Nursing students' academic conditions, psychological distress, and intention to leave school: A cross-sectional study

Abstract

Background: Psychological distress and intention to leave school are highly prevalent among nursing students. Academic conditions, including psychosocial stressors and school-work-life conflicts, could contribute to psychological distress and intention to leave school.

Objective: To explore the associations between academic conditions and 1) psychological distress and 2) intention to leave school.

Design: Cross-sectional correlational design.

Settings: Data collection was performed in February and October 2021 in two nursing schools in Canada: Cegep (publicly funded college, technical degree) and university (bachelor's degree).

Participants: 230 nursing students (Cegep 131, university 99).

Methods: A self-administered online questionnaire assessed academic conditions (psychosocial stressors (Demand-Control-Support, Effort-Reward Imbalance and Overcommitment scales) and school-work-life conflicts (single item)), psychological distress (Kessler-6 scale), intention to leave school, and several covariates. Poisson robust multivariate regression models were built to explore the associations between academic conditions and 1) psychological distress and 2) intention to leave school.

Results: A large proportion of participants experienced high efforts, school-work-life conflicts, overcommitment, and psychological distress (49.5-84.7 %). One out of five participants had had intention to leave school "many times" (Cegep 20.61 %; university 22.22 %). In adjusted analysis, overcommitment and school-work-life conflicts were associated with a higher prevalence of psychological distress (Prevalence ratio = 2.10; 95 % Confidence Intervals = 1.15-3.84 and Prevalence ratio = 2.32; 95 % Confidence Intervals = 1.24-4.32, respectively). Adverse associations were observed between effort-reward imbalance (Prevalence ratio = 2.32; 95 % Confidence Intervals = 1.09-4.94) as well as school-work-life conflicts (Prevalence ratio = 2.40; 95 % Confidence Intervals = 1.05-5.45) and intention to leave school.

Conclusions: Academic conditions might be risk factors for psychological distress and intention to leave school among nursing students. Interventions targeting modifiable academic conditions might improve nursing students' mental health and retention.

Keywords: Demand-control-support; Effort-reward imbalance; Intention to leave; Mental health; Nursing students; Psychological distress; Psychosocial stressors; School-work-life conflicts.