Asian Journal of Nursing Education and Research.

12(1): January - March, 2022

ISSN 2231-1149 (Print) Available online at

2349-2996 (Online) www.anvpublication.org
DOI: 10.52711/2349-2996.2022.00014
Asian Journal of
Vol. 12 | Issue-01|
January - March | 2022 Nursing Education and Research
Home page www.ajner.com

RESEARCH ARTICLE

Depression, Anxiety and Stress among Nursing Students

Namrata Sachan1, Neeraj Yadav1, Priyanka Masih1, Priyanka Spencer1, Rashmi Gautam1,
Rashmi Rawat1, Alwin Issac2*
1
College of Nursing, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
2
All India Institute of Medical Sciences, Bhubaneswar.
*Corresponding Author Email: [email protected], [email protected],
[email protected], [email protected], [email protected],
[email protected], [email protected]
ABSTRACT:
Background: Acquiring enrolment into a collegiate course of study marks the commencement of accomplishing
a vocational destination. Nonetheless, the asperity of collegiate educational activity can be arduous. There isn’t
any incertitude that nursing is a worthwhile and rewarding job for all those who dream of a career in healthcare.
Although the profession has its own perks, demanding and frantic schedule isn’t oblivious. Stress, depression,
and anxiety have the potency to intervene with learning, impact academic achievements, and spoil clinical
practice performance. Methodology: With this view in mind, a cross sectional descriptive study was carried out
among the Nursing colleges in the district of Lucknow, Uttarpradesh to assess the level of stress, depression and
anxiety among the second, third and fourth year B.Sc nursing students using DASS-21 scale. Results: It was
quite astonishing to find out that, among the 300 students who were enrolled into the study; fourth year B.Sc
nursing students had a higher level of stress, depression and anxiety. Conclusion: Managing stress in a
profession like nursing is not easy as pie, yet adaptive techniques should be employed to palliate the pressure and
retrieve control. The key to this lies within each individual, which is to experiment and find out own stress
management techniques that works best for each.

KEYWORDS: Nurses, Students, Depression, Anxiety, Adolescent, Stress

INTRODUCTION: Having to equipoise didactic and clinical courses while

No doubt, nursing is a fruitful and rewarding job for concurrently counterbalancing financial, family and
those who dream of a successful career in health care. other life issues has the potency to exasperate any stress
Along with certain benefits, it comes with a demanding or anxiety induced by the nursing course alone. 5 The
and frenzied schedule. Nursing students undergo high grimness of the nursing syllabus also steers to stress
heightened levels of stress and anxiety end-to-end their and anxiety; because being a loser in either a course or a
education.1 In fact students of nursing encounter program results in lost time and investment in the
additional anxiety, especially test anxiety, than students student’s education, which in turn causes a holdup in
from any of the other healthcare fields of study. 2–4 futurity earning potency.6 Heightened levels of stress
have been linked to mediocre health and depression.7
Regrettably stress and anxiety can have an innumerable
damaging consequences on a student, which faculty see
Received on 18.12.2020 Modified on 10.06.2021 daily.8 Stress can impact health, memory, problem-
Accepted on 28.08.2021 ©A&V Publications All right reserved solving, and the potential to deal, all of which can steer
Asian J. Nursing Education and Research. 2022; 12(1):70-74. to reduced scholastic performance.9 Later on, reduced
DOI: 10.52711/2349-2996.2022.00014 academic performance can steer to elevated stress levels,
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 Asian Journal of Nursing Education and Research. 12(1): January - March, 2022

catching the student in an unhealthful wheel of distress.question is to be answered on a 5 point rating scale. Each
Fortuitously, academicians and decision-makers can of the total score obtained for DAS is multiplied by 2.
enforce many schemes in the nursing curriculum to For depression 0-9 is normal, 10-13 is mild, 14-20 is
reduce stress in scholars. It is imperative to address these
moderate 21-27 is severe and >28 is extreme severe. For
heightened levels of distress in nursing students, as they
anxiety 0-7 is normal, 8-9 is mild, 10-14 is moderate, 15-
can have a detrimental effect on their performance and 19 is severe, >20 is extreme severe. For stress 0-14 is
well-being. normal, 15-18 is mild, 19-25 is moderate, 26-33 is severe
and >34 is extreme severe. Reliability score of DASS-21
In Northern India, there is circumscribed evidence is p=0.9410
relating to mental health troubles among undergraduate
nursing students. Owing to a dearth of data, this study Data was collected after a formal approval from
intended to assess the prevalence of Depression, Anxiety principals of selected Nursing colleges. Then
and Stress (DAS) among nursing students and its pattern Demographic proforma and DASS-21 scale were given
as the academic year progresses. to the students with a brief explanation on the purpose of
the study. They were also assured about the
METHODOLOGY: confidentiality of their responses. The data was analyzed
A Cross sectional descriptive study was conducted. by using statistical measurements and tabulated.
Nursing Colleges in the District of Lucknow were
selected randomly. From the selected colleges, 300 RESULTS AND DISCUSSION:
samples were drawn by Disproportionate Stratified 1) Sample characteristics:
Random Sampling with 100 samples each from 2nd, 3rd Among 2nd year B. Sc nursing students, majority were
and 4th year B. Sc Nursing students. DAS were assessed female (79%), 57% of them stays in hostel, 52% has 6-7
by DASS-21 scale. hours of sleep, 53% did not indulge in spiritual activities
and majority (58%) did not indulge in outdoor activities.
The following data collection instruments were used in Majority (63%) were of the opinion that they choose
order to obtain the relevant data nursing as a profession by choice. (Table-1)

Tool 1: Demographic proforma Among 3rd year B. Sc nursing students, majority were
It consisted of 10 questions and was developed to collect female (67%), 53% of them stays in hostel, 42% has 6-7
the information on sample characteristics. The hours of sleep, majority (55%) did not indulge in
characteristic included: Year of student, Gender, Family spiritual activities and 55% did not indulge in outdoor
income, Residence (Hostelite/Non-hostelite), Hours of activities. Majority (67%) were of the opinion that they
sleep, Hours spend on social media, Spiritual practice, choose nursing as a profession by choice. (Table-1)
Outdoor games, Reason for selecting nursing profession,
Prior history of mental illness. Among 4th year B. Sc nursing students, majority were
female (82%), 56% of them stays in hostel, majority
Tool 2: DASS-21 scale (51%) has 6-7 hours of sleep, 53% spends 1-2 hour on
Tool consists of 21 questions to assess the level of DAS. social media, 66% did not indulge in outdoor activities.
The tool has 21 questions and of the 21 questions, seven Majority (67%) were of the opinion that they choose
questions are based on depression, seven questions are nursing as a profession by choice. (Table-1)
on anxiety, and seven questions are on stress. Each

Table 1: Description of sample characteristics (N=300)

Sl. No. Demographic Proforma 2nd year 3rd year 4th year
Frequency Percentage (%) Frequency Percentage Frequency Percentage
(N=100) (N=100) (%) (N=100) (%)
1.1 Year of student 100 100 100 100 100 100
1.2 Gender
a) Male 21 21 33 33 18 18
b) Female 79 79 67 67 82 82
1.3 Income
a) < 10,000 Rs 10 10 9 9 15 15
b) 10,000 – 20,000 16 16 18 18 23 23
c) 20,000 – 30,000 36 36 26 26 28 28
d) >30,000 38 38 47 47 34 34
1.4 Resides in
a) Hostel 57 57 53 53 56 56
b) Home 43 43 47 47 44 44

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1.5 Hours of sleep

a) 2 - 6 hrs 25 25 24 24 25 25
b) 6 – 7 hrs 52 52 42 42 51 51
c) 7 – 8 hrs 19 19 27 27 12 12
d) >8 hrs 4 4 7 7 12 12
1.6 Hours spent on social
media
a) <1 hr 28 28 19 19 17 17
b) 1 – 2 hr 36 36 37 37 53 53
c) 2 – 3 hrs 16 16 37 37 21 21
d) NA 20 20 7 7 9 9
1.7 Indulgence in spiritual
practice
a) Yes 53 53 45 45 50 50
b) No 47 47 55 55 50 50
1.8 Indulgence in outdoor
games
a) Yes 42 42 45 45 34 34
b) No 58 58 55 55 66 66
1.9 Reason for selecting
this course
a) by force 57 57 33 33 33 33
b) by choice 63 63 67 67 67 67
1.10 Prior history of mental
illness
a) Anxiety 3 3 1 1 4 4
b) Depression 3 3 0 0 4 04
c) Stress 15 15 17 17 14 14
d) None 79 79 82 82 78 78

2) Depression among nursing students: extremely severe levels of anxiety. Among 3 rd year
Assessment of depression level among B.Sc nursing 9(9%) has severe levels of anxiety and 19(19%) has
students revealed that among 2nd year B.Sc nursing extremely severe levels of anxiety. Among 4th year
students 7(7%) has severe depression and 2(2%) has 18(18%) has severe levels of anxiety and 13(13%) has
extremely severe levels of depression. Among 3 rd year extremely severe levels of anxiety. (Figure 2)
6(6%) has severe levels of depression and 5(5%) has
extremely severe levels of depression. Among 4th year
10(10%) has severe levels of depression and 10(10%)
has extremely severe levels of depression. (Figure 1)

Figure 2: Level of anxiety among nursing students

4) Stress among nursing students:

Assessment of stress level among B.Sc nursing students
Figure 1: Level of depression among nursing students revealed that among 2nd year B.Sc nursing students
12(12%) has severe stress and 4(4%) has extremely
3) Anxiety among nursing students: severe levels of stress. Among 3rd year 10(10%) has
Assessment of anxiety level among B.Sc nursing severe levels of stress and 2(2%) has extremely severe
th
students revealed that among 2nd year B.Sc nursing levels of stress. Among 4 year 10(10%) has severe
students 16(16%) has severe anxiety and 14(14%) has levels of stress and 13(13%) has extremely severe levels
of stress. (Figure 3)
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 Asian Journal of Nursing Education and Research. 12(1): January - March, 2022

ACKNOWLEDGEMENT:
The authors are highly indebted to all the participants
and administrators of the institute who lend their helping
hands in completion of the study.

CONFLICT OF INTEREST:
The authors declare no conflict of interest.

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