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García-Rivas A, Martos-Cabrera MB, Membrive Jiménez MJ, Aguayo-Estremera R, Suleiman Martos N, Albendín-García L, Gómez-Urquiza JL. Anxiety in Nursing Students during the COVID-19 Pandemic: Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:1575. [PMID: 39201134 PMCID: PMC11353448 DOI: 10.3390/healthcare12161575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 08/04/2024] [Accepted: 08/05/2024] [Indexed: 09/02/2024] Open
Abstract
OBJECTIVES To analyse the influence of the COVID-19 pandemic on the development of anxiety in nursing students and the factors involved. DESIGN A systematic review and meta-analysis. DATA SOURCE PubMed, CINAHL, Scopus and Web of Science. BACKGROUND Nursing students are at an increased risk of developing mental overload, due to the presence of many sources of stress during their academic training. Therefore, the COVID-19 pandemic has had an impact on the mental health of the general population, especially on healthcare workers and consequently on students undertaking placements in healthcare settings. METHODS A systematic review was conducted using PubMed, CINAHL, Scopus and Web of Science databases. A total of 24 articles were included in the review, and 20 articles were selected for the meta-analysis. RESULTS We found that the anxiety scores of nursing students during the COVID-19 pandemic were slightly higher (50%) than before the pandemic. The most influential risk factors for developing anxiety were academics, age, gender, having children, living in urban areas or with family, having an addiction to social networks, and having a fear of becoming infected with COVID-19. Resilience, spiritual support and feelings of happiness protected students against the risk of developing high levels of anxiety. CONCLUSIONS The COVID-19 pandemic has led to increased levels of anxiety in nursing students. Thirty-five percent of the meta-analytically analysed sample had elevated levels of anxiety.
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Affiliation(s)
- Aroa García-Rivas
- Hospital Quirón Salud Sagrado Corazón, C. Rafael Salgado, 3, 41013 Sevilla, Spain
| | - María Begoña Martos-Cabrera
- San Cecilio Clinical University Hospital, Av. Del Conocimiento s/n, Andalusian Health Service, 18071 Granada, Spain
| | | | - Raimundo Aguayo-Estremera
- Department of Psychobiology and Methodology in Behavioral Sciences, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain
| | | | - Luis Albendín-García
- Casería de Montijo Health Center, Granada Metropolitan District, Andalusian Health Service, Calle Joaquina Eguaras nº 2, Edificio 2 1ª Planta, 18013 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
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Luz CSDS, Fonseca AETPD, Santos JS, Araujo JF, Duarte LL, Moreno CRDC. Association of Meal Timing with Sleep Quality and Anxiety According to Chronotype: A Study of University Students. Clocks Sleep 2024; 6:156-169. [PMID: 38534799 DOI: 10.3390/clockssleep6010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/03/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
There are several determinants of mental health symptoms, ranging from individual characteristics to social factors. Consistent with patterns in the general population, students with evening characteristics tend to exhibit more anxiety symptoms and poorer sleep quality compared to morning students. Meal timing also appears to affect sleep and may be associated with mental health symptoms. In this context, the aim of the present study was to investigate the association of the timing of the main and last meals of the day with sleep quality and anxiety levels, according to the chronotype of university students. This study was conducted in colleges in São Paulo, Brazil, and involved application of a questionnaire to 162 university students. The questionnaire collected sociodemographic information meal and study times, and included scales assessing eveningness and morningness, sleep quality, and anxiety. Students demonstrating a phase delay in both chronotype and dinner timing exhibited higher levels of anxiety compared to morning-type students. Although no associations were observed between meal timing and sleep quality, sleeping later was associated with poorer sleep quality. The study suggests that evening students and those who eat late at night are more prone to presenting mental health symptoms. More studies are needed to further investigate this association.
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Affiliation(s)
- Cristina Souza da Silva Luz
- Department of Health, Life Cycles, and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | | | - Jefferson Souza Santos
- Department of Health, Life Cycles, and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
- Department of Theory and Foundations of Education, Education Sector, Federal University of Paraná, Curitiba 80230-130, Brazil
| | - John Fontenele Araujo
- Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal 59078-900, Brazil
| | - Leandro Lourenção Duarte
- Department for Health Sciences, Federal University of Recôncavo da Bahia, Cruz das Almas 44380-000, Brazil
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Ramón-Arbués E, Sagarra-Romero L, Echániz-Serrano E, Granada-López JM, Cobos-Rincón A, Juárez-Vela R, Navas-Echazarreta N, Antón-Solanas I. Health-related behaviors and symptoms of anxiety and depression in Spanish nursing students: an observational study. Front Public Health 2023; 11:1265775. [PMID: 38179570 PMCID: PMC10764461 DOI: 10.3389/fpubh.2023.1265775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Background Symptoms of anxiety and depression are prevalent among young adults and are a significant public health issue. College students are at a higher risk of experiencing poor mental health than other young people due to several factors, including moving away from home, financial pressures, heavy workload, poor time management skills, competitivity, new processes of socialization and insufficient coping mechanisms, among others. In addition, nursing students' mental and physical health may also be affected by unhealthy lifestyle habits and health-related behaviors. Aim To determine the prevalence of symptoms of depression and anxiety, and the association between these symptoms and health-related behaviors, in a population of Spanish student nurses. Methods Cross-sectional study on a sample of 339 nursing students. We used the Hospital Anxiety and Depression Scale, the International Physical Activity Questionnaire-Short form, the Spanish Healthy Eating Index and an "ad hoc" questionnaire for sociodemographic variables. The association between psychological symptoms and health-related behaviors was analyzed through binary logistic regression models. Results The prevalence of symptoms of depression and anxiety was 3.8% and 24.5%, respectively. Negative health-related behaviors were frequent, namely tobacco and alcohol consumption, suboptimal physical activity and diet. Moderate physical activity was associated with a lower probability of experiencing depressive symptoms. Symptoms of anxiety were related to a low level of physical activity, an unhealthy diet and alcohol consumption ≥2 times a week. Conclusion Student nurses could benefit from the implementation of both physical and mental health promotion initiatives.
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Affiliation(s)
- Enrique Ramón-Arbués
- Universidad San Jorge, Faculty of Health Sciences, Zaragoza, Spain
- SAPIENF Research Group, University of Zaragoza, Zaragoza, Spain
- GAIAS Research Group, University San Jorge, Zaragoza, Spain
| | - Lucía Sagarra-Romero
- Universidad San Jorge, Faculty of Health Sciences, Zaragoza, Spain
- GAIAS Research Group, University San Jorge, Zaragoza, Spain
| | - Emmanuel Echániz-Serrano
- SAPIENF Research Group, University of Zaragoza, Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, Faculty of Health Sciences, Zaragoza, Spain
| | - José Manuel Granada-López
- SAPIENF Research Group, University of Zaragoza, Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, Faculty of Health Sciences, Zaragoza, Spain
| | - Ana Cobos-Rincón
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Noelia Navas-Echazarreta
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Isabel Antón-Solanas
- SAPIENF Research Group, University of Zaragoza, Zaragoza, Spain
- Department of Physiatry and Nursing, University of Zaragoza, Faculty of Health Sciences, Zaragoza, Spain
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Agyapong-Opoku G, Agyapong B, Obuobi-Donkor G, Eboreime E. Depression and Anxiety among Undergraduate Health Science Students: A Scoping Review of the Literature. Behav Sci (Basel) 2023; 13:1002. [PMID: 38131858 PMCID: PMC10740739 DOI: 10.3390/bs13121002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
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.
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Affiliation(s)
- Gerald Agyapong-Opoku
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Gloria Obuobi-Donkor
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada (E.E.)
| | - Ejemai Eboreime
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada (E.E.)
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Ramón-Arbués E, Granada-López JM, Satústegui-Dordá PJ, Echániz-Serrano E, Sagarra-Romero L, Antón-Solanas I. Psychological distress in nursing students: relationship with screen time, diet and physical activity. Rev Lat Am Enfermagem 2023; 31:e3959. [PMID: 37493726 PMCID: PMC10370156 DOI: 10.1590/1518-8345.6746.3959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/08/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE to determine the prevalence of anxiety and depression symptoms, as well as their association with screen time, diet and physical activity, in a cohort comprised by nursing students. METHOD a descriptive and cross-sectional study conducted with a sample of 648 Nursing students. The instruments used were the Hospital Anxiety and Depression Scale, the short version of the International Physical Activity Questionnaire and the Spanish Healthy Eating Index (Índice de Alimentación Saludable Español, IASE). Different multiple linear regression models were performed to analyze the association between anxiety/depression symptoms and screen time, diet and physical activity. RESULTS the prevalence values for anxiety and depression symptoms were 24.1% and 3.7%, respectively. Prolonged screen times (>6 hours a day), low levels of physical activity and inadequate diet were independently and significantly associated with deeper psychological symptoms. CONCLUSION Nursing students' mental health might benefit from the implementation of initiatives promoting healthy lifestyles.
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Affiliation(s)
- Enrique Ramón-Arbués
- Universidad San Jorge, Facultad de Ciencias de la Salud, Villanueva de Gállego, Aragón, España
| | | | | | | | - Lucía Sagarra-Romero
- Universidad San Jorge, Facultad de Ciencias de la Salud, Villanueva de Gállego, Aragón, España
| | - Isabel Antón-Solanas
- Universidad de Zaragoza, Facultad de Ciencias de la Salud, Zaragoza, Aragón, España
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Martínez‐Vázquez S, Martínez‐Galiano JM, Peinado‐Molina RA, Hernández‐Martínez A. Magnitude of general anxiety disorder among nursing students and its associated factors. Health Sci Rep 2023; 6:e1405. [PMID: 37455708 PMCID: PMC10338764 DOI: 10.1002/hsr2.1405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/02/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
Background University training in nursing together with other student variables can increase the risk of anxiety in students. It is important to assess the student's level of anxiety, which can have repercussions on their training and mental health. There are several validated tools such as the generalized anxiety disorder scale (GAD-7). Objective To know which factors are associated with the appearance of anxiety and which protect against it in university nursing students. Method A cross-sectional descriptive study was carried out in which 170 university nursing students from University of Jaén participated. A bivariate and multivariate analysis was performed, calculating odds ratio and adjusted odds ratio (aOR) with 95% confidence intervals (CIs) to determine which factors were associated with a higher score on the GAD-7 questionnaire, and therefore with the presence of anxiety. Results In total, 66.5% (113) of the students have suffered an anxiety crisis on some occasion and 48.8% (83) of the students did not carry out activities of any kind to control anxiety and stress. Practicing religious and spiritual beliefs increased the probability of having anxiety compared to those who did not have religious beliefs (aOR = 3.92; 95% CI = 1.09, 14.08), as well as having previously suffered an anxiety crisis (aOR = 5.13; 95% CI = 2.39, 11.04). Protective factors against anxiety appear to be second-year students (aOR = 0.33; 95% CI = 0.16, 0.72) and being deeply satisfied with the teaching staff (aOR = 0.03; 95% CI = 0.01, 0.79). Discussion/Implications for practice Knowing the factors that are associated with the appearance of anxiety is necessary to facilitate early detection and care in nursing university students.
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Affiliation(s)
| | - Juan Miguel Martínez‐Galiano
- Department of NursingUniversity of JaenJaenSpain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | | | - Antonio Hernández‐Martínez
- Department of NursingFaculty of Nursing of Ciudad Real, The University of Castilla‐La ManchaCiudad RealSpain
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de Freitas PHB, Meireles AL, Ribeiro IKDS, Abreu MNS, de Paula W, Cardoso CS. Symptoms of depression, anxiety and stress in health students and impact on quality of life. Rev Lat Am Enfermagem 2023; 31:e3884. [PMID: 37075384 PMCID: PMC10208634 DOI: 10.1590/1518-8345.6315.3884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 11/06/2022] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE to evaluate the association between quality of life and presence of symptoms of depression, anxiety, and stress in college students in the health area. METHOD cross-sectional study that included 321 students from undergraduate courses in the health area. Quality of life was measured using the World Health Organization scale, abbreviated version, in the physical, psychological, social relations and environment domains, and symptoms were assessed by the depression, anxiety and stress scale. Multivariate analysis was performed using robust linear regression to evaluate the association between quality of life and symptoms. RESULTS a negative association was observed between the quality of life and depression symptoms in all domains, while anxiety symptoms showed a negative association in the environment domain, and stress symptoms had a negative association in the psychological domain. Symptom severity was unfavorably associated with quality of life, that is, the greater the symptom severity, the lower the mean scores in all domains. CONCLUSION symptoms of depression, anxiety, and stress were prevalent and had a negative impact on students' quality of life, especially in the presence of depressive symptoms. The decrease in scores was significantly associated with the severity of symptoms.
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Affiliation(s)
| | - Adriana Lúcia Meireles
- Universidade Federal de Ouro Preto, Departamento de Nutrição Clínica e Social, Ouro Preto, MG, Brasil
| | | | - Mery Natali Silva Abreu
- Universidade Federal de Minas Gerais, Departamento de Gestão em Saúde, Belo Horizonte, MG, Brasil
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