Examining Anxiety and Depression Levels among Undergraduate Nursing Students: A Cross-Sectional Study

Examining Anxiety and Depression Levels among Undergraduate Nursing Students: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Examining Anxiety and Depression Levels among Undergraduate Nursing Students: A Cross-Sectional Study Jalal Uddin, Tazveen Fariha This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4308747/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 29 Dec, 2024 Read the published version in BioMed Target Journal → Version 1 posted You are reading this latest preprint version Abstract Background Mental health is a critical aspect of well-being, especially among undergraduate nursing students. Nursing students face unique stressors that can impact their mental health. This study aimed to determine the of anxiety and depression level among undergraduate nursing students at Chattogram International Nursing College (CINC) in Bangladesh. Methods A cross-sectional study design was employed, and data were collected using an online questionnaire (google form) that included the Hospital Anxiety and Depression Scale (HADS). Convenience sampling was used to select 120 BSc Nursing students aged over 18 years. Data analysis was conducted using SPSS version 25. Results The majority of participants were female (88.3%), and the mean age was 20.47 years. The prevalence of anxiety was 66.0%, with 28.0% scoring in the normal range, 28.0% in the borderline abnormal range, and 38.0% in the abnormal range. For depression, 59.2% scored in the normal range, 22.4% in the borderline abnormal range, and 18.4% in the abnormal range. Pearson correlation test showed gender was significantly associated with anxiety (p = 0.004), while no significant associations were found between depression and gender, academic qualifications, contagious disease status, or close family members' infection status. Conclusion This study highlights a significant burden of anxiety among undergraduate nursing students at CINC, with a substantial proportion experiencing abnormal levels of anxiety. The findings underscore the importance of addressing mental health issues among nursing students and implementing strategies to promote their mental well-being. Health Policy depression anxiety nursing students mental health Background The World Health Organization (WHO) underscores the significance of mental health in its strategy for preventing, treating, and overcoming mental health disorders (WHO, 2013). Mental health issues are a primary cause of disability and a major public health concern globally, posing challenges in disease management and showing an increasing prevalence (Wainberg et al., 2017 ; GBD 2017 Disease and Injury Incidence and Prevalence Collaborators, 2018 ). Depression and anxiety serve as crucial indicators of mental health and when left untreated, can have adverse effects on individuals (Teh et al., 2015 ; Al-Naggar & Al-Naggar, 2012 ). Depression is characterized by symptoms such as loss of interest in daily activities, changes in weight, sleep disturbances, low energy, difficulty concentrating, feelings of worthlessness or guilt, and thoughts of death or suicide (Chand & Arif, 2023 ). Globally, an estimated 12–50% of college students meet the criteria for a mental disorder, highlighting the significant prevalence of mental health issues among this population (Bruffaerts et al., 2018 ). Factors contributing to the development of anxiety and depression among college students include academic stress from exams and workload, limited free time for leisure activities, competitive environments, concerns about meeting parental expectations, the challenge of forming new relationships, and adjusting to a new living environment (Kumaraswamy, 2013 ). Additionally, biological factors such as age and gender, especially being female, can influence the likelihood of experiencing these mental health issues, along with financial pressures (Bangasser et al., 2010 ; Flatt, 2013). Nursing students often face elevated levels of stress compared to students in other academic programs, which can lead to feelings of anxiety and depression (Samson, 2019 ). They are more susceptible to depression than students in other medical fields, likely due to the demanding nature of their coursework and clinical experiences (Moreira & Furegato, 2013 ). Factors contributing to depression among nursing students include academic pressures, challenges in clinical settings, and personal issues (Puthran et al., 2016 ). Research suggests that nursing students are particularly vulnerable to depression during their initial year of education and when they begin clinical rotations (Janatolmakan et al., 2019 ). This study represents the first investigation of depression, and anxiety, among undergraduate nursing students at an educational institute in Bangladesh. The examination of psychiatric morbidity among university students is crucial, as many mental disorders tend to emerge during college years (Scott et al., 2016 ). Given the dearth of data on anxiety and depression rates among undergraduates at Chattogram International Nursing College (CINC), this study aimed to assess the Anxiety and Depression levels among undergraduate Nursing Students in Bangladesh. Methodology This study employed a cross-sectional design to assess the depression and anxiety level among undergraduate nursing students at Chattogram International Nursing College (CINC) in Bangladesh. Sample size The initial sample size for this study was calculated to be 384 using the formula "n = (Z^2 * P * q) / d^2", where "Z" is 1.96, "P" is 0.5, "q" is 1 - P, and "d" is 0.05. Due to limitations in recruitment and data collection, the final number of participants included in the study was 120. Challenges such as difficulties in reaching out to potential participants and time constraints contributed to this reduced sample size. Instruments The questionnaire consisted of two sections: demographic information and the Hospital Anxiety and Depression Scale (HADS). The demographic section of the questionnaire collected information on participants' age, gender, academic qualifications, marital status, living arrangements, and employment status. These variables were chosen to provide a comprehensive overview of the sample population and to allow for the exploration of potential associations with anxiety and depression levels. Hospital Anxiety and Depression Scale (HADS) is a widely used self-report questionnaire designed to assess levels of anxiety and depression in individuals. It consists of 14 items, with 7 items each for the anxiety (HADS-A) and depression (HADS-D) subscales (Michopoulos et al., 2008 ). Participants were asked to rate each item based on how they have been feeling over the past week. Responses were scored on a 4-point Likert scale (0–3), with higher scores indicating more severe symptoms. The total score for each subscale (HADS-A and HADS-D) ranges from 0 to 21, with scores between 0 and 7 considered normal, 8 to 10 indicating borderline abnormality, and 11 to 21 suggesting abnormal levels of anxiety or depression (Michopoulos et al., 2008 ). The HADS has been widely used in various populations and has demonstrated good reliability and validity. Data Collection Data for this study were collected during the last week of December 2023 using a cross-sectional design. The aim was to assess the prevalence of depression and anxiety among undergraduate nursing students at Chattogram International Nursing College (CINC) in Bangladesh. The data collection method involved the use of an online questionnaire created with Google Forms. A total of 120 participants were recruited for the study. Participants were selected using convenience sampling and were required to meet the inclusion criteria of being BSc Nursing students at CINC and being aged 18 years or older. Participation in the study was voluntary, and all participants provided informed consent before completing the questionnaire. Ethical approval for the study was obtained from the institutional review board of CINC. Participants were assured of confidentiality, and their responses were anonymized. Results Table 1 Demographic characteristics of the participants Variable Frequency Percentage Age Mean 20.47 (SD 1.445) 18–20 years 48 40.0 21–22 years 71 59.2 23–25 years 1 0.8 Gender Female 106 88.3 Male 14 11.7 Academic Qualifications B.Sc. in nursing 1st year 41 31.1 B.Sc. in nursing 2nd year 46 34.8 B.Sc. in nursing 3nd year 37 28.0 Marital Status Married 2 1.7 Single 117 97.5 Living with Alone 5 4.2 Friends 42 35 Parents 62 51.7 Relatives 10 8.3 Employment Status Studying 115 95.8 Working and studying 4 3.3 The demographic characteristics of the participants are shown in Table 1 . A total of 120 participants completed the survey, with the majority being female (88.3%) and the remaining 11.7% being male. The age of participants ranged from 18 to 25 years, with the largest proportion falling in the 21–22 age group (59.2%). 31.1% were in their first year of B.Sc in Nursing, constituting 41 individuals. Additionally, 34.8% were in their second year of B.Sc in Nursing, totaling 46 individuals. Furthermore, 28.0% were in their third year of B.Sc in Nursing, comprising 37 individuals. In terms of marital status, the vast majority of participants were single (97.5%), while a small percentage were married (1.7%). Participants reported various living arrangements, with the majority living with their parents (51.7%) or friends (35.0%). Regarding employment status, most participants were studying (95.8%), while a small percentage were working and studying (3.3%). Table 2 Responses to Stress, Fear/Anxiety, and Contagious Disease ​​ Variable Frequency Percentage Do you feel stress in your daily life? No 4 3.3 Sometimes 88 73.3 Yes 28 23.3 Do you experience fear or anxiety in your daily life? No 16 13.3 Sometimes 68 56.7 Yes 36 30 Have you been infected with a contagious disease? No 106 88.3 Yes 13 10.8 Have any of your close family members been infected? No 98 81.7 Yes 21 17.5 Participants' responses regarding stress, fear/anxiety, and contagious diseases are displayed in Table 2 . In terms of stress, the majority of participants reported experiencing stress sometimes (73.3%), while a smaller proportion reported experiencing stress regularly (23.3%). Only a small percentage of participants reported not experiencing stress at all (3.3%). Regarding fear or anxiety, the majority of participants reported experiencing these feelings sometimes (56.7%), while 30.0% reported experiencing fear or anxiety regularly. A smaller percentage of participants reported not experiencing fear or anxiety at all (13.3%). When asked about being infected with a contagious disease, the majority of participants reported not being infected (88.3%), while 10.8% reported being infected. Lastly, regarding close family members being infected, the majority of participants reported that their close family members were not infected (81.7%), while 17.5% reported that their close family members were infected. Table 3 HADS-A Scores Score Frequency Percent Normal 37 28.0 Borderline abnormal 37 28.0 Abnormal 50 38.0 Total 124 94.0 Table 3 presents the scores for the Hospital Anxiety and Depression Scale for anxiety (HADS-A). Among the participants, 28.0% scored in the normal range for anxiety, 28.0% scored in the borderline abnormal range, and 38.0% scored in the abnormal range. Table 4 HADS-D Scores Score Frequency Percent Normal 74 59.2 Borderline abnormal 28 22.4 Abnormal 23 18.4 Total 125 94.7 Table 4 displays the scores for the Hospital Anxiety and Depression Scale for depression (HADS-D). The majority of participants scored in the normal range for depression, accounting for 59.2% of the sample. Meanwhile, 22.4% scored in the borderline abnormal range, and 18.4% scored in the abnormal range. Table 5 Bivariate Analysis Results for Anxiety Variable Anxiety No Anxiety Yes p Value Age 20.38 (1.516) 20.51 (1.428) 0.868 Gender Female 28 (75.7%) 79 (94.0%) 0.004 Male 9 (24.3%) 5 (6.0%) Academic Qualifications B.Sc. in nursing 1st year 16 (43.2%) 25 (29.1%) 0.147 B.Sc. in nursing 2nd year 9 (24.3%) 36 (41.9%) B.Sc. in nursing 3rd year 12 (32.4%) 25 (29.1%) Table 5 presents the bivariate analysis results for anxiety among nursing students. Significant associations were found between anxiety and gender (p = 0.004), with 75.7% of females and 94.0% of males reporting anxiety. However, no significant association was found between anxiety and academic qualifications (p = 0.147). Table 6 Bivariate Analysis Results for Depression Variable Depression No Depression Yes p Value Age 20.29 (1.486) 20.74 (1.352) 0.183 Gender Female 63 (87.5) 45 (90.0) 0.67 Male 9 (12.5) 5 (10.0) Academic Qualifications B.Sc. in nursing 1st year 27 (36.5) 14 (28.0) 0.615 B.Sc. in nursing 2nd year 26 (35.1) 20 (40.0) B.Sc. in nursing 3rd year 21 (28.4) 16 (32.0) Contagious Disease Status Yes 6 (8.3%) 7 (14.0%) 0.318 No 66 (91.7%) 43 (86.0%) Close Family Members Infection Status Yes 11 (15.3%) 11 (22.0%) 0.342 No 61 (84.7%) 39 (78.0%) Table 6 presents the bivariate analysis results for depression among nursing students. No significant associations were found between depression and gender (p = 0.670), academic qualifications (p = 0.615), contagious disease status (p = 0.318), or close family members' infection status (p = 0.342). The table provides insight into the prevalence of depression among nursing students and its non-significant associations with these factors. Discussion In this study, the majority of participants were female (n = 116, 88.3%), with only 14 (11.7%) being male. This gender distribution contrasts with a previous study on university students, where males accounted for 50.4% of participants, differing significantly from the 49.6% of females (Asif et al., 2020 ). Another study reported that most respondents were female (n = 238), making up 84.7% of the sample (Sakai et al., 2022 ). The age distribution among respondents in this study showed that the majority were aged 21–22 years (59.2%), with 40.0% in the 18–20 years age group. This distribution contrasts somewhat with findings from a study on college-going students, where 66.6% fell into the 18–20 years age bracket and 33.4% were in the 21–24 years age group (Cheung et al., 2016 ). Similarly, another study reported that most nursing students surveyed were 21 years old (50.9%), followed by 20-year-olds (30.6%) and 22-year-olds (18.5%) (Sakai et al., 2022 ). This study included participants at different stages of their B.Sc in Nursing program: 31.1% were in the first year (41 individuals), 34.8% were in the second year (46 individuals), and 28.0% were in the third year (37 individuals). Comparatively, a previous study among college students showed 20% from 1–2 semesters, 28.4% were from 3–4 semesters, 14.6% were from 5–6 semesters (Asif et al., 2020 ). The study found that 28.0% of participants had normal anxiety levels, 28.0% were borderline abnormal, and 38.0% were abnormal. For depression, 59.2% were normal, 22.4% were borderline abnormal, and 18.4% were abnormal. This contrasts with a study reporting higher rates of depression (40.5%) and anxiety (68.3%) among undergraduate students in Pakistan (Syed et al., 2018 ). Moreover, a significant majority of students (51%, n = 350) reported experiencing anxiety and depression at moderate to extremely severe levels (Samson, 2019 ). Our study revealed a significant association between anxiety and gender (p = 0.004), with 75.7% of females and 94.0% of males reporting anxiety. This aligns with Nagaraja G. M's findings (2015), which showed a higher proportion of male students experiencing anxiety. In contrast, Javanovic et al. (2017) reported that female participants were significantly more exposed to symptoms of anxiety. Similarly, Zaher JS et al. ( 2016 ) found a similar trend when comparing depression and anxiety among nurses in critical care and internal surgical units at hospitals. No significant association was found between age, academic qualifications, and anxiety. Additionally, there were no significant associations between depression and gender (p = 0.670), academic qualifications (p = 0.615), contagious disease status (p = 0.318), or close family members' infection status (p = 0.342). These results contrast with a study conducted in Hong Kong, China, which found increased levels of depression associated with academic qualifications among second-year students (Cheung et al., 2016 ). This suggests that the factors influencing anxiety and depression in nursing students may vary between different populations and settings. Conclusion This study is the first to examine the prevalence of depression and anxiety among baccalaureate nursing students at Chattogram International Nursing College (CINC) in Bangladesh. The findings underscore the high prevalence of anxiety among these students, with a substantial proportion experiencing abnormal levels of anxiety. The majority of students scored in the normal range for depression. Gender was found to be significantly associated with anxiety, with a higher proportion of females experiencing anxiety compared to males. These results highlight the need for interventions and support systems to address the mental health needs of nursing students, particularly focusing on reducing anxiety levels. Future research should explore additional factors that may contribute to anxiety and depression among nursing students in Bangladesh, as well as evaluate the effectiveness of interventions aimed at promoting mental well-being in this population. Declarations Acknowledgments: We would like to thank Chattogram International Nursing College (CINC) for granting permission to collect data for this study. Declaration of Interest Statement: The authors declare no conflicts of interest. Funding: The author(s) reported there is no funding associated with the work featured in this article. References Al-Naggar, R. A., & Al-Naggar, D. H. (2012). Prevalence and Associated Factors of Emotional Disorder among Malaysian University Students. Public Health, 4, 11. Asif, S., Mudassar, A., Shahzad, T. Z., Raouf, M., & Pervaiz, T. 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Comparing depression, anxiety, and stress among the nurses in the critical care and internal surgical units at the selected hospitals of the social security organization of Tehran. International Journal of Medical Research and Health Sciences, 5, 254-261. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Published Journal Publication published 29 Dec, 2024 Read the published version in BioMed Target Journal → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4308747","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":294318775,"identity":"036e5428-7c03-4b78-93b7-9499cc6bf8f6","order_by":0,"name":"Jalal Uddin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA10lEQVRIiWNgGAWjYBAC9gYGBmYGBgs5fhCLwcCCsBZGiBYJY8meAyAtEsRrSTSYkQDiE6NlRvrDxwUVEgkGks+vbvhRIMHA396dQEBLjrHxjDMSeebSOWU3e4AOkzhzdgMhLWzSvG0SxZazc9Ju8AC1GEjkEtKS/kya959E4oabZ9Ju/iFGi+CMBDNp3gaglhvsx24TZYs0zxtjY55joEDOYbstYyDBQ9AvfOzAEOOpsQFG5fFnN9/8ATLae/FrQQI8BmCSWOUgwP6AFNWjYBSMglEwggAAwY9C6re7sngAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0001-5807-9813","institution":"University of Nevada Las Vegas","correspondingAuthor":true,"prefix":"","firstName":"Jalal","middleName":"","lastName":"Uddin","suffix":""},{"id":294318776,"identity":"4e6ba96f-6bab-46c0-8e16-20c4ce70d0d3","order_by":1,"name":"Tazveen Fariha","email":"","orcid":"","institution":"Chattogram International Nursing College","correspondingAuthor":false,"prefix":"","firstName":"Tazveen","middleName":"","lastName":"Fariha","suffix":""}],"badges":[],"createdAt":"2024-04-23 02:24:48","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-4308747/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4308747/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.59786/bmtj.225","type":"published","date":"2024-12-30T00:00:00+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":74089753,"identity":"bf3aec97-9921-4c9e-bffc-0a355df6bc98","added_by":"auto","created_at":"2025-01-17 15:55:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":678347,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4308747/v1/04201eb8-e814-4777-9ea5-6973d0971e12.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eExamining Anxiety and Depression Levels among Undergraduate Nursing Students: A Cross-Sectional Study\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eThe World Health Organization (WHO) underscores the significance of mental health in its strategy for preventing, treating, and overcoming mental health disorders (WHO, 2013). Mental health issues are a primary cause of disability and a major public health concern globally, posing challenges in disease management and showing an increasing prevalence (Wainberg et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; GBD 2017 Disease and Injury Incidence and Prevalence Collaborators, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Depression and anxiety serve as crucial indicators of mental health and when left untreated, can have adverse effects on individuals (Teh et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Al-Naggar \u0026amp; Al-Naggar, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Depression is characterized by symptoms such as loss of interest in daily activities, changes in weight, sleep disturbances, low energy, difficulty concentrating, feelings of worthlessness or guilt, and thoughts of death or suicide (Chand \u0026amp; Arif, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eGlobally, an estimated 12\u0026ndash;50% of college students meet the criteria for a mental disorder, highlighting the significant prevalence of mental health issues among this population (Bruffaerts et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Factors contributing to the development of anxiety and depression among college students include academic stress from exams and workload, limited free time for leisure activities, competitive environments, concerns about meeting parental expectations, the challenge of forming new relationships, and adjusting to a new living environment (Kumaraswamy, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Additionally, biological factors such as age and gender, especially being female, can influence the likelihood of experiencing these mental health issues, along with financial pressures (Bangasser et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Flatt, 2013).\u003c/p\u003e \u003cp\u003eNursing students often face elevated levels of stress compared to students in other academic programs, which can lead to feelings of anxiety and depression (Samson, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). They are more susceptible to depression than students in other medical fields, likely due to the demanding nature of their coursework and clinical experiences (Moreira \u0026amp; Furegato, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Factors contributing to depression among nursing students include academic pressures, challenges in clinical settings, and personal issues (Puthran et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Research suggests that nursing students are particularly vulnerable to depression during their initial year of education and when they begin clinical rotations (Janatolmakan et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study represents the first investigation of depression, and anxiety, among undergraduate nursing students at an educational institute in Bangladesh. The examination of psychiatric morbidity among university students is crucial, as many mental disorders tend to emerge during college years (Scott et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Given the dearth of data on anxiety and depression rates among undergraduates at Chattogram International Nursing College (CINC), this study aimed to assess the Anxiety and Depression levels among undergraduate Nursing Students in Bangladesh.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eThis study employed a cross-sectional design to assess the depression and anxiety level among undergraduate nursing students at Chattogram International Nursing College (CINC) in Bangladesh.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSample size\u003c/h2\u003e \u003cp\u003eThe initial sample size for this study was calculated to be 384 using the formula \"n = (Z^2 * P * q) / d^2\", where \"Z\" is 1.96, \"P\" is 0.5, \"q\" is 1 - P, and \"d\" is 0.05. Due to limitations in recruitment and data collection, the final number of participants included in the study was 120. Challenges such as difficulties in reaching out to potential participants and time constraints contributed to this reduced sample size.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eInstruments\u003c/h2\u003e \u003cp\u003eThe questionnaire consisted of two sections: demographic information and the Hospital Anxiety and Depression Scale (HADS). The demographic section of the questionnaire collected information on participants' age, gender, academic qualifications, marital status, living arrangements, and employment status. These variables were chosen to provide a comprehensive overview of the sample population and to allow for the exploration of potential associations with anxiety and depression levels. Hospital Anxiety and Depression Scale (HADS) is a widely used self-report questionnaire designed to assess levels of anxiety and depression in individuals. It consists of 14 items, with 7 items each for the anxiety (HADS-A) and depression (HADS-D) subscales (Michopoulos et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). Participants were asked to rate each item based on how they have been feeling over the past week. Responses were scored on a 4-point Likert scale (0\u0026ndash;3), with higher scores indicating more severe symptoms. The total score for each subscale (HADS-A and HADS-D) ranges from 0 to 21, with scores between 0 and 7 considered normal, 8 to 10 indicating borderline abnormality, and 11 to 21 suggesting abnormal levels of anxiety or depression (Michopoulos et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). The HADS has been widely used in various populations and has demonstrated good reliability and validity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData Collection\u003c/h2\u003e \u003cp\u003eData for this study were collected during the last week of December 2023 using a cross-sectional design. The aim was to assess the prevalence of depression and anxiety among undergraduate nursing students at Chattogram International Nursing College (CINC) in Bangladesh. The data collection method involved the use of an online questionnaire created with Google Forms. A total of 120 participants were recruited for the study. Participants were selected using convenience sampling and were required to meet the inclusion criteria of being BSc Nursing students at CINC and being aged 18 years or older. Participation in the study was voluntary, and all participants provided informed consent before completing the questionnaire. Ethical approval for the study was obtained from the institutional review board of CINC. Participants were assured of confidentiality, and their responses were anonymized.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of the participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMean 20.47 (SD 1.445)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;20 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21\u0026ndash;22 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e23\u0026ndash;25 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAcademic Qualifications\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB.Sc. in nursing 1st year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB.Sc. in nursing 2nd year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB.Sc. in nursing 3nd year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e117\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLiving with\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFriends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelatives\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eEmployment Status\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudying\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking and studying\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe demographic characteristics of the participants are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. A total of 120 participants completed the survey, with the majority being female (88.3%) and the remaining 11.7% being male. The age of participants ranged from 18 to 25 years, with the largest proportion falling in the 21\u0026ndash;22 age group (59.2%). 31.1% were in their first year of B.Sc in Nursing, constituting 41 individuals. Additionally, 34.8% were in their second year of B.Sc in Nursing, totaling 46 individuals. Furthermore, 28.0% were in their third year of B.Sc in Nursing, comprising 37 individuals. In terms of marital status, the vast majority of participants were single (97.5%), while a small percentage were married (1.7%). Participants reported various living arrangements, with the majority living with their parents (51.7%) or friends (35.0%). Regarding employment status, most participants were studying (95.8%), while a small percentage were working and studying (3.3%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eResponses to Stress, Fear/Anxiety, and Contagious Disease ​​\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eDo you feel stress in your daily life?\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you experience fear or anxiety in your daily life?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHave you been infected with a contagious disease?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHave any of your close family members been infected?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eParticipants' responses regarding stress, fear/anxiety, and contagious diseases are displayed in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. In terms of stress, the majority of participants reported experiencing stress sometimes (73.3%), while a smaller proportion reported experiencing stress regularly (23.3%). Only a small percentage of participants reported not experiencing stress at all (3.3%). Regarding fear or anxiety, the majority of participants reported experiencing these feelings sometimes (56.7%), while 30.0% reported experiencing fear or anxiety regularly. A smaller percentage of participants reported not experiencing fear or anxiety at all (13.3%). When asked about being infected with a contagious disease, the majority of participants reported not being infected (88.3%), while 10.8% reported being infected. Lastly, regarding close family members being infected, the majority of participants reported that their close family members were not infected (81.7%), while 17.5% reported that their close family members were infected.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHADS-A Scores\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScore\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBorderline abnormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbnormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the scores for the Hospital Anxiety and Depression Scale for anxiety (HADS-A). Among the participants, 28.0% scored in the normal range for anxiety, 28.0% scored in the borderline abnormal range, and 38.0% scored in the abnormal range.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHADS-D Scores\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScore\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBorderline abnormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbnormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e displays the scores for the Hospital Anxiety and Depression Scale for depression (HADS-D). The majority of participants scored in the normal range for depression, accounting for 59.2% of the sample. Meanwhile, 22.4% scored in the borderline abnormal range, and 18.4% scored in the abnormal range.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate Analysis Results for Anxiety\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnxiety No\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAnxiety Yes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.38 (1.516)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.51 (1.428)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.868\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (75.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79 (94.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (24.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (6.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAcademic Qualifications\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB.Sc. in nursing 1st year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (43.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (29.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.147\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB.Sc. in nursing 2nd year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (24.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (41.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB.Sc. in nursing 3rd year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (32.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (29.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e presents the bivariate analysis results for anxiety among nursing students. Significant associations were found between anxiety and gender (p\u0026thinsp;=\u0026thinsp;0.004), with 75.7% of females and 94.0% of males reporting anxiety. However, no significant association was found between anxiety and academic qualifications (p\u0026thinsp;=\u0026thinsp;0.147).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate Analysis Results for Depression\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDepression No\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDepression Yes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.29 (1.486)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.74 (1.352)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.183\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63 (87.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45 (90.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (10.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAcademic Qualifications\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB.Sc. in nursing 1st year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (36.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (28.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.615\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB.Sc. in nursing 2nd year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26 (35.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (40.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB.Sc. in nursing 3rd year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (28.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (32.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eContagious Disease Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (14.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.318\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66 (91.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (86.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eClose Family Members Infection Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (15.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (22.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.342\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61 (84.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (78.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e presents the bivariate analysis results for depression among nursing students. No significant associations were found between depression and gender (p\u0026thinsp;=\u0026thinsp;0.670), academic qualifications (p\u0026thinsp;=\u0026thinsp;0.615), contagious disease status (p\u0026thinsp;=\u0026thinsp;0.318), or close family members' infection status (p\u0026thinsp;=\u0026thinsp;0.342). The table provides insight into the prevalence of depression among nursing students and its non-significant associations with these factors.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, the majority of participants were female (n\u0026thinsp;=\u0026thinsp;116, 88.3%), with only 14 (11.7%) being male. This gender distribution contrasts with a previous study on university students, where males accounted for 50.4% of participants, differing significantly from the 49.6% of females (Asif et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Another study reported that most respondents were female (n\u0026thinsp;=\u0026thinsp;238), making up 84.7% of the sample (Sakai et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe age distribution among respondents in this study showed that the majority were aged 21\u0026ndash;22 years (59.2%), with 40.0% in the 18\u0026ndash;20 years age group. This distribution contrasts somewhat with findings from a study on college-going students, where 66.6% fell into the 18\u0026ndash;20 years age bracket and 33.4% were in the 21\u0026ndash;24 years age group (Cheung et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Similarly, another study reported that most nursing students surveyed were 21 years old (50.9%), followed by 20-year-olds (30.6%) and 22-year-olds (18.5%) (Sakai et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study included participants at different stages of their B.Sc in Nursing program: 31.1% were in the first year (41 individuals), 34.8% were in the second year (46 individuals), and 28.0% were in the third year (37 individuals). Comparatively, a previous study among college students showed 20% from 1\u0026ndash;2 semesters, 28.4% were from 3\u0026ndash;4 semesters, 14.6% were from 5\u0026ndash;6 semesters (Asif et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe study found that 28.0% of participants had normal anxiety levels, 28.0% were borderline abnormal, and 38.0% were abnormal. For depression, 59.2% were normal, 22.4% were borderline abnormal, and 18.4% were abnormal. This contrasts with a study reporting higher rates of depression (40.5%) and anxiety (68.3%) among undergraduate students in Pakistan (Syed et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Moreover, a significant majority of students (51%, n\u0026thinsp;=\u0026thinsp;350) reported experiencing anxiety and depression at moderate to extremely severe levels (Samson, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOur study revealed a significant association between anxiety and gender (p\u0026thinsp;=\u0026thinsp;0.004), with 75.7% of females and 94.0% of males reporting anxiety. This aligns with Nagaraja G. M's findings (2015), which showed a higher proportion of male students experiencing anxiety. In contrast, Javanovic et al. (2017) reported that female participants were significantly more exposed to symptoms of anxiety. Similarly, Zaher JS et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) found a similar trend when comparing depression and anxiety among nurses in critical care and internal surgical units at hospitals.\u003c/p\u003e \u003cp\u003eNo significant association was found between age, academic qualifications, and anxiety. Additionally, there were no significant associations between depression and gender (p\u0026thinsp;=\u0026thinsp;0.670), academic qualifications (p\u0026thinsp;=\u0026thinsp;0.615), contagious disease status (p\u0026thinsp;=\u0026thinsp;0.318), or close family members' infection status (p\u0026thinsp;=\u0026thinsp;0.342). These results contrast with a study conducted in Hong Kong, China, which found increased levels of depression associated with academic qualifications among second-year students (Cheung et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). This suggests that the factors influencing anxiety and depression in nursing students may vary between different populations and settings.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study is the first to examine the prevalence of depression and anxiety among baccalaureate nursing students at Chattogram International Nursing College (CINC) in Bangladesh. The findings underscore the high prevalence of anxiety among these students, with a substantial proportion experiencing abnormal levels of anxiety. The majority of students scored in the normal range for depression. Gender was found to be significantly associated with anxiety, with a higher proportion of females experiencing anxiety compared to males. These results highlight the need for interventions and support systems to address the mental health needs of nursing students, particularly focusing on reducing anxiety levels. Future research should explore additional factors that may contribute to anxiety and depression among nursing students in Bangladesh, as well as evaluate the effectiveness of interventions aimed at promoting mental well-being in this population.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank Chattogram International Nursing College (CINC) for granting permission to collect data for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of Interest Statement:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author(s) reported there is no funding associated with the work featured in this article.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAl-Naggar, R. A., \u0026amp; Al-Naggar, D. H. (2012). Prevalence and Associated Factors of Emotional Disorder among Malaysian University Students. Public Health, 4, 11.\u003c/li\u003e\n \u003cli\u003eAsif, S., Mudassar, A., Shahzad, T. Z., Raouf, M., \u0026amp; Pervaiz, T. (2020). Frequency of depression, anxiety and stress among university students. Pakistan Journal of Medical Sciences, 36(5), 971-976. https://doi.org/10.12669/pjms.36.5.1873\u003c/li\u003e\n \u003cli\u003eBangasser, D. A., Curtis, A., Reyes, B. A. S., Bethea, T. T., Parastatidis, I., Ischiropoulos, H., ... Valentino, R. J. (2010). Sex differences in corticotropin-releasing factor receptor signaling and trafficking: Potential role in female vulnerability to stress-related psychopathology. Molecular Psychiatry, 15, 877, 896\u0026ndash;904. https://doi.org/10.1038/mp.2009.123\u003c/li\u003e\n \u003cli\u003eBruffaerts, R., Mortier, P., Kiekens, G., Auerbach, R. P., Cuijpers, P., Demyttenaere, K., ... Kessler, R. C. (2018). Mental health problems in college freshmen: Prevalence and academic functioning. Journal of Affective Disorders, 225, 97\u0026ndash;103. https://doi.org/10.1016/j.jad.2017.07.044\u003c/li\u003e\n \u003cli\u003eChand, S. P., \u0026amp; Arif, H. (2023). Depression. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430847/\u003c/li\u003e\n \u003cli\u003eCheung, T., Wong, S. Y., Wong, K. Y., Law, L. Y., Ng, K., Tong, M. T., ... Yip, P. S. F. (2016). Depression, anxiety and symptoms of stress among baccalaureate nursing students in Hong Kong: A cross-sectional study. International Journal of Environmental Research and Public Health, 13, 779. https://doi.org/10.3390/ijerph13080779\u003c/li\u003e\n \u003cli\u003eGBD 2017 Disease and Injury Incidence and Prevalence Collaborators. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u0026ndash;2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392, 1789\u0026ndash;1858. https://doi.org/10.1016/S0140-6736(18)32279-7\u003c/li\u003e\n \u003cli\u003eJanatolmakan, M., Andaieshgar, B., Aryan, A., Jafari, F., \u0026amp; Khatony, A. (2019). Comparison of Depression Rate Between the First- and Final-Year Nursing Students in Kermanshah, Iran. Psychology Research and Behavior Management, 12, 1147-1153. https://doi.org/10.2147/PRBM.S238873\u003c/li\u003e\n \u003cli\u003eJovanovic, V., Djonovic, N., \u0026amp; Dutina, A. (2017). Factors associated with the depression, anxiety and stress among High Medical School of Professional Studies students. Medicinski casopis, 51, 7-14. https://doi.org/10.5937/mckg51-14379\u003c/li\u003e\n \u003cli\u003eKruisselbrink Flatt, A. (2013). A Suffering Generation: Six Factors Contributing to the Mental Health Crisis in North American Higher Education. College Quarterly, 16(1).\u003c/li\u003e\n \u003cli\u003eKumaraswamy, N. (2013). Academic stress, anxiety and depression among college students\u0026mdash;A brief review. International Review of Social Sciences and Humanities, 5, 135\u0026ndash;143.\u003c/li\u003e\n \u003cli\u003eMichopoulos, I., Douzenis, A., Kalkavoura, C., Christodoulou, C., Michalopoulou, P., Kalemi, G., Fineti, K., Patapis, P., Protopapas, K., \u0026amp; Lykouras, L. (2008). Hospital Anxiety and Depression Scale (HADS): validation in a Greek general hospital sample. Annals of general psychiatry, 7, 4. https://doi.org/10.1186/1744-859X-7-4\u003c/li\u003e\n \u003cli\u003eMoreira, D. P., \u0026amp; Furegato, A. R. (2013). Stress and depression among students of the last semester in two nursing courses. Revista Latino-Americana de Enfermagem, 21(SPE), 155\u0026ndash;162. https://doi.org/10.1590/S0104-11692013000700020\u003c/li\u003e\n \u003cli\u003eNagaraja, G. M., Reddy, M., Ravishankar, S., Jagadisha, D., \u0026amp; Muninarayana, D. (2015). Study the prevalence of depression among nursing college students of Kolar District, Karnataka State. IOSR Journal of Humanities and Social Science, 20(5), 135-139. DOI: 10.9790/0837-2052135139\u003c/li\u003e\n \u003cli\u003ePuthran, R., Zhang, M. W., Tam, W. W., \u0026amp; Ho, R. C. (2016). Prevalence of depression amongst medical students: A meta-analysis. Medical Education, 50(4), 456\u0026ndash;468. https://doi.org/10.1111/medu.12962\u003c/li\u003e\n \u003cli\u003eSakai, M., Nakanishi, M., Yu, Z., Takagi, G., Toshi, K., Wakashima, K., \u0026amp; Yoshii, H. (2022). Depression and anxiety among nursing students during the COVID-19 pandemic in Tohoku region, Japan: A cross-sectional survey. Japanese Journal of Nursing Science, 19(3), e12483. https://doi.org/10.1111/jjns.12483\u003c/li\u003e\n \u003cli\u003eSamson, P. (2019). Role of Coping in Stress, Anxiety, Depression among Nursing Students of Purbanchal University in Kathmandu. Journal of Nepal Health Research Council, 17(3), 325\u0026ndash;330. https://doi.org/10.33314/jnhrc.v17i3.1843\u003c/li\u003e\n \u003cli\u003eScott, K. M., Lim, C., Al-Hamzawi, A., Alonso, J., Bruffaerts, R., Caldas-de-Almeida, J. M., ... de Jonge, P. (2016). Association of mental disorders with subsequent chronic physical conditions: World Mental Health Surveys from 17 countries. JAMA Psychiatry, 73, 150\u0026ndash;158. https://doi.org/10.1001/jamapsychiatry.2015.2688\u003c/li\u003e\n \u003cli\u003eSyed, A., Ali, S. S., \u0026amp; Khan, M. (2018). Frequency of depression, anxiety and stress among the undergraduate physiotherapy students. Pakistan Journal of Medical Sciences, 34(2), 468\u0026ndash;471. https://doi.org/10.12669/pjms.342.12298\u003c/li\u003e\n \u003cli\u003eTeh, C. K., Ngo, C. W., Binti Zulkifli, R. A., Vellasamy, R., \u0026amp; Suresh, K. (2015). Depression, Anxiety and Stress among Undergraduate Students: A Cross Sectional Study. Open Journal of Epidemiology, 5, 260\u0026ndash;268. https://doi.org/10.4236/ojepi.2015.54031\u003c/li\u003e\n \u003cli\u003eWainberg, M. L., Scorza, P., Shultz, J. M., Helpman, L., Mootz, J. J., Johnson, K. A., ... Arbuckle, M. R. (2017). Challenges and Opportunities in Global Mental Health: A Research-to-Practice Perspective. Current Psychiatry Reports, 19, 28. https://doi.org/10.1007/s11920-017-0774-0\u003c/li\u003e\n \u003cli\u003eWorld Health Organization. (2013). Mental Health Action Plan 2013\u0026ndash;2020. Geneva, Switzerland. Available online: https://apps.who.int/iris/bitstream/handle/10665/89966/9789241506021_eng.pdf;jsessionid=3C7CA0AF1F871585FF7EB0BCB0432D04?sequence=1 (accessed on 24 September 2020).\u003c/li\u003e\n \u003cli\u003eZaher, J. S., Vafaei, M., \u0026amp; Abianch, E. E. (2016). Comparing depression, anxiety, and stress among the nurses in the critical care and internal surgical units at the selected hospitals of the social security organization of Tehran. International Journal of Medical Research and Health Sciences, 5, 254-261.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"Chattogram International Nursing College","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"depression, anxiety, nursing students, mental health","lastPublishedDoi":"10.21203/rs.3.rs-4308747/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4308747/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eMental health is a critical aspect of well-being, especially among undergraduate nursing students. Nursing students face unique stressors that can impact their mental health. This study aimed to determine the of anxiety and depression level among undergraduate nursing students at Chattogram International Nursing College (CINC) in Bangladesh.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study design was employed, and data were collected using an online questionnaire (google form) that included the Hospital Anxiety and Depression Scale (HADS). Convenience sampling was used to select 120 BSc Nursing students aged over 18 years. Data analysis was conducted using SPSS version 25.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe majority of participants were female (88.3%), and the mean age was 20.47 years. The prevalence of anxiety was 66.0%, with 28.0% scoring in the normal range, 28.0% in the borderline abnormal range, and 38.0% in the abnormal range. For depression, 59.2% scored in the normal range, 22.4% in the borderline abnormal range, and 18.4% in the abnormal range. Pearson correlation test showed gender was significantly associated with anxiety (p\u0026thinsp;=\u0026thinsp;0.004), while no significant associations were found between depression and gender, academic qualifications, contagious disease status, or close family members' infection status.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThis study highlights a significant burden of anxiety among undergraduate nursing students at CINC, with a substantial proportion experiencing abnormal levels of anxiety. The findings underscore the importance of addressing mental health issues among nursing students and implementing strategies to promote their mental well-being.\u003c/p\u003e","manuscriptTitle":"Examining Anxiety and Depression Levels among Undergraduate Nursing Students: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-24 06:01:51","doi":"10.21203/rs.3.rs-4308747/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8569155a-8da9-4e41-9164-be645081f4e9","owner":[],"postedDate":"April 24th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":31024034,"name":"Health Policy"}],"tags":[],"updatedAt":"2025-01-17T15:55:07+00:00","versionOfRecord":{"articleIdentity":"rs-4308747","link":"https://doi.org/10.59786/bmtj.225","journal":{"identity":"biomed-target-journal","isVorOnly":true,"title":"BioMed Target Journal"},"publishedOn":"2024-12-30 00:00:00","publishedOnDateReadable":"December 30th, 2024"},"versionCreatedAt":"2024-04-24 06:01:51","video":"","vorDoi":"10.59786/bmtj.225","vorDoiUrl":"https://doi.org/10.59786/bmtj.225","workflowStages":[]},"version":"v1","identity":"rs-4308747","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4308747","identity":"rs-4308747","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}