Aims
To examine the impact of various factors affecting nurses' mental health during the COVID‐19 pandemic.
Design
An online cross‐sectional study.
Methods
Registered nurses who graduated from a nursing school in Southern California, USA, participated in the study from 20 April–10 May 2020 (
N
= 320). Kendall's tau correlations and multivariate logistic regression procedures were performed with stress, anxiety and depression as outcome variables.
Results
Most nurses reported moderate/high stress (80.1%), while 43% and 26% reported moderate/severe anxiety and depression, respectively. COVID‐19 patient care was positively associated with moderate/severe high stress (OR = 2.25;
p
= .012) and moderate/severe anxiety (OR = 3.04;
p
< .001), whereas quarantine was associated with moderate/severe depression (OR = 2.68;
p
< .001). High levels of family functioning, resilience and spirituality predicted two‐ to sixfold lower odds of moderate/severe stress, anxiety or depression. High resilience, spirituality and family functioning appear to be good coping mechanisms for nurses against stress, anxiety and depression during the pandemic.
The COVID-19 pandemic and consequent lockdown have precipitated significant disruption in the educational system. Nursing students are known to have higher levels of stress and anxiety than other non-nursing students, but there is a dearth of evidence regarding the impacts of the COVID-19 lockdown on their mental health and coping mechanisms. Purpose: The aim of this study was to explore the influence of coping mechanisms as predictors of stress, anxiety, and depression among nursing students during the COVID-19 lockdown. Methods: A cross-sectional online survey was conducted from 20 April to 10 May 2020 among 173 nursing students at a private university in Southern California, USA. Results: Self-reported stress, anxiety, and depression were significantly higher during the lockdown compared to the pre-lockdown period (p < 0.001). Almost a quarter of participants reported high stress, while more than half reported moderate-to-severe symptoms of anxiety and depression. High resilience was negatively associated with high stress (Odds Ratio (OR) = 0.46; 95% Confidence Interval (CI) = 0.22–0.98; p = 0.045), moderate-to-severe anxiety (OR = 0.47; 95%CI = 0.25–0.90; p = 0.022), and moderate-to-severe depression (OR = 0.50; 95%CI = 0.26–0.95; p = 0.036). Similarly, high family functioning was negatively associated with high stress (OR = 0.41; 95%CI = 0.20–0.86; p = 0.018), moderate-to-severe anxiety (OR = 0.41; 95%CI = 0.21–0.80; p = 0.009), and moderate-to-severe depression (OR = 0.41; 95%CI = 0.20–0.81; p = 0.011). High spiritual support was negatively associated with moderate-to-severe depression (OR = 0.48; 95%CI = 0.24–0.95; p = 0.035). Conclusions: During the COVID-19 lockdown, nursing students experienced remarkable levels of poor mental health. High levels of resilience and family functioning were associated with 2- to 2.4-fold lower risk of stress, anxiety, and depression, whereas high spiritual support was associated with 2-fold lower risk of depression. As the pandemic evolves, fostering these coping mechanisms may help students to maintain their psychological wellbeing.
Therapeutic alliance, as measured by KAS-R, predicted approximately one-third of patients' general satisfaction and empowerment was a significant predictor variable.
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