Association of stress factors and depressive symptoms with the academic performance of nursing students

Fonseca, Jose Ricardo Ferreira da; Calache, Ana Lucia Siqueira Costa; Santos, Maiara Rodrigues dos; Silva, Rodrigo Marques da; Moretto, Simone Alvarez

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Revista da Escola de Enfermagem da USP

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Original Article • Rev. esc. enferm. USP 53 • 2019 • https://doi.org/10.1590/S1980-220X2018030403530 copy

Association of stress factors and depressive symptoms with the academic performance of nursing students^* * Extracted from the thesis: “Fatores de estresse, sintomas depressivos, suporte social e resiliência associados ao desempenho acadêmico em estudantes de enfermagem”, Escola de Enfermagem, Universidade de São Paulo, 2016.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To verify the association of stress factors and depressive symptoms with the academic performance of nursing students.

Method:

Cross-sectional, quantitative, observational research conducted at a public university in Manaus. Socio-demographic data, academic performance coefficient and individual semester performance, the Instrument for the Assessment of Stress in Nursing Students and the CES-D Center for Epidemiologic Studies Depression Scale were used to characterize the students. Pearson's correlation coefficient, ANOVA test and multiple linear regression were used for the analysis.

Results:

155 nursing students participated in the study. The stress factors “performance of practical activities”, “professional communication” and “professional education” had a positive correlation with individual semester performance, while the factors “depressive affect”, “interpersonal” and “somatic/attitudes” had a negative correlation.

Conclusion:

The present study identified positive impacts of stress factors on academic performance, however, the presence of depressive symptoms was associated with lower academic performance.

DESCRIPTORS
Students, Nursing; Stress, Psychological; Depression; Academic Performance

Domains	Classification of stress intensity and corresponding quartiles of scores
Domains	Low stress intensity (25%)	Medium stress intensity (50%)	High stress intensity (75%)	Very high stress intensity (100%)
Performance of Practical activities (6 items) 0 to 18 points	0 – 9 points	10 – 12 points	13 – 14 points	15 – 18 points
Professional Communication (4 items) 0 to 12 points	0 – 5 points	6 Points	7 – 8 points	9 – 12 points
Time Management (5 items) 0 to 15 points	0 – 10 points	11 – 12 points	13 – 14 points	15 points
Environment (4 items) (0 to 12 points)	0 – 7 points	8 – 10 points	11 points	12 points
Professional Education (6 items) 0 to 18 points	0 – 9 points	10 points	11 – 12 points	13 – 18 points
Theoretical Activity (5 items) 0 to 15 points	0 – 9 points	10 – 11 points	12 – 13 points	14 – 15 points

ASNS domains	Classification of stress intensity
	Low	Medium	High	Very high
	N (%)	N (%)	N (%)	N (%)
Performance of practical activities	87 (56.1)	46 (29.7)	10 (6.5)	12 (7.7)
Professional communication	83 (53.5)	30 (19.4)	32 (20.6)	10 (6.5)
Time Management	108 (69.7)	33 (21.3)	12 (7.7)	2 (1.3)
Environment	96 (61.9)	38 (24.5)	2 (1.3)	19 (12.3)
Professional education	84 (54.2)	15 (9.7)	29 (18.7)	27 (17.4)
Theoretical activity	112 (72.3)	26 (16.8)	14 (9.0)	3 (1.9)

Psycho-emotional factors and their domains	Academic performance coefficient (CRE)		Individual semester performance (RSI)
Psycho-emotional factors and their domains	R	p-value	r	p-value
Stress
Performance of practical activities	−0.005	0.950	0.197	0.014^* * p < 0.05 – Pearson correlation coefficient.
Professional communication	−0.004	0.959	0.206	0.010^* * p < 0.05 – Pearson correlation coefficient.
Time Management	−0.099	0.221	−0.089	0.269
Environment	−0.128	0.113	0.006	0.939
Professional education	−0.010	0.902	0.260	0.001^* * p < 0.05 – Pearson correlation coefficient.
Theoretical activity	−0.137	0.089	0.122	0.130
Depressive symptomatology
Depressive affect factor	−0.017	0.835	−0.179	0.026^* * p < 0.05 – Pearson correlation coefficient.
Interpersonal fator	−0.066	0.414	−0.189	0.018^* * p < 0.05 – Pearson correlation coefficient.
Positive affect factor	−0.037	0.649	−0.096	0.233
Somatic/attitudes factor	−0.101	0.211	−0.167	0.038^* * p < 0.05 – Pearson correlation coefficient.

Parameters	β	SE	t	P	95% CI
Parameters	β	SE	t	P	Lower limit	Upper limit
Intercept	7.397	0.118	62.724	< 0.001^* * All associations with p values < 0.05.	7.164	7.630
People in the household				0.003^* * All associations with p values < 0.05.
Father and mother	0.000
Father or mother	0.015	0.138	0.112	0.911	−0.256	0.287
Alone	−1.174	0.300	−3.918	< 0.001^* * All associations with p values < 0.05.	−1.766	−0.581
Relatives or friends	−0.070	0.192	−0.363	0.717	−0.450	0.310
Spouse or significant other	−0.234	0.168	−1.393	0.166	−0.566	0.098
Semester				0.003^* * All associations with p values < 0.05.
First semester	0.000
Third semester	−0.150	0.202	−0.743	0.459	−0.549	0.249
Fifth semester	−0.097	0.234	−0.417	0.677	−0.559	0.364
Seventh semester	0.564	0.323	1.744	0.083	−0.075	1.203
Ninth semestre	0.058	0.332	0.176	0.861	−0.599	0.716
Number of approvals in classes	0.014	0.009	1.533	0.127	−0.004	0.031

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Ana Lucia Siqueira Costa Calache, Av. Dr. Enéas Carvalho de Aguiar, 419, Cerqueira César CEP 05403-000 – São Paulo, SP, Brazil anascosta@usp.br