COVID-19 pandemic and its psychological impact among healthy Portuguese and Spanish nursing students
Few studies have explored the impacts of COVID-19 and lockdown on the mental health of undergraduate nursing students. This study aimed: a) to explore perceived stress among undergraduate nursing students in Portugal and Spain during the COVID-19 pandemic outbreak; and b) to analyze several COVID-19 related factors and psychological issues that may be associated with perceived stress. A cross-sectional study was conducted with a convenience sample of Portuguese and Spanish undergraduate nursing students (n=1075). The data gathered included demographic information, questions about COVID-19 related factors, and psychological issues. Data were analyzed using multiple logistic regression with a degree of significance at p<0.05. High perceived stress scores were found in 558 participants (51.9%). Students with high perceived stress most likely had a COVID-19 diagnosis in their household; their household income had been affected by the COVID-19 pandemic; experienced difficulty falling asleep or sleeping all night; consumed junk food in excess; neglected their appearance; felt headaches, stomach aches, and back pain; and lacked the patience or desire to exercise.
Additionally, high perceived stress was negatively associated with life satisfaction. The results provide evidence that infectious diseases, such as COVID-19, may significantly influence mental health. Further research should explore the long-term psychological effects of the COVID-19 pandemic among nursing students.
1. World Health Organization. Mental health and psychosocial considerations during the COVID-19 outbreak. Published 2020. https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf
2. Nogueira PJ, De Araújo Nobre M, Nicola PJ, Furtado C, Vaz Carneiro A. Excess Mortality Estimation During the COVID-19 Pandemic: Preliminary Data from Portugal. Acta Med Port. 2020;33(6):376-383. doi:10.20344/amp.13928
3. World Health Organization. Numbers at glance. Published 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019?gclid=Cj0KCQjw9b_4BRCMARIsADMUIyrjXDTkj_UICJJQkprBmJ79gUtwUNmW-YIvP0Ci1vIq09xgMzyEn-waAjgBEALw_wcB
4. World Health Organization. Coronavirus disease (COVID-19) pandemic. Published 2020. https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19
5. Organization for Economic Co-operation and Development (OECD). The territorial impact of COVID-19: Managing the crisis across levels of government. Published 2020. http://www.oecd.org/coronavirus/policy-responses/the-territorial-impact-of-covid-19-managing-the-crisis-across-levels-of-government-d3e314e1/
6. Young ME, Norman GR, Humphreys KR. Medicine in the popular press: the influence of the media on perceptions of disease. PLoS One. 2008;3(10):e3552-10. doi:10.1371/journal.pone.0003552
7. Blankenberger B, Williams AM. COVID and the impact on higher education: The essential role of integrity and accountability. Administrative Theory & Praxis. Published online 2020:1-20. doi:10.1080/10841806.2020.1771907
8. Zhai Y, Du X. Addressing collegiate mental health amid COVID-19 pandemic. Psychiatry Research. 2020;288:113003. doi:10.1016/j.psychres.2020.113003
9. Grubic N, Badovinac S, Johri AM. Student mental health in the midst of the COVID-19 pandemic: A call for further research and immediate solutions. Int J Soc Psychiatry. 2020;66(5):517-518. doi:10.1177/0020764020925108
10. McDaid S, Kousoulis A. Tackling social inequalities to reduce mental health problems: How everyone can flourish equally. Published 2020. https://www.mentalhealth.org.uk/publications/tackling-social-inequalities-reduce-mental-health-problems
11. Stangor C, Wallinga J. Introduction to Psychology. Published 2014. https://opentextbc.ca/introductiontopsychology/
12. Shacham M, Hamama-Raz Y, Kolerman R, Mijiritsky O, Ben-Ezra M, Mijiritsky E. COVID-19 Factors and Psychological Factors Associated with Elevated Psychological Distress among Dentists and Dental Hygienists in Israel. IJERPH. 2020;17(8):2900. doi:10.3390/ijerph17082900
13. Folkman S. Stress, coping, and hope. Psycho-Oncology. 2010;19(9):901-908. doi:10.1002/pon.1836
14. Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research. 2020;287:112934. doi:10.1016/j.psychres.2020.112934
15. Savitsky B, Findling Y, Ereli A, Hendel T. Anxiety and coping strategies among nursing students during the covid-19 pandemic. Nurse Education in Practice. 2020;46:102809. doi:10.1016/j.nepr.2020.102809
16. Wills E, Mcewen M. Bases Teóricas de Enfermagem [Theoretical Bases of Nursing]. Artmed Editora; 2015.
17. Querido A. A promoção da esperança em fim-de-vida: avaliação da efetividade de um programa de intervenção em pessoas com doença crónica avançada e progressiva [The promotion of hope at the end-of-life: evaluation of the effectiveness of an intervention program in people with advanced and progressive chronic disease]. Published online 2013.
18. Meseguer M, Fernández M, Soler M. Propiedades Psicométricas de la escala abreviada de Esperanza de Herth (HHI) en una muestra multiocupacional de la Región de Murcia [Psychometric properties of Herth´s short scale (HHI) in a multioccupational sample from Murcia]. In: Comunicación Presentada al I Congreso de Centros Universitarios de Relaciones Laborales y Ciencias Del Trabajo. ; 2013.
19. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. Journal of Health and Social Behavior. 1983;24(4):385-396. doi:10.2307/2136404
20. Trigo M, Canudo N, Branco F, Silva D. Estudo das propriedades psicométricas da Perceived Stress Scale (PSS) na população portuguesa. Psychologica. 2010;53:353-378. doi:10.14195/1647-8606_53_17
21. Remor E. Psychometric properties of a European Spanish version of the Perceived Stress Scale (PSS). Span J Psychol. 2006;9(1):86-93. doi:10.1017/s1138741600006004
22. Firmino C, Valentim O, Sousa L, Antunes A, Marques F, Simões C. Stress, anxiety and depression in Portuguese nursing students. In: Sequeira C, Carvalho JC, Sá L, Seabra P, Silva M, Araújo O, eds. IX Congreso Internacional ASPESM: Salud Mental Para Todos. ASPESM; 2018:109-118.
23. Mirón J, Goldberg X, López-Sola C, et al. Perceived Stress, Anxiety and Depression Among Undergraduate Students: An Online Survey Study. Journal of Depression and Anxiety. 2019;8:330. doi:10.4172/2167-1044.1000330
24. Maia BR, Dias PC. Anxiety, depression and stress in university students: the impact of COVID-19. Estudos de Psicologia (Campinas). 2020;37:e200067. doi:10.1590/1982-0275202037e200067
25. Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian Journal of Psychiatry. 2020;52:102066. doi:10.1016/j.ajp.2020.102066
26. Xiao H, Zhang Y, Kong D, Li S, Yang N. The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China. Med Sci Monit. 2020;26:e923549. doi:10.12659/msm.923549
27. Wang C, Pan R, Wan X, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. IJERPH. 2020;17(5):1729. doi:10.3390/ijerph17051729
28. Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet. 2020;395(10229):1014-1015. doi:10.1016/s0140-6736(20)30633-4
29. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062. doi:10.1016/s0140-6736(20)30566-3
30. Garfin DR, Silver RC, Holman EA. The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure. Health Psychology. 2020;39(5):355-357. doi:10.1037/hea0000875
31. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress amongChinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psych. 2020;33(2):e100213. doi:10.1136/gpsych-2020-100213
32. Xiang YT, Yang Y, Li W, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7(3):228-229. doi:10.1016/s2215-0366(20)30046-8
33. Lee C, Hwang Y. The Effects of Hope, Emotional Intelligence, and Stress on the Self-esteem of Rural Elementary School Students in Korea: The Mediating Effect of Social Support. Indian Journal of Science and Technology. 2016;9(26):1-7. doi:10.17485/ijst/2016/v9i26/97278
34. Runcan P, Iovu M. Emotional Intelligence and Life Satisfaction in Romanian University Students: The Mediating Role of Self-Esteem and Social Support. Revista de Cercetare si Interventie Sociala. 2013;40:137-148.
35. Anbumalar C, Dorathy A, Jaswanti V, Priya D, Reniangelin D. Gender Differences in Perceived Stress levels and Coping Strategies among College Students. The International Journal of Indian Psychology. 2017;4(4):22-33. doi:10.25215/0404.103
36. Eisenbarth C. Coping with stress: gender differences among college students. College Student Journal. 2019;53(2):151.
37. Zachary Z, Brianna F, Brianna L, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obesity Research & Clinical Practice. 2020;14(3):210-216. doi:10.1016/j.orcp.2020.05.004
38. World Health Organization. Mental health and psychosocial considerations during the COVID-19 outbreak. Published 2020. https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf?sfvrsn=6d3578af_2
39. Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The Fear of COVID-19 Scale: Development and Initial Validation. Int J Ment Health Addiction. Published online 2020:1-9. doi:10.1007/s11469-020-00270-8
40. Satici B, Gocet-Tekin E, Deniz ME, Satici SA. Adaptation of the Fear of COVID-19 Scale: Its Association with Psychological Distress and Life Satisfaction in Turkey. Int J Ment Health Addiction. Published online May 8, 2020:1-9. doi:10.1007/s11469-020-00294-0
41. Thakur V, Jain A. COVID 2019-suicides: A global psychological pandemic. Brain, Behavior, and Immunity. 2020;88:952-953. doi:10.1016/j.bbi.2020.04.062