Similar results were obtained in the follow-up study conducted with students at the faculty of medicine of the same university before the pandemic. The collection of second timepoint data after the COVID-19 pandemic may have caused students to experience mental, economic, and parental problems and increased anxiety. There was a significant increase in the prevalence of depressive symptoms only for the ≥21 cut-off point of BDI at the end of the education, but no significant change was found at the lower cut-off points. ResultsĪccording to the results of the study, the GHQ-12 and STAI scores of the students increased significantly at the end of their education, and when the prevalence was evaluated according to the cut-off points, the presence of psychological distress and state anxiety was found in more than half of them. The level of significance for statistical tests was established as p < 0.05. Since there was a significant relationship between doing regular physical exercise, smoking, perceived health status, IAT score, and psychological scale scores in a binary analysis, these variables were included in the regression model. Sex and age were added to the model because they were found to be significant in the literature and could also be confounders. Nine stressful life events with the second timepoint score above 4 (financial problems, worrying about the future-individual, worrying about the future-communal, high expectations of the family, worrying about exam, accommodation problems, family-oriented problems, dissatisfaction with major, and dissatisfaction with social activities) and other variables (sex, age, doing regular physical exercise, smoking, perceived health status, and IAT score) were added to the model as independent variables. GHQ-12, BDI, S-Anxiety, and T-Anxiety scores (second timepoint) were determined as dependent variables. For this, four separate multiple regression models (backward elimination method) were created. Multiple regression analysis was used to define predictor factors for psychological distress, depression, and anxiety scores. Pearson’s correlation coefficient test was used to evaluate the relationship between GHQ-12, BDI, and STAI. Reliability analyses of the scales were performed using Cronbach’s alpha coefficients. The paired samples t-test was used to compare means, and McNemar’s test was used to compare frequencies in the paired groups. Descriptive statistics were defined by number, percentage, mean, standard deviation, and minimum-maximum values. Study data were evaluated using SPSS (Statistical Package for the Social Sciences) version 23.0 (IBM, Armonk, NY, USA). Interventions to reduce stress, anxiety, and psychological distress are needed to improve the mental health status of nursing students. The psychological indicators increased significantly in nursing students during their education. As a result of linear regression, “dissatisfaction with major” was found as a determinant on all scale scores. A significant increase in perceived stress levels between the two timepoints was also found for numerous stressful life events. There was a significant increase in the prevalence of depressive symptoms for the ≥21 cut-off point of BDI in the fourth year of the study cohort. Nursing students’ GHQ-12 and STAI scores and averages increased significantly from first timepoint to second timepoint ( p < 0.05). The changes between the two timepoints were examined. The process was repeated for the same students again in the fourth year (second timepoint). All students were asked to answer a questionnaire measuring their possible stressful life events (first timepoint). The General Health Questionnaire (GHQ-12), the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI) were applied to students within the faculty of nursing within the first week of the 2018–2019 academic year. The aim of this longitudinal study is to determine how stressful life events, psychological distress, depressive symptoms, and anxiety change in a cohort of students from one nursing faculty during the education process and to document the factors related to psychological distress, depressive symptoms, and anxiety during the fourth year of education.
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