Abstract
Background: Undergraduate nursing students have a high level of stress and depressive symptoms. Despite growing awareness of mental health issues in nursing students, no recent systematic review assessed the global prevalence of stress and depressive symptoms in undergraduate nursing students, nor the contributing sociodemographic and interpersonal factors.
Purpose Statement: The purpose of this review is to 1) identify the prevalence of stress and depressive symptoms among undergraduate nursing students, and 2) identify the sociodemographic and interpersonal factors that contribute to these symptoms.
Methods: This review follows the PRISMA guidelines. Four databases were searched. Narrative synthesis was used to explore the contributing risk factors. Prevalence rates of stress and depressive symptoms were calculated using random-effects models. Subgroup analyses were performed based on the severity of symptoms, study location, assessment instruments, and country income groups. Effect size, 95% confidence intervals (CIs) and p-values are reported.
Results: A total of 43 articles were included in the review. The prevalence of depressive symptoms and stress was 47%, p<0.01, and 49%, p<0.01, respectively. For depressive symptoms, studies conducted in Latin America reported the highest prevalence at 57%, as did studies from lower-middle-income countries (60%) and those using the BDI-II assessment tool (68%). For stress, the highest prevalence was found in North America (69%), high-middle-income countries (63%), and studies using the PSS-10 assessment tool (57%). The sociodemographic factors— younger age, female gender, being single, lower income, family financial challenges, lack of children, and housing insecurity—are associated with increased stress and depressive symptoms. Interpersonal conflicts were also linked to higher levels of stress and depressive symptoms.
Discussion: The high prevalence of depressive symptoms and stress in nursing students highlights a global mental health issue that requires urgent attention. The regional variations emphasize the need for culturally tailored interventions to address the mental health challenges faced by nursing students worldwide. Nursing students' ability to manage mental health issues impacts their capacity to provide high-quality care. Therefore, it is crucial for educators, faculty, and researchers to foster a supportive and resilient student body to ensure a diverse and sustainable healthcare workforce.
Notes
References: Asturias, N., Andrew, S., Boardman, G., & Kerr, D. (2021). The influence of socio-demographic factors on stress and coping strategies among undergraduate nursing students. Nurse Educ Today, 99, 104780. https://doi.org/10.1016/j.nedt.2021.104780
Baruah, C., Saikia, H., Gupta, K., & Ohri, P. (2022). Prevalence and correlates of Depression, Anxiety and Stress among Nursing Students. Indian Journal of Community Health, 34(2), 259-264. https://doi.org/10.47203/IJCH.2022.v34i02.021
Chaabane, S., Chaabna, K., Bhagat, S., Abraham, A., Doraiswamy, S., Mamtani, R., & Cheema, S. (2021). Perceived stress, stressors, and coping strategies among nursing students in the Middle East and North Africa: an overview of systematic reviews. Syst Rev, 10(1), 136. https://doi.org/10.1186/s13643-021-01691-9
Coelho, L. D. S., Tony, A. C. C., Laguardia, G. C. A., Santos, K. B. D., Friedrich, D. B. C., Cavalcante, R. B., & Carbogim, F. D. C. (2021). Are symptoms of depression and anxiety in nursing students associated with their sociodemographic characteristics? Rev Bras Enferm, 74(suppl 3), e20200503. https://doi.org/10.1590/0034-7167-2020-0503
Das, B. N., Mohandas, A., & Syed, S. (2021). Study of stress, anxiety, depression and coping strategies among nursing students in a tertiary care teaching hospital, South India. Int J Community Med Public Health, 8, 3400-3405. https:doi.org/10.18203/2394-6040.ijcmph20212594
McDermott, R. C., Fruh, S. M., Williams, S., Hauff, C., Graves, R. J., Melnyk, B. M., & Hall, H. R. (2020). Nursing students' resilience, depression, well-being, and academic distress: Testing a moderated mediation model. J Adv Nurs, 76(12), 3385-3397. https://doi.org/10.1111/jan.14531
Mills, A., Ryden, J., & Knight, A. (2020). Juggling to find balance: hearing the voices of undergraduate student nurses. Br J Nurs, 29(15), 897-903. https://doi.org/10.12968/bjon.2020.29.15.897
Stubin, C. A., Ruth-Sahd, L., & Dahan, T. A. (2024). Promoting Nursing Student Mental Health Wellness: The Impact of Resilience-Building and Faculty Support. Nurse educator, 49(3), 119-124. https://doi.org/10.1097/NNE.0000000000001535
Verma, P., Verma, M., Lahri, B., Pakhare, A., & Das, S. (2021). Study of Depressive, Anxiety, and Stress Symptoms and Their Associated Risk Factors among Undergraduate Nursing Students in Central India: A Cross-Sectional Study. Journal of Primary Care Specialties, 2(3), 80-84.
Zeng, Y., Wang, G., Xie, C., Hu, X., & Reinhardt, J. D. (2019). Prevalence and correlates of depression, anxiety and symptoms of stress in vocational college nursing students from Sichuan, China: a cross-sectional study. Psychol Health Med, 24(7), 798-811. https://doi.org/10.1080/13548506.2019.1574358
Sigma Membership
Alpha Eta
Type
Poster
Format Type
Text-based Document
Study Design/Type
Meta-Analysis/Synthesis
Research Approach
Quantitative Research
Keywords:
Stress and Coping, Health Equity or Social Determinants of Health, Depression, Nursing Students
Recommended Citation
Xu, Ling; Morales, Michael Joshua Gozum; Hoffmann, Thomas; and Leung, Cherry, "Prevalence of Stress and Depression in Nursing Students: A Systematic Review and Meta Analysis" (2025). International Nursing Research Congress (INRC). 162.
https://www.sigmarepository.org/inrc/2025/posters_2025/162
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Prevalence of Stress and Depression in Nursing Students: A Systematic Review and Meta Analysis
Seattle, Washington, USA
Background: Undergraduate nursing students have a high level of stress and depressive symptoms. Despite growing awareness of mental health issues in nursing students, no recent systematic review assessed the global prevalence of stress and depressive symptoms in undergraduate nursing students, nor the contributing sociodemographic and interpersonal factors.
Purpose Statement: The purpose of this review is to 1) identify the prevalence of stress and depressive symptoms among undergraduate nursing students, and 2) identify the sociodemographic and interpersonal factors that contribute to these symptoms.
Methods: This review follows the PRISMA guidelines. Four databases were searched. Narrative synthesis was used to explore the contributing risk factors. Prevalence rates of stress and depressive symptoms were calculated using random-effects models. Subgroup analyses were performed based on the severity of symptoms, study location, assessment instruments, and country income groups. Effect size, 95% confidence intervals (CIs) and p-values are reported.
Results: A total of 43 articles were included in the review. The prevalence of depressive symptoms and stress was 47%, p<0.01, and 49%, p<0.01, respectively. For depressive symptoms, studies conducted in Latin America reported the highest prevalence at 57%, as did studies from lower-middle-income countries (60%) and those using the BDI-II assessment tool (68%). For stress, the highest prevalence was found in North America (69%), high-middle-income countries (63%), and studies using the PSS-10 assessment tool (57%). The sociodemographic factors— younger age, female gender, being single, lower income, family financial challenges, lack of children, and housing insecurity—are associated with increased stress and depressive symptoms. Interpersonal conflicts were also linked to higher levels of stress and depressive symptoms.
Discussion: The high prevalence of depressive symptoms and stress in nursing students highlights a global mental health issue that requires urgent attention. The regional variations emphasize the need for culturally tailored interventions to address the mental health challenges faced by nursing students worldwide. Nursing students' ability to manage mental health issues impacts their capacity to provide high-quality care. Therefore, it is crucial for educators, faculty, and researchers to foster a supportive and resilient student body to ensure a diverse and sustainable healthcare workforce.
Description
This study assesses the global prevalence of stress and depressive symptoms among nursing students and identifies contributing factors. We found that 47% of students experienced depressive symptoms, and 49% reported stress. Factors such as younger age, female gender, lower income, and interpersonal conflicts were linked to higher levels of stress and depression. Our findings highlight the need for global mental health interventions and support systems to promote students' well-being.