Adapting to Covid-19 Pandemic: A Critical Literature Review of the Psychological Impact among Nursing Students
DOI:
https://doi.org/10.31674/mjn.2022.v13i04.012Abstract
Introduction: The Coronavirus disease 2019 (COVID-19) was first identified in Wuhan City, China, in 2019. Efforts were made to cordon off the city in a bid to contain the virus. The tumultuous developments in nursing education, along with the national healthcare crisis caused by the COVID19 pandemic, formed a precarious direction for nursing faculty, many of whom had little prior experience teaching in an online environment. This literature review aims to understand the psychological impacts of the COVID-19 pandemic on nursing students.
Methods: A literature search was conducted with the following electronic databases: ProQuest, EBSCOhost, Medline, Google Scholar, PubMed and National Center for Biotechnology Information (NCBI). Search terms included "psychological impacts," "mental health," "COVID-19," "pandemic", and "nursing students". The articles were reviewed based on relevance. The inclusion criteria consisted of (1) pre-licensure nursing students; (2) mental health as the key issue; (3) during the ongoing COVID-19 pandemic; (4) journal article and a research manuscript. A total of 104 articles were initially found using the above keywords. After screening using the criteria, 23 articles were relevant to be included in this review.
Results: The themes that were identified after a comprehensive review of the articles are:
(1) depression, (2) anxiety, (3) stress, (4) fear and (5) academic performance.
Conclusion: The nursing students had to endure psychological impacts due to the COVID-19 pandemic and all the changes it brought about. Nursing educators must find the right balance between best-fit teaching methods and a supportive role in their students' mental health.
Keywords:
Psychological Impact, Covid-19, Pandemic, Nursing Students, Mental HealthDownloads
References
Asaad, A., El-Sokkary, R., Alzamanan, M., & El-Shafei, M. (2020). Knowledge and attitudes towards middle east respiratory syndrome-coronavirus (MERS-CoV) among health care workers in South-Western Saudi Arabia. Eastern Mediterranean Health Journal, 26(4), 435–442. https://doi.org/10.26719/emhj.19.079
Aslan, H., & Pekince, H. (2020). Nursing students’ views on the COVID-19 pandemic and their perceived stress levels. Perspectives in Psychiatric Care, 695–701. https://doi.org/10.1111/ppc.12597
Assi, M., Maatouk, I., & Jaspal, R. (2020). Psychological distress and self-harm in a religiously diverse sample of Lebanese students. Mental Health, Religion & Culture, 23(7), 591–605. https://doi.org/10.1080/13674676.2020.1788524
Bakker, E. J. M., Kox, J. H. A. M., Boot, C. R. L., Francke, A. L., van der Beek, A. J., & Roelofs, P. D. D. M. (2020). Improving mental health of student and novice nurses to prevent dropout: A systematic review. Journal of Advanced Nursing, 76(10), 2494–2509. https://doi.org/10.1111/jan.14453
Becerra-García, J. A., Giménez Ballesta, G., Sánchez-Gutiérrez, T., Barbeito Resa, S., & Calvo Calvo, A. (2020). Psychopathological symptoms during Covid-19 quarantine in spanish general population: a preliminary analysis based on sociodemographic and occupational-contextual factors. Revista Espanola de Salud Publica, 94.
Begam, B., & Devi, K. (2020). A Study to Assess the Perceived Stress among Nursing Students during COVID-19 Lockdown. International Journal of Science and Healthcare Research, 5, 388.
Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 287(112934), 112934. https://doi.org/10.1016/j.psychres.2020.112934
Carolan, C., Davies, C. L., Crookes, P., McGhee, S., & Roxburgh, M. (2020). COVID 19: Disruptive impacts and transformative opportunities in undergraduate nurse education. Nurse Education in Practice, 46(102807), 102807. https://doi.org/10.1016/j.nepr.2020.102807
Chen, J.-Y. (2010). Morale and role strain of undergraduate nursing students in a pediatric clinical setting. The Journal of Nursing Research: JNR, 18(2), 144–153. https://doi.org/10.1097/JNR.0b013e3181e365a0
Choi, E. P. H., Ho, M., & Smith, R. (2020). What can we do for part-time nursing students during the COVID-19 pandemic? Medical Education, 54(7), 667–668. https://doi.org/10.1111/medu.14196
Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. (2020). The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nature Microbiology, 5(4), 536–544. https://doi.org/10.1038/s41564-020-0695-z
Cullen, W., Gulati, G., & Kelly, B. D. (2020). Mental health in the COVID-19 pandemic. QJM: Monthly Journal of the Association of Physicians, 113(5), 311–312. https://doi.org/10.1093/qjmed/hcaa110
Deo, P. K., Budhathoki, S., Raut, J., Adhikari, B., & Shrestha, J. (2020). Factors Associated with Perceived Stress, Anxiety, Depression, Insomnia during COVID-19 Outbreak among Nursing Students. International Journal of Science and Research, 9(9), 23–29. https://doi.org/10.21275/SR20826170002
Dong, L., & Bouey, J. (2020). Public mental health crisis during COVID-19 pandemic, China. Emerging Infectious Diseases, 26(7). https://doi.org/10.3201/eid2607.202407
Dubey, S., Biswas, P., Ghosh, R., Chatterjee, S., Dubey, M. J., Chatterjee, S., Lahiri, D., Lavie, C. J. ;. S., Biswas, P., Ghosh, R., Chatterjee, S., Dubey, M. J., Chatterjee, S., Lahiri, D., & Lavie, C. J. (2020). Psychosocial impact of COVID-19. Diabetes and Metabolic Syndrome. Clinical Research and Reviews, 5.
Eweida, R. S., Rashwan, Z. I., Desoky, G. M., & Khonji, L. M. (2020). Mental strain and changes in psychological health hub among intern-nursing students at pediatric and medical-surgical units amid ambience of COVID-19 pandemic: A comprehensive survey. Nurse Education in Practice, 49(102915), 102915. https://doi.org/10.1016/j.nepr.2020.102915
Fitzgerald, A., & Konrad, S. (2021). Transition in learning during COVID-19: Student nurse anxiety, stress, and resource support. Nursing Forum, 56(2), 298–304. https://doi.org/10.1111/nuf.12547
Fowler, K., & Wholeben, M. (2020). COVID-19: Outcomes for trauma-impacted nurses and nursing students. Nurse Education Today, 93(104525), 104525. https://doi.org/10.1016/j.nedt.2020.104525
García-González, J., Ruqiong, W., Alarcon-Rodriguez, R., Requena-Mullor, M., Ding, C., & Ventura-Miranda, M. I. (2021). Analysis of anxiety levels of nursing students because of e-learning during the COVID-19 pandemic. Healthcare (Basel, Switzerland), 9(3), 252. https://doi.org/10.3390/healthcare9030252
Green, C. (2020). Teaching accelerated nursing students’ self-care: A pilot project. Nursing Open, 7(1), 225–234. https://doi.org/10.1002/nop2.384
Guillasper, J. N., Oducado, R. M. F., & Soriano, G. P. (2021). Protective role of resilience on COVID-19 impact on the quality of life of nursing students in the Philippines. Belitung Nursing Journal, 7(1), 43–49. https://doi.org/10.33546/bnj.1297
Hsieh H.-Y., Hsu Y.-Y., Ko N.-Y., & Yen M. (2020). Nursing education strategies during the COVID-19 epidemic. Hu li za zhi The Journal of Nursing, 67(3), 96–101. https://doi.org/10.6224/JN.202006_67(3).13
Huang, L., Lei, W., Xu, F., Liu, H., & Yu, L. (2020). Emotional responses and coping strategies in nurses and nursing students during Covid-19 outbreak: A comparative study. PloS One, 15(8), e0237303. https://doi.org/10.1371/journal.pone.0237303
Hysenbegasi, A., Hass, S. L., & Rowland, C. R. (2005). The impact of depression on the academic productivity of university students. The Journal of Mental Health Policy and Economics, 8(3), 145–151.
Inés Gallego-Gómez, J., Campillo-Cano, M., Carrión-Martínez, A., Balanza, S., Teresa Rodríguez-González-Moro, M., & Simonelli-Muñoz, A. J. (2020). The COVID-19 Pandemic and Its Impact on Homebound Nursing Students. 1–12.
Iorga, M., Dondas, C., & Zugun-Eloae, C. (2018). Depressed as freshmen, stressed as seniors: The relationship between depression, perceived stress and academic results among medical students. Behavioral Sciences, 8(8). https://doi.org/10.3390/bs8080070
Jackson, D., Bradbury-Jones, C., Baptiste, D., Gelling, L., Morin, K., Neville, S., & Smith, G. D. (2020). Life in the pandemic: Some reflections on nursing in the context of COVID-19. Journal of Clinical Nursing, 29(13–14), 2041–2043. https://doi.org/10.1111/jocn.15257
Jung, S. J., & Jun, J. Y. (2020). Mental health and psychological intervention amid COVID-19 outbreak: Perspectives from South Korea. Yonsei Medical Journal, 61(4), 271–272. https://doi.org/10.3349/ymj.2020.61.4.271
Kalkan Uğurlu, Y., Mataracı Değirmenci, D., Durgun, H., & Gök Uğur, H. (2021). The examination of the relationship between nursing students’ depression, anxiety and stress levels and restrictive, emotional, and external eating behaviors in COVID-19 social isolation process. Perspectives in Psychiatric Care, 57(2), 507–516. https://doi.org/10.1111/ppc.12703
Kim, J. S., & Choi, J. S. (2016). Factors influencing emergency nurses’ burnout during an outbreak of Middle East respiratory syndrome Coronavirus in Korea. Asian Nursing Research, 10(4), 295–299. https://doi.org/10.1016/j.anr.2016.10.002
Leigh, J., Vasilica, C., Dron, R., Gawthorpe, D., Burns, E., Kennedy, S., Kennedy, R., Warburton, T., & Croughan, C. (2020). Redefining undergraduate nurse teaching during the coronavirus pandemic: use of digital technologies. British Journal of Nursing (Mark Allen Publishing), 29(10), 566–569. https://doi.org/10.12968/bjon.2020.29.10.566
Li, Z.-S., & Hasson, F. (2020). Resilience, stress, and psychological well-being in nursing students: A systematic review. Nurse Education Today, 90(104440), 104440. https://doi.org/10.1016/j.nedt.2020.104440
Ma, Y., Rosenheck, R., & He, H. (2020). Psychological stress among health care professionals during the 2019 novel coronavirus disease Outbreak: Cases from online consulting customers. Intensive & Critical Care Nursing: The Official Journal of the British Association of Critical Care Nurses, 61(102905), 102905. https://doi.org/10.1016/j.iccn.2020.102905
McKenzie, S. H., & Harris, M. F. (2013). Understanding the relationship between stress, distress and healthy lifestyle behaviour: a qualitative study of patients and general practitioners. BMC Family Practice, 14(1), 166. https://doi.org/10.1186/1471-2296-14-166
Medina Fernández, I. A., Carreño Moreno, S., Chaparro Díaz, L., Gallegos-Torres, R. M., Medina Fernández, J. A., & Hernández Martínez, E. K. (2021). Fear, stress, and knowledge regarding COVID-19 in nursing students and recent graduates in Mexico. Investigacion y Educacion En Enfermeria, 39(1). https://doi.org/10.17533/udea.iee.v39n1e05
Merikangas, K. R., He, J.-P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989. https://doi.org/10.1016/j.jaac.2010.05.017
Mitchell, A. E. P. (2018). Psychological distress in student nurses undertaking an educational programme with professional registration as a nurse: their perceived barriers and facilitators in seeking psychological support. Journal of Psychiatric and Mental Health Nursing, 25(4), 258–269. https://doi.org/10.1111/jpm.12459
Morin, K. H. (2020). Nursing education after COVID-19: Same or different? Journal of Clinical Nursing, 29(17–18), 3117–3119. https://doi.org/10.1111/jocn.15322
Njim, T., Mbanga, C., Mouemba, D., Makebe, H., Toukam, L., Kika, B., & Mulango, I. (2020). Determinants of depression among nursing students in Cameroon: a cross-sectional analysis. BMC Nursing, 19(1), 26. https://doi.org/10.1186/s12912-020-00424-y
Oducado, R. M., Tuppal, C., Estoque, H., Sadang, J., Superio, D., Real, D. V., Roa, M. N., Malaga, X., Quiros, J., Fajardo, M. T., & Dela Rosa, R. (2021). Internet use, eHealth literacy and fear of COVID-19 among nursing students in the Philippines. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3762848
Przedworski, J. M., Dovidio, J. F., Hardeman, R. R., Phelan, S. M., Burke, S. E., Mphil, M. A., Ruben, S. P., Perry, D. J., Burgess, D. B., Nelson, M. W., Yeazel, J. M., & Knudsen, M. (2016). A Comparison of the Mental Health and Well-Being of Sexual Minority and Heterosexual First-Year Medical Students: A Report From Medical Student CHANGES. Physiology & Behavior, 176(1), 139–148.
Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020). A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. General Psychiatry, 33(2), e100213. https://doi.org/10.1136/gpsych-2020-100213
Rafati, F., Nouhi, E., Sabzevari, S., & Dehghan-Nayeri, N. (2017). Coping strategies of nursing students for dealing with stress in clinical setting: A qualitative study. Electronic Physician, 9(12), 6120–6128. https://doi.org/10.19082/6120
Rahman, M. A., Hoque, N., Alif, S. M., Salehin, M., Islam, S. M. S., Banik, B., Sharif, A., Nazim, N. B., Sultana, F., & Cross, W. (2020). Factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia. Globalization and Health, 16(1), 95. https://doi.org/10.1186/s12992-020-00624-w
Ramos-Morcillo, A. J., Leal-Costa, C., Moral-García, J. E., & Ruzafa-Martínez, M. (2020). Experiences of nursing students during the abrupt change from face-to-face to e-learning education during the first month of confinement due to COVID-19 in Spain. International Journal of Environmental Research and Public Health, 17(15), 5519. https://doi.org/10.3390/ijerph17155519
Reverté-Villarroya, S., Ortega, L., Lavedán, A., Masot, O., Burjalés-Martí, M. D., Ballester-Ferrando, D., Fuentes-Pumarola, C., & Botigué, T. (2021). The influence of COVID-19 on the mental health of final-year nursing students: comparing the situation before and during the pandemic. International Journal of Mental Health Nursing, 30(3), 694–702. https://doi.org/10.1111/inm.12827
Ribeiro, F. M. S. E. S., Mussi, F. C., Pires, C. G. da S., Silva, R. M. da, Macedo, T. T. S. de, & Santos, C. A. de S. T. (2020). Stress level among undergraduate nursing students related to the training phase and sociodemographic factors. Revista Latino-Americana de Enfermagem, 28, e3209. https://doi.org/10.1590/1518-8345.3036.3209
Ridner, S. H. (2004). Psychological distress: concept analysis. Journal of Advanced Nursing, 45(5), 536–545. https://doi.org/10.1046/j.1365-2648.2003.02938.x
Ríos-Risquez, M. I., García-Izquierdo, M., Sabuco-Tebar, E. de L. Á., Carrillo-Garcia, C., & Solano-Ruiz, C. (2018). Connections between academic burnout, resilience, and psychological well‐being in nursing students: A longitudinal study. Journal of Advanced Nursing, 74(12), 2777–2784. https://doi.org/10.1111/jan.13794
Roca, J., Canet-Vélez, O., Cemeli, T., Lavedán, A., Masot, O., & Botigué, T. (2021). Experiences, emotional responses, and coping skills of nursing students as auxiliary health workers during the peak COVID-19 pandemic: A qualitative study. International Journal of Mental Health Nursing, 30(5), 1080–1092. https://doi.org/10.1111/inm.12858
Romero-Blanco, C., Rodríguez-Almagro, J., Onieva-Zafra, M. D., Parra-Fernández, M. L., Prado-Laguna, M. D. C., & Hernández-Martínez, A. (2020). Sleep pattern changes in nursing students during the COVID-19 lockdown. International Journal of Environmental Research and Public Health, 17(14), 5222. https://doi.org/10.3390/ijerph17145222
Savitsky, B., Findling, Y., Ereli, A., & Hendel, T. (2020). Anxiety and coping strategies among nursing students during the covid-19 pandemic. Nurse Education in Practice, 46(102809), 102809. https://doi.org/10.1016/j.nepr.2020.102809
Siegel, R. S., & Dickstein, D. P. (2012). Anxiety in adolescents: Update on its diagnosis and treatment for primary care providers. Adolescent Health, Medicine and Therapeutics, 3, 1–16. https://doi.org/10.2147/AHMT.S7597
Smith, G. D., Ng, F., & Ho Cheung Li, W. (2020). COVID-19: Emerging compassion, courage and resilience in the face of misinformation and adversity. Journal of Clinical Nursing, 29(9–10), 1425–1428. https://doi.org/10.1111/jocn.15231
Sögüt, S., Dolu, İ., & Cangöl, E. (2021). The relationship between COVID-19 knowledge levels and anxiety states of midwifery students during the outbreak: A cross-sectional web-based survey. Perspectives in Psychiatric Care, 57(1), 246–252. https://doi.org/10.1111/ppc.12555
Stark, M. A., Manning-Walsh, J., & Vliem, S. (2005). Caring for self while learning to care for others: a challenge for nursing students. The Journal of Nursing Education, 44(6), 266–270. https://doi.org/10.3928/01484834-20050601-05
Taylor, R., Thomas-Gregory, A., & Hofmeyer, A. (2020). Teaching empathy and resilience to undergraduate nursing students: A call to action in the context of Covid-19. Nurse Education Today, 94(104524), 104524. https://doi.org/10.1016/j.nedt.2020.104524
Tee, M. L., Tee, C. A., Anlacan, J. P., Aligam, K. J. G., Reyes, P. W. C., Kuruchittham, V., & Ho, R. C. (2020). Psychological impact of COVID-19 pandemic in the Philippines. Journal of Affective Disorders, 277, 379–391. https://doi.org/10.1016/j.jad.2020.08.043
Tung, Y.-J., Lo, K. K. H., Ho, R. C. M., & Tam, W. S. W. (2018). Prevalence of depression among nursing students: A systematic review and meta-analysis. Nurse Education Today, 63, 119–129. https://doi.org/10.1016/j.nedt.2018.01.009
Usher, K., Wynaden, D., Bhullar, N., Durkin, J., & Jackson, D. (2020). The mental health impact of COVID-19 on pre-registration nursing students in Australia. International Journal of Mental Health Nursing, 29(6), 1015–1017. https://doi.org/10.1111/inm.12791
Wang, C., & Zhao, H. (2020). The impact of COVID-19 on anxiety in Chinese university students. Frontiers in Psychology, 11, 1168. https://doi.org/10.3389/fpsyg.2020.01168
WHO announces COVID-19 outbreak a pandemic (2020). https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who-announces-covid-19-outbreak-a-pandemic
Xavier, B., Camarneiro, A. P., Loureiro, L., Menino, E., Cunha-Oliveira, A., & Monteiro, A. P. (2020). Impact of covid-19 on the family, social, and academic dynamics of nursing students in Portugal. Revista de Enfermagem Referencia, 2020(4). https://doi.org/10.12707/RV20104
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