Relationship between depression, anxiety, cognitive distortions, and psychological well-being among nursing students

Mental Health of Nursing Students: A Bibliometric Review Based on CiteSpace Visual Analysis

Background: The mental health of nursing students directly affects their future performance, quality of patient care, and personal development. Therefore, an in-depth understanding of research in this area can assist in implementing effective measures to improve the mental health of nursing students. Aim: This study used bibliometric analyses to identify and analyze articles, authors, journals, and research institutes investigating nursing students' mental health in terms of thematic structure and topic evolution, aiming to provide direction and guidance for future research. Methods: In this retrospective bibliometric analysis, data were downloaded from the Web of Science Core Collection on August 15, 2024. Subsequently, CiteSpace software was employed to analyze the annual number of publications and citations, explore relationships between authors, institutions, countries, and keywords, and summarize research hotspots and frontiers in the field of nursing students' mental health. Results: Articles published from database inception to August 15, 2024, were screened, leading to the retrieval of 3803 relevant articles. The United States of America was the leading country in terms of research output on the mental health of nursing students, with 982 (25.79%) published articles, while the United States Department of Health and Human Services provided the most funding. Furthermore, Happell, B was the most productive author in this field, with 80 published papers. Lastly, Nurse Education Today was the most prolific journal in nursing education. Conclusion: The main recent research trends include the psychological profile of nursing students, intervention strategies for improving the mental health of nursing students, and the influence of educational methods, clinical experience, and humanistic care on the mental health of nursing students. These trends imply that researchers should develop targeted training programs, apply information technology, and implement personalized teaching to enhance the psychological resilience of the nursing student population. Moreover, higher education institutions should provide nursing students with more comprehensive and effective mental health support by maintaining mental health files, strengthening mental health education, providing psychological counseling services, and establishing social support systems.

A network analysis of the heterogeneity and associated risk and protective factors of depression and anxiety among college students

BACKGROUND

Comorbidity of depression and anxiety is common among adolescents and can lead to adverse outcomes. However, there is limited understanding of the latent characteristics and mechanisms governing these disorders and their interactions. Moreover, few studies have examined the impacts of relevant risk and protective factors.

METHODS

This cross-sectional study involved 1,719 students. Mplus 8.0 software was used to conduct latent profile analysis to explore the potential categories of depression and anxiety comorbidities. R4.3.2 software was used to explore the network of core depression and anxiety symptoms, bridge these disorders, and evaluate the effects of risk and protective factors.

RESULTS

Three categories were established: "healthy" (57.8%), "mild depression-mild anxiety" (36.6%), and "moderately severe depression-moderate anxiety" (5.6%). "Depressed mood", "nervousness", and "difficulty relaxing" were core symptoms in both the depression-anxiety comorbidity network and the network of risk and protective factors. Stress perception and neuroticism serve as bridging nodes connecting some symptoms of depression and anxiety and are thus considered the most prominent risk factors.

CONCLUSIONS

According to the core and bridging symptoms identified in this study, targeted intervention and treatment can be provided to groups with comorbid depression and anxiety, thereby reducing the risk of these comorbidities in adolescents.

The effect of a mindfulness-based cognitive therapy program on depression, anxiety, stress, and cognitive flexibility in nursing students: A randomized clinical trial

BACKGROUND

It is known that the depression, anxiety, and stress levels of the nursing students are higher compared to the general student population. Nursing educators should use evidence-based, effective, and innovative interventions to help students recognize and reduce their mental symptoms.

AIM

This study aimed to determine the effect of the online mindfulness-based cognitive therapy program, which was implemented for nursing students, on depression, anxiety, stress and cognitive flexibility levels.

METHODS

This randomized controlled trial study adopted a pretest-posttest-follow-up test research design.

RESULTS

As a result of the analyses, the intervention group had lower scores in the post-test and follow-up test measurements of the depression, anxiety and stress dimensions of the Depression-Anxiety and Stress Scale compared to the control group, and there was a statistically significant difference between them (p < 0.05). The post-test and follow-up test Cognitive Flexibility Inventory scores of intervention students were higher than those of the students in the control group and there was a statistically significant difference between them (p < 0.05).

CONCLUSION

The results of this study demonstrate that this program can reduce depression, anxiety, stress and increase cognitive flexibility levels among nursing students.

Relationship between resilience, social support and psychological well-being in nursing students

Background

Nursing students face significant academic stress, often surpassing that of other disciplines, due to exposure to diverse clinical settings and challenging patient conditions. This stress can lead to psychological issues like anxiety and depression, impacting their well-being.

Aim and Methods

This study aimed to assess resilience and social support levels among 160 Generic BS Nursing students in five Public and Private nursing education institutions of Lahore, Pakistan and explore their relationship with psychological well-being by using a cross-sectional correlational study. A p-value of 0.05 was considered significant.

Results

Results showed 47.5% of participants were aged 17-21, and 52.55% were older than 22. Most (88.8%) were female. Resilience scores were low-to-moderate (mean: 66.50 ± 14.7), psychological well-being was moderate (mean: 56.35 ± 18.98) and social support was low (mean: 5.07 ± 1.21). Notably, no significant differences were found between third and fourth-year students.

Conclusion

This study highlighted the positive relationship between resilience, social support and psychological well-being among nursing students. Resilience plays a vital role in mitigating stress's adverse effects, and strong support from family and friends contributes to positive psychological health.

Stress, mental health, and protective factors in nursing students: An observational study

BACKGROUND

Nursing students suffer high levels of stress, especially in the first year.

OBJECTIVES

to compare academic stress at the beginning and end of nursing studies; to analyse the relationships between academic stress, mental health, and protective factors; and to examine whether resilience mitigates the effect of academic stress on psychological well-being.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

Sample was 370 first- and fourth-year nursing students from Spain (University of Castilla-La Mancha, University of Cantabria, and University of Sevilla).

VARIABLES AND DATA COLLECTION

We assessed academic and clinical stress, coping skills, anxiety, depression, psychological well-being, and resilience were measured.

DATA ANALYSIS

We performed a descriptive analysis of the study sample, as well as correlation and hierarchical regression models. Additionally, mediation models were estimated.

RESULTS

First-year students presented higher academic stress than fourth-year students. Clinical stress, anxiety, depression, and emotional coping predicted academic stress, while academic stress, depression, and coping skills predicted psychological well-being. Mediation models showed a significant path between academic stress, resilience, depression, and psychological well-being.

CONCLUSION

Academic stress has a detrimental effect on the mental health. Coping strategies and resilience may be protective factors that should be encouraged in interventions designed to improve psychological well-being.

Polygenic risk scores for mood and related disorders and environmental factors: Interaction effects on wellbeing in the UK biobank

Mood disorders have a genetic and environmental component and interactions (GxE) on the risk of psychiatric diseases have been investigated. The same GxE interactions may affect wellbeing measures, which go beyond categorical diagnoses and reflect the health-disease continuum. We evaluated GxE effects in the UK Biobank, considering as outcomes subjective wellbeing (feeling good and functioning well) and objective measures (education and income). We estimated the polygenic risk scores (PRSs) of major depressive disorder, bipolar disorder, schizophrenia, and attention deficit hyperactivity disorder. Stressful/traumatic events during adulthood or childhood were considered as E variables, as well as social support. The addition of the PRSxE interaction to PRS and E variables was tested in linear or multinomial regression models, adjusting for confounders. We included 33 k-380 k participants, depending on the variables considered. Most PRSs and E factors showed additive effects on outcomes, with effect sizes generally 3-5 times larger for E variables than PRSs. We found some interaction effects, particularly when considering recent stress, history of a long illness/disability/infirmity, and social support. Higher PRSs increased the negative effects of stress on wellbeing, but they also increased the positive effects of social support, with interaction effects particularly for the outcomes health satisfaction, loneliness, and income (p < Bonferroni corrected threshold of 1.92e-4). PRSxE terms usually added ∼0.01-0.02% variance explained to the corresponding additive model. PRSxE effects on wellbeing involve both positive and negative E factors. Despite small variance explained at the population level, preventive/therapeutic interventions that modify E factors could be beneficial at the individual level.

The Mediating Role of Rumination and Self-Regulation Between Self-Generated Stress and Psychological Well-Being

In this study, we aimed to examine the relationships between self-generated stress (SGS) and psychological well-being (PWB) and the mediating role of self-critical rumination (SCR) and self-regulation in this relationship. In this direction, the Self-Generated Stress Scale (SGSS) was adapted into Turkish in the first study. In the second study, we tested the mediating role of SCR and self-regulation in the relationship between SGS and PWB in university students. The findings showed that the Self-Generated Stress Scale is a valid and reliable measurement tool for Turkish culture and PWB and self-regulation have partial mediating roles in the relationship between SGS and PWB. These results contribute to a better understanding of the association between SGS and PWB.

Dietary acid load, depression, and anxiety: results of a population-based study

BACKGROUND

Dietary acid load seems to be associated with psychological disorders through several mechanisms, and may barricade their treatment and recovery. The aim of current study was to evaluate the relationship between dietary acid load, using potential renal acid load (PRAL) and dietary acid load (DAL) scores, with the severity of depression and anxiety among Iranian adults.

METHODS

A total of 6531 participants aged 35-65 years were recruited in this cross-sectional study. A validated food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. DAL was estimated using PRAL and DAL scores. Depression and anxiety were screened using Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI).

RESULTS

In the fully adjusted model, women with the highest DAL or PRAL had higher odds of more severe depression compared to those in the lowest category (OR = 1.20; 95% CI = 1.03-1.42 and OR = 1.20; 95% CI = 1.03-1.39, respectively). No significant association was observed between DAL and PRAL and depression severity in men and in the population as a whole. Regarding the association between PRAL and anxiety severity, there was no significant association when separated by sex. However, in the fully adjusted model for the whole population, participants in the highest tertile of PRAL had 13% greater odds of more severe anxiety than the lowest tertile (OR: 1.13, 95% CI: 1.01-1.13). No significant association was observed between DAL and anxiety severity in women, men or in the whole population.

CONCLUSION

Women, but not men, with higher dietary acid load had significantly higher odds of having more severe depression. A significant positive association was also observed between dietary acid load and anxiety in the whole population.

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.

Relationship between depression and quality of life among students: a systematic review and meta-analysis

The objectives of this systematic review were to estimate the prevalence of depression and to identify the relationship between depression and quality of life (QOL) among high school and university students. Literature search was performed in the Scopus, Embase, PubMed, Scielo, CINAHL and Web of Science databases, following the PRISMA methodology. The results were presented through descriptive approaches and meta-analysis. Thirty-six studies met the eligibility criteria, and twenty-six were included in the meta-analysis. The prevalence of depressive symptoms was 27% (95% CI 0.21-0.33) among students, being high school and university students was 25% (95% CI 0.14-0.37) and 27% (95% CI 0.20-0.34), respectively, and most studies have shown that depression was associated with low QOL. Among the limitations of the study is the difficulty of generalizing the results found, considering the large sample of health students. New studies should be conducted considering the severity, duration, and patterns of depressive symptoms in high school and university students, to better understand the relationship between depression and QOL.

Psychological Distress, Depression, and Anxiety in Nursing Students: A Longitudinal Study

The aim of this longitudinal study is to determine how stressful life events, psychological distress, depressive symptoms, and anxiety change in a cohort of students from one nursing faculty during the education process and to document the factors related to psychological distress, depressive symptoms, and anxiety during the fourth year of education. The General Health Questionnaire (GHQ-12), the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI) were applied to students within the faculty of nursing within the first week of the 2018-2019 academic year. All students were asked to answer a questionnaire measuring their possible stressful life events (first timepoint). The process was repeated for the same students again in the fourth year (second timepoint). The changes between the two timepoints were examined. Nursing students' GHQ-12 and STAI scores and averages increased significantly from first timepoint to second timepoint (p < 0.05). There was a significant increase in the prevalence of depressive symptoms for the ≥21 cut-off point of BDI in the fourth year of the study cohort. A significant increase in perceived stress levels between the two timepoints was also found for numerous stressful life events. As a result of linear regression, "dissatisfaction with major" was found as a determinant on all scale scores. The psychological indicators increased significantly in nursing students during their education. Interventions to reduce stress, anxiety, and psychological distress are needed to improve the mental health status of nursing students.

A Utilização da Imitação Facial em Tarefas de Reconhecimento de Expressões Emocionais

Resumo A imitação facial é um comportamento involuntário capaz de facilitar a transmissão de informações não verbais relevantes em diferentes contextos sociais. Este estudo teve por objetivo analisar a capacidade de reconhecimento de expressões emocionais enquanto o observador tensiona a própria face ou imita a face-alvo. A hipótese utilizada foi a de que indivíduos que tensionam a própria face terão menor probabilidade de acertos na execução das tarefas de reconhecimento de expressões emocionais e aqueles que imitam a expressão terão uma maior probabilidade de acertos na execução das mesmas tarefas. A amostra foi composta por 30 participantes, divididos em dois grupos experimentais: o Grupo Imitação (GI) e o Grupo Ruído (GR), ambos com 18 participantes do sexo feminino e 12 do sexo masculino. O experimento consistiu em apresentar fotos de atores expressando facialmente uma emoção básica por 10 segundos. Neste período, os participantes deveriam, então, observar ou intervir facialmente, imitando ou tensionando a própria face (de acordo com o grupo alocado, Imitação ou Ruído). Após os 10 segundos executando a instrução (observar, imitar ou interferir), o participante deveria responder - entre as opções alegria, tristeza, nojo, raiva, surpresa e medo - a emoção correspondente à imagem. Os resultados apresentaram diferenças significativas quando comparadas as tarefas de tensionar ou imitar a face-alvo, sugerindo que a alteração da própria face do observador pode influenciar durante o desempenho de uma tarefa de reconhecimento de emoções em faces.

The effect of cognitive-behavioral therapy on stress and anxiety of women with premature ovarian insufficiency: A randomized controlled trial

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N64. Date of registration: 14/02/2021. URL: https://en.irct.ir/user/trial/52024/view; date of first registration: 17/02/2021.

Female gender and low physical activity are risk factors for academic stress in incoming nursing students

PURPOSE

Nursing students suffer from stress more frequently than other students. The objective was to analyze the academic stressors that most affect new nursing students.

DESIGN AND METHODS

A cross-sectional study on new nursing students.

FINDINGS

Two hundred and eighty-two students, 78% women, mean age of 21.46 (6.1) years. Giving presentations in class and lack of time for homework are the items that cause the greatest academic stress. Women had higher levels of academic stress, and higher levels of physical activity are related to lower academic stress.

PRACTICE IMPLICATIONS

Women have a higher level of academic stress. Doing sport is a protective factor that diminishes academic stress the more it is practiced. Encouraging nursing students to play sports could be beneficial in reducing their academic stress, with women benefiting the most.

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.

Moderating Role of Coping Style on the Relationship between Stress and Psychological Well-Being in Hong Kong Nursing Students

AIMS AND OBJECTIVES

To examine whether coping styles moderate the influence of stressors and psychological well-being in Hong Kong nursing students.

BACKGROUND

Stress could contribute to psychological distress in nursing students. Coping strategies are essential to mitigate psychological distress. So far, the moderating effects of coping between stressors and psychological well-being has not been thoroughly investigated.

DESIGN

This is a cross-sectional study conducted at four higher education institutions in Hong Kong.

METHODS

We recruited a convenience sample of 293 nursing students in February 2018. The Stressors in Nursing Students Scale-Chinese version (SINS-CN), Brief Cope Inventory-Chinese version (Brief COPE-C), and the Chinese version of the General Health Questionnaire-12 (C-GHQ-12) were used to measure the stressors, coping styles, and psychological well-being, respectively. Three multiple hierarchical linear regression models were used to identify the associations between the variables.

RESULTS

The stressors related to clinical learning, confidence, and personal problems were significant in explaining the psychological well-being. The coping strategies also predicted the psychological well-being and explained 44.5% of the variance. The coping strategy-accommodation-moderated the relationship between personal problems and psychological well-being.

CONCLUSION

Problem-solving and accommodation types of coping were adaptive to stress and effective in promoting psychological well-being. However, using accommodation to cope with stressors related to personal problems will exacerbate the negative effects of the personal problems on the psychological well-being.

RELEVANCE TO CLINICAL PRACTICE

This study reveals the relationships between stressors, coping, and psychological well-being. Nurse educators must be aware of nursing student coping styles so they may devise strategies to promote effective coping to reduce the psychological distress among nursing students.

The effect of anxiety on thriving levels of university students during the COVID-19 pandemic

Background

During the COVID-19 pandemic, university students struggle with unexpected changes in their lives, which have adverse effects on their levels of anxiety and thriving. Thriving with its two subdimensions, namely vitality and learning, is a prominent concept for university students due to contributing the academic achievement and wellbeing.

Aim

This study aimed to examine the effect of anxiety on thriving levels of university students during the COVID-19 pandemic.

Methods

An analytical and cross-sectional study was conducted between December 1, 2020 and January 6, 2021. Data were collected using online surveys with convenience sampling method. The sample consisted of 322 university students from a health sciences school of a public university in Turkey.

Findings

The students' anxiety and thriving levels were found to be moderate with 10.38 ± 5.24 and 3.41 ± 0.85, respectively. The results also indicated that anxiety had negative and significant effect on thriving and its subdimensions of vitality and learning. In addition, anxiety level differed significantly according to gender, worried about getting COVID-19 virus and following the COVID-19 cases on a daily basis while thriving level only differed significantly according to the gender.

Discussion

Consistent with previous literature, university students experienced high level of anxiety during the COVID-19 pandemic according to the current study. The students with high level of anxiety had lower vitality and learning scores comparing to their peers with low level of anxiety. This result is crucial, because students with high levels of thriving can cope with stress and feel themselves better psychologically than others.

Conclusion

This study showed that the students exhibited higher anxiety symptoms and had lower levels of thriving. Therefore, interventions, psychological support, and instrumental support are recommended to improve psychological health of university students.

Well-Being in Highly Hypnotizable Persons

Both hypnotizability and well-being are relevant to health. This study aimed to investigate whether high hypnotizability was positively associated with well-being and whether the latter was related to the activity of the behavioral inhibition/approach system (BIS/BAS). ANOVA revealed significantly higher scores on the General Well-Being Index (PGWBI) in highly hypnotizable (highs, n = 31) compared with low hypnotizable participants (lows, n = 53), with medium hypnotizable participants (mediums, n = 41) exhibiting intermediate values. This finding was discussed in relation to other hypnotizability-related traits, such as morpho-functional brain characteristics, equivalence between imagery and perception, and interoceptive sensitivity. A secondary finding was a nonsignificant gender difference in scores on the PGWBI. The highs' higher well-being could be considered a favorable prognostic factor for physical and mental health.

Self-compassion, Resilience, Fear of COVID-19, Psychological Distress, and Psychological Well-being among Turkish Adults

During the COVID-19 pandemic, it is important to examine the variables that may affect the psychological distress and psychological well-being of individuals. This study aims to investigate the mediating effects of psychological resilience, fear of COVID-19, and psychological distress on the relationship between self-compassion and psychological well-being among Turkish adults. The participants of this study were chosen through the convenience sampling method. Participants consist of 617 Turkish adults, 461 (74.7%) females and 156 (25.3%) males. The participants' ages vary between 18 and 24 (M age  = 30.44, SD = 11.45). The relations between variables were examined by bootstrapping procedure. The results showed that self-compassion, resilience, fear of COVID-19, psychological distress, and psychological well-being are significantly inter-correlated. Self-compassion significantly predicts psychological well-being through the mediating factors of resilience, fear of COVID-19, and psychological distress. It was also found that psychological distress is a mediating factor for the relationship between fear of COVID-19, resilience, and psychological well-being. The indirect effects of self-compassion on psychological well-being through mediating variables were found to be significant. Based on the findings, it can be said that self-compassion decreases individuals' psychological distress and increases their well-being by increasing their resilience. Consequently, psychoeducational programs designed to increase self-compassion and resilience can be vital to support individuals' mental health. In light of the literature, the results, implications, and limitations were discussed.

Spanish Version of the Revised Mental Health Inventory-5 (R-MHI-5): New Psychometric Evidence from the Classical Test Theory (CTT) and the Item Response Theory Perspective (IRT)

The study’s objective was to evaluate the psychometric properties of the revised version of the MHI-5, for which a sample of 1002 university students of both sexes (41.4% men and 58.6% women) between the ages of 17 to 35 years (M = 21.4; SD = 3.4) was collected. Along with the R-MHI-5, other instruments were applied to measure anxiety and depression. Regarding the results, it was evidenced that the model with two related factors presents better fit indices (CFI = .99; TLI = .99; RMSEA = .071) compared to a one-dimensional model (CFI = .74; TLI = .48; RMSEA = .422). Also, it was found that the factorial structure of the MHI-5 did not show evidence of being strictly invariant for the group of men and women. However, it did show evidence of partial invariance for the group of adolescents and adults. Furthermore, the latent relationships model showed that psychological well-being is negatively related to anxiety (− .25) and depression (− .37), and psychological distress is positively related to anxiety (.85) and depression (.87). From the IRT perspective, all items present adequate discrimination indices, with item 4 being the most accurate item to assess psychological well-being. Regarding psychological distress, items 3 and 5 are the most accurate to assess this dimension. It is concluded that the scale that the R-MHI-5 is an instrument with robust psychometric evidence from the perspective of CTT and IRT.

Internet Use and Psychosomatic Symptoms among University Students: Cross-Sectional Study

Background: Although the internet facilitates access to a wide range of knowledge and evidence, overuse among young people is associated with lower wellbeing and psychosomatic symptoms. The aim of this cross-sectional study is to explore the relationship between internet use, mental wellbeing, and psychosomatic symptoms among university students in Slovenia. Methods: We used correlation matrix plots to identify correlated symptoms and multivariate logistic regression to analyze the relationship between the time spent on the internet or computer and psychosomatic symptoms controlling for gender. Symptoms were measured using the Health Behavior of School Children scale. Results: Out of 464 students, the majority (64.7%, n = 300) were healthcare students and 35.3% (n = 164) were computer science students. Among somatic symptoms, headaches were associated with more time spent on the computer (r = −0.17, p < 0.001) and were significantly more prevalent in computer science students compared to health science students (χ2(1) = 8.52, p = 0.004). Time spent using the internet for spare time activities was associated with lower nervousness (r = 0.15, p = 0.005). Conclusions: Computer science students reported more frequent psychological symptoms compared to health science students and less somatic symptoms.

Depression, anxiety and stress symptoms in Brazilian university students during the COVID-19 pandemic: Predictors and association with life satisfaction, psychological well-being and coping strategies

Background

The COVID-19 pandemic raises concerns about the mental health of the world population. Protection measures to prevention the disease impacted education and undergraduate students were exposed to additional stressors.

Objectives

Analyze depression, anxiety and stress symptoms in undergraduates, their respective predictors and the association with satisfaction with life, psychological well-being and coping strategies.

Methods

An online cross-sectional study was conducted from September 14 to October 19, 2020, involving undergraduate students enrolled in 33 courses from 5 public university campuses in the state of Parana, Brazil, using: questionnaire with sociodemographic, academic, health and pandemic effects variables; Depression, Anxiety and Stress Scale-21 (DASS-21); Satisfaction with Life Scale (SWLS); Psychological Well-Being (PWB); BriefCOPE. The convenience sample was composed of 1,224 participants, with 18 years old or older, that completed all research instruments. Spearman correlation and logistic analysis (univariate and multivariate) were applied to the collected data.

Results

Most of the undergraduates presented symptoms of depression (60.5%), anxiety (52.5%) and stress (57.5%). Depression, anxiety and stress presented significant correlations in common: negative with satisfaction with life, all dimensions of psychological well-being, and 3 adaptive copings (active coping, planning, positive reframing); positive with 5 maladaptive copings (behavioral disengagement, denial, self-blame, self-distraction, substance use). In addition, there were 7 common predictors for symptoms of depression, anxiety and stress: female; age 18–24 years old; having a chronic disease; lower scores in 2 dimensions of psychological well-being (positive relations with others, self-acceptance); higher scores in 2 maladaptive copings (self-blame, substance use).

Conclusions

The data indicate a high prevalence of symptoms of depression, anxiety and stress, and suggest that higher scores of satisfaction with life, psychological well-being dimensions and adaptive copings may present protective effects in undergraduates during a pandemic crisis.

Resilience as a mediator in the relationship between stress-associated with the Covid-19 pandemic, life satisfaction, and psychological well-being in student nurses: A cross-sectional study

Aim

This study examined the direct and indirect effects of stress associated with the pandemic on student nurses’ life satisfaction and psychological well-being through the intermediary role of resilience.

Background

The coronavirus disease 2019 (COVID-19) outbreak has brought additional stress to those in nursing programs, who were already under high pressure. This has resulted in increased mental and psychological issues in student nurses. The role of resilience as a mediator reducing the effects of pandemic-associated stress on student nurses’ outcomes remains unexplored.

Design

Cross-sectional study.

Methods

This was an online survey that used four standardized scales and was completed by 301 student nurses in the Philippines. The data were collected from September 2020 to October 2020.

Results

Filipino student nurses experienced stress associated with the pandemic at a high level; however, their resilience, life satisfaction and psychological well-being were found to be moderate to high. Increased pandemic-associated stress was associated with reduced life satisfaction and poorer psychological well-being. Further, resilience was found to reduce the negative effects of pandemic-associated stress on the life satisfaction and psychological well-being of student nurses.

Conclusions

This study highlights the importance of building resilience in student nurses during the coronavirus pandemic to sustain their mental and psychological well-being and improve their life satisfaction.

The Impact of Interpersonal Cognitive Distortions on Satisfaction with Life and the Mediating Role of Loneliness

Loneliness and cognitive distortions have serious negative effects on life satisfaction and are seen as related to each other. However, what mediates in these relationships has not been adequately analyzed. This study aims to analyze the effect between cognitive distortions and life satisfaction by asserting the mediating role of loneliness. For this purpose, we conducted a cross-sectional study with 978 people over the age of 20 from various parts of Turkey using a general screening model. Firstly, we analyzed the direct effect of interpersonal rejection, interpersonal misperception, and unrealistic relationship expectation, which are sub-dimensions of cognitive distortions, loneliness, and life satisfaction. Secondly, we analyzed the effects of independent, mediation, and interaction (Loneliness X age) variables on satisfaction with life. Thirdly, we applied direct regression analysis between independent, mediating, and dependent variables to conduct the mediation analysis of the study. Also, we examined age as a moderator between loneliness and life satisfaction. The results showed loneliness as an essential determinant between cognitive distortions and life satisfaction. Moreover, in the moderation analysis, we found some age-related differences between loneliness and life satisfaction. According to this, both loneliness and life satisfaction increased with increasing age. However, life satisfaction decreased as loneliness increased in young people. Being able to compensate for loneliness in the aging process is an essential psychological indicator. Although young people have more opportunities than older people, their ability to cope with negative situations such as loneliness is largely undeveloped. These results showed both psychological and sociological problems of loneliness. Therefore, the results can be useful for the prevention of loneliness and the development of intervention programs.

Sources of Stress and Coping Strategies Among Undergraduate Nursing Students Across All Years

Background

Undergraduate nursing students experience high levels of stress during their programs. The literature on their stress is extensive, however, what is less well-known are the specific sources of stresses for students in different years of study.

Purpose

The aim of this study is to understand nursing students’ sources of stress and coping strategies in each year of study.

Method

A transversal descriptive qualitative study was used. A sample of 26 undergraduate students attending a university in Montreal, Canada were recruited and participated in a semi-structured interview. Data were analysed using inductive thematic analysis.

Results

The sources of stress differed according to year of study and related significantly to the specific novelty of that year. For first-year students, their stress was related to their academic courses. High clinical performance expectations and a lack of time for their personal lives was a main source of stress for second-year students. The prospect of graduating and transitioning into the work environment caused stress for students in their final year. Students across all years of study utilized similar coping strategies.

Conclusion

The findings suggest that interventions can be developed to address the sources of stress experienced by nursing students in each year of study.

A descriptive study of adverse childhood experiences and depression, anxiety, and stress among undergraduate nursing students

BACKGROUND/SIGNIFICANCE

The 10-point Adverse Childhood Experiences (ACEs) score measures childhood exposure to traumatic events. An ACEs score of 4 or higher has been associated with long-term physical and mental health problems, and increased mortality. It is unclear if the rates of undergraduate nursing students experiencing ACEs is different from the general population, and what impact ACEs has on nursing students' depression, anxiety and stress.

PURPOSE

The purpose of this study was to assess the rate of ACEs in nursing students and to examine the relationship between ACEs and perceived depression, anxiety, and stress among undergraduate nursing students.

METHODS

This is a descriptive correlational study to determine Adverse Childhood Experiences (ACEs) scores and Modified Depression Anxiety and Stress Scale (DASS-21) scores for undergraduate pre-licensure students at a private mid-western college. Students' ACEs scores were correlated with DASS-21 scores and demographic data.

RESULTS

409 students volunteered to participate in the study. Seventeen percent of students had high ACEs scores (≥4). Those students with high ACEs scores also scored statically significantly higher on the DASS-21 items relating to depression, anxiety, and stress.

CONCLUSION/IMPLICATIONS

Results from this study demonstrated that many nursing students have experienced ACEs and nursing students with ACEs scores of 4 or higher had higher rates of depression, anxiety, and stress. These findings should drive faculty in nursing programs to acknowledge the prevalence of ACEs among their nursing students and recognize that impact on the mental health of students.

Reliability and Validity of the Chinese Version of the Cognitive Distortions Questionnaire (CD-Quest) in College Students

BACKGROUND The aim of this study was to evaluate the reliability and validity of the Chinese version of the Cognitive Distortions Questionnaire (CD-Quest) among Chinese college students. MATERIAL AND METHODS A total of 460 college students from Jining were recruited in the study. Sample 1, including 239 college students, was tested for item analysis and exploratory factor analysis. Sample 2, including 221 college students, was tested for confirmatory factor analysis and criterion validity. The criterion validity was tested using the Negative Automatic Thoughts questionnaire (ATQ) and Dysfunctional Attitudes Scale (DAS). Test-retest reliability was evaluated in 40 college students from sample 1 with  4 weeks interval. RESULTS The corrected item-total correction (ITC) ranged from 0.675 (emotional reasoning) to 0.829 (unfair comparison). Exploratory factor analysis revealed the variance of the CD-Quest items was unidimensional, and it explained 55.261% of the data variance. Confirmatory factor analysis indicated all regression coefficients were higher than 0.4. The criterion validity was excellent, as shown by the relationships among CD-Quest, DAS, and ATQ (r=0.447, 0.566, respectively). Cronbach's alpha coefficient was 0.941 and the test-retest reliability was 0.928. CONCLUSIONS The Chinese version of CD-Quest had good reliability and validity, suggesting it is a reliable tool to evaluate cognitive distortion of Chinese college students.

Health and Wellbeing in Higher Education: A Comparison of Music and Sport Students Through the Framework of Self Determination Theory

Students in Higher Education report high levels of mental health issues and psychological distress. Paradoxical findings on performance-orientated students, such as athletes and musicians, suggest that the demands of highly skilled vocations may enhance wellbeing while being detrimental to physical and mental health. To provide timely and appropriate help, institutions need to understand what areas of health and wellbeing are compromised in different student groups. In this study, we compared performance-orientated (music and sport) students to other students and the general population on a selection of wellbeing (WHO5, PWS, and WEMWBS), mental and physical health (K10, SF12, and PHQ9), and trait measures (TIPI, LOT-R, and PCS). Through an online survey (N = 273), data were collected from bachelor and master students (n = 135 music, n = 67 sport, n = 71 controls). Students' scores were compared to the general population, where norm values were available, and analyzed within and between groups. Multiple regression was performed to investigate trait measures as predictors of wellbeing. All groups scored significantly below population norms for wellbeing and mental health. One third were classed as having moderate to severe depression. Musicians scored higher openness to experience than athletes. While sport students showed a highly homogenous within-group profile, music students' scores differed significantly across study courses (e.g., performance and composition). Predictors for wellbeing were: optimism and emotional stability (all students); additionally conscientiousness (sport and music); and perceived competence (music only). As expected, students reported more health and wellbeing issues than general population. Distinct profiles of wellbeing were apparent for performance-orientated students. Results are in line with Self Determination Theory and suggest the need for institutions to embed health and wellbeing into a 'living curriculum' to accommodate the needs of different student groups. The WHO5 emerged as a parsimonious yet sensitive measure for mental health and wellbeing in student populations.

The effects of group mindfulness-based cognitive therapy in nursing students: A quasi-experimental study

BACKGROUND

Academic and clinical stressors are experienced by most nursing students enrolled in a nursing education program. The students who cannot effectively deal with these stressors experience stress, anxiety and depression.

OBJECTIVE

The aim of this study was to determine the effects of group mindfulness-based cognitive therapy on mindfulness, depression, anxiety, and stress levels in nursing students.

DESIGN

This quasi-experimental study was carried out using a nonrandomized control group pre-test, post-test, and follow up design.

SETTING

Department of Nursing, Faculty of Health Sciences, University of Aksaray, Turkey.

PARTICIPANTS

Eighty-two second-year undergraduate university nursing students.

METHODS

The group mindfulness-based cognitive therapy program was conducted with the experimental group. The Mindful Attention Awareness Scale (MAAS) and The Depression, Anxiety and Stress Scale (DASS) were measured at pre- and post- intervention, and at a 4-months follow-up.

RESULTS

The post-test mean scores of MAAS of the experimental group were statistically higher than the control group (p = .006). When the mean scores obtained in the pre-test, post-test and follow-up measurements were compared, the mean scores of MAAS increased (p = .000) and stress scores decreased significantly in the experimental group (p = .004).

CONCLUSION

A group mindfulness-based cognitive therapy program conducted with nursing students had an effect on students' mindful attention awareness and stress levels. These study results indicate that this program can be used to reduce the levels of stress in nursing students.