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

An Exploration of Student Nurses' Experiences of Burnout during the COVID-19 Pandemic Using the Copenhagen Burnout Inventory (CBI)

Burnout amongst healthcare professionals has been a long-considered condition associated with the workplace environment. Student nurses studying at Sheffield Hallam University continued to engage in their training during the COVID-19 pandemic; however, the stressors of this experience were anecdotally highlighted to their academic staff. Furthermore, burnout can be linked to the ongoing difficulties with recruitment and retention of nursing staff within the NHS workforce. This work aimed to determine the burnout among nursing students experience by obtaining quantitative data to understand their experiences. The Copenhagen Burnout Inventory was used to gauge levels of burnout across the different fields of nursing students. Results identified that: (1) mental health students reported feeling tired significantly less often than child and adult field students (mean rating of 69% versus 91.7% and 84.0%, respectively); (2) students aged 30-39 feel tired significantly less often than both younger student age groups (mean rating 59.4% versus 82.8% and 90.6%); (3) there was a significant difference in how often different age groups felt "tired of working with clients" (F(4) = 2.68, p = 0.04) and that "they couldn't take it anymore" (F(4) = 2.53, p = 0.05); (4) child-field students reported generally higher levels of global burnout (mean CBI total = 57.9%) whilst mental health students reported lower levels (mean CBI total = 54.1%). Considering these results, it is imperative for both higher education institutions and potential employers to consider the impact of COVID-19 and burnout, and the levels of support offered to student nurses during their training and transition to practice as newly qualified nurses.

Stress Impact and Care for COVID-19: Pilot Education and Support Course Decreases Burnout Among Nursing Students

BACKGROUND

Nurses and nursing students have been at the forefront of the fight against COVID-19, often working in conditions that produce stress injuries and burnout. Early recognition and mitigation of stress and emotional trauma help prevent burnout.

AIMS

To evaluate the effectiveness of an online 8-hour stress awareness course and associated 1-hour support group in reducing stress and burnout among nursing students.

METHODS

We conducted a program evaluation for an online stress awareness pilot course offered to nursing students. The course, and associated support groups led by trained psychiatric mental health nurse practitioner students, included a common language for talking about stress, screening tools for recognizing stress injuries, and strategies for improving self-care. Students completed pre- and post-course surveys. Outcome measures included changes on course learning objectives, level of burnout, health-related locus of control, and experiences of stress and coping.

RESULTS

Nursing students (n = 360) enrolled in the course, and 224 (62%) completed pre- and post-course surveys. Sixty percent rated the course excellent or very good. Depression Anxiety and Stress Scales and Impact of Event Scale Revised scores were within established normal ranges. There was a significant increase in all nine course learning objectives (p < .001) and decreased signs of stress (p < .001). Students' level of burnout decreased by odds ratio = 0.58 (95% CI: [0.4, 0.9], p < .006).

CONCLUSIONS

Nursing leaders can use psychoeducational strategies to mitigate the impact of stress, build confidence, and support nursing students entering the workforce during these unprecedented times.

Relationship between Anxiety, Depression and Learning Burnout of Nursing Undergraduates after the COVID-19 Epidemic: The Mediating Role of Academic Self-Efficacy

BACKGROUND

Although cross-sectional studies on the learning status of nursing undergraduates during the COVID-19 epidemic have surged, few studies have explored the normalization of COVID-19 on students' learning burnout and mental health. The study was designed to investigate the learning burnout of nursing undergraduates in school under the normalization of the COVID-19 epidemic and explore the hypothesized mediation effect of academic self-efficacy in the relationship between anxiety, depression and learning burnout in Chinese nursing undergraduates.

METHODS

A cross-sectional study was conducted among nursing undergraduates in the school of nursing of a university in Jiangsu Province, China (n = 227). A general information questionnaire, College Students' Learning Burnout Questionnaire, Generalized Anxiety Disorder Scale (GAD-7), and Patient Health Questionnaire depression scale (PHQ-9) were administered. Descriptive statistical analysis, Pearson correlation analysis, and multiple linear regression analysis were performed via SPSS 26.0. Process plug-in (Model 4) was used to test the mediating effect of academic self-efficacy (bootstrap 5000 iterations, α = 0.05).

RESULTS

Learning burnout (54.1 ± 0.656) was positively correlated with anxiety (4.6 ± 0.283) and depression (5.3 ± 0.366) (p < 0.01) and was negatively correlated with academic self-efficacy (74.41 ± 0.674) (p < 0.01). Academic self-efficacy plays a mediating role between anxiety and learning burnout (0.395/0.493, 80.12%) and a mediating role between depression and learning burnout (0.332/0.503, 66.00%).

CONCLUSION

Academic self-efficacy has a significant predictive effect on learning burnout. Schools and teachers should strengthen the screening and counselling of students' psychological problems, detect learning burnout caused by emotional problems in advance and improve students' initiative and enthusiasm for learning.

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.

Coronavirus and Health Anxiety of Nursing Students in Two Different Countries

INTRODUCTION

Even under normal circumstances, anxiety is quite common among nursing students. Therefore, this study compared nursing students' health and coronavirus anxiety in two European countries.

METHOD

The sample of the descriptive, cross-sectional study consisted of 685 undergraduate students studying at two different nursing schools in Turkey and Portugal. The study data were collected with the Personnel Data Collection Form, Coronavirus Anxiety Scale, and Short Health Anxiety Inventory.

RESULTS

While there was no difference between the Coronavirus Anxiety Scale scores of Turkish and Portuguese nursing students (p > .05), a statistically significant difference was found between the Short Health Anxiety Inventory total scores and negative consequences scores (p < .05).

DISCUSSION

Against the pandemic that the whole world is experiencing, it is recommended to compare nursing students in a cultural context and take precautions.

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.