, valid, and reliable scales: the Psychological Distress Scale (K-10), the Emotional Burnout Scale (EBS), and the short version of the Connor-Davidson Resilience Scale (CD-RISC10). A total of 393 students of different Spanish universities participated in this study. A valid linear regression model was obtained, which allowed verifying that psychological distress is explained, with 37% variance, by emotional burnout and resilience. The total score in emotional burnout has more relevance than the total score in resilience, and the latter has a negative tendency. Facing the factors that generate emotional burnout in students in the academic scope and promoting resilience in them are fundamental aspects that contribute to their psychological well-being. The reflection should be extended to clinical practices. Universities are urged to think about last-year students, their experiences, perceptions, and feelings, to determine how their susceptibility to emotional burnout and psychological distress can be minimized in their future clinical practices. Strategies to promote their resilience should also be studied.

Health as expanding consciousness: Change of psychological situation in nursing students

AIM

This study aims to explore the mind of Chinese nursing students transitioning to online education in the pandemic using health as expanding consciousness (HEC) as methodology.

DESIGN

A qualitative, descriptive study based on interviews.

METHODS

This qualitative study was conducted from September to November 2021 by students in the Guangzhou university of Chinese medicine. Thirteen participants were recruited using purposive sampling. A questionnaire containing two sections with demographic information, the General Self-Efficacy Scale (GSES) and the Connor-Davidson resilience scale (CD-RISC)-10 was collected to explore the health of participants.

RESULTS

A total of 13 participants were enrolled in the study (69% female). Students ranged in age between 19 and 24 years and the mean age was 22 years. All students lived with their families. Five participants (38%) had a master's degree in nursing, three (23%) were in fourth year of college, four (30%) were in third year of college and one (7%) was in their second year of college respectively. More than half of the participants had high levels of mental toughness and self-efficacy. Four generic categories were identified form a unitary-transformative paradigm perspective. The respondents reported three health pattern phases: Curriculum Transformation, Curriculum adaptation and Curriculum expansion.

CONCLUSION

This research backs up Newman's hypothesis, and supports the theoretical framework. HEC explains well the psychology of nursing students during the epidemic. More research is needed in the future to develop comprehensive, targeted emotional regulation therapies for nursing students.

Academic self-efficacy, self-esteem, satisfaction with studies, and virtual media use as depression and emotional exhaustion predictors among college students during COVID-19

The aim of the study was to explore the relationship between depression, emotional exhaustion, self-esteem, satisfaction with studies, academic self-efficacy, and the use of virtual media in Peruvian university students during the coronavirus disease 2019 (COVID-19) pandemic. A total of 569 college students (61.9% female), with a mean age of 21.73 years (standard deviation = 4.95), responded to the following questionnaires: Academic Self-Efficacy Scale, Single Item Self-Esteem Scale, Brief Scale of Satisfaction with Studies, Scale of Use of Virtual Media, Patient Health Questionnarie-2, and Single Item of Academic Emotional Exhaustion. Correlation statistics, regression models, and structural equation modeling (SEM) were used for data analysis. The results demonstrated a direct and significant correlation between virtual media use, academic self-efficacy, self-esteem, depression, and emotional exhaustion (p <.01). In addition, satisfaction with studies (β = −0.13), academic self-efficacy (β = −0.19), self-esteem (β = −0.14), and emotional exhaustion (β = 0.19) predicted depression significantly, whereas virtual media use (β = 0.17), study satisfaction (β = 0.09), and depression (β = 0.20) predicted emotional exhaustion associated with academics. The SEM model indicated that self-esteem, satisfaction with studies, and academic self-efficacy negatively predict depression, whereas academic self-efficacy positively predicts virtual media use. Finally, both virtual media use and depression positively predict emotional exhaustion. This model presents optimal goodness-of-fit indices (X² = 8.926, df = 6, p =.178; comparative fit =.991, Tucker–Lewis =.979, root mean square error of approximation =.029 [confidence interval 90% =.000–.067], standardized root mean square residual =.022). Thus, academic self-efficacy, self-esteem, satisfaction with studies, and virtual media use predict depression and emotional exhaustion among college students during the COVID-19 pandemic.

Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review

BACKGROUND

A rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors.

AIMS

The aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health.

METHOD

Searches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health.

RESULTS

The 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure.

CONCLUSIONS

Our findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.

Stressor Factors for Spanish Nursing Students in a Pandemic Context: An Observational Pilot Survey

BACKGROUND

The context of the pandemic in Spain meant a high demand for care. The purpose of this pilot work was to determine the stress factors, conducted on final-year nursing students at a Spanish university, who volunteered to carry out healthcare tasks, in pandemic and post-pandemic contexts.

METHODS

An observational prospective cohort pilot survey was conducted with an intentional sampling of the forty-seven students. We collected sociodemographic and stressor data using the validated KEZKAK questionnaire. The STROBE checklist was used to evaluate the study.

RESULTS

The median scores obtained from nursing students incorporated as auxiliary health workers are lower than those who were not incorporated, and statistically significant differences were found: lack of skills and abilities (p = 0.016); relationship with tutors and colleagues (p = 0.004); impotence and uncertainty (p = 0.011); inability to manage the relationship with the patient (p = 0.009); emotional involvement (p = 0.032); distress caused by the relationship with patients and item overload (p = 0.039); and overload items (p = 0.011). The post-pandemic only maintained "lack of skill and abilities" (p = 0.048), from nursing students incorporated as auxiliary health workers.

CONCLUSION

This pilot study showed that nursing students who joined as auxiliary health personnel presented less perceived stress than non-incorporated nursing students. Still, more prospectively designed clinical research is needed.

First-Year College Students' Mental Health in the Post-COVID-19 Era in Guangxi, China: A Study Demands-Resources Model Perspective

The post-COVID-19 era means that the COVID-19 is basically under control; however, the risk of the pandemic still affects people's work, study, and life, physically and psychologically. In this era, due to the more challenges first-year college students face, more attention should be paid to their mental health. An emerging study demands-resources (SD-R) model can explain the influencing mechanism of college students' mental health. This model suggests that study demands increase the risk of student burnout, which results in mental health problems; meanwhile, study resources reduce student burnout and increase student engagement, thus improving mental health. Based on the SD-R model, this study explores the impacts of time pressure, emotional exhaustion, perceived social support, and student engagement on mental health and provides adequate measures to reduce the risk of mental health problems among first-year students. Time pressure, perceived social support, emotional exhaustion, student engagement, and mental health scales were used to investigate 537 first-year students at three universities in Guangxi, China, of whom 290 (54%) were female, and 247 (46%) were male, and the average age was 18.97 ± 1.01. Results indicated that: (1) Moderate scores on time pressure and emotional exhaustion and slightly-above-the-median scores on perceived social support, student engagement, and mental health were found among first-year students in the post-COVID-19 era. (2) Time pressure had a positive relationship with emotional exhaustion and a negative relationship with mental health. (3) Perceived social support was negatively correlated with emotional exhaustion but positively correlated with student engagement, and thus improved mental health. Results of this study with a sample of first-year college students in China support the hypotheses based on the SD-R model. These findings suggest that increasing perceived social support and student engagement while decreasing time pressure and emotional exhaustion may promote mental health among first-year college students.

Diagnostic Concordance between the Visual Analogue Anxiety Scale (VAS-A) and the State-Trait Anxiety Inventory (STAI) in Nursing Students during the COVID-19 Pandemic

Anxiety is one of the most common problems among nursing students. The State-Trait Anxiety Inventory (STAI) is used to detect anxiety in this population; however, its length hinders speedy detection. For this reason, a faster and more efficient instrument is needed for early detection. This study aimed to determine the relationship between the anxiety measurement scales State-Trait Anxiety Inventory (STAI) and the Visual Analogue Scale for Anxiety (VAS-A) by establishing a discrimination threshold through the contrast of true positive rates (VPR) and false positive rates (FPR). To this end, a cross-sectional quantitative observational and analytical study was carried out on 185 fourth-year nursing students. The data collected were anxiety (STAI and VAS-A) and socio-demographic variables during the COVID-19 pandemic. The results showed a correlation between the two scales (VAS-A and STAI). The VAS-A is a useful instrument for assessing students in a crisis that could potentially generate anxiety. The study established a reasonably safe error probability range (>5%), allowing the VAS-A scale to be used as a rapid diagnostic or pre-diagnostic tool, depending on the scores. The study shows that speedy detection of anxiety using the VAS-A and an in-depth approach with the STAI by teaching staff in crises is possible.

Health-Promoting Quality of Life at Work during the COVID-19 Pandemic: A 12-Month Longitudinal Study on the Work-Related Sense of Coherence in Acute Care Healthcare Professionals

(1) Background: During a pandemic, the wellbeing of healthcare professionals is crucial. We investigated the long-term association of the Work-related Sense of Coherence (Work-SoC) and the evolution of psychological health symptoms of acute care healthcare professionals during the first year of the COVID-19 pandemic. (2) Methods: This longitudinal observational study enrolled 520 multinational healthcare professionals, who completed an online survey every three months from April 2020 to April 2021. Mixed linear models examined the associations between Work-SOC and COVID-19-related anxiety, perceived vulnerability, depressiveness, and psychological trauma symptomatology. (3) Results: Healthcare professionals with a higher Work-SoC reported lower levels of COVID-19-related anxiety, perceived vulnerability, depressiveness, and psychological trauma symptomatology in April 2020 than healthcare professionals with an average or lower Work-SoC, but the levels increased to higher values in April 2021. Healthcare professionals with a lower Work-SoC reported higher levels of depressiveness and psychological trauma symptomatology in April 2020 but lower levels in April 2021. (4) Conclusions: Healthcare professionals with higher levels of Work-related Sense of Coherence might be protected against variations in psychological symptoms for about three months, but this protection seems to decrease as the pandemic continues, resulting in mental health deterioration. In contrast, healthcare professionals with a lower Work-SoC might be protected at later stages of the pandemic.

Quality of life and academic resilience of Filipino nursing students during the COVID-19 pandemic: a cross-sectional study

OBJECTIVES

Studies on quality of life (QoL) and academic resilience among nursing students during the Coronavirus disease (COVID-19) pandemic remain underreported. This study investigated the relationship between nursing students' QoL and academic resilience and their predictors during the COVID-19 pandemic.

METHODS

A descriptive survey, cross-sectional study that used two self-reported questionnaire scales to evaluate the QoL and academic resilience of Filipino nursing students (n=924). Chi-squared test and multiple regression were used to analyze the data.

RESULTS

There was no significant association between the QoL and academic resilience to participants' profile variables. Gender and year level of nursing students were significant predictors of QoL and academic resilience.

CONCLUSIONS

Our study concludes that a better understanding of the QoL and academic resilience, which are two distinct concepts critical in developing a student's mental well-being, will help stakeholders in nursing education establish effective psychoeducation programs for nursing students.

A multi-level examination of nursing students' resilience in the face of the COVID-19 outbreak: A cross-sectional design

AIMS

To examine nursing students' stress and coping with the coronavirus disease 2019 (COVID-19) pandemic through an ecological model of resilience. Specifically, to examine the relative contribution of different resilience levels in decreasing nursing students' strain symptoms: at the individual level, resilience trait; at the relational level, students' coping strategies; at the university level, nursing students' perceptions on their university's readiness to handle the virus outbreak; and at the national level, nursing students' trust in policymakers' decisions.

DESIGN

The study used a cross-sectional design.

METHODS

Undergraduate students of five universities were recruited via an electronic link sent to their emails during the first months of the COVID-19 outbreak: May-July 2020. Of them, 492 participants completed the research questionnaire.

RESULTS

Hierarchical Regression Analysis revealed that nursing students' resilience, as a multi-level factor, decreased the students' level of strain symptoms above and beyond their stress levels and control variables. Specifically, the nursing students' trait resilience, perceptions of their university's positive response to the pandemic and trust in their national policymakers were negatively associated with their strain symptoms. Conversely, disengagement-in-emotion coping strategies was positively associated with the students' strain symptoms.

CONCLUSIONS

Nursing students' resilience should be seen as a flexible resource that can be developed and influenced by their academic and clinical training, and by the intentions and actions of their university and the nursing administration at the Ministry of Health (MOH).

IMPACT

The findings call for the nursing administration at the MOH and for the university deans and department heads to prepare in advance a crisis plan that could be rapidly and effectively implemented when needed. Furthermore, topics such as developing flexible coping strategies should be integrated into the nursing curricula. These would allow students to prepare and cope better with adversity in their routine and in times of crisis.

Creating Effective Post-Pandemic Psychiatric Nursing Clinical Experiences Using the Roy Adaptation Model

Introduction

The COVID-19 pandemic significantly impacted students in psychiatric clinical rotations. Clinicals were frequently limited or canceled, restricting exposure of student nurses to this experience. Many modifications led to permanent changes in the psychiatric clinical setting.

Objectives

The purpose of this manuscript is to provide a cohesive approach to serving student nurses in the post-pandemic psychiatric clinical setting.

Methods

A theoretical exploration of the literature framed by the Roy Adaptation Model (RAM) was conducted.

Discussion

Results are presented using the four modes of the theory: Physiological, Self-Concept, Role Function, and Interdependence.

Conclusions

Findings include strategies to enhance student learning while supporting students' health and wellness. Educators and practitioners should provide high-quality, safe learning environments for student nurses.

A cross-sectional study of the psychological impact of the COVID-19 pandemic on undergraduate and graduate students in Japan

Background

Due to the COVID-19 pandemic, a state of emergency was declared in Japan and university classes were suspended, causing concern about the deterioration of the mental health of isolated students. This study aimed to understand students’ mental health status during the COVID-19 pandemic and suggest measures to prevent depressive anxiety among them.

Method

Undergraduate and graduate students at one national and two private universities in the Kansai region were surveyed. The Kessler Psychological Distress Scale-6 was used to assess the students’ mental health. Questions were included to assess students’ awareness of COVID-19 and changes in lifestyle habits, including drinking, smoking, gaming, and other addictive habits. The University of Tokyo Health Sociology's version of the Sense of Coherence Scale was used to assess the ability to cope with stressors.

Results

More than 50% of undergraduate and graduate students felt more than mild depressive anxiety and approximately 11% felt severe depressive anxiety, indicating that anxiety about the future worsened the levels of depressive anxiety. Life with reversed day and night schedules was associated with the worsening of depressive anxiety levels, but a high sense of coherence was associated with decreased levels of depressive anxiety.

Conclusion

COVID-19 pandemic triggered isolation which led to worsening the mental health of undergraduate and graduate students. Psychological support for lifestyle and a sense of coherence is necessary to prevent mental health deterioration among isolated students.

Limitations

As we were unable to contact all students, the sample bias may affect interpretation of the data

Predictors of university nursing students burnout at the time of the COVID-19 pandemic: A cross-sectional study

BACKGROUND

Little is known about the stress and burnout experienced by undergraduate and graduate nursing students during the COVID-19 pandemic. Academic burnout among nursing students can have an impact on students' learning ability, health, and wellbeing and on the quality of care and intention to leave the profession post-graduation.

OBJECTIVES

Evaluate the predictors of nursing students' personal, academic, and collaboration-related burnout during the COVID-19 pandemic.

DESIGN

Cross-sectional two-site study.

SETTINGS

Icelandic universities offering nursing education.

PARTICIPANTS

Graduate and undergraduate nursing students in Iceland (N = 1044) were asked to participate in the study, with a response rate of 32.7%.

METHODS

An online survey was used to evaluate the students' stress and burnout in spring 2020.

RESULTS

The main findings show that 51% of the variability in the students' personal burnout was explained by their perceived stress, mental health, and perceived support. Furthermore, the students' perceived stress, support, and educational levels predicted 42% of the variability in their academic burnout. Burnout related to collaborating with fellow-students was explained by the nursing students' physical health and by their educational level, explaining 6% of the variability in fellow-students burnout.

CONCLUSION

University administrators might consider adding academic support facilities into their undergraduate nursing programs and teaching their students healthy coping skills.

A national survey of the impact of COVID-19 on personal, academic, and work environments of nursing students

BACKGROUND

Nursing students are experiencing life changing events in their personal, academic, and work environments since the onset of the pandemic.

PURPOSE

The purpose of this study was to describe and explore the effects of COVID-19 on personal, workforce, and academic experiences of nursing students (N = 620).

METHOD

A 68-item survey with three areas of focus surrounding academic, workforce and personal experiences was distributed to multiple schools across the United States. The analysis compares student responses from the five regions of the US.

FINDINGS

Significant differences were found in the pairwise comparisons. The analysis revealed the academic changes were generally viewed as negative. Fear/anxiety and political influences impacted the outcomes of the pandemic.

DISCUSSION

Understanding the effects of the pandemic on the personal, work and academic experiences of nursing students will assist academia and healthcare in adapting existing policies to meet student needs in the various regions of the United States.

Experiences, emotional responses, and coping skills of nursing students as auxiliary health workers during the peak COVID-19 pandemic: A qualitative study

The COVID-19 crisis in Spain has exacerbated the shortage of nursing staff to respond to increasing healthcare demands. For this reason, nursing students were requested to collaborate voluntarily as auxiliary health staff. This emergency has led to mental health problems in health professionals, hence the relevance of coping techniques. The objectives of this study were to explore the experiences and emotional responses of final-year nursing students who volunteered to carry out healthcare relief tasks during the peak of the COVID-19 pandemic, and to identify the coping strategies they adopted to deal with this situation. A qualitative study was conducted in the constructivist paradigm. Purposive sampling was used, and twenty-two students participated in semi-structured interviews, which were then content-analysed. The study is reported using the COREQ checklist. Five themes emerged in the 'Experiences and emotional response' dimension (context, patients, emotions and feelings, risk of contagion, and personal satisfaction), and three themes emerged in the 'Coping strategies' dimension strategies in the work environment, in daily life and personal life. Although the students expressed negative emotions due to the highly complex context and lack of professional experience, they evaluated the experience positively in terms of learning and usefulness. Most notably, the students employed adaptive coping strategies to deal with the pandemic.

Internal Locus of Control and Sense of Coherence Decrease During the COVID-19 Pandemic: A Survey of Students and Professionals in Social Work

Mental health is severely challenged by the COVID-19 pandemic due to a variety of restrictions in public and private life. Students in particular may face additional and unique stressors: face-to-face classes have been largely replaced by digital formats, leading to further reduced social contacts, thus facilitating the development of psychological symptoms. In this study, we aimed to assess the impact of the current peri-pandemic situation on students' 1) locus of control and 2) sense of coherence, both of which have been linked to mental health in previous work. A total of 403 social work students from Germany participated, providing both retrospective (pre-pandemic) and current (February/March 2021) ratings. Furthermore, 324 social work professionals were included to analyze differences between both groups. Locus of control shifted significantly from internal to external during the pandemic for students and professionals. Furthermore, high mental burden correlated with increased external and decreased internal locus of control. Sense of coherence decreased during the pandemic for the entire sample and correlated with high mental burden. Overall, students showed a stronger drop compared to professionals, primarily due to a more pronounced decrease in perceived meaningfulness (all p < 0.001). In summary, students and professionals responded with increased feelings of powerlessness in the absence of sufficient coping strategies-this could lead to further deterioration of mental health as the pandemic continues. In this context, students appear to be particularly vulnerable to a reduction in sense of coherence. We conclude that interventions to improve coping strategies are urgently needed.

Korean Nursing Students' Emotional Response Types to Pandemic: Application of Q-Methodology

The aim of this study is to investigate the emotional responses of nursing students to the COVID-19 pandemic and the characteristics of these responses using the Q-methodology. The focus of the Q-methodology is to discover research participants' subjective viewpoints. In May 2021, 50 Korean nursing students from first year to fourth year were selected to participate in the study, and data were collected by asking them to classify 37 selected Q-statements in a normal distribution on a 9-point scale. In the final analysis, a P-sample of 38 nursing students was used. The emotional responses of the Korean nursing students were categorized into four types: self-protection (Type 1), pessimism about the current situation (Type 2), realistic optimism (Type 3), and developmental-seeking (Type 4). The four factors accounted for 39% of the total variance. The individual explanatory powers of the four factors were 8%, 12%, 13%, and 6%, respectively. Thus, the study explored the subjectivity of emotional responses of Korean nursing students to the pandemic. The study recommends considering the results for intervention programs that are designed to prepare nursing students for future health crises and pandemics.

Effects of an Existential Nursing Intervention for College Students in the COVID-19 Pandemic Situation

This study designed an intervention based on logo-autobiography to reduce Korean college students' stress and depression and help them find meaning in their lives amidst the COVID-19 pandemic. A quasi-experimental design was used to conduct group interventions among college students. A total of 22 and 26 participants were included in the experimental and control groups, respectively. The experimental group received six sessions of a logo-autobiography for college students (LAC). The effects of the LAC interventions were assessed at baseline, post-intervention, and four weeks after the program's end to determine their retention rate. The effects of group, time, and the group-by-time interaction were verified using generalized estimating equations with an autoregressive correlation structure. The experimental group exhibited significantly lower levels of stress and depression and higher levels concerning the meaning of life than the control group. However, only the effects on stress and the meaning of life continued four weeks after the intervention's end. Based on this study's results, LAC can be considered a useful method for reducing stress and depression in college students who have just started their adult life, as well as for aiding them in their pursuit for the meaning of life.

Esperança e Bem-Estar Psicológico durante a Crise Sanitária pela COVID-19: Estudo com Estudantes de Enfermagem

Resumo Objetivo analisar as relações entre a esperança e o bem-estar psicológico de estudantes de enfermagem portugueses durante a crise pandêmica pela COVID-19. Método estudo descritivo-correlacional, com recurso a questionário online para coleta de dados. Participaram 705 estudantes de enfermagem com idade média de 21,74 anos (DP=4,44). Os instrumentos de coleta de dados utilizados foram a Escala de Esperança de Herth (HHI-PT) e a Escala de Medida de Manifestação de Bem-Estar Psicológico (EMMBEP). Foi utilizada a estatística descritiva e inferencial. Resultados na HHI-PT, o domínio afectivo-comportamental obteve a pontuação média mais alta, 3,30 (DP=0,45); no EMMBEP, foi o domínio sociabilidade, 3,64 (DP=0,77). Havia correlações moderadas a fortes (0,383 <r <0,917) entre o global e todos os domínios da esperança e bem-estar psicológico (≤0.001). Conclusão e implicações para a prática a esperança e o bem-estar psicológico dos estudantes de enfermagem durante a pandemia são variáveis correlacionados positivamente entre si. As medidas de promoção da saúde mental, a implementar pelas instituições de ensino, devem ter em consideração a associação entre essas duas variáveis.