Impacts of Coping Mechanisms on Nursing Students' Mental Health during COVID-19 Lockdown: A Cross-Sectional Survey

Fostering Improved Mental and Spiritual Health of Nursing Students During COVID and Beyond

ABSTRACT

Nursing school is a highly stressful experience for most nursing students. The COVID-19 pandemic intensified stress levels for undergraduate students with serious impacts on mental health. Faculty acted to provide solutions such as debriefings and fostering safe places inside and outside of class where students could release negative emotions and develop positive coping skills. The integration of faith and the caring outreach by the faculty also strengthened students' emotional, mental, and spiritual health.

Supporting Mental Health Well-Being in the Most Vulnerable Future Nurses

AIM

The aim of the study was to explore relationships between perceived faculty support and prevalence of severe/extremely severe depression, anxiety, and stress levels among undergraduate baccalaureate nursing students.

BACKGROUND

Emerging research supports nursing students suffering from extreme psychological distress. Educational success and mental health wellness are influenced by external support.

METHOD

A mixed-methods design was used for this descriptive, cross-sectional study. A national convenience sample of 1,163 undergraduate baccalaureate nursing students completed the Depression, Anxiety and Stress Scale-21, Perceived Faculty Support Scale, and a demographic questionnaire. Emerging themes in the qualitative data were identified.

RESULTS

Nearly 54 percent of nursing students suffered from severe/extremely severe depression, anxiety, or stress. Faculty support was critical to nursing student mental health well-being.

CONCLUSION

This multisite study provides a better understanding of the enormity of psychological distress among undergraduate baccalaureate nursing students and emphasizes the immediate need for faculty to provide necessary support to this vulnerable student population.

Anxiety in Nursing Students during the COVID-19 Pandemic: Systematic Review and Meta-Analysis

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.

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

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

Promoting Nursing Student Mental Health Wellness: The Impact of Resilience-Building and Faculty Support

BACKGROUND

Being aware of elevated levels of student psychological distress by nursing faculty, and subsequently responding to it, may diminish nursing students' experience of negative mental health well-being.

PURPOSE

Relationships between perceived faculty support, resiliency, and the prevalence of depression, anxiety, and stress among undergraduate nursing students were explored.

METHODS

An exploratory mixed-methods design was used for this descriptive, cross-sectional study. The Depression, Anxiety, and Stress Scale-21, Brief Resilience Scale, Perceived Faculty Support Scale, a demographic questionnaire, and open-ended questions were used to collect data. A convenience sample of 989 undergraduate baccalaureate nursing students from across the United States completed the surveys.

RESULTS

Study results revealed resilience strategies and psychological and functional supportive faculty behaviors and actions are substantial predictors of lower depression, anxiety, and stress in undergraduate baccalaureate nursing students.

CONCLUSIONS

Investments in faculty development to support nursing student resilience may reduce the degree of negative mental health well-being that students exhibit related to nursing education and promote their successful transition to nursing practice.

Family functioning in students of health sciences in four Latin American countries: a study of the structure and factorial invariance of the FACES III scale. A cross-sectional study

BACKGROUND

Psychometric studies of the FACES III scale in Spanish-speaking countries show a lack of agreement on the factorial structure of the scale. In addition, most of the studies have only performed exploratory analyses of its factorial structure.

OBJECTIVE

The objective of the present study was to confirm the structure and factorial invariance of the FACES III scale in nursing and obstetric students from Chile, Colombia, Peru, and Mexico.

METHODS

A total of 3303 students from the four countries participated in this study (Colombia = 1559, Chile = 1224, Peru = 215, Mexico = 305).

RESULTS

The results of the study showed that the Bi-factor model presents the best-fit indexes to the data from Colombia, Chile, and Mexico, but not from Peru. In addition, it was found that this model showed evidence of being strictly invariant among the three countries in the sequence of the invariance models proposed: metric invariance (ΔRMSEA = .000), scalar (ΔRMSEA = .008), and strict (ΔRMSEA = .008). The bi-factor model also showed adequate reliability indexes in the three countries.

CONCLUSION

It is concluded that the FACES III scale shows adequate psychometric performance under a bi-factor model in nursing and obstetric students from Colombia, Chile, and Mexico. The lack of fit of the model in Peru could be associated with the small sample size.

Evaluation of the psychometric properties of the family adaptability and cohesion scale (FACES III) through item response theory models in students from Chile and Colombia

BACKGROUND

A psychometric study of the Family Adaptability and Cohesion Scale (FACES III) has been conducted in Spanish-speaking countries from the perspective of the classical test theory. However, this approach has limitations that affect the psychometric understanding of this scale.

OBJECTIVE

Accordingly, this study used the item response theory to investigate the psychometric performance of the items. Furthermore, it evaluated the differential performance of the items for Colombia and Chile.

METHOD

For this purpose, 518 health science students from both countries participated. Confirmatory Factor Analysis was used.

RESULTS

The study results revealed that the cohesion and adaptability items presented adequate discrimination and difficulty indices. In addition, items 5, 8, 13, 17, and 19 of cohesion indicated differential functioning between students from both countries, with Chilean students exhibiting a greater discriminatory power. Further, the Colombian group exhibited a greater discriminatory power for item 18 of adaptability.

CONCLUSIONS

The study concluded that the items of FACES III indicated adequate psychometric performance in terms of their discriminative capacity and difficulty in Chile and Colombia.

Student-Led Stress Reduction Support Groups: A Qualitative Program Evaluation

BACKGROUND

Burnout and attrition in nursing have been accelerated by the coronavirus disease 2019 (COVID-19) pandemic. Nursing students experience greater stress than non-nursing students but often lack adequate institutional support to build resiliency. Support groups are an effective strategy for processing stress that are underused in nursing education. An innovative online stress impact course was developed at a college of nursing to address students' stress during the pandemic. The course culminated in a voluntary virtual support group led by a Psychiatric Mental Health Nurse Practitioner graduate student. The aim of this qualitative program evaluation was to determine how graduate nursing students experienced the stress support group.

METHOD

This study used qualitative exploratory analysis of support group reflections from 47 graduate nursing students.

RESULTS

Four themes emerged: (1) Making Positive Connections; (2) Leveraging Skills to Manage Stress; (3) Beneficial; and (4) Facing Trauma.

CONCLUSION

Graduate student-led support groups are a feasible and effective strategy to mitigate stress and improve nursing student resiliency. [J Nurs Educ. 2023;62(12):711-715.].

The effect of COVID-19 on fear, anxiety, and sleep in nursing students

PURPOSE

This research was conducted to determine the effect of COVID-19 on fear, anxiety, and sleep in nursing students.

METHODS

The sample of the study consisted of 1222 students in the 2019-2020 academic year who were members of the student nurses association. The data were collected online via Google Form between June and August 2020 using the student information form containing socio-demographic characteristics, the Generalized Anxiety Disorder 7-Item (GAD-7) Scale, the fear of COVID-19 scale, and the Bergen Insomnia Scale.

RESULTS

In our study, the mean score of the fear of COVID-19 scale of nursing students was 18.23 ± 6.31, and it was determined that 51.8% had sleep problems and 70.9% had anxiety (39.9% mild, 20.8% moderate, and 10.2% severe). In simple linear regression analysis, the fear of COVID-19 was found to be statistically significant and positively correlated with anxiety (β: 0.383, p = 0.001), and the fear of COVID-19 (β: 0.120, p = 0.001) and anxiety (β: 0.346, p = 0.001) was found to be statistically significant and positively correlated with sleep.

CONCLUSION

In our study, there is a relationship between nursing students' fear of COVID-19 and anxiety and sleep quality. Accordingly, it is recommended to train students in effective methods for coping with the fear of COVID-19, and to take initiatives to reduce related anxiety and sleep problems.

Animal-Assisted Interventions on a College Campus to Improve Wellness: Adventures With the Northern Michigan University Wildpups

BACKGROUND

The prevalence of anxiety and stress among university students has been well established. However, limited studies document the effects of animal-assisted interventions (AAI) on college campuses.

METHOD

An AAI program was created and implemented during the 2021-2022 academic year to study the effects on students' stress and anxiety. Five faculty dog and handler teams, called the "Wildpups," participated in events that allowed individuals to interact with registered therapy dogs. Nursing students assessed vital signs including heart rate, respiratory rate, and blood pressure before and after events. The State-Trait Anxiety Inventory survey was used to assess pre- and postperceived anxiety, and a visual analog scale was used to assess pre- and postperceived stress.

RESULTS

Participants' blood pressure, heart and respiratory rates, and perceived stress and anxiety decreased significantly after events.

CONCLUSION

Embedded AAI programs on college campuses positively affect the life and mental well-being of individuals. [J Nurs Educ. 2023;62(11):631-637.].

Sense of Coherence or resilience as predictors of psychological distress in nursing students during the COVID-19 pandemic

Background

The COVID-19 pandemic lead to the occurrence of numerous psychological distress among students. This study aimed to determine the level of psychological distress as well as the predictive role of Sense of Coherence (SOC) and resilience in nursing students.

Methods

A cross-sectional descriptive study was conducted on 310 nursing students in Ahvaz Jundishapur University of Medical Sciences, Iran. The data of the study was collected through the demographic information questionnaire, the General Health Questionnaire (GHQ), the Academic Resilience Inventory (ARI), and the Sense of Coherence Scale (SOC-13).

Results

Students' mean scores for the GHQ, ARI, and SOC were 5.81 ± 1.37, 102.88 ± 11.91, and 54.54 ± 6.46, respectively. Regression models showed that two domains of SOC [meaningfulness (β = -0.28, p < 0.001), manageability (β = -0.19, p = 0.001)], female gender (β = 0.12, p = 0.015), and overall ARI (β = -0.12, p = 0.037), were significantly associated with the GH of nursing students. SOC domains [meaningfulness (β = -0.19, p = 0.002), manageability (β = -0.15, p = 0.006)], problem-oriented/positive thinking domain of ARI (β = -0.15, p = 0.011), sex (β = 0.12, p = 0.015), and history of death in first-degree relatives (β = 0.12, p = 0.021) were significantly associated with social dysfunction domain of GH. Three domains of SOC [meaningfulness (β = -0.26, p < 0.001), manageability (β = -0.13, p = 0.032), and comprehensibility (β = -0.13, p = 0.039)], were significantly associated with psychological distress domain of GH.

Conclusion

Our results indicated that low SOC and resilience were predictors of psychological distress in nursing students. Accordingly, interventions such as teaching stress management skills, the skills of using positive coping methods in dealing with stressful situations, and self-management skills are necessary to improve the level of resilience and SOC in nursing students.

Enablers, barriers and strategies to build resilience among cancer survivors: a qualitative study protocol

Cancer is a life-threatening illness affecting all dimensions of a person's health. Cancer survivors must build resilience to face this adversity and continue their life projects. The present study explores the enablers, barriers, and strategies to build resilience among cancer survivors. This qualitative, descriptive exploratory study will use purposive sampling to recruit cancer survivors and healthcare professionals from two hospital centers in Lisbon and Tagus Valley. Interviews will be conducted until data saturation occurs. Data analysis will be performed using an inductive content analysis process with the help of the QDA Miner Lite database. The findings from this study will generate knowledge that may help stakeholders to identify effective strategies to build resilience among cancer survivors. By implementing strategies to foster resilience, healthcare professionals can potentially promote positive adaptations to cancer by strengthening resilience enablers and reducing the impact of barriers.

Nursing students' learning commitment, self-efficacy and grit during the COVID 19 pandemic: Quantitative empirical research on adaptation to college life

AIMS

To examine the learning commitment, self-efficacy, grit and adaptation to college life among Korean nursing students, under the prolonged COVID-19 situation, and identify the factors that affect their adaptation to college life.

DESIGN

A cross-sectional study.

METHODS

The participants were 247 nursing students. The instruments used in the study were the Learning Commitment Scale for Adults, Self-Efficacy Scale, Grit Scale and Campus Life Adaptation Scale (developed for Korean nursing students). A multiple linear regression analysis was conducted using SPSS 23.0.

RESULTS

Adaptation to college life had significant positive correlations with learning commitment, self-efficacy and grit. Moreover, self-efficacy and learning commitment were key correlators for adapting to college life.

Loneliness before and after COVID-19: Sense of Coherence and Hope as Coping Mechanisms

The COVID-19 pandemic posed a major threat to public health, with long-lasting consequences for the daily habits and practices of people around the world. The combination of hazardous health conditions and extensive changes to people's daily routines due to lockdowns, social restrictions, and employment uncertainty have led to mental health challenges, reduced levels of subjective wellbeing, and increased maladaptive behaviors and emotional distress. Nevertheless, some studies have reported increased adaptive functioning and resilience after the pandemic, suggesting a more complex pattern of effects. The goals of the current study were to explore the role of two coping variables, sense of coherence and hope, in people's emotional wellbeing and adaptation in dealing with loneliness before and after such a stressful period. In a cross-sectional study, 974 Israeli participants (sample 1: 540 participants before the pandemic; sample 2: 434 participants after the pandemic restrictions) answered online questionnaires about their loneliness, hope and sense of coherence levels before and after the pandemic. While the two groups did not differ in their levels of hope, the participants in the group before COVID-19 reported lower levels of loneliness and sense of coherence. However, the results also indicated that although the COVID-19 pandemic was related to increased levels of loneliness, the participants' sense of coherence mediated this increase and their levels of hope moderated it. The theoretical contribution of these findings is discussed, as well as interventional implications and future directions.

Cultivating support during COVID-19 through clinical supervision: A discussion article

AIM

This article aims to discuss how clinical supervision is an important approach in supporting frontline nurses and students during and post COVID-19 through the lens of the nursing metaparadigms.

DESIGN

Discussion article.

METHODS

Discourse of the literature considering the importance of working collaboratively with healthcare and educational organisations in operationalising clinical supervision.

RESULTS

The evidence base supporting clinical supervision as an effective support strategy for nurses exists, however, its implementation and practice has become sporadic. A resurgence is required to support student's and nurse's during this pandemic. It is timely for nurse educators to creatively engage with clinical partners in supporting clinical supervision to enhance both nurses and students pandemic practice experiences. Clinical supervision is proposed as one strategy to support and guide both nurses and students to develop, strengthen and challenge the effectiveness of their care during COVID-19.

From disobedience to struggle for adaptation: ​​nursing students' experiences of attending the clinical learning environment during Covid-19 pandemic

BACKGROUND

The Covid-19 pandemic has affected the clinical education of nursing students all over the world. Considering the importance of clinical education and clinical learning environment (CLE) in the education of nursing students, identifying the challenges and problems faced by these students during the covid-19 pandemic helps to plan more effectively in this regard. The aim of this study was to investigate the experiences of nursing students in CLEs during the Covid-19 pandemic.

METHODS

A descriptive qualitative research was conducted, which used a purposive sampling technique to recruit 15 undergraduate nursing students from Shiraz University of Medical Sciences between July 2021 and September 2022. Data were collected through in-depth semi-structured interviews. For data analysis, conventional qualitative content analysis based on Graneheim and Lundman approach was used.

RESULTS

The data analysis led to emergence of two themes of "disobedience " and "struggle for adaptation". The disobedience theme consists of two categories: "objection to attend CLE" and "patient marginalization". The theme of struggle for adaptation includes two categories: "using support sources" and "applying problem-oriented strategies".

CONCLUSION

At the beginning of the pandemic, the students were unfamiliar due to the disease, as well as fear of contracting themselves and infecting others, so they tried not to be in the clinical environment. However, they gradually tried to adapt to the existing conditions by applying support resources and using problem-oriented strategies. Policymakers and educational planners can use the results of this study to plan for solving the challenges of students during future pandemics and improve the condition of CLE.

An integrative review of resilience among nursing students in the context of nursing education

AIM

This integrative review aimed to examine empirical research on resilience among nursing students in the context of nursing education. Resilience helps nursing students handle challenges, such as changing learning styles and experiencing their first clinical practice.

DESIGN

An integrative review.

METHODS

The search terms focused on resilience and health in nursing students and nursing education. The database used in this review were CINAHL Plus, PubMed and MEDLINE. The Mixed Methods Appraisal Tool appraised the studies' quality.

RESULTS

This study explored 52 records and revealed three current research focuses related to nursing students' resilience: (1) the concept and description of resilience, (2) the characteristics affecting resilience and (3) the mediating role of resilience in maintaining holistic health. Recommendations include adding a resilience topic to the nursing curriculum, providing resilience enhancement programs, examining the relationship between resilience and holistic health and exploring the influence of resilience about global health crises.

PUBLIC CONTRIBUTION

Resilience among nursing students plays a vital role in helping them to overcome adversities during their nursing education. Additionally, after graduation, nursing students can continue contributing to society as resilient Registered Nurses in the future.

Family Functioning as an Explanatory Factor of Empathic Behavior in Argentine Medical Students

Empathy is a relevant competence in the study and practice of medicine whose development could depend on the functioning style of each family. This study aims to compare the distribution of empathy levels, about functionality or dysfunction, and the three styles, which can be derived from family functioning in the families of Argentine medical students. Previously providing evidence of the validity of the family functioning measure. As well as provide evidence of the validity of the measure of family functioning.

METHODS

Ex post facto design: 306 Argentine medical students who had already taken the Jefferson Scale of Empathy-Spanish Edition (JSE-S) and the abbreviated Spanish Family Adaptability and Cohesion Evaluation Scale (FACES-20). A gender-weighted linear regression analysis was made, establishing an ANOVA and multiple comparisons via DMS to determine the effect of functional and dysfunctional families' balanced, intermediate and extreme functioning styles concerning empathy.

RESULTS

Students who presented dysfunction in familial cohesion and adaptability showed measures of empathy greater than those classified as functional. Differences of cohesion were statistically significant in compassionate care, perspective taking and general empathy. These components were significantly higher in students from families classified as extreme than balanced ones. Students classified within families with either extreme or dysfunctional styles showed greater levels of empathy than more adaptive and functional ones, except in the 'walking in patient's shoes' component where differences were not observed.

CONCLUSIONS

Individual resilience as an intervening variable in the presence of empathy is discussed.

IMPLICATIONS

The study of empathy, its associated variables, and the conditions of its development remains a central theme in relation to students and professionals of the health sciences. To achieve an effective professional practice, it is necessary to develop human capacities such as empathy and personal resilience.

Factors Influencing Spiritual Health among Nursing Students in the Prolonged COVID-19 Situation

The COVID-19 pandemic is not only an epidemiological crisis but also a spiritual health crisis that affects nursing students. Spiritual health is essential in maintaining and promoting physical and mental health to achieve happiness, potential, meaning, and purpose of life even during a pandemic. This descriptive cross-sectional study aimed to examine factors affecting spiritual health of nursing college students. The study adheres to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. A total of 219 nursing students from three nursing colleges in Metropolitan D city participated in the study through an online Google Form questionnaire from 2-18 September 2021. The mean score of spiritual health was 96.98 ± 11.54 (out of 120 points); spiritual health was significantly positively correlated with life satisfaction and academic performance (p < 0.001) and negatively correlated with academic stress (p < 0.001). Factors significantly affecting spiritual health were academic stress (ß = -2.21, p = 0.045), life satisfaction (ß = 3.85, p < 0.001), and academic performance; below score of 3.0 (ß = -2.08, p = 0.039). The explanatory power of these effects was 30.7%. As a future professional nurse who will work in the clinical field where the demand for the spiritual care of patients is increasing, it is necessary to develop and apply a curriculum that can improve the spiritual health of nursing students.

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

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

Evaluation of Health-Related Quality of Life and Mental Health in 729 Medical Students in Indonesia During the COVID-19 Pandemic

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has impacted the health-related quality of life (HRQoL) and mental health worldwide. However, its impact on medical students in Indonesia has not been well documented. This study aimed to evaluate HRQoL and mental health in 729 Indonesian medical students during the COVID-19 pandemic. MATERIAL AND METHODS We conducted a cross-sectional study from 31 August to 30 September 2021. The study instrument was an online questionnaire that was distributed via social media platforms. The 12-item short form version 2 (SF12v2) was used to measure HRQoL, and the 21-item Depression, Anxiety, and Stress Scale (DASS-21) was used to measure mental health. RESULTS From 729 Indonesian medical students included in the analyses, 37.3% had impaired physical component and 66.9% had impaired mental component of HRQoL. The determinants were medical students' island of residence, history of hospitalization, and family member's hospitalization and death due to COVID-19. Concerning mental health, the prevalence of reported symptoms of depression, anxiety, and stress were 45.4%, 65.2%, and 60.9%, respectively. Sex, study method, grade, previous COVID-19 disease severity, comorbidities, previous learning experience, and history of family isolation were identified as the determinants of mental health. CONCLUSIONS This study highlights the adverse effects of COVID-19 on HRQoL and mental health in Indonesian medical students. The results identified key associations, including SARS-CoV-2 infection and comorbidities experienced by the students, the health of their families, including grief following bereavement, and the effects of social isolation during the pandemic.

An Exploration of Psychological Resilience among Undergraduate Nursing Students Undertaking an Adult Nursing Virtual Practicum during the Coronavirus Pandemic in Taiwan: A Qualitative Study

This qualitative study aimed to explore the psychological resilience of undergraduate nursing students partaking in a virtual practicum during the coronavirus pandemic (COVID-19) in Taiwan. The virtual practicum, a form of online learning, creates challenges compared to the traditional teaching-learning experience of an actual clinical placement. Exploring how students overcome learning difficulties and build resilience is necessary for a new learning environment or for future online learning. Constructivist grounded theory and the Standards for Reporting Qualitative Research checklist were followed. Purposive and theoretical sampling were used to recruit 18 student nurses for data saturation. Semi-structured, face-to-face interviews were conducted individually to collect data. Initial, focused, and theoretical coding and constant comparative data analysis were performed. Credibility, originality, resonance, and usefulness guided the assessment of the study's quality. The core category of psychological resilience in the virtual practicum was constructed to reflect Taiwanese nursing students' progress and experiences of learning during the virtual practicum. This core category consisted of three subcategories: (i) learning difficulties within one's inner self; (ii) staying positive and confident; and (iii) knowing what is possible. The findings identified psychological resilience as an important factor for students to adjust to the adverse experiences of a rapidly changing learning environment, such as the virtual practicum. The substantive theory of psychological resilience provided a frame of reference for coping with possible future difficulties. Correspondingly, psychological resilience reflected individuals' potential characteristics and may help students to enter and remain in the nursing profession.

Self-Compassion and Resilience in a National Sample of Nursing Students Amid the COVID-19 Pandemic

Nationwide, nursing students experienced multiple interruptions in learning because of the pandemic. Little is known about the impact of COVID-19 on resilience and self-compassion. A descriptive cross-sectional design was used to examine pandemic-related factors, resilience, and self-compassion using the Brief Resilience and Self-Compassion scales. The majority of participants (n = 259, 73.4 percent) described declining mental health. There was a moderate relationship between resilience, self-compassion, and age (r = .30, n = 353, p = .00/r = .290, n = 353, p < .01). Resilience and self-compassion are integral to student success. Strategies to support students' mental and physical health are discussed.

Steps toward a resilient future nurse workforce

INTRODUCTION

The psychosocial needs of nursing students are a pressing matter as mental health disorders may affect nursing students' journeys as professional nurses.

LITERATURE REVIEW

Psychological distress and burnout in nurses are threats to worldwide health care, as the stress associated with the COVID-19 pandemic could lead to an unstable future global nurse workforce.

DISCUSSION

Resiliency training can positively impact nurse stress, mindfulness, and resilience, as resilient nurses are better able to manage their response to stress and adversity which will contribute to positive patient outcomes.

IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE

Educating faculty on resilience will aid nurse educators to create new student instructional approaches to improve mental health wellness.

CONCLUSIONS

Supportive faculty behaviors, self-care techniques, and resilience-building infused throughout the nursing curriculum may promote the effective transitioning of students into practice, providing the necessary foundation for improving workplace stress management and increasing longevity and satisfaction in the profession.

Fostering Resilience in Nursing Through R.E.S.T

ABSTRACT

With about one-third of nurses having expressed an intention to leave the profession or change jobs in 2022, the effects of nursing job stress are evident. For nurses to continue to provide care in high stress, they must practice self-compassion and build resilience. The importance of resilience education and self-compassion for nurses and in nursing education is discussed from a Christian perspective, along with self-care strategies using the R.E.S.T. (Relationship, Exercise, Self-Compassion, Transformative Thinking) framework. Strategies for building resilience for both individuals and organizations are offered.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Innovative use of a flipped-classroom approach to teach fundamental nursing skills

Prelicensure nursing students are required to master fundamental nursing skills. The COVID-19 pandemic created challenges in maintaining excellence while teaching skill acquisition. The purpose of this study was to evaluate skill validation scores and student satisfaction and self-confidence using a flipped classroom approach and a low-fidelity simulation model to innovatively teach skill acquisition. Researchers used a quasi-experimental method to compare skill validation scores of a control group and intervention group using independent samples t-test. Researchers also evaluated whether prelicensure nursing students had satisfaction and self-confidence with this teaching strategy. Findings suggested that skills validations scores were no different using a flipped-classroom approach than in-person instruction. Prelicensure nursing students were satisfied and self-confident following the implementation of this teaching strategy. This teaching strategy has the potential to decrease in-person clinical practice time, provide alternative opportunities for clinical make-up and remediation, and decrease cost.

Instructors’ caring behaviors, burnout, satisfaction, and academic performance of nursing students in online education and the pandemic era

Objective: This study aimed to determine the predictive ability of instructors’ online caring behaviors, online learning burnout, and satisfaction with online learning on nursing students’ academic performance.

Methods: This was a cross-sectional study employing the administration of online self-report measures among 606 undergraduate students in one large nursing school in the Philippines. Statistical analysis involved the use of descriptive statistics, Pearson’s r, and linear regression.

Results: The mean scores in the instructors’ online caring behaviors scale, online learning burnout scale, online learning satisfaction scale, and self-reported academic performance were 3.88 ± 0.70, 4.00 ± 0.84, 2.51 ± 0.96, and 3.25 ± 0.79 respectively. Satisfaction (β = 0.216, P = 0.000), burnout (β = 0.-098, P = 0.019), and instructors’ caring behaviors (β = 0.096, P = 0.030) explained 11.7% of the variability in the students’ academic performance.

Conclusions: Instructors’ caring behavior and levels of burnout and satisfaction are linked to students’ academic success in the virtual learning environment. This study calls for nursing instructors to be mindful of signs of burnout, employ proactive measures that promote satisfactory learning, and foster more caring behaviors in this time of global health crisis.

Mediating Role of Resilience on Nursing Faculty and Student QoL during COVID-19

COVID-19 greatly impacted nursing education and required nursing faculty and students to quickly adapt to changes caused by disease mitigation. The purpose of this study was to examine the mediating effects of resilience between the influence of demographics and school-related risk factors and nursing faculty and student quality of life (QoL) during the COVID-19 pandemic. A secondary data analysis was conducted using structural equation modeling to examine the mediating role of resilience on latent variables. Resilience had a positive, direct effect on nursing faculty and student QoL. Having a designated home workspace and being well-prepared for online learning had positive, indirect effects on QoL, mediated through resilience. Assisting children with schoolwork had a negative impact on the psychological and environmental QoL domains. Remarkably, having a caregiver role positively influenced the psychological QoL domain. Supporting and promoting faculty and nursing students' health and well-being is imperative during and after the pandemic.

Connecting lived experiences of pre-nursing students during COVID-19 with learner well-being: A qualitative inquiry

AIM

To explore pre-nursing students' experiences and identify factors influencing their well-being as learners during COVID-19.

DESIGN

A qualitative descriptive design was used.

METHODS

Short answer study data (n = 289) were collected in Fall 2020 as part of a larger IRB-approved survey-based study focused on pre-nursing students. Participants were presented with three short answer questions designed to elicit a description of their experiences as a pre-nursing student. NVivo and reflexive thematic analysis were used to analyse participant responses.

RESULTS

Six themes related to learner well-being emerged from the data. Learner well-being was supported by achieving academic goals, experiencing positive feelings about current course content, creating connections with peers and envisioning themselves as nurses in the future. Negative contributors to pre-nursing student well-being included managing fears of program rejection and juggling multiple roles and demands. Online learning necessitated by COVID-19 created opportunities for loneliness and isolation from peers, technological difficulties and additional psychological stress, which also contributed negatively to learner well-being.

CONCLUSION

These findings illustrate pre-nursing students' experiences and provide support for the influence of the learning environment and factors within the individual on the well-being of learners.

IMPACT

Students preparing to apply to nursing programs are an understudied population and little is known about their well-being as learners. Survey-based open-ended short answer questions can be utilized to gain rich insight into their experiences. The study themes and sub-themes can be utilized for discussion and reflection in courses with pre-nursing students and as a starting point for additional conversations between pre-nursing students and educators regarding improving the support of well-being in learners. Additional research and evidence-based interventions that promote learner well-being in pre-nursing students are needed as they prepare for nursing program admission and to support their academic progression.

PATIENT OR PUBLIC CONTRIBUTION

Members of the public were not involved in the design or conduct of the study, analysis, or interpretation of the data, or in the preparation of the manuscript because the study focus is on gaining an understanding the experiences of pre-nursing students and their well-being.

Impact of COVID-19 pandemic lockdown on the mental health status of Indian undergraduate health professional students

Introduction and Aim: The psychological effects of the COVID-19 outbreak and related lockdown measures among the Indian population are less known. Undergraduate students are prone to mental health problems making them more vulnerable to the impact of the pandemic and its lockdown. This study sought to determine the impact of the COVID-19 pandemic lockdown on the mental health status of undergraduate health professional students of a tertiary care setup.  Materials and Methods: A cross-sectional study was carried on undergraduate health professional students of a private Deemed-to-be University. 246 participants took part in this study. A questionnaire was provided as a Google form containing 26 questions. It captured the main dimensions of mental health-related issues in undergraduate students. Paired ‘t’ test was employed to compare the mental health status of the participants before and during the lockdown.  Results: A significant majority of our participants experienced stress during the lockdown. There was no significant effect of gender, the number of household members, or prior mental health challenges on the mental status of the students. COVID-19 updates on central government introduced mobile application significantly decreased stress but reports from television/radio and social media significantly contributed to stress. Students engaged in online academic activities of more than four hours per day were significantly stressed. Conclusion: Undergraduate health professional students in our study were significantly more stressed during the lockdown as compared to the pre-lockdown period. Academic online activity also significantly contributed to stress with more than four hours of online engagement precipitating severe stress.

A longitudinal study of student nurse anxiety and distress during transitions in learning due to the COVID-19 pandemic

This longitudinal study investigated anxiety, distress, and related symptoms experienced by undergraduate student nurses as they transitioned in March of 2020 to a virtual classroom due to the COVID-19 pandemic and in August of 2021 back to in-person learning. Qualtrics survey links were distributed at the end of the spring 2020 and fall 2021 semesters; survey response rates were 63% (n = 50) and 42% (n = 21), respectively. The 2020 cohort had a mean symptom rate of 4.32 out of 13 symptoms; the 2022 mean decreased to 2.47. Overall, symptoms decreased during the study period, but issues of anxiety and distress remained, particularly over academic-related issues.

Death anxiety, moral courage, and resilience in nursing students who care for COVID-19 patients: a cross-sectional study

Background

Being on the frontline of the battle against COVID-19, nurses and nursing students have been under considerable psychological stress and pressure. The present study is done to explore death anxiety, moral courage, and resilience in nursing students caring for COVID-19 patients in the south of Iran.

Methods

The present study is cross-sectional research conducted between September and December 2021. A total of 420 senior nursing students (nursing interns) who were undergoing their clinical training courses were invited to participate in the study by convenience sampling method from three hospitals affiliated with the University of Medical Sciences of Southern Iran. Data were collected using a demographics survey, Nurses’ Moral Courage Questionnaire, Connor-Davidson Resilience Scale, and Templer’s Death Anxiety Scale. 

Results

The nursing students participating in this study had a death anxiety mean score of 12.78 ± 1.17. The results showed that there was a significant and indirect correlation between death anxiety on the one hand and moral courage (r = -0.91, p < 0.001) and resilience (r = -0.89, p < 0.001) on the other in nursing students caring for patients with COVID-19. Also, it was found that there was a significant and direct correlation between the students’ resilience and moral courage scores (r = 0.91, p < 0.001).

Conclusion

The nursing students caring for COVID-19 patients had experienced high levels of death anxiety in the past few months. Considering the persistence of the COVID-19 crisis in Iran and other countries, there is an urgent need for measures to preserve and improve the physical, mental, and spiritual health of nursing students, enhance their moral courage and resilience and reduce their death anxiety.

The Influence of Physical Distancing, Sense of Belonging, and Resilience of Nursing Students on Their Viral Anxiety During the COVID-19 Era

OBJECTIVE

We aimed to explore how nursing students' adherence to physical distancing, sense of belonging, or resilience may be associated with viral anxiety during the coronavirus disease (COVID-19) era in South Korea.

METHODS

We conducted an online survey among nursing students from December 8-10, 2021. The survey gathered participants' age, sex, grades, living area, and responses to questions on COVID-19. In addition, responses to Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), adherence to physical distancing, Sense of Belonging Instrument, Calling and Vocation Questionnaire, Patient Health Questionnaire-9 items (PHQ-9), and Connor-Davidson Resilience Scale-2 (CD-RISC2) items were gathered.

RESULTS

The SAVE-6 score was significantly correlated with adherence to physical distancing (r=0.29), PHQ-9 (r=0.26), and CD-RISC2 (r=-0.34, all p<0.01) similar to partial correlation analysis adjusting participants' group (freshmen and sophomores vs. juniors and seniors). A linear regression analysis revealed that viral anxiety of nursing students was predicted by sex (female, β=0.20, p=0.001), adherence to physical distancing (β=0.25, p<0.001), sense of belonging (β=0.16, p=0.014), and CD-RISC2 score (β=-0.32, p<0.001) (adjusted R2=0.24, F=10.01, p<0.001).

CONCLUSION

We observed that adherence to physical distancing, sense of belonging, and their resilience influenced nursing student's viral anxiety. An appropriate support system to manage viral anxiety is needed for nursing students during the COVID-19 pandemic.

Predictive Model of the Psychological Well-Being of Nursing Students During the COVID-19 Lockdown

Introduction

Lockdowns due to the COVID-19 pandemic radically changed nursing education. Along with social isolation, the transition to distance education affected the well-being of students in several countries, particularly Portugal and Spain.

Objectives

To identify which variables are predictors of psychological well-being for Portuguese and Spanish nursing students during mandatory lockdowns.

Methods

A multicenter, cross-sectional, descriptive, correlational study involving a sample of 1075 students (944 women, mean age 22.46 + /−4.95 years). Data were collected from an online questionnaire which applied the following scales: Perceived Stress Scale (α = .820); Brief COPE-14 Subscales (α = .430 < 0.930); Well-being Manifestations Measure Scale (α = .940); Herth Hope Index (α = .850). A multiple regression model was created to predict the psychological well-being of nursing students.

Results

The following predictor variables were identified in the model of the psychological well-being of students during the COVID-19 pandemic: perceived stress ( β = .405; p ≤ .001); hope ( β = .404; p ≤ .001); and the mechanisms of active coping ( β = .405; p ≤ .001), planning ( β = .097; p ≤ .001), and positive reinterpretation ( β = .053; p  =  .12). These five variables predicted 62.0% of the nursing students’ psychological well-being ( R2 = .620; F  =  350.82; p ≤ .001).

Conclusion

Promoting students’ mental health is essential, especially in periods of great adversity, such as a pandemic. Our results lead the way for the design and validation of an intervention program that addresses the five variables identified as predictors of students’ psychological well-being.

Perceived Stress and Coping Behavior of Nurses Caring for Critical Patients with COVID-19 Outbreak in Taiwan: A Mixed-Methods Study

Severe pneumonia with novel pathogens, also called COVID-19, caused a pandemic in Taiwan as well as in the rest of the world in May 2021. Nurses are under great stress when caring for critically ill patients with COVID-19. This study aimed to explore the perceived stress and coping behaviors of nurses caring for critically ill patients with COVID-19 using a mixed-methods approach. We recruited 85 nurses from a special intensive care unit (ICU) of a medical center in Taiwan between May and June 2021. To gather data, we used a questionnaire on basic characteristics, the perceived stress scale (PSS-14), and the brief coping orientation to problems experienced inventory (B-COPE), then conducted a qualitative interview. The results showed that the average perceived stress level among nurses was 25.4 points, and most of them perceived moderate stress. The top three coping behaviors practiced by the nurses were active coping, planning, and acceptance. Nurses who received less perceived support from their friends or families and who had shorter working experience in nursing had significantly higher stress levels. The qualitative results revealed that the nurses' perceived stress came from fear, worry, and the increased burden caused by caring for critical patients with COVID-19. Coping behaviors included rest, seeking support, and affirmative fighting. Based on these findings, it is suggested that the support nurses receive from their families is an important predictor of perceived stress. Therefore, it is suggested that nurses be provided with more support in dealing with stress caused by caring for critical patients with COVID-19 in special ICUs.

A Mixed-Methods and Prospective Approach to Understanding Coping Behaviors, Depression, Hopelessness, and Acute Stress in a U.S. Convenience Sample During the COVID-19 Pandemic

The COVID-19 pandemic has led to increases in U.S. residents' stressors while limiting many of the resources previously available to cope with stress. Coping behaviors may contribute to the prevention or proliferation of psychological distress during and after the pandemic. Understanding these coping behaviors and associated psychological outcomes can help health educators develop programs that encourage effective coping and promote mental health. This study used a sequential mixed-methods approach informed by Roth and Cohen's conceptualization of coping to understand the use of approach coping behaviors- which are active and directed toward the perceived threat-and avoidance coping behaviors-which include activity directed away from perceived threat during the COVID-19 pandemic. U.S. residents (N = 2,987) were surveyed online in April 2020 and again in September 2021. Open-ended responses at baseline were thematically analyzed to illustrate coping behaviors in participants' own words. At baseline, more than half (56%) of the sample met criteria for probable depression, 51% for acute stress symptoms, and 42% for moderate to severe hopelessness. At follow-up, 45% meet criteria for probable depression and 23% for acute stress. However, the proportion of the sample who reported moderate to severe hopelessness increased to 48%. We used mixed-effects general linear models to examine changes over time and found that increases in approach coping behaviors were associated with decreases in depressive symptoms and hopelessness; increases in avoidance coping were associated with higher levels of depressive symptoms and higher levels of hopelessness. Increases in both types of coping were associated with increases in acute stress symptoms related to COVID-19. Although there was some attenuation in distress in our sample between April 2020 and September 2021, our findings suggest a need for interventions that encourage the use of approach coping behaviors and that both increase access to and decrease stigma for mental health support.

Psychological impact of the COVID-19 pandemic on nursing students in the first wave: A cross-sectional survey

Aim

The aim of the study was to evaluate the psychological impact on nursing students at the end of period of confinement during the first wave of the COVID‐19 outbreak in Spain.

Design

A cross‐sectional study reported in line with the STROBE guidelines.

Methods

Nursing students were invited to complete an online questionnaire at the end of the 2019–2020 academic year using convenience sampling. The questionnaire collected data on sociodemographic factors, work, and life experiences in relation to COVID‐19, habits and lifestyle using the World Health Organization Five Well‐Being Index (WHO‐5) and the Generalized Anxiety disorder‐7 scale. Variables related to anxiety were analysed using multiple lineal regression analysis,

Results

The prevalence of low psychological well‐being in the 203 students was 44.3% and of anxiety 55.7%. In the multivariate analysis the variables associated with anxiety were having worked in the pandemic, having had symptoms of COVID‐19 and having been afraid of getting infected.

Conclusions

The levels of anxiety due to the COVID‐19 pandemic in nursing students have been high, and levels of psychological well‐being have been low. The fact of having worked during the pandemic, having had symptoms compatible with COVID‐19 or being afraid of getting infected are associated with the highest scores for anxiety.

Relevance to clinical practice

This study gives more evidence on the psychological impact on nursing students during the first wave of the pandemic in Spain. This can be used to design anxiety management programmes for inclusion into teaching syllabuses. It also gives arguments for the setting up of psychological and emotional support services for these students and other healthcare professionals working during the pandemic.

Predictors of effective clinical teaching - nursing educators' perspective

BACKGROUND

The clinical teaching is the core component of the nursing curriculum, the alarming pandemic rates brought uncertainty to clinical teaching, weighing the safety of patients, students, and faculty, which demanded essential modification in clinical teaching and resulted in challenges in relation to effective response to clinical teaching requirements. This study aimed to assess the effective clinical teaching from the nurse educators' perspective during the remote teaching that followed the COVID-19 pandemic.

METHODS

This study is a national Web-based descriptive study. Participants were recruited from five major Nursing Colleges in Oman. Descriptive and inferential as well as multiple linear regression analyses were conducted.

RESULTS

A total of 127 nurse educators completed the survey with mean age of 43.9 (SD = 6.9) years. The overall effective clinical teaching score was 54.4 (SD = 10.9) which is considered acceptable, although the nurse educators in Oman reported the highest score on the safety dimension of the effective clinical teaching. Furthermore, females, doctoral prepared nurse educators, and those who acted as preceptors reported higher effective clinical teaching levels compared to their counterparts. The regression analysis showed that age, gender, and attending infection control training are significant predictors of effective clinical teaching.

CONCLUSION

The paradigm shift in clinical teaching requires adequate measures including identification and appropriate training of clinical instructors and preceptors to meet clinical teaching demands in remote teaching. It is also important to take actions that promote and maintain the safety prioritization in bedside clinical teaching. These measures might positively impact on the nursing education process.

Predictors of effective clinical teaching - nursing educators' perspective

BACKGROUND

The clinical teaching is the core component of the nursing curriculum, the alarming pandemic rates brought uncertainty to clinical teaching, weighing the safety of patients, students, and faculty, which demanded essential modification in clinical teaching and resulted in challenges in relation to effective response to clinical teaching requirements. This study aimed to assess the effective clinical teaching from the nurse educators' perspective during the remote teaching that followed the COVID-19 pandemic.

METHODS

This study is a national Web-based descriptive study. Participants were recruited from five major Nursing Colleges in Oman. Descriptive and inferential as well as multiple linear regression analyses were conducted.

RESULTS

A total of 127 nurse educators completed the survey with mean age of 43.9 (SD = 6.9) years. The overall effective clinical teaching score was 54.4 (SD = 10.9) which is considered acceptable, although the nurse educators in Oman reported the highest score on the safety dimension of the effective clinical teaching. Furthermore, females, doctoral prepared nurse educators, and those who acted as preceptors reported higher effective clinical teaching levels compared to their counterparts. The regression analysis showed that age, gender, and attending infection control training are significant predictors of effective clinical teaching.

CONCLUSION

The paradigm shift in clinical teaching requires adequate measures including identification and appropriate training of clinical instructors and preceptors to meet clinical teaching demands in remote teaching. It is also important to take actions that promote and maintain the safety prioritization in bedside clinical teaching. These measures might positively impact on the nursing education process.

The Relationship between Emotional Stability, Psychological Well-Being and Life Satisfaction of Romanian Medical Doctors during COVID-19 Period: A Cross-Sectional Study

Due to the COVID-19 pandemic, as well as the fast progression of modern society, occupational stress has recently reached alarming levels with consequences for doctors’ psychological well-being. The aim of this study was to analyze the relationship among emotional stability, psychological well-being, and life satisfaction of medical doctors. We conducted a cross-sectional study on 280 medical doctors from Romania between February 2021 and September 2021, in the period between the third and fourth pandemic waves, who were evaluated by the DECAS, ASSET, and Satisfaction with Life scales. Our results showed that emotional stability is negatively correlated with psychological well-being (r = −0.526, p < 0.000) and positively correlated with life satisfaction (r = 0.319, p < 0.0001). Between psychological well-being and life satisfaction, we found a negative correlation (r = −0.046, p < 0.001). This study shows that there is a correlation among emotional stability, psychological well-being, and life satisfaction, which is why it can be considered that Romanian doctors have generated coping mechanisms during the COVID-19 pandemic.

Do Psychological Resilience and Emotional Intelligence Vary Among Stress Profiles in University Students? A Latent Profile Analysis

The coronavirus/COVID-19 pandemic has brought about significant changes in the lifestyle of students. However, despite an extensive study of students’ life stress using a non-comprehensive scale and variable-centered approach, it has been little studied with a comprehensive scale and person-centered approach. Using the Student-Life Stress Inventory-revised (SSI-R), we analyzed students’ latent stress profiles and examined differences in psychological resilience and emotional intelligence by comparing stress profiles from a sample of 418 undergraduate and graduate students (aged 18–36) in various departments of eight universities in Turkey. We identified five distinct stress profiles, defined as an extremely low stress group (ELSG), a low stress group (LSG), a medium stress group (MSG), a high stress group (HSG), and an extremely high stress group (EHSG). We found that (1) MSG and HSG were similar in terms of emotional intelligence, resilience, and possession of high standards, and they reported higher levels of physiological, emotional, and behavioral reactions than ELSG and LSG; (2) MSG felt more pressure than HSG; (3) ELSG reported higher levels of emotional intelligence (wellbeing, self-control, and emotionality) than others. Also, EHSG reported lower levels of emotional intelligence (specifically self-control) than others; (4) whereas resilience was highly positively correlated to wellbeing, resilience and wellbeing were moderately negatively correlated to stress. Extremely low stress group and LSG reported higher levels of resilience than others. Medium stress group, HSG, and EHSG did not differ with regard to resilience and wellbeing. Our results suggest that, university students are able to maintain their functionality by coping up with stress in some ways, no matter how stressful they are. These findings are discussed in relation to the relevant literature.

Stress and depression in undergraduate students during the COVID-19 pandemic: Nursing students compared to undergraduate students in non-nursing majors

Background

The COVID-19 pandemic exacerbated an already alarming mental health crisis on college campuses. Nursing students were uniquely impacted through the loss of clinical practicum experiences.

Purpose

The purpose of this study was to explore relationships between student perceptions of life-stress and depressive symptoms during the COVID-19 pandemic in nursing students compared to students in other academic disciplines. A secondary purpose of this study was to understand nursing student perceptions of how the COVID-19 pandemic impacted their educational experience.

Methods

School-related life stress and depression measures were studied in a cross-section of 2326 undergraduate students using an anonymous online survey. Follow-up qualitative data were collected (N = 12) to further explore relationships between school-related life stress and depression in nursing students.

Results

Nursing students had higher levels of student-life stress but fewer depressive symptoms than students in any other academic major. Students related that social support and belongingness were critical to their academic perseverance.

Conclusions

Differences between nursing and non-nursing students are likely due to a multifactorial combination of social support, resilience, and posttraumatic growth.

Anxiety and fear of COVID-19 among nursing students during the COVID-19 pandemic: A descriptive correlation study

PURPOSE

The aim of this study was to assess current situations regarding anxiety and fear of coronavirus disease 2019 (COVID-19) level among nursing students.

DESIGN AND METHODS

A descriptive correlation design was adopted. The sample consisted of 234 nursing students. Data were collected using sociodemographic form, Beck Anxiety Inventory (BAI), and Fear of COVID-19 scale.

FINDINGS

The mean BAI score of the students was 26.56 ± 8.86 and Fear of COVID-19 total score was 18.95 ± 7.00. A positive correlation between total scores of the BAI and Fear of COVID-19. The results of this study reveal that anxiety and fear of COVID-19 levels were high among nursing students.

PRACTICE IMPLICATIONS

These findings have underlined there is an urgent need for interventions to reduce anxiety and fear of COVID-19 among nursing students.

Faculty supportive behaviors and nursing student mental health: a pilot study

OBJECTIVES

Relationships between perceived faculty support and prevalence of depression, anxiety, and stress among undergraduate nursing students were explored.

METHODS

A mixed method design was used for this descriptive, cross-sectional pilot study. Depression, Anxiety and Stress Scale-21 (DASS-21), Perceived Faculty Support Scale (PFSS), a demographic questionnaire, and open-ended questions were used to collect data.

RESULTS

Nursing students experienced moderate depression and stress, and severe anxiety. Perceived faculty support was moderate. An inverse correlation between select perceived faculty supportive behaviors and depression, anxiety, and stress was evident. Student stressors were related to faculty actions. The theme being attentive to student stress emerged from the qualitative data.

CONCLUSIONS

Symptoms of poor mental health among undergraduate nursing students are prevalent and represent a significant public health concern among nursing students. Nurse educators must develop psychological and functional supportive behaviors to promote mental health during nursing students' transition throughout the nursing program and beyond.

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

Introduction

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

Objectives

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

Methods

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

Results

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

Conclusion

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

Protective and Non-Protective Factors of Mental Health Distress in the United States during the COVID-19 Pandemic: A Systematic Review

Background and objectives: Health care organizations continue to respond to the COVID-19 global pandemic and an ongoing array of related mental health concerns. These pandemic-related challenges continue to be experienced by both the U.S. population and those abroad. Materials and methods: This systematic review queried three research databases to identify applicable studies related to protective and non-protective factors of mental health distress experienced during the pandemic within the United States. Results: Three primary factors were identified as protective factors, potentially helping to moderate the incidence of mental distress during the pandemic: demographics, personal support/self-care resources, and income/financial concerns. Researchers also identified these same three constructs of non-protective factors of mental health distress, as well as two additional variables: health/social status and general knowledge/government mistrust. Conclusions: This systematic review has identified protective and non-protective factors of mental health distress experienced in the United States during the COVID-19 pandemic (to date) that can further assist medical providers in the U.S. and beyond as the pandemic and related mental health concerns continue at a global level.

Coping with Fears of Covid-19 Pandemic Among Nursing Students During Clinical Practice: Malawi's Perspective

PURPOSE

Fears of the Covid-19 pandemic have brought additional psychological pressure among nursing students. Nursing students at Mzuzu University in Malawi resumed clinical practice amidst the first wave of the pandemic and completed their rotation from September to December 2020. However, it was not known how they were coping with fears of the Covid-19 pandemic during clinical practice and this had set the impetus for conducting this study.

METHODS

The study used qualitative approach employing a descriptive phenomenological design. Four focus group discussions (FGDs) were conducted on students who had completed a clinical rotation during the first wave of the Covid-19 pandemic.

RESULTS

Four themes emerged from the data analysis, and these were staying positive amidst the Covid-19 pandemic; applying the Covid-19 preventive measures; the role of religion and use of avoidance strategies.

CONCLUSION

Students should be encouraged to use coping strategies that have been proven to promote psychological well-being in times of crisis such as the Covid-19 pandemic.

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

AIM

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

BACKGROUND

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

DESIGN

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

DATA SOURCES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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.