SYMPTOMS OF ANXIETY IN NURSING SCHOOL STUDENTS OF AYUB TEACHING HOSPITAL, ABBOTTABAD

Abstract

Background: Nursing students experience combined academic and clinical demands that may increase anxiety and interfere with learning, well-being, and clinical performance.

Objective: To estimate the frequency and severity of anxiety symptoms among nursing students at Ayub Teaching Hospital, Abbottabad, and to examine associations with selected demographic and academic factors.

Methods: A single-centre cross-sectional study enrolled 148 nursing students aged 16–25 years between 1 December 2020 and 31 May 2021 using non-probability convenience sampling. Anxiety symptoms were assessed with the seven-item Generalized Anxiety Disorder scale (GAD-7). Scores were classified as minimal (0–4), mild (5–9), moderate (10–14), or severe (15–21). Clinically important symptom burden was defined as GAD-7 ≥10. Associations were summarized using odds ratios (ORs), 95% confidence intervals (CIs), Fisher’s exact tests, and a test for trend across academic years.

Results: The mean age was 18.90 ± 2.81 years. GAD-7 scores indicated minimal symptoms in 6 students (4.1%), mild symptoms in 117 (79.1%), moderate symptoms in 21 (14.2%), and severe symptoms in 4 (2.7%). Overall, 142 students (95.9%; 95% CI 91.4–98.1) reported at least mild symptoms, whereas 25 (16.9%; 95% CI 11.7–23.7) had moderate-to-severe symptoms. Moderate-to-severe symptoms were more frequent among married than single students (87.5% vs 12.9%; OR 47.44, 95% CI 5.51–408.50; p<0.001) and among students aged ≥20 years than those aged <20 years (34.9% vs 9.5%; OR 5.09, 95% CI 2.06–12.57; p<0.001). The proportion increased from 6.8% in first year to 36.1% in fourth year (p for trend<0.001). Recent and upcoming examinations were not significantly associated with moderate-to-severe symptoms.

Conclusion: Anxiety symptoms were common, although the proportion with GAD-7 scores ≥10 was substantially lower than the proportion reporting any symptoms. Older, married, and senior-year students may require particular attention. Because the study was cross-sectional, single-centre, and conducted during the COVID-19 period, the results should be interpreted as exploratory and not as evidence of causation or a clinical diagnosis.