The prevalence of mental health issues among nursing students: An umbrella review synthesis of meta-analytic evidence.

Background: The ongoing global student mental health crisis indicates the urgent need for updated research specifically targeting nursing students. Considering their anticipated transition into healthcare professions, their mental well-being is critical, not only for their academic performance but also for the quality of care they will deliver in their professional roles.

Objective: To estimate the prevalence of mental health issues among nursing students by synthesizing data from systematic reviews and meta-analyses.

Design: An umbrella review of published prevalence meta-analyses.

Review Methods: Publication records were retrieved from four databases-PubMed, CINAHL, PsycINFO, and Scopus-up to September 2024. The methodological quality of each meta-analysis was assessed using the A Measurement Tool for the Assessment of Multiple Systematic Reviews (AMSTAR-2). Assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline checklist. A random-effects model was used for the meta-analysis, and the I index was employed to assess between-study heterogeneity. Additionally, the Risk of Bias in Systematic Reviews tool was used to assess review quality, including calculation of overlap between primary studies and adherence to GRADE criteria.

Results: Twenty-five meta-analyses, comprising 375 primary studies and a total of 171,828 nursing students, were included, revealing an overall prevalence of mental health issues at 27 % (95 % CI: 25 % - 30 %). Sleep disturbances were the most prevalent at 50 % (95 % CI: 28 % - 72 %), followed by fear at 41 % (95 % CI: 7 % - 75 %), burnout at 32 % (95 % CI: 25 % - 38 %), and depression at 29 % (95 % CI: 21 % - 38 %). Nomophobia/smartphone addiction had a prevalence of 30 % (95 % CI: 12 % - 49 %), anxiety 29 % (95 % CI: 17 % - 40 %), and stress 27 % (95 % CI: 17 % - 37 %). Lower prevalence rates were observed for smoking, eating disorders, post-traumatic stress disorder, and suicidal ideation/attempts. Significant heterogeneity was noted, particularly in the meta-analyses for anxiety, nomophobia/smartphone addiction, and stress.

Conclusions: Our review identified eleven prevalent mental health issues among nursing students, with sleep disturbances, anxiety, depression, and burnout being the most common. Behavioral issues, such as nomophobia, are also rising concerns. These findings indicate the need for targeted interventions and further research into causal factors (e.g., geographical and cultural contexts), gender disparities (as most studies focused on female students), and resilience-building strategies.

Registration: The study protocol was uploaded to the Open Science Framework (OSF) at https://doi.org/10.17605/OSF.IO/EN7UX (registered on 28/10/23).

Tweetable Abstract: Among nursing students, overall mental health issues are at 27 %. Key concerns include sleep disturbances, burnout, anxiety, and depression. Nomophobia prevalence also warrants further study.