# Prevalence of Stress, Depressive Symptoms, and Contributing Factors Among Undergraduate Nursing Students: A Systematic Review and Meta-Analysis

## TL;DR

This study finds that nearly half of undergraduate nursing students experience stress and depressive symptoms, with factors like financial issues and social conflicts playing a role.

## Contribution

The study provides a comprehensive meta-analysis of stress and depressive symptoms in nursing students, identifying key contributing factors across diverse settings.

## Key findings

- Depressive symptoms were most common in lower–middle-income countries and with the Beck Depression Inventory II.
- Stress was highest in upper–middle-income countries and when measured with the Perceived Stress Scale-10.
- Younger age, financial issues, and social dissatisfaction were significant contributing factors.

## Abstract

Background/Objectives: Undergraduate nursing students experience high levels of stress and depressive symptoms. This study investigated the prevalence of stress and depressive symptoms among undergraduate nursing students and analyzed the sociodemographic and interpersonal factors influencing these conditions. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four databases (PubMed, Web of Science, Embase, and CINAHL) were searched for studies published between 2019 and 2024. Both narrative synthesis and meta-analysis were conducted to identify contributing factors and estimate the pooled prevalence rates. Prevalence rates of stress and depressive symptoms were estimated using random-effects models. Subgroup analyses were performed based on the severity of symptoms, study location, country income group, and measurement tool. Effect size, 95% confidence intervals, and p-values were reported. Results: The review included 54 studies. The prevalence of depressive symptoms and stress was 48% and 55%, respectively. Depressive symptoms were most prevalent in studies conducted in lower–middle-income countries and those using the Beck Depression Inventory II. Stress prevalence was highest in studies from upper–middle-income countries and those using the Perceived Stress Scale-10. Significant associations among sociodemographic and interpersonal factors include younger age, female gender, single status, financial issues, poor perceived health, conflicts with friends, and dissatisfaction with social activities. Conclusions: Nearly half of undergraduate nursing students from diverse settings experienced significant stress and depressive symptoms, driven by multiple sociodemographic and interpersonal factors.