Cumulative risk factors, Problematic smartphone use and Depressive symptoms in Nursing Students：a cross-sectional study

Background: No single risk factor is decisive in shaping an individual's healthy development. This study was to analyze that depressive symptoms are related to a cumulative risk index composed of individual, family and social variables among nursing students. Methods: We recruited 1716 Chinese nursing students from 3 universities via a paperless survey that measured a set of individual, family and social risk factors of depressive symptoms. Results: Regardless of the combination of factors, as the number of risk factors increased, the mean of depressive symptom scores also increased, with statistically significant difference, and the proportion of the normal group became lower, the proportion of different depressive symptoms severity groups showed an increasing trend( P <0.001). A high risk cluster of poor sleep quality combined with problematic smartphone use was associated with high levels of depressive symptom ( P < 0.001). Conclusion: The depressive symptoms of nursing students were positively related to the cumulative risk of individual, family and social variables. Among them, a cluster with poor sleep quality combined with problematic smartphone had the highest risk.