Analysis of anxiety levels and attitudes of nursing students toward the nursing profession during the COVID-19 pandemic

Nursing/midwifery students' perceptions of caring pedagogy and online learning during the COVID-19 pandemic

AIM

This study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID-19 pandemic. In addition, it aimed to determine if the COVID-19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce.

DESIGN

Mixed methods.

METHODS

A multi-centre cross-sectional survey of Australian nursing and midwifery students was undertaken to explore students' experience of learning during the COVID-19 pandemic.

RESULTS

There are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning to practice and healthcare workforce retention. The study found that although students were somewhat satisfied with online learning during COVID-19, students reported significant issues with knowledge/skill acquisition and barriers to the learning process. The students reported feeling less prepared for practice and identified how clinical staff were unable to provide additional guidance and support due to increased workloads and stress. The textual responses of participants highlighted that connection/disconnection, empathy and engagement/disengagement had an impact on learning during COVID-19.

CONCLUSION

Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. In addition, graduates entering the workforce felt less prepared for entry into practice due to changes in education delivery during COVID-19 that they perceived impacted their level of clinical skills, confidence and ability to practice as new graduate nurses/midwives.

PATIENT OR PUBLIC CONTRIBUTION

Not applicable.

IMPACT

Attention must be given to the transition of new graduate nurses and midwives whose education was impacted by pandemic restrictions, to support their professional career development and to ensure retention of future healthcare workforce. Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. Educators should consider how connection and engagement can be actively embedded in the online learning environment.

Experiences of family caregivers of nurses infected with COVID-19: a qualitative study

BACKGROUND

Nurses, as the main healthcare workers during the COVID-19 pandemic, were at high risk of contracting the disease. Family caregivers played a vital role in the support and recovery of patients with COVID-19. The experiences of family caregivers of nurses are very important due to the nature of their job. However, little information is available in this field. To this end, the present study aimed to explore the experiences of family caregivers of nurses who recovered from COVID-19.

METHODS

This descriptive qualitative study was conducted in one of the hospitals in southeastern Iran in 2022. The participants were 12 family caregivers of nurses who recovered from COVID-19 and were selected through purposive sampling. The data were collected through semi-structured interviews and analyzed using conventional content analysis. The Consolidated Criteria for Reporting Qualitative research checklist was used to report the findings.

RESULTS

The analysis of the data revealed psychosocial consequences as main theme, three categories and nine subcategories including negative emotions and attitudes (fear of deterioration/death, fear of frequent infection, fear of transmitting infection to others, despair of recovery, Changing attitudes toward the nursing profession), caregiver burden (role conflict, economic pressure) and lack of support, ineffective interactions and isolation (Lack of support from nursing managers and colleagues, ineffective interactions and isolation).

CONCLUSION

Like other caregivers, family caregivers of nurses recovered from COVID-19 experienced psychosocial consequences and a heavy burden of responsibility. However, what differentiates our findings from the results reported in previous studies is the change in caregivers' attitudes toward nursing and regret for their family members being nurses. The lack of support from medical staff and managers for nurses, the condition of nurses frequently contracting COVID-19 due to the nature of their profession, and the fear of transmitting the infection to others due to contact with COVID-19 patients in the workplace expose these caregivers to additional stress and many risks. Thus, these caregivers need more attention and support in similar situations; an issue that seems to have been neglected during the COVID-19 pandemic.

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

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

Depression and Anxiety among Undergraduate Health Science Students: A Scoping Review of the Literature

Background: Health science students in post-secondary institutions experience high levels of depression and anxiety due to increased stress levels, workload, low socioeconomic status, and history of family mental illness, among other factors. Given the significant negative impact that depression and anxiety can have on undergraduate health science students, it is essential to understand the prevalence and correlation of these conditions in this population. In light of this, this scoping review aims to identify, document, and analyze the literature on the prevalence and determinants of anxiety and depression among undergraduate health sciences students and identify gaps in knowledge for future research. Methods: This scoping review was planned and executed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the Scoping Reviews statement. A comprehensive and systematic search was carried out for five databases, namely MEDLINE, Scopus, EMBASE, CINAHL, and PubMed. Results: From the literature identified by our search strategy, the lowest prevalence for anxiety was 5.8%, and the highest was 82.6%, with a median of 44.25%. The prevalence of depression ranged from a high of 88.8% to a low of 2.1%, with a median value of 34.8%. Our analysis revealed that correlates of anxiety and depression among health science students include sociodemographic factors such as age, sex, gender, relationships, ethnicity, and family history, personal health conditions, and academic and socioeconomic issues. Conclusions: With the high incidence of anxiety and depression among health science students, there is an increasing need to find practical remedies to support these students. It is also essential for policymakers and university authorities to implement interventions such as supportive text messages and other strategies geared toward providing support and improving the psychological well-being of health science students.

Emotional and Psychological Effects of the COVID-19 Pandemic on Nursing Students

ABSTRACT

The COVID-19 pandemic impacted the mental health and educational experiences of nursing students in undergraduate and graduate programs. A larger mixed-methods study aimed to understand how COVID-19 impacted personal lives and learning experiences of students across all programs levels. This article reports on qualitative data obtained from focus groups organized by student program level. Six themes emerged, including fear and uncertainty, trust in God, educational and career concerns, concerns about family, mental health issues, and isolation/lack of human touch. Key areas covered are the emotional and psychological effects of COVID-19 and its factors and the role of faith during COVID-19 among nursing students.

Influence of the Psychological Effect of COVID-19 on Saudi Student Nurses' Attitudes toward Nursing and Their Future Career Plans

BACKGROUND

The effects of COVID-19 on the attitude of student nurses toward the nursing profession remain unclear because few studies have been conducted on this topic. Thus, this study examines the influence of the psychological effects of COVID-19 on student nurses' attitudes toward the nursing profession and their desire to become nurses.

METHOD

The study utilised a quantitative, cross-sectional, and observational design. It surveyed a convenience sample of 726 student nurses in Saudi Arabia during the first semester of the 2021-2022 academic year.

RESULTS

The students reported low levels of COVID-19 fear, anxiety, stress, phobia, and obsession. The students reported positive attitudes toward the nursing profession and 86.0% highlighted their desire to continue with nursing as their future profession. Gender, knowing someone infected with COVID-19, confidence in the government's pandemic response, fear, anxiety, and phobia were significant predictors of the nurses' attitudes. Community, family members in the profession, "COVID-19-related anxiety", and "preference for the nursing profession" were significant predictors of the student's desire to continue nursing.

CONCLUSIONS

Living in a rural community, having family members in the nursing profession, having low levels of COVID-19-related anxiety, and having positive attitudes toward nursing increased the likelihood of nursing students continuing their nursing careers during the COVID-19 pandemic.

Perceived social support and professional identity in nursing students during the COVID-19 pandemic era: the mediating effects of self-efficacy and the moderating role of anxiety

BACKGROUND

Health professionals, including nurses, experienced heavy workloads and significant physical and mental health challenges during the coronavirus disease (COVID) 19 pandemic, which may affect career choices for those considering nursing and for nursing students. The COVID-19 pandemic is not only a period of risk, but also an occasion to redeploy the professional identity (PI) of nursing students. However, the relationship between perceived social support (PSS), self-efficacy (SE), PI and anxiety remains unclear under the background of COVID-19. This study aims to explore whether PSS has an indirect effect on PI through mediation of SE and whether the anxiety can moderate the relationship between PSS and SE in nursing students during their internship period.

METHODS

An observational, national cross-sectional study was conducted following the STROBE guidelines. An online questionnaire was completed by 2,457 nursing students from 24 provinces in China during their internship during September to October 2021. Measures included Chinese translations of the Professional Identity Questionnaire for Nursing Students, the Perceived Social Support Scale, the General Self-Efficacy Scale, the 7-item Generalized Anxiety disorder scale.

RESULTS

Both PSS (r = 0.46, p < 0.001) and SE (r = 0.51, p < 0.001) were positively correlated with PI. The indirect effect of PSS on PI through SE was positive (β = 0.348, p < 0.001), with an effect of 72.7%. The results of the moderating effect analysis showed that anxiety attenuated the effect of PSS on SE. Moderation models indicated that anxiety has a weak negative moderating effect on the effect of PSS on SE (β =-0.0308, p < 0.05).

CONCLUSIONS

A better PSS and higher scores in SE were associated with PI in nursing students, and a better PSS had an indirect effect on the PI of nursing students through SE. Anxiety played a negative moderating role in the relationship between PSS and SE.

How has the COVID-19 pandemic influenced nursing students' academic experience and career choices? A qualitative descriptive analysis

COVID-19 control measures influenced education and training environments and profoundly impacted nursing students' career prospects and academic lives. This study intends to elucidate the impact of the COVID-19 pandemic on nursing students' academic experience and career choices. A qualitative descriptive study was conducted at a 4-year university in Japan, using semi-structured interviews with 14 nursing students. Sandelowski's qualitative descriptive analysis was conducted. We identified 11 categories that summarize COVID-19's influence on students' academic experience and career choices: "Forced change to a new learning system," "Difficult learning thoroughly with restricted face-to-face interactions," "Worries regarding teacher evaluations when face-to-face interactions are restricted," "Adapting to changes in the learning environment," "Finding new ways to learn due to the different learning environment," "Worries regarding career decision-making after losing opportunities to obtain career information," "Fully utilizing limited information resources in deciding where to work while being influenced by others," "Coping with a confusing new job hunting system," "Worries about becoming a nurse without enough practical experience," "Conscious of working as a nurse while facing infections," and "Support from those around me is helpful in an unfamiliar environment." The categories comprised four elements: academic impact, employment/career impact, future impact on working as a nurse, and environmental support. Building an online education/training program, ensuring the availability of regular psychological support, providing abundant information on employment, installing an information desk, and providing regular feedback were considered imperative for supporting nursing students.

The link among academic stress, sleep disturbances, depressive symptoms, academic performance, and the moderating role of resourcefulness in health professions students during COVID-19 pandemic

Background

The rapid shift to virtual learning in response to the COVID-19 pandemic contributed to high academic stress among health profession students. High academic stress was associated with impaired psychosocial well-being and decreased academic performance.

Objectives

The purpose of this study was to assess the relationship between academic stress, anxiety, sleep disturbances, depressive symptoms, academic performance, and the moderating effect of resourcefulness among undergraduate health profession students.

Methods

This descriptive and cross-sectional study included undergraduate health profession students. The primary investigator distributed the study link to all students through the university's Central Messaging Centre, Twitter account, and WhatsApp. The study variables were measured using the Student Life Stress Inventory, the Generalized Anxiety Disorder-7 questionnaire, the Centre for Epidemiology Scale of Depression, the Pittsburgh Sleep Quality Index, and the Resourcefulness Skills Scale. Pearson R correlation and linear regression analysis were utilized for statistical analysis.

Results

Our sample included 94 undergraduate health profession students, 60 % of which were females with a mean age of 21, and the majority were nursing and medicine students. High academic stress, anxiety, sleep disturbances, depressive symptoms, and resourcefulness were reported among 50.6 %, 43 %, 79.6 %, 60.2 %, and 60 % of the participants, respectively. However, no effect of resourcefulness was found on any of the study variables. Instead, academic stress and sleep disturbances were the strongest predictors of depressive symptoms regardless of the level of resourcefulness.

Conclusion

Adequate academic support during virtual learning and tools to early detect subtle signs of high academic stress, anxiety, depression, and sleep disturbance should be routinely utilized by educational institutions. In addition, incorporating sleep hygiene and resourcefulness training in health professions education is highly indicated.

Could Intern Health Care Students Control Their Emotions and Make a Career Plan During the COVID-19 Pandemic?

The negative effects of the pandemic caused students to make changes in their career plans and their ability to manage their emotional states. Not only health students in our country, but also students in other countries of the world experienced fear, anxiety, and unwillingness to participate in professional practices and the provision of care for patients with COVID-19 during the COVID-19 pandemic. The study was conducted to determine factors influencing intern healthcare students' career adaptability and their ability to manage emotions during the COVID-19 pandemic. The sample of this cross-sectional study consisted of 219 intern healthcare students studying at the Faculty of Health Sciences Undergraduate Program of a University in the fall semester of the 2020 to 2021 academic year. The study data were collected online using the Personal Information Form, Career Adapt-Ability Scale (CAAS), and Courtauld Emotional Control Scale (CECS). The data obtained were analyzed by using the independent samples t-test, Analysis of Variance (ANOVA), correlation tests, and the regression model to distinguish variables significantly. Two models explained more than 50% of the variance of CAAS and CECS regarding COVID-19, and 5.1% of the career planning regarding the period during the COVID-19 pandemic (P < .05). As the students' control over their careers decreased during the COVID-19, their feelings of anxiety and unhappiness increased (P < .05). Of the variables, sex, department, future expectations, the position dreamed of being in after graduation, and attitudes toward patient care with COVID-19 affected their CAAS and CECS scores.

Nursing Student and Faculty Narratives During COVID-19 Pandemic: Challenges and Recommendations From a Canadian Perspective

Introduction

Worldwide, COVID-19 affected nursing students' and faculty's mental and physical health. The final clinical placement for fourth-year nursing students during the third wave of COVID-19 in Toronto, Canada, included direct patient care without vaccination eligibility. Students' experiences during the pandemic and faculty exposure to teaching and supporting them provide unique reflective opportunities.

Objective

To examine the lived experiences of nursing students and faculty during the third wave of the COVID-19 pandemic.

Methods

The study used a qualitative phenomenological design with thematic analysis. A voluntary response sample of 80 participants shared their narratives of working and teaching during January to May 2021. An optional interview guide offered open-ended questions requiring reflection. The study was conducted in a nursing school in Toronto, Canada during fourth-year baccalaureate students final clinical placement settings.

Results

A total of 77 fourth-year baccalaureate nursing students and three faculty members participated. Thematic analysis of nursing student narratives identified four main themes: (i) fear and anxiety of COVID-19 during clinical practice; (ii) impact on students' learning environments; (iii) intrinsic and extrinsic factors that enabled students to persevere; and (iv) how to deal with future pandemics. Thematic analysis of faculty narratives identified three main themes: (i) the importance of preparatory work; (ii) psychological and physical manifestations of supporting students; and (iii) the resilience of students and faculty.

Conclusion

Future disease outbreaks and other large-scale health events will require nurse educators to understand and plan strategies for both themselves and students practicing in high-risk clinical settings. Nursing schools should rethink all fourth-year students' experiences, perceptions, and feelings to minimize their susceptibility to physical and psychological distress.

The effect of mindfulness-based mandala activity on anxiety and spiritual well-being levels of senior nursing students: A randomized controlled study

PURPOSE

This study aimed to determine the effectiveness of mindfulness-based mandala activity on the anxiety levels and spiritual well-being of nursing students who started clinical practice after distance education during COVID-19 period.

DESIGN AND METHODS

This study is a randomized controlled study employing a pre-/posttest design with a single-blind, parallel group. The study was completed with a total of 170 participants (n = 84, intervention group; n = 86, control group). Data were collected using the Descriptive Characteristics Form, State-trait Anxiety Inventory, Spirituality Well-Being Scale, and Scale of Positive and Negative Experience. The intervention group participated in three mindfulness-based mandala sessions. This study was registered with ClinicalTrials.gov as NCT05053178.

FINDINGS

In three sessions, there was a significant decrease in the intervention group compared with the control group regarding the mean values of pretest and posttest anxiety levels. Evaluation of the mean scores Spiritual Well-Being Scale before and after the intervention showed a significant decrease in the scores between groups (p < 0.05).

PRACTICE IMPLICATIONS

With mindfulness-based mandala activity, the well-being of nursing students can be increased.

Impact of COVID-19 on Nursing Students: Factors Associated with PTSD Risk

ABSTRACT

The COVID-19 pandemic rapidly transformed nursing education, creating multiple stressors for students. The researchers in this study examined how undergraduate and graduate nursing students at a faith-based university perceived the impact of COVID-19. A multiple linear regression model explored the effect of 17 variables on the Impact of Events Scale-Revised (IES-R) scores. Anxiety level, quality of sleep, and perceived health demonstrated a statistically significant influence on IES-R scores; 27% of students had IES-R scores above 33, indicating high risk for posttraumatic stress disorder. Strategies to help address student stress and anxiety are discussed.

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.

The Influence of Family Function on Occupational Attitude of Chinese Nursing Students in the Probation Period: The Moderation Effect of Social Support

PURPOSE

The purpose of this study was to explore the factors influencing the occupational attitudes of nursing students in the probation period.

METHODS

Nursing students in the probation period from five hospitals completed an anonymous survey. The instruments included the nursing occupational attitude scale, family adaptability, partnership, growth, affection, and resolve index, and perceived social support scale. The study examined the moderation model between family function, perceived social support, and occupational attitudes using PROCESS 3.2.

RESULTS

For nursing students, when social support was low, family function had a significant positive impact on occupational attitudes and intentions, and the effect was much higher than that of perceived social support.

CONCLUSION

Family function has a significant positive explanatory effect on attitude and intention (β = .13, p < .001 and β = .12, p < .001); the interaction term between family function and perceived social support are significant (β = .01, p < .001 and β = .01, p < .001). Perceived social support has a significant moderating effect on the relationship between family function and occupational attitudes of nursing students in the probation period. Family function has a significant difference in the occupational attitudes and intentions of nursing students with low perceived social support. Nursing students perceive social support in the probation period has a significant moderation effect in the relationship between their family function and occupational attitudes. Interns with low family function should be given more social support to improve their occupational attitudes.

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.

Analysis of anxiety levels and attitudes of nursing students toward the nursing profession during the COVID-19 pandemic

PURPOSE

This study was conducted to analyze the anxiety levels and attitudes of nursing students for the nursing profession during the COVID-19 pandemic.

METHODS

Data collection forms were sent online to nursing students of three different state or foundation universities in Turkey. In all, 456 individuals who answered the data collection forms were included in the study.

FINDINGS

Study results revealed that the total average score for the "Attitude Scale for Nursing Profession" was 162 ± 15.6. The Professional characteristics subdimension score average was 80.64 ± 7.02. Furthermore, the state of choosing nursing profession subdimension score average was 50.05 ± 9.23, whereas the Attitude for the general status of nursing profession subdimension score average was 34.38 ± 2.97. Due to the pandemic, anxiety levels for the nursing profession were 4.86 ± 2.76 (between 0 and 10). It was determined that nursing students who studied in cities where the virus was very common had a more positive attitude toward the profession. Anxiety levels of nursing students studying in cities where the virus impact was moderate and in cities where the virus presence was quite common were higher (p > 0.05). PRACTICAL IMPLICATIONS: It was found that nursing students had a positive and high-level attitude toward the nursing profession. Furthermore, the results demonstrated that attitudes toward the nursing profession decreased significantly as anxiety increased.

An Examination of the Relationship between Fear of Coronavirus (COVID-19) in First Year Nursing Students and Their Attitudes to the Profession

This study was conducted with the aim of determining the fear of coronavirus (COVID-19) and attitudes to the profession in first year nursing students, and examining the relationship between them. The descriptive study was conducted in April and May 2021 with first year students at the Nursing Department of Bursa Uludağ University. The research sample consisted of 156 students who participated voluntarily in the study. A Student Description Form, a Coronavirus (COVID-19) Fear Scale and an Attitude Scale for the Nursing Profession were used to collect research data. It was found that the nursing students included in the study had mean scores of 161.49±19.54 on the Attitude Scale for the Nursing Profession (ASNP) and 17.50±5.87 on the COVID-19 fear scale, and that there was a significant positive correlation between the two scores. The means scores on the ASNP and COVID-19 Fear Scale of female students and of students who experienced fear during the pandemic were significantly higher than those of other students (p<0.05). It was also determined that the attitude scores of students who had chosen the nursing department willingly were significantly higher than those of other students (p<0.05).