An evaluation of mental health and emotion regulation experienced by undergraduate nursing students in China during the COVID-19 pandemic: A cross-sectional study

The relationship between difficulties in emotion regulation and solution-focused thinking in nursing students

AIM

The aim of this study was to investigate the relationship between emotion regulation difficulty and solution-focused thinking in nursing students.

BACKGROUND

It is essential for nursing students to possess solution-focused thinking and emotion regulation skills to cope effectively with stressors arising from their developmental processes, the nature of education and the profession. This is crucial for enhancing the quality of nursing care.

DESIGN

The study design was cross-sectional descriptive and correlational design.

METHODS

The convenience sample of the study consisted of 416 nursing students. The research was conducted between January 20 and February 15, 2024. Data were collected in Türkiye with the difficulties in emotion regulation scale-brief form and the solution focused inventory. Data were analyzed using multivariate linear regression analysis.

RESULTS

An increase of 1 unit in the level of emotion regulation difficulty was associated with a decrease of 0.236 units in participant resource activation and 0.524 units in problem disengagement (p<.001). An increase of 1 unit in the level of emotion regulation difficulty was also associated with an increase of 0.876 units in participant goal orientation (p<.001). Grade point average, grade and age were identified as factors influencing the sub-dimensions of solution-focused thinking (p<.05).

CONCLUSIONS

The study showed that emotion regulation difficulty is an important predictor of solution-focused thinking in nursing students. Therefore, students' emotion regulation difficulties and solution-focused thinking should be evaluated by academic nurses from the beginning of students' enrollment. Also, it is recommended that intervention programs focusing on developing emotion regulation and solution-focused thinking skills for nursing students should be included and implemented in the nursing curriculum.

Depression in nursing students during the COVID-19 pandemic: Systematic review and meta-analysis

The pandemic meant a change in academic approach. This had an impact on the mental health of students, leading to, among other problems, depressive disorders. The aim of this study was to find out the prevalence and factors that favoured the development of depression in nursing students during the COVID-19 pandemic. A systematic review with meta-analysis of prevalence was conducted in October 2023, using Pubmed, CINAHL and Scopus as the data sources used for the search. This review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Search equation was: "(undergraduate nurses OR nursing students) AND depression AND (COVID-19 OR Sars-CoV-2)". The final set of articles was N = 12. Quantitative primary studies using anonymous scales and surveys to assess the prevalence of depression in nursing students in the last 3 years were included. Studies show a high prevalence of depression among young university students with figures above 50%. The total sample of students in the meta-analysis was n = 4,479 with a prevalence value of 32% (CI95% 22%-42%). Affected students are characterised by young, female students. Concerns included generalised academic uncertainty, social isolation, work overload, fear of contagion and concern about teaching delivery. Coping mechanisms were generally resilience, spiritual support, laughter therapy, seeking information about COVID-19 and eating food. In conclusion, students, especially female students, are at high risk of depression due to social isolation. In addition, coping techniques were inadequate and future strategies to prevent this situation should be considered.

Coping with Non-COVID-19 Health Problems Through Communicative Action in Cyberspace

This study investigated how the online health information behaviors of U.S. adults with illnesses unrelated to COVID-19 virus infection affected their coping with health problems and concerns during the COVID-19 pandemic. Guided by the cybercoping model (Kim & Lee, 2014), the study examined associations between these patients' online information behaviors (information seeking and information forwarding) and coping outcomes (health problems and affective states). The study further explored the mediating roles of health coping processes (problem-and emotion-focused) in the associations between these information behaviors and coping outcomes. Survey data from 687 participants were analyzed using structural equation modeling. The results highlighted the significance of information forwarding in enhancing both coping processes and outcomes, while information seeking enhanced problem-focused coping and health-problem coping outcomes alone. These associations were more pronounced among U.S. adults without chronic conditions than among those with chronic illnesses. These findings' implications, the study's limitations, and suggestions for future research were also addressed.

Learning strategies of undergraduate nursing students during the COVID-19 pandemic

OBJECTIVES

to analyze the learning strategies used by nursing students from a public university, in remote teaching, during the COVID-19 pandemic.

METHODS

a cross-sectional study developed with nursing students who attended remote teaching classes. The sample was obtained by convenience and data were collected online, with 112 participants. Student and Mann-Whitney tests were performed for data analysis.

RESULTS

the most frequently used learning strategies were self-regulatory and cognitive. There was moderate use of interpersonal help-seeking and emotional control strategies. Male students, with a private study environment and good internet connection, used emotional control strategies more frequently.

CONCLUSIONS

self-regulatory and cognitive learning strategies, appropriate for higher education, were frequently used by nursing students, which is an important tool for adapting these students to the university context.

COVID and depression among stratified population groups: a narrative review

The Covid-19 pandemic has impacted and infiltrated every aspect of our lives. Successive lockdowns, social distancing measures, and reduction in economic activity have developed a new way of living and, in many cases, tend to lead to depression. The initial strict lockdown for about 3 months and eventually for a few more months has imposed greater challenges on children and adolescents in terms of psychological problems and psychiatric disorders. Regardless of their viral infection status, many people have been affected by the psychosocial changes associated with the Covid-19 pandemic. In the present review, we have attempted to evaluate the impact of COVID on the mental health of people from different age groups and occupations. The present review has highlighted the need for taking effective measures by the stakeholder to cope with depression among human population groups worldwide.

Emotion regulation in undergraduate nursing students: A latent profile analysis

BACKGROUND

Current research on emotion regulation of undergraduate nursing students mainly focused on the overall level of emotion regulation and its relationship with other variables, ignoring the individual heterogeneity of emotion regulation of undergraduate nursing students.

AIM

By latent profile analysis (LPA), this study aimed to identify different emotion regulation profiles among undergraduate nursing students and to explore demographic and personal factors associated with different emotion regulation profiles.

METHOD

This was a cross-sectional study. A total of 578 nursing students were investigated by the demographic questionnaire, the emotion regulation scale, the Connor-Davidson resilience scale-10 item and the core self-evaluations scale. LPA was used to analyze the latent profiles of emotion regulation among undergraduate nursing students. And multiple logistic regression was used to explore the predictors of different profiles.

RESULT

Three potential profiles were identified: profile 1-- low suppression and moderate reappraisal group, profile 2-- moderate suppression and high reappraisal group, profile 3-- high suppression and high reappraisal group. Resilience, family monthly income and perception of nursing profession were predictors of different profiles.

CONCLUSION

Most nursing students were classified into profile 2 and their emotion regulation was relatively good. However, students in profile 1 were with moderate cognitive reappraisal and students in profile 3 were with high expressive suppression, and their emotion regulation need to be further improved by increasing their cognitive reappraisal and decreasing their expressive suppression. Strategies tails to improve resilience, increase scholarships and change the perception of nursing profession may be effective ways to improve emotion regulation of undergraduate nursing students in different profiles.

Thriving psychological well-being in undergraduate nursing student: a grounded theory study with the life grid approach

BACKGROUND

Psychological well-being (PWB) plays a vital role in successful adaptation to the Bachelor of Nursing journey and affects career development. However, there is little known about the functional and social processes associated with enhancing well-being specific to the subjective perspective of nursing students.

AIM

To investigate how nursing students promote their psychological well-being to conceptualize thriving psychological well-being.

METHOD

This qualitative study analyzed and reviewed a life grid and semi-structured in-depth interviews of 20 Chinese Nursing graduates by investigators and participants, following Charmaz's constructivist grounded theory. The constant comparative method was used to analyze data. This study took place between 2020 and 2022.

RESULTS

All participants experienced fluctuations in psychological well-being. This study identified a new understanding of how nursing students enhance their psychological well-being. Thriving awareness was co-constructed as the core category and based on the relationship with a supportive environment, the thriving psychological well-being of nursing students is conceptualized.

CONCLUSIONS

It is imperative to enhance the psychological counseling and support for nursing students during their clinical placements, during the period just entering university as well as after repeated outbreaks of COVID-19. Nursing educators and administrators could develop appropriate educational programs and interventions based on the theoretical model-Thriving psychological well-being.

Mental distress and well-being of university students amid COVID-19 pandemic: findings from an online integrative intervention for psychology trainees

Introduction

University students have been severely affected by the COVID-19 pandemic, as significant changes supervened their academic and social life. To tackle these challenges, several adjustments in the educational methods may be warranted for cultivating a positive environment at higher education institutions. The aim of this study was to investigate the risk and protective factors of students' mental health and well-being as well as their potential for flourishing in an undergraduate clinical psychology course that took place online due to the COVID-19 restrictive measures and incorporated positive psychology exercises as a means to empower young people amid the adverse conditions of the lockdown.

Methods

In total, 124 students attended the course and completed mental health (i.e., DASS-9, HADS, ERQ) and well-being (i.e., MHC-SF, SWLS, PANAS, GQ-6, BRS) measures at two time points (pre-and-post-test), during the first restrictions in Greece (March-June 2020).

Results

According to the results, students aged 18-20 years old reported higher levels of stress [χ² = 14.72, p = 0.002], while students who felt that the quality of their studies had deteriorated [χ² = 6.57, p = 0.038] reported increased levels of anxiety. High levels of depression were correlated with worse relationships with significant others (z = 7.02, p = 0.030 and χ² = 11.39, p = 0.003 for family and friends, respectively), while gratitude and resilience were positively correlated with improved relationships with others, both during and after the lockdown. Factors associated with students' well-being were satisfaction with life and gratitude.

Discussion

These results suggest that well-being enhancement factors may have added value to current educational practices for promoting students' mental health and well-being in times of crisis.

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.

Mediating role of resilience between learning engagement and professional identity among nursing interns under COVID-19: A cross-sectional study

AIM

The aim of the study was to explore the mediating effect of resilience between learning engagement and professional identity of nursing interns.

DESIGN

A descriptive, cross-sectional study design.

METHODS

An online questionnaire survey was conducted among nursing interns in Fujian Medical University from February 2022 to April 2022 by convenience sampling. The scores of learning engagement, resilience and professional identity were evaluated. The PROCESS Marco in SPSS was used to analyse the mediating effect.

RESULTS

A total of 222 senior nursing students participated in the questionnaire survey. Both learning engagement (r = 0.491, p < 0.01) and resilience (r = 0.537, p < 0.01) correlated positively with PI. Resilience is also positively related to PI (r = 0.693, p < 0.01). Also resilience played a partial mediating role in the relationship between learning engagement and professional identity (a*b = b = 0.2451, 95% CI: 0.1543, 0.3581), and its effect accounted for 53.3%.

Academic stress, COVID-19 anxiety, and quality of life among nursing students: The mediating role of resilience

AIM

This study investigated the mediating role of resilience in the relationship between academic stress, COVID-19 anxiety, and quality of life (QoL) among Filipino nursing students during the COVID-19 pandemic.

BACKGROUND

The COVID-19 pandemic has impacted the QoL of nursing students who are experiencing mental health issues. The mediating role of resilience in mitigating the effects of academic stress and COVID-19 anxiety on nursing students' QoL remains understudied.

METHODS

This study employed a correlational cross-sectional design, with a convenience sample of 611 Filipino nursing students. Data were collected using the scales Connor and Davidson Resilience, Brunnsviken Brief Quality of Life, COVID-19 Anxiety, and Perception of Academic Stress and analyzed using Pearson's r, bivariate analysis, and multistage regression analyses.

RESULTS

Academic stress and COVID-19 anxiety negatively correlated with QoL and resilience. Resilience was positively associated with QoL and reduced the effect of academic stress on QoL, indicating that resilience is a crucial mediating variable between academic stress and QoL. Finally, resilience had a significant mediating influence on QoL, as evidenced by a reduction in the effect of COVID-19 anxiety on QoL among nursing students.

CONCLUSIONS

Filipino nursing students' QoL was affected by academic stress and COVID-19-related anxiety. However, resilience mediated this impact, preserving QoL.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nursing colleges and affiliated hospitals must collaborate to monitor academic stress and pandemic-related anxiety. Nursing students should be provided with programs such as seminars and team-building activities to enhance their resilience.

The relationship between depression, anxiety, e-health literacy, and health-promoting behavior in nursing students during COVID-19

The purpose of this study was to identify the correlation between depression, anxiety, e-health literacy (eHL), and health-promoting behaviors among nursing students during the coronavirus disease 2019 (COVID-19) pandemic, and to identify the factors affecting health-promoting behaviors. A cross-sectional study was conducted online, recruiting 301 nursing students recruited from 4 universities in the Chungcheng Province and Daejeon Metropolitan City in South Korea between May 28 and June 30, 2021. Data were analyzed using SPSS WIN 27.0. The general characteristics of the study participants were analyzed by frequency and percentage, and the degree of depression, anxiety, eHL, and health-promoting behaviors were calculated as averages and standard deviations. Differences in health-promoting behaviors according to general characteristics were analyzed using independent t tests and analysis of variance, and a post hoc Scheffe test was conducted. Correlations between depression, anxiety, eHL, and health-promoting behaviors were measured using Pearson correlation matrices. Stepwise multiple regression was performed to identify factors affecting health-promoting behaviors. During the COVID-19 pandemic, the average level of depression and anxiety was reported to be 3.93 (4.71) and 3.40 (4.30), respectively; 33.2% of nursing students experienced more than mild depression and 29.2% experienced anxiety. The average eHL level was 3.91 (0.56), and the average of health-promoting behaviors was 2.43 (0.45). Depression was positively correlated with anxiety (R = 0.734, P < .001) and negatively correlated with health-promoting behaviors (r = -0.198, P = .001), whereas eHL had a positive correlation with health-promoting behaviors (R = 0.347, P < .001). The factors affecting health-promoting behaviors were religion (β = -0.160, standard error [SE] = 0.048), current health status (β = -0.097, SE = 0.032), frequency of searching the Internet for health-related information in a week (β = -0.070, SE = 0.026), interest in health (β = -0.191, SE = 0.039), and critical eHL (β = 0.243, SE = 0.040); the explanatory power was 27.4%. Results demonstrate that during the COVID-19 pandemic, higher depression and anxiety among nursing students decreased health-promoting behaviors, while higher eHL increased health-promoting behaviors, and eHL was a major factor affecting health-promoting behaviors. These results contribute to the provision of basic data for the development of nursing intervention programs and educational strategies that can establish correct health-promoting behaviors by managing depression and anxiety among nursing students and improving eHL.

Factors related to mental health effect among nursing students in Japan and the United States during the coronavirus pandemic: A cross-sectional study

In the context of mental health, university students have been considered a vulnerable population. However, limited studies have underscored the association between preventive health behaviour levels and mental health effects among nursing students. The current cross-sectional study provides a comparative analysis of the impact of mental health factors on nursing students in Japan and the United States (US) in the context of the coronavirus disease 2019 (COVID-19) pandemic. The study consisted of 878 participants, comprising both undergraduate and graduate nursing students from four universities in Japan, and one from the US. Hierarchical logistic regression was used to analyse the participant data in this study. In contrast to the American students, the Japanese students demonstrated significantly lower levels of perceived control and significantly higher levels of preventive health behaviours. Furthermore, Japanese students exhibited significantly higher levels of stress and/or symptoms of depression induced by the social distancing orders compared to the American students (z = -4.218, P < 0.001). However, no difference was observed after adjusting for perceived control, individual factors, socio-economic factors, and preventive behaviours. During the pandemic, risk factors that can worsen mental health among the nursing students included younger age [odds ratio (95%CI) = 0.62 (0.48-0.81)], women [OR = 2.17 (1.02-4.61)], higher preventive health behaviour [OR = 1.05 (1.02-1.08)], lower perceived control [OR = 0.97 (0.94-0.99)], and lower perceived health competence [OR = 0.93 (0.90-0.96)]. Thus, this study recommends establishing training programmes that enhance perceived control and perceived health competence while encouraging preventive behaviour to support the mental health of nursing students, particularly young female students.

The Relationship Between Personality Traits and Clinical Decision-Making, Anxiety and Stress Among Intern Nursing Students During COVID-19: A Cross-Sectional Study

Purpose

The aim of this study was to investigate whether the personality traits of intern nursing students could serve as valid predictors of their psychological status and clinical decision making. Additionally, we aimed to understand the psychological state of intern nursing students during the regular epidemic prevention and control stage of COVID-19.

Participants and Methods

This study was designed as a cross-sectional survey. A total of 181 intern nursing students involved in clinical placements participated in this study. Participants provided relevant data by completing the Big Five Inventory-44, the Self-Rating Anxiety Scale, the Perceived Stress Scale 14, and the Clinical Decision-Making in Nursing Scale.

Results

The results showed that neuroticism (β = -0.282, p < 0.01) and openness (β = 0.302, p < 0.001) played significant roles in predicting clinical decision-making skills among intern nursing students. Regression analysis also showed extraversion (β = -0.249, p < 0.01), openness (β = 0.2, p < 0.01), and neuroticism (β = 0.391, p < 0.001) could significantly predict stress in intern nursing students. The agreeableness (β = -0.354, p < 0.001) and neuroticism (β = 0.237, p < 0.01) could also predict the anxiety of intern nursing students. Additionally, some intern nursing students still suffered from anxiety and stress in the context of the ongoing pandemic.

Conclusion

Personality traits are good predictors of clinical decision-making, anxiety and stress among intern nursing students. In conclusion, the openness in personality traits of intern nursing students should be valued and cultivated in clinical work, which will benefit the development of nursing talents.

Fear Related to COVID-19, Mental Health Issues, and Predictors of Insomnia among Female Nursing College Students during the Pandemic

Fear of infection has been sparked by the advent of the novel coronavirus disease (COVID-19). Insomnia in college students, especially its correlations and predictions with mental diseases, remains a research concern. Aim: To estimate the prevalence of fear related to COVID-19, depression, anxiety, and insomnia among female nursing college students throughout the pandemic and to determine the predictors of insomnia. Methods: A web-based cross-sectional descriptive study used 145 female nursing college students. Results: Students reported fear related to COVID-19, depression, and anxiety at rates of 79.3%, 30.2%, and 35.2%, respectively. Insomnia disturbed 24.7% of students. Anxiety predicted worsening insomnia in the student (AOR = 1.08, 95% CI: 0.92−0.97, p < 0.001). Fear related to COVID-19 was also a predictor (AOR = 0.96, 95% CI: 1.07−1.21, p < 0.05). Additionally, when depression severity declined, the chance of insomnia improved (AOR = 0.87, 95% CI: 0.85−0.91, p < 0.001). Insomnia was more common in chronically unwell students (AOR = 1.50, 95% CI = 1.01−2.24, p < 0.05). Conclusion: During the COVID-19 pandemic, university students’ mental health should be monitored, and all essential safeguards should be taken, including resource allocation, awareness raising efforts, and the building of a mental health counseling facility.

Translation and validation of the Chinese version of the Friedman life balance scale among nursing students: A psychometric analysis

AIM

To conduct a Chinese translation and validation of the Friedman Life Balance Scale (FLBS).

BACKGROUND

Prevalence of mental disorders is high among nursing students. Life balance is important for nursing students, which may help them increase efficiency in their studies and develop physical and psychological health. Yet, little is known about life balance in nursing students. Therefore, it is crucial to evaluate the status of life balance of the students to lay the foundation for exploring its associated factors.

DESIGN

A multi-centre cross-sectional design.

METHOD

The study was comprised of 420 nursing students from 15 hospitals and two educational institutes in East, North and Northeast China from July 2021 to January 2022. The Chinese version of the FLBS was translated and adapted based on published, standardized, international guidelines. Psychometric evaluation included floor and ceiling effects, factorial validity, convergent validity, discriminant validity, internal consistency, test-retest reliability, diagnosis accuracy and calibration. The tests used for validity included floor and ceiling effects, confirmatory factor analysis, average extracted variance (AVE) value, composite reliability, correlations with life satisfaction and subjective well-being. The tests used for reliability incudes Cronbach's alpha and intraclass correlation coefficients. Diagnosis accuracy was tested by the area under the curve and calibration was tested by Hosmer-Lemeshow goodness-of-fit test.

RESULTS

The Chinese version of the Friedman life balance scale did not demonstrate floor or ceiling effect, showing content validity is not limited. Confirmatory factor analysis showed acceptable model fit after it was modified. Convergent validity and discriminant validity of the Friedman life balance scale were supported, except subscales two and three were not discriminated well by AVE technique. The internal consistency was acceptable and the test-retest reliability was good with 0.858. The area under the curve was 0.762 and the optimal cut-off point for depressive symptoms was 44. Hosmer-Lemeshow goodness-of-fit test showed the calibration to be acceptable. Life balance is moderate among Chinese nursing students. The subscale "self-forgive, compassion, love" had the highest correlations with well-being and life satisfaction.

CONCLUSIONS

The Chinese version of the Friedman life balance scale is a suitable instrument for assessing life balance in Chinese-speaking contexts. It also may have potential utility in identifying nursing students with or without depressive symptoms that may need further examination. Future work should examine additional samples of Chinese nursing students, as well as, perhaps other student populations to determine the extent to which the psychometric properties of the FLBS generalize to other students and contexts.

Factors associated with mental health among undergraduate nursing students early in the COVID-19 pandemic: an integrative review

OBJECTIVES

We aimed to synthesize research findings identifying factors associated with mental health in undergraduate nursing students early in the COVID-19 pandemic.

METHODS

Seven electronic databases were searched using key terms and subject headings. JBI Critical Appraisal Checklists were used to evaluate research report quality.

RESULTS

Among 23 reports (19 quantitative and four qualitative) meeting inclusion criteria, negative emotional responses to COVID-19 (fear of infection, perceived risk, uncertainty about care/future), negative behavioral responses to COVID-19 (eating behaviors, problematic internet use, insomnia), and negative coping strategies were associated with more adverse mental health symptoms. Conversely, social support, professional identity, preventive behaviors, sufficient personal protective equipment (PPE), and positive coping strategies were related to fewer symptoms.

CONCLUSIONS

During a pandemic, undergraduate nursing students require educational support to promote their ability to avoid severe mental health disorders. Also, educators should strengthen students' professional identity, provide infection prevention knowledge and skills, and supply sufficient PPE.

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.

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.

The relations between emotion regulation, depression and anxiety among medical staff during the late stage of COVID-19 pandemic: a network analysis

Existing research proposed that moving from a disorder-level analysis to a symptom-level analysis may provide a more fine-grained understanding of psychopathology. This study aimed to explore the relations between two dimensions (i.e., cognitive reappraisal, CR; expressive suppression, ES) of emotion regulation and individual symptoms of depression and anxiety among medical staff during the late stage of COVID-19 pandemic. We examined depression symptoms, anxiety symptoms and emotion regulation among 420 medical staff during the late stage of COVID-19 pandemic via network analysis. Two networks (i.e. emotion regulation-depression network and emotion regulation-anxiety network) were constructed in the present study. Bridge centrality index was calculated for each variable within the two networks. Among the present sample, the prevalences of depression and anxiety are 39.5% and 26.0%. CR and ES showed distinct connections to symptoms of depression and anxiety. Results of bridge centrality showed that in both networks, CR had a negative bridge expected influence value while ES had a positive bridge expected influence value. The results revealed the specific role of CR and ES in relation to depression and anxiety at a symptom level. Implications for clinical preventions and interventions are discussed.

Emotion Regulation and Psychological Capital of Chinese University Students during the COVID-19 Pandemic: The Serial Mediation Effect of Learning Satisfaction and Learning Engagement

The mediating mechanism between the emotion regulation and psychological capital of university students is currently unclear. This study analyzed the serial mediation of learning satisfaction and learning engagement on the relationship between the emotion regulation and psychological capital of university students during the coronavirus disease 2019 (COVID-19) pandemic. A total of 328 undergraduates and postgraduates from universities in different regions of China were surveyed through an online questionnaire. The tools used in the study were the emotion regulation questionnaire, university student learning satisfaction questionnaire, learning engagement questionnaire, and psychological capital questionnaire. The analysis revealed both direct and indirect mediation effects. It was found that emotion regulation can positively predict psychological capital. Further, learning satisfaction and learning engagement can act as mediating variables between emotion regulation and psychological capital, respectively. Learning satisfaction and learning engagement can also have a serial mediation effect between emotion regulation and psychological capital. The results show that learning support should be strengthened to improve the learning satisfaction and learning engagement of students and, consequently, enhance their psychological capital.

Perceived Parenting Style and Subjective Well-Being among Chinese Nursing Undergraduates: The Role of Self-Efficacy and Gender

The question of how to improve the subjective well-being (SWB) of nursing students is an important factor for reducing nursing loss and improving nursing quality. The current study aimed to investigate the influence of parenting style and self-efficacy (SE) on SWB among Chinese nursing undergraduates. The moderating role of gender between parenting style and SWB was also examined. Descriptive analysis, Pearson's correlation analysis, and the Hayes' PROCESS Macro Model 4 and Model 5 were used to analyze the available data. A total of 665 nursing undergraduates (M_age = 19.86, SD = 1.19) completed questionnaires. The results showed that PPS was positively correlated with SWB (r = 0.421, p < 0.01), while NPS was negatively correlated with SWB (r = -0.167, p < 0.01). Meanwhile, SE was positively correlated with PPS (r = 0.167, p < 0.01) and negatively correlated with NPS (r = -0.175, p < 0.01). In addition, SE was positively correlated with SWB (r = 0.273, p < 0.01) and played a partial mediating role in the association between parenting style and SWB. Furthermore, gender moderated the direct effect of parenting style on SWB. Specifically, compared with male nursing students, parenting style has a greater influence on the SWB of female nursing students. These findings can be used to develop targeted improvement strategies for nursing educators to improve SWB levels among nursing undergraduates.

The impact of the COVID-19 pandemic on the mental health of Portuguese university students

Worldwide, the COVID-19 pandemic has had a disruptive effect on daily routines, especially for university students. This study aimed to compare pre-pandemic domains of students' mental health during the pandemic lockdown. One cross-sectional study was conducted in two waves with academic students from 20 Portuguese universities, in March 2020 before the COVID-19 pandemic (n = 3579) and 2 months after the first lockdown in May 2020 (n = 1228). The Positive Mental Health Questionnaire (PMHQ), the Mental Health Knowledge Questionnaire, the Mental Health-promoting knowledge, and the Psychological Vulnerability Scale were used. Statistical analyses were performed by bivariate associations and multiple linear regression models. Students were mostly women (79%), with an average age of 23.2 years (SD = 6.6), displaced from their family environment (43%), out-of-home (43%), and scholarship holders (37%). Higher scores found in the PVS were associated with decreased PMHQ in both moments (P < 0.01). These cross-sectional studies showed a slight variation in the mental health variables studied in the period before and during the COVID-19 outbreak. Being a woman, younger, out-of-home, and having a scholarship (P < 0.01) seem to increase susceptibility to mental health variation before and during the pandemic. Universities should develop strategies that promote students' mental health.

Predicting nursing students' psychological well-being: network analysis based on a model of thriving through relationships

BACKGROUND

Psychological well-being plays a vital role in nursing students' mental health and affects their decisions to stay in the nursing profession, particularly during the COVID-19 outbreak. Close relationships are undeniably linked to psychological well-being, but it is unknown how the specific pathways through which close relationships are related to each other and which are most strongly linked to nursing students' psychological well-being.

AIMS

To explore the network structure, central and bridge factors among well-being characteristics, and predictors based on a model of thriving through relationships.

METHODS

A cross-sectional research design was used with a sample of undergraduate nursing students (531 participants from the Southwest part of China). We used a network model to analyze the network structure of perceived social support, mindfulness, self-integrity, self-compassion, professional self-concept, savoring, intentional self-regulation, non-relational self-expansion, relational self-expansion, attachment insecurity, and psychological well-being.

RESULTS

 A highly interconnected network of psychological well-being featured predictors and traits were formed. Node 8 (self-kindness), node 9 (self-judgment), and node 23 (non-relational self-expansion) were the predictors with the highest centrality in the network. Perceived social support and professional self-concept were most central in linking predictors to psychological well-being traits. Attachment insecurity was a non-supportive factor for predicting psychological well-being among female nursing students.

CONCLUSIONS

Interventions based on these supportive/non-supportive predictors, which operate on different psychological levels, hold promise to achieve positive effects on psychological well-being among nursing students.

Interventions in Chinese Undergraduate Students' Mental Health: Systematic Review

BACKGROUND

Over 30% of university students from 8 countries were afflicted with mental distress according to a World Health Organization survey. Undergraduate students in increasing numbers in China have also been reported to suffer from different mental problems. Various psychological distresses significantly impact their academic and daily life, thereby causing role impairments and unsatisfactory academic achievements. While the prevalence of, diverse underlying factors for, and interventions of social support in college students' mental health have extensively been investigated in China, there is no study exclusively focusing on the impact of interventions on their psychological well-being.

OBJECTIVE

The aim of this review was to identify and synthesize the interventions in the mental health concerns of Chinese undergraduate students studying in China reported in the literature to inform educational authorities, college and university management, students' affairs counselors, and mental health providers.

METHODS

We performed a systematic review and reported the research findings of previous studies according to the protocol of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. First, based on the predefined search strategy, keyword searches were performed in the PubMed and ProQuest databases to retrieve relevant studies. Subsequently, we screened the candidate articles based on predefined inclusion and exclusion criteria. Finally, we analyzed the included papers for qualitative synthesis.

RESULTS

We retrieved a total of 675 studies from the PubMed and ProQuest databases using the search strategy on March 15, 2022. Among these candidate studies, 15 that were not written in English, 76 duplicates, and 149 studies of other document types were removed before screening. An additional 313 studies were excluded in the screening process, with 73 articles ruled out for being not relevant to interventions, not related to mental health, or not focused on undergraduate students in the full-text review. As a result, 49 papers were eligible and included in this systematic review. In the qualitative synthesis, we divided the interventions reported in the selected studies into two categories: (1) social support from government authorities, university authorities, students' affairs counselors and teachers, family members, health care authorities and professionals, and the media (various online platforms), and (2) various coping strategies adopted by undergraduate students themselves. We identified further research on mental health interventions that may be delivered by digital medical platforms, conversational agents (eg, chatbots), and researchers.

CONCLUSIONS

This was the first systematic review of interventions to address the mental health concerns of Chinese undergraduate students studying in China. The categorization of reported interventions and the identification of new intervention channels can effectively inform stakeholders. Interventions for undergraduate students' mental health is a research topic worth further investigation.

Intelligent Recognition and Analysis of Negative Emotions of Undergraduates Under COVID-19

Background

The outbreak and spread of COVID-19 has brought a tremendous impact on undergraduates' study and life, and also caused anxiety, depression, fear and loneliness among undergraduates. If these individual negative emotions are not timely guided and treated, it is easy to cause the amplification of social negative emotions, resulting in individual and collective irrational behavior, and ultimately destroy social stability and trust foundation. Therefore, how to strengthen the analysis and guidance of negative emotions of undergraduates has become an important issue to be urgently solved in the training of undergraduates.

Method

This paper presents a weight and structure double-determination method. Based on this method, a Radial Basis Function Neural Networks (RBFNN) classifier is constructed for recognizing negative emotions of undergraduates. After classifying the input psychological crisis intervention scale samples by the RBFNN classifier, recognition of negative emotions for undergraduates are divided into normal, mild depression, moderate depression and severe depression.

Experiments

Afterwards, we analyze negative emotions of undergraduates and give some psychological adjustment strategies. In addition, the experiment results demonstrate that the proposed method has a good performance in terms of classification accuracy, classification time and recognition rate of negative emotions among undergraduates.

'Learning in and out of lockdown': A comparison of two groups of undergraduate occupational therapy students' engagement in online-only and blended education approaches during the COVID-19 pandemic

INTRODUCTION

In many countries, the COVID-19 pandemic resulted in sudden changes to the delivery of health professions education in response to local and national lockdowns. Within occupational therapy, university education programs traditionally delivered in face-to-face classroom, and clinical settings, the transition to online learning presented unique issues and challenges for faculty and students. This study compared the experiences and perceptions of learning in two groups of occupational therapy students during the pandemic: one group converted to online learning only and the other had a blended approach that combined face-to-face on-campus learning with some online lecture content delivery.

METHODS

Two hundred and eight (n = 208) undergraduate occupational therapy students from three Australian universities completed an online self-report demographic questionnaire and two standardised instruments: the Student Engagement in the e-Learning Environment Scale and the Distance Education Learning Environment Scale. An independent-samples t test with bootstrapping was completed to examine differences in students' scores.

RESULTS

Statistically significant differences were observed between the online and blended learning groups across a range of the SELES and DELES subscales. The strongest findings related to psychological motivation (p = 0.001), personal relevance (p = 0.001), interactions with instructors (p = 0.002), instructor support (p = 0.001), student interaction & collaboration (p = 0.001), and cognitive problem solving (p = 0.001).

CONCLUSION

Occupational therapy students who transitioned to online-only learning experienced higher levels of motivation, interactions with instructors and peers, and self-directed learning than students who experienced a blended education delivery approach of face-to-face and online learning. The findings extend educators' understanding of the matrix of factors that have impacted students' education during COVID-19 and support the development of contemporary and pedagogically sound online and traditional modes of occupational therapy instruction. The results provide evidence of the importance of well-structured programs that facilitate active and flexible learning, provide meaningful and positive experiences, and promote initiatives safeguarding social and personal well-being. Further research in this area is recommended.

Mental Health Among Medical Students During COVID-19: A Systematic Review and Meta-Analysis

Background

The mental health of medical students is an issue worthy of attention, especially during COVID-19. Many studies have shown that depression and anxiety are the main problems faced by medical students. To assess the pooled prevalence of depression and anxiety among medical students worldwide, we conducted this meta-analysis.

Methods

According to PRISMA, we used a computerized strategy to search studies in EMBASE, PubMed, PsycArticles, Web of Science, and China Biology Medicine disc. The pooled prevalence of depression and anxiety was calculated by a random-effects model. Heterogeneity was explored by subgroup analysis. Sensitivity analysis and publication bias were also carried out in this meta-analysis.

Results

Of 1316 studies, 41 studies were selected based on 36608 medical students. The pooled depression prevalence was 37.9% (95% CI: 30.7-45.4%), and pooled anxiety prevalence was 33.7% (95% CI: 26.8-41.1%). The prevalence of depression and anxiety among medical students varied by gender, country, and continent.

Conclusion

The data reported that the prevalence of depression and anxiety among medical students during COVID-19 was relatively higher than those of the general population and the healthcare workers. The impact of COVID-19 on medical students and how to protect the mental health of medical students are needed to determine through further research.

Systematic Review Registration

[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021274015], identifier [CRD42021274015].

Depression and anxiety among nursing students during the COVID-19 pandemic in Tohoku region, Japan: A cross-sectional survey

Aim

Restrictions such as physical distancing and online learning for college students were implemented due to the COVID‐19 pandemic. Owing to this, students may experience psychological distress from social isolation and loneliness. Nursing students are subjected to an exacerbated level of distress during the pandemic due to their role as health professionals. Therefore, the present study aimed to investigate the level of anxiety and depression among Japanese nursing students, according to their perceived vulnerability to COVID‐19.

Methods

A total of 281 college students (104 nursing students and 177 other college students) responded to a web‐based anonymous questionnaire survey from 18 August to 31 October 2020. The Hospital Anxiety and Depression Scale was used to evaluate anxiety (HADS‐A) and depression (HADS‐D). Perceived vulnerability to COVID‐19 was assessed using the Perceived Vulnerability to Disease Scale.

Results

In both groups of students, the prevalence of both anxiety (30.5% in nursing students; 69.5% in others) and depressive symptoms (31.1% in nursing students; 68.9% in others) were remarkably high. There were no significant differences in anxiety and depression between nursing and other students after adjusting for perceived vulnerability to COVID‐19 plus socio‐demographic characteristics and stress coping styles. Perceived vulnerability and its interactions with nursing did not show a significant association with either depression or anxiety.

Conclusion

This study highlights the need for greater support and preventive strategies for mental health problems for college students during the COVID‐19 pandemic regardless of perceived vulnerability.

Mindfulness-based online intervention on mental health among undergraduate nursing students during coronavirus disease 2019 pandemic in Beijing, China: A randomized controlled trial

OBJECTIVE

To evaluate the effect of mindfulness intervention on improving mental health among undergraduate nursing students during the coronavirus disease 2019 (COVID-19) pandemic in China.

METHODS

An online mindfulness intervention course named Mindfulness Living With Challenge (MLWC) was developed by the research team, and a randomized controlled trial using MLWC among Chinese undergraduate nursing students was carried out. A total of 120 undergraduate nursing students were randomized into control (60 students) and intervention groups (60 students) via a WeChat mini program. Self-administered questionnaire surveys were conducted at pre- and post-intervention, measuring depression, anxiety, stress, mindfulness, and perceived social support. After intervention, the acceptance of the online mindfulness course among participants was assessed by employing the theory of technology acceptance model (TAM).

RESULTS

Among the enrolled 120 participants, 86.67% (52/60) and 93.33% (56/60) of the intervention and control groups remained completed the trial and the questionnaire surveys. Compared with the control group, the reduction of anxiety and stress symptoms, as well as the improvement of mindfulness level and perceived social support in the MLWC intervention group were statistically significant (P < 0.05), while the change in depression was not statistically significant. The scores of the four dimensions in TAM ranged from (5.88 ± 0.94) to (5.91 ± 0.97).

CONCLUSION

Online mindfulness intervention implemented in this study is effective in improving mental health among undergraduate nursing students, and they were interested in this intervention.

CLINICAL TRIAL REGISTRATION

[www.ClinicalTrials.gov], identifier [ChiCTR2 200058103].

Investigating Effects of COVID-19 Pandemic on the Mental Health of Nursing Students During Remote Learning: An Experience from Dong A University, Vietnam

Introduction

There was a radically changed in nursing education during the nationwide lockdown due to the COVID-19 outbreaks. The transition to remote learning stressed nursing students in many countries, particularly in Vietnam. However, there is still lacking a novel study to describe the mental characteristics of nursing students in detail.

Objectives

To assess the mental health of nursing students, including stress, anxiety, and depression, and to identify the related factors to their mental health during the online study period because of the COVID-19 pandemic.

Methods

A cross-sectional survey was conducted on 540 nursing students at Dong A university using a socio-demographic questionnaire, the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21). Data were analyzed by descriptive statistics and tests, including Mann-Whitney, Kruskal-Wallis, and Spearman's correlation to identify the related factors.

Results

In total 540 participants, nursing students reported stress (N  =  120, 22.2%), anxiety (n  =  195, 36.1%), and depression symptoms (n  =  135, 23.1%). There was a significant relationship between age, work status, married status, number of children, stress, anxiety, and depression (P < 0.01). In addition, our study showed a negative correlation between frequency of physical activity, perceived health and stress (r  =  -0.117; p < 0.01, r  =  -0.127, p < 0.01), anxiety (r  =  -0.133; p < 0.01, r  =  -0.112, p < 0.01), depression (r  =  -0.134; p < 0.01, r  =  -0.135, p < 0.01). A significant relationship was observed between e-learning space and Internet status with mental health (p < 0.05). Especially, there was no association between average online learning time, academic workload, stress, anxiety, and depression (p > 0.05). However, the authors found a positive association between perceived level of stress related to evaluative activities and stress, anxiety, depression (r  =  0.120, p < 0.01; r  =  0.089, p < 0.05; r  =  0.088, p < 0.05).

Conclusion

Nursing students suffered stress, anxiety, and depression during online learning due to the COVID-19 pandemic in the presence of some related factors. Therefore, this study may increase more attention of universities, families, and governments to reduce the stress of nursing students during distance education.

Impact of the COVID-19 pandemic on the mental health of nursing students in Japan: a cross-sectional study

BACKGROUND

The effect of the prolonged coronavirus disease (COVID-19) pandemic on the mental health of nursing students is unclear. This study assesses the prevalence of anxiety, depression, and insomnia among nursing students in Japan during the pandemic and determines the risk factors associated with such symptoms.

METHODS

An online survey-based cross-sectional study was conducted from August 16 to October 16, 2021. Participants were first- to fourth-year nursing students enrolled in undergraduate programs at the eight universities in Japan. Anxiety, depression, and insomnia were assessed using the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Insomnia Severity Index-7, respectively. We calculated descriptive statistics for each measurement item and performed univariate and logistic regression analyses to evaluate the potential risk factors.

RESULTS

We received responses from 1,222 of 3,056 nursing students (response rate: 40.0%). After 25 participants were excluded due to missing outcome values, 1,197 students (valid response rate: 98.0%) were included in the analysis. The prevalence of anxiety, depression, and insomnia was 4.8%, 12.4%, and 18.0%, respectively. The risk of anxiety was lower among participants who did not have any relatives or friends who had been infected with SARS-CoV-2 than among those who did (aOR 0.36, 95% CI 0.14-0.94). The risk of depression was higher among participants whose financial status had worsened during the pandemic than among those whose financial status had not changed (aOR 3.44; 95% CI 1.98-5.96). Common factors that increased the risk of anxiety, depression, and insomnia were life satisfaction and fear of COVID-19.

CONCLUSION

Mental health-related symptoms among nursing students in Japan have not necessarily worsened with the spread of COVID-19 but were exacerbated by the intensity of changes in daily living and fear, which are psychosocial effects associated with the pandemic.

Post-secondary Student Mental Health During COVID-19: A Meta-Analysis

The COVID-19 pandemic has posed notable challenges to post-secondary students, causing concern for their psychological well-being. In the face of school closures, academic disruptions, and constraints on social gatherings, it is crucial to understand the extent to which mental health among post-secondary students has been impacted in order to inform support implementation for this population. The present meta-analysis examines the global prevalence of clinically significant depression and anxiety among post-secondary students during the COVID-19 pandemic. Several moderator analyses were also performed to examine sources of variability in depression and anxiety prevalence rates. A systematic search was conducted across six databases on May 3, 2021, yielding a total of 176 studies (1,732,456 participants) which met inclusion criteria. Random-effects meta-analyses of 126 studies assessing depression symptoms and 144 studies assessing anxiety symptoms were conducted. The pooled prevalence estimates of clinically elevated depressive and anxiety symptoms for post-secondary students during the COVID-19 pandemic was 30.6% (95% CI: 0.274, 0.340) and 28.2% (CI: 0.246, 0.321), respectively. The month of data collection and geographical region were determined to be significant moderators. However, student age, sex, type (i.e., healthcare student vs. non-healthcare student), and level of training (i.e., undergraduate, university or college generally; graduate, medical, post-doctorate, fellow, trainee), were not sources of variability in pooled rates of depression and anxiety symptoms during the pandemic. The current study indicates a call for continued access to mental health services to ensure post-secondary students receive adequate support during and after the COVID-19 pandemic. Systematic Review Registration: PROSPERO website: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021253547.

Impact of the COVID-19 pandemic on mental health of nursing students in Japan: protocol for a cross-sectional study

INTRODUCTION

The COVID-19 pandemic is spreading globally with a high risk of mortality. It is also significantly affecting mental health. For nursing students, the impact of COVID-19 on mental health is predicted to be significant; however, sufficient data have not been obtained. Therefore, this study will aim to assess the mental health of nursing students and evaluate the related factors.

METHODS AND ANALYSIS

This proposed study is a cross-sectional survey using a self-report questionnaire. An online questionnaire will be distributed among all nursing students of eight universities in Japan. The survey questionnaire will consist of questions related to demography, life satisfaction, fear of COVID-19, mental health and physical activities. The target sample size is 1300 nursing students. We will calculate descriptive statistics for each measurement item and perform univariate and logistic regression analyses to evaluate the potential risk factors for anxiety, depression and insomnia symptoms in nursing students. The strength of association will be assessed using the OR and its 95% CIs. Statistical significance will be set at a p<0.05.

ETHICS AND DISSEMINATION

The protocol was approved by the Institutional Review Board (IRB) of the University of Hyogo on 22 March 2021 (ID: 2020F29). In addition, all of the participating facilities required ethical approval from their local IRBs. The findings will be disseminated through peer-reviewed publications and conference presentations. We believe that the proposed large-scale investigation of the mental health of nursing students during the COVID-19 pandemic and the relationship between mental health and fear of COVID-19 are novel and will be a strength of this study.

Recovering and rebuilding after COVID-19: What are the best ways to support medical radiation science students?

The Covid-19 pandemic and lockdown periods have impacted Medical Radiation Science (MRS) students professionally and personally. This Editorial provides commentary on two papers that generate discussion on how MRS students can be supported during these challenging times. We highlight how Universities and clinical departments can support students through tailored and proactive support, building resilience and peer group supervision.

Prevalence of mental health problems and sleep disturbances in nursing students during the COVID-19 pandemic: A systematic review and meta-analysis

AIM

To identify the prevalence of mental health problems and sleep disturbances among nursing students during the COVID-19 pandemic.

BACKGROUND

As a future professional workforce, nursing students are expected to play a role in controlling the COVID-19 pandemic; however, physical and mental health problems may hinder their willingness to stay in the nursing profession. Evidence of the prevalence of the health problems among nursing students related to COVID-19 may allow educators to manage their students' health problems and make them feel more positive about their future careers.

DESIGN

Systematic review and meta-analysis. This study was prospectively registered with PROSPERO.

DATA SOURCES

Databases, including CINAHL, Embase, PubMed and Web of Science, were searched for all related journal articles, from database inception to June 29, 2021, published between 2020 and 2021.

METHODS

This review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using a PICOS search strategy. A DerSimonian-Laird random-effects model was used to estimate the prevalence and potential heterogeneity among the selected studies using the Cochran Q statistic and I-square test. Publication bias was assessed using the Egger intercept test.

RESULTS

Seventeen studies were included in the meta-analysis, representing 13,247 nursing students. During the COVID-19 pandemic, the prevalence of four health problems and sleep disturbances were identified. The health problem with the highest prevalence in nursing students was depression (52%). Other COVID-19-related health problems were fear (41%), anxiety (32%) and stress (30%) and sleep disturbances (27%).

CONCLUSIONS

The findings from this study showed that strategies are necessary to manage nursing students' teaching and learning during the COVID-19 pandemic or similar future situations. Our results suggest that preparing modified distance learning might reduce the prevalence of health problems related to the educational process. In addition, providing regular mental health assessments or online mental health services to students may improve their mental health and increase their well-being. Nursing education policies regarding clinical practice remain to be formulated to ensure the achievement of competencies to support future careers while considering the mental readiness and safety of students.