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      Perceived Stress and Coping Strategies among Nursing Students during the COVID-19 Pandemic: A Systematic Review


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          Background and Objective: Stress is common among nursing students, especially during COVID-19, because of direct contact with patients, so they need to cope with the stressors. The aim of this systematic review was to assess the level of perceived stress and coping strategies by nursing students during the COVID-19 pandemic. Material and Methods: Databases such as MEDLINE, PubMed, ScienceDirect, Cochrane Library, and Web of Science were searched using keywords. The authors used keywords (perceived stress, coping strategies or resilience, and nursing students). The language was restricted to English. The studies, conducted between December 2019 and December 2021, were included. The full articles were checked for eligibility. The reference manager software EndNote X4 was used for sorting and managing studies. This systematic review was registered on PROSPERO with a number: CRD42021267791. Results: Five studies were included in this review: the first study, from the Philippines, showed that levels of stress and coping strategies were estimated to be 79% and 76.8%, respectively; the second study, from Saudi Arabia, found that the rate of stress among nursing students was 30.9% with several strategies for coping, while the other study from Saudi Arabia showed that the stress level is 1.32 (low stress) and 1.95 (moderate stress) with different coping strategies (avoidance 1.47, problem solving 2.09, stay optimistic 2.06, and transference 1.87); the fourth study from the USA showed that the rate of stress is high 24.7%, with high levels of resilience among nursing students; and the fifth study showed that the rate of stress is 20.94 in the UK and 21.54 in China, with a resilience of 26.70 in the UK and 25.18 in China. Conclusion: The current systematic review showed that nursing students have a high level of stress in all included countries (the Philippines, Saudi Arabia, the USA, the UK, and China), and they developed appropriate coping strategies to face the situation.

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          Most cited references36

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          The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories

          The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.
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            Prevalence of Symptoms of Depression, Anxiety, Insomnia, Posttraumatic Stress Disorder, and Psychological Distress among Populations Affected by the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

            Highlights • Infectious disease outbreaks are associated with mental health symptoms and disorders • Pooled prevalence of depression, anxiety, insomnia, PTSD, and psychological distress were 15.97%, 15.15%, 23,87%, 21.94%, and 13.29%, respectively • No significant differences were observed for gender, geographical regions, and healthcare workers (except for insomnia, which was more prevalent among healthcare workers) • This study provides findings that will guide research and the development of better mental health programs during and after the pandemic
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              Anxiety and coping strategies among nursing students during the covid-19 pandemic

              Anxiety is highly prevalent among nursing students even in normal circumstances. In Israel during the covid-19 pandemic and mandatory lockdown, nursing students encountered a new reality of economic uncertainty, fear of infection, challenges of distance education, lack of personal protection equipment (PPE) at work etc. The objective of this study was to assess levels of anxiety and ways of coping among nursing students in the Ashkelon Academic College, Southern District, Israel. A cross-sectional study was conducted among all 244 students in the nursing department during the third week of a national lockdown. Anxiety level was assessed using the Generalized Anxiety Disorder 7-Item Scale with a cut-off point of 10 for moderate and of 15 for severe anxiety. Factor analysis was used to identify coping components. The prevalence of moderate and severe anxiety was 42.8% and 18.1% respectively. Gender, lack of PPE, parental status, and fear of infection were significantly associated with a higher anxiety score. Stronger self-esteem and usage of humor were associated with significantly lower anxiety levels, while mental disengagement with higher anxiety levels. The nursing department's staff may contribute in lowering student anxiety by staying in contact with students and encouraging and supporting them through this challenging period.

                Author and article information

                Saudi Journal of Health Systems Research
                S. Karger AG
                September 2022
                22 August 2022
                : 2
                : 3
                : 85-93
                [_a] aNursing Department, Faculty of Applied Medical Sciences, Albaha University, Al-Baha, Saudi Arabia
                [_b] bNursing College, Najran University, Najran, Saudi Arabia
                [_c] cNursing Department, Faculty of Medical Sciences and Nursing, Alrayan College, Almadina, Saudi Arabia
                Author information
                526061 Saudi J Health Syst Res 2022;2:85–93
                © 2022 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.

                : 27 April 2022
                : 13 July 2022
                Page count
                Figures: 1, Tables: 4, Pages: 9
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/526061
                Self URI (text/html): https://www.karger.com/Article/FullText/526061
                Self URI (journal page): https://www.karger.com/Tap/Home/278492
                The authors declare that there are no received funds for this study.
                Systematic Review

                Internal medicine,Respiratory medicine,Clinical Psychology & Psychiatry,Microbiology & Virology,Infectious disease & Microbiology
                Perceived stress,Resilience,Nursing students,Coping strategies,COVID-19


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