# Global prevalence of different levels of anxiety and stress symptoms in healthcare students: A meta-analysis and meta-regression

## TL;DR

This study finds that healthcare students worldwide experience high rates of anxiety and stress, with factors like geography and study quality affecting prevalence.

## Contribution

The paper provides the first global meta-analysis of anxiety and stress levels in healthcare students and identifies key factors influencing prevalence.

## Key findings

- Moderate anxiety symptoms affect 22% of healthcare students globally.
- Geographic region and study quality significantly influence prevalence estimates.
- Stress symptoms are most commonly unspecified (36%) among healthcare students.

## Abstract

There are limited reviews to report the different levels of anxiety and stress symptoms among students studying nursing, pharmacy, and allied health.

To calculate the global prevalence of different levels of anxiety and stress symptoms among healthcare students and examine the factors that affect the different levels of prevalence estimates.

A three-step comprehensive search of 10 databases was conducted. Meta-analysis, subgroup analyses, and meta-regression were performed using the meta package in R software. The Newcastle-Ottawa Scale and Grading of Recommendations Assessments, Development and Evaluation criteria were utilised for the quality appraisal of included studies and the certainty of the evidence, respectively.

A total of 112 studies with 42,331 healthcare students across 43 countries were selected. The prevalences of unspecified, mild, moderate, severe, and extremely severe anxiety symptoms were 41% (95% CI: 33–50), 15% (95% CI: 12–19), 22% (95% CI: 19–26), 10% (95% CI: 8–13), 14% (95% CI: 11–17), respectively. The prevalences of unspecified, mild, moderate, severe, and extremely severe stress symptoms were 36% (95% CI: 25–47), 15% (95% CI: 12–18), 32% (95% CI: 25–40), 11% (95% CI: 8–15), 4% (95% CI: 2–5), respectively. A series of subgroup and meta-regression analyses identified geographic region, use of an instrument, type of healthcare students, sample size and study quality were significantly impacted prevalence estimates.

Findings can contribute as evidence to raising awareness about different levels of anxiety and stress symptoms. Early screening and tailored preventive interventions can help eliminate the prevalence in healthcare students.

The online version contains supplementary material available at 10.1186/s12991-025-00618-1.