i

Dear community of the Chilean Journal of Nursing, we inform you that we continue to receive articles for publication this 2024,
with a continuous publication system on Nursing and Health Sciences topics;
and an average publication time of nine weeks from article submission to publication. (GUIDELINES FOR THE AUTOR)

 

Relationship between clinical practice and mental health in nursing students at a Chilean university

Authors

Download

Abstract

Introduction: Nursing education involves a high academic workload and early exposure to complex clinical contexts, factors that can affect students’ mental health. Methodology: Quantitative correlational cross-sectional study. The Depression, Anxiety and Stress Scale was applied to students from different academic levels. Sociodemographic data, academic workload, and clinical experiences were collected in person. Descriptive analyses of sociodemographic variables and inferential analyses using Student’s t-test and one-way ANOVA were performed. The study was approved by the institutional Ethics Committee. Results: The sample consisted of 105 students from the second (n=31), third (n=39), and fourth year (n=35), selected through non-probabilistic convenience sampling. It included 67.6% women and 28.6% men. Men reported higher levels of depression (M=9.87), anxiety (M=16.07), and stress (M=19.60) than women (M=8.53; M=13.31; M=18.96), although without statistically significant differences (p>0.05). Third-year students showed higher means in all three variables, suggesting greater academic demands at this level. Furthermore, students who reported negative clinical experiences presented higher levels of anxiety (M=15.48) compared to those with positive experiences (M=12.68). Conclusions: Academic workload and the quality of clinical experiences have a significant impact on the mental health of nursing students. Identifying risk groups and critical moments makes it possible to guide emotional support strategies and strengthen coping skills from the early stages of training.

Keywords:

Nursing Students , Psychological Stress , Anxiety , Depression , Mental Health

References

Osborn TL, Wasanga CM, Ndetei DM. Transforming mental health for all. The BMJ. 2022; 377:o1593. https://doi.org/10.1136/bmj.o1593

Organización Mundial de la Salud (OMS). Salud mental: fortalecer nuestra respuesta. Ginebra: OMS; 2018. https://www.who.int/es/news-room/fact-sheets/detail/mental-health-strengthening-our-response

Martins TB, Lorenzetti Branco JH, Martins TB, Santos GM, Andrade A. Impact of social isolation during the COVID-19 pandemic on the mental health of university students and recommendations for the post-pandemic period: A systematic review. Brain, Behav Immun – Heal. 2025;43:100941. https://doi.org/10.1016/j.bbih.2024.100941

Haruna U, Mohammed AR, Braimah M. Understanding the burden of depression, anxiety and stress among first-year undergraduate students. BMC Psychiatry. 2025;25(1). https://doi.org/10.1186/s12888-025-07069-8

Shiraly R, Roshanfekr A, Asadollahi A, Griffiths MD. Psychological distress, social media use, and academic performance of medical students: the mediating role of coping style. BMC Med Educ. 2024;24(1). https://doi.org/10.1186/s12909-024-05988-w

Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391–400. https://doi.org/10.1016/j.jpsychires.2012.11.015

World Health Organization. Expanding our understanding of Post COVID-19 condition: report of a WHO webinar. Geneva: WHO. 2021. https://www.who.int/publications/i/item/9789240025035

Li W, Zhao Z, Chen D, Peng Y, Lu Z. Prevalence and associated factors of depression and anxiety symptoms among college students: a systematic review and meta‐analysis. J Child Psychol . 2022;63(11):1222–1230. https://doi.org/10.1111/jcpp.13606

Dessauvagie AS, Dang HM, Nguyen TAT, Groen G. Mental Health of University Students in Southeastern Asia: A Systematic Review. Asia Pacific J Public Heal. 2022;34(2–3):172–181. https://doi.org/10.1177/10105395211055545

Instituto Nacional de la Juventud (INJUV). La salud mental de los jóvenes en Chile claves y perspectivas para abordar la problemática. Revisa RT. 2019;30:1-16

Macías M, Madariaga C, Valle M, Zambrano J. Estrategias de afrontamiento individual y familiar frente a situaciones de estrés psicológico. Psicol desde el Caribe. 2013;30(1):123–45.

Pulido‐Martos M, Augusto‐Landa JM, Lopez‐Zafra E. Sources of stress in nursing students: a systematic review of quantitative studies. Int Nurs Rev. 2012;59(1):15–25. https://doi.org/10.1111/j.1466-7657.2011.00939.x

Jimenez C, Navia‐Osorio PM, Diaz CV. Stress and health in novice and experienced nursing students. J Adv Nurs. 2010;66(2):442–455. https://doi.org/10.1111/j.1365-2648.2009.05183.x

Labrague LJ. Umbrella Review: Stress Levels, Sources of Stress, and Coping Mechanisms among Student Nurses. Nurs Reports. 2024;14(1):362–75. https://doi.org/10.3390/nursrep14010028

Vo TN, Chiu HY, Chuang YH, Huang HC. Prevalence of Stress and Anxiety Among Nursing Students: A Systematic Review and Meta-analysis. Nurse Educ. 2023 May;48(3):E90–E95. https://doi.org/10.1097/nne.0000000000001343

Andargeery SY, Altaweel EA, Alkorbi FS, Alyousef LA, Alanazi BF, Idriss SH, et al. Nursing students’ academic burnout: its prevalence and association with self-efficacy, psychological distress, and quality of learning experience. BMC Nurs. 2025;24(1). https://doi.org/10.1186/s12912-025-03242-2

Al‐Zayyat AS, Al‐Gamal E. Perceived stress and coping strategies among Jordanian nursing students during clinical practice in psychiatric/mental health courses. Int J Ment Health Nurs. 2014;23(4):326–335. https://doi.org/10.1111/inm.12054

Jeng C, Braun LT. Bandura’s Self-Efficacy Theory. J Holist Nurs. 1994;12(4):425–436. https://doi.org/10.1177/089801019401200411

Momeni M, Asadi M, Shadin H, Noorian S, Senmar M. Self-efficacy of clinical performance in nursing students and its relationship with the motivation of field choice and clinical education status. BMC Med Educ. 2025;25(1). https://doi.org/10.1186/s12909-025-07372-8

Labrague LJ, McEnroe-Petitte DM, Gloe D, Thomas L, Papathanasiou I V., Tsaras K. A literature review on stress and coping strategies in nursing students. J Ment Heal. 2017;26(5):471–480. https://doi.org/10.1080/09638237.2016.1244721

Antúnez Z, Vinet E V. Escalas de Depresión, Ansiedad y Estrés (DASS - 21): Validación de la Versión abreviada en Estudiantes Universitarios Chilenos. Ter psicológica. 2012;30(3):49–55. http://dx.doi.org/10.4067/S0718-48082012000300005

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. PLoS Med. 2007;4(10):e296. https://doi.org/10.1136/bmj.39335.541782.AD

San Rafael-Gutiérrez S, Arreciado-Marañón A, Bernaus-Poch E, Vers-Prat O. Factores que influyen en la elección de los estudios de enfermería. Enferm Clin. 2010;20(4):236–42. https://doi.org/10.1016/j.enfcli.2010.04.003

Ayala RA, Holmqvist MT, Messing HB, Browne RF. Blessed art thou among women: male nursing students and gender inequalities in Chile. Nurse Educ Today. 2014 Dec;34(12):1480–1484. https://doi.org/10.1016/j.nedt.2014.04.022

Sevilla MP, Rangel VS. Males in nurse technician programs: a social cognitive analysis of gender differences in career development. Int J Educ Vocat Guid. 2024. https://doi.org/10.1007/s10775-024-09679-2

Salvo J, Villagrán F, Aravena C, Campos D, Cid J, Cruces S, et al. Depresión, ansiedad y estrés en estudiantes de enfermería. J Heal med sci. 2021;7(2):80–90.

De la Cruz Machay KL. Resiliencia en estudiantes de pregrado de enfermería: una revisión sistemática. Investig e Innovación Rev Científica Enfermería. 2024;4(1):91–104. https://doi.org/10.33326/27905543.2024.1.1883

Sánchez-Padilla ML, Hernández-Benítez R, González-Muñoz S. Depresión, ansiedad y estrés post COVID-19 en estudiantes del Área Académica de Enfermería del Instituto de Ciencias de la Salud de la Universidad Autónoma del Estado de Hidalgo. Educ y Salud: Boletín Científico. 2023;11(22):166–171. https://doi.org/10.29057/icsa.v11i22.10641

Maza Ramon EL, Carrión Cabrera MS. Nivel de estrés, ansiedad y depresión en estudiantes de enfermería de la Universidad Nacional de Loja. Enfermería Investig. 2023;8(3):11–6.

Cleary M, Visentin D, West S, Lopez V, Kornhaber R. Promoting emotional intelligence and resilience in undergraduate nursing students: An integrative review. Nurse Educ Today. 2018;68:112–120. https://doi.org/10.1016/j.nedt.2018.05.018

Dwyer PA, Hunter Revell SM. Preparing Students for the Emotional Challenges of Nursing: An Integrative Review. J Nurs Educ. 2015;54(1):7–12. https://doi.org/10.3928/01484834-20141224-06