Abstract
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.
Highlights
The COVID-19 pandemic and subsequent mandatory lockdown to suppress transmission of the SARS-CoV-2 virus have caused significant global disruption of the educational system
The study findings showed that female gender, concerns of academic progress, and fear of infection correlated with higher anxiety
Almost a quarter (23.1%) were registered nurses enrolled in graduate programs or with COVID-19 patients, while three quarters had experienced quarantine or self-isolation a baccalaureate degree completion program
Summary
The COVID-19 pandemic and subsequent mandatory lockdown to suppress transmission of the SARS-CoV-2 virus have caused significant global disruption of the educational system. The rapid shift from inperson to online learning, as well as concerns over educational progress and future job opportunities, contributed greatly to increased levels of stress and anxiety [3,4]. A national survey of 26,181 college students in USA reported that about a half were either diagnosed or treated for anxiety, depression, or panic attacks within the past year [5]. In China, the arrival of the COVID-19 pandemic has resulted in even higher levels of stress, anxiety, and depression among college students [8,9]. A study from Israel demonstrated that during the third week of COVID-19 lockdown, more than half of nursing students reported moderateto-severe anxiety symptoms [10]. The study findings showed that female gender, concerns of academic progress, and fear of infection correlated with higher anxiety
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
