Abstract

In the field of mental health, depression and anxiety are very pertinent disorders whose matter of course cannot be over emphasized. A rising issue in our community has been that of anxiety and depression whose effects on learning are not to be neglected. Nursing students are not to be exempted from this problem. Being affected by these disorders necessitate prompt intervention to bring about better learning outcome, hence better health care providers. This study was aimed at identifying the socio-demographic and personal risk factors of anxiety and depression, determining the prevalence of students affected by these disorders and to verify the effect(s) of these disorders on students’ learning ability. A cross-sectional study involving 125 nursing students was carried out during a one-month period+. Participants were enrolled by a convenience sampling method. The adopted HADS (hospital anxiety and depression scale) was used alongside a structured questionnaire to collect socio-demographic and personal data. The data was analyzed using the statistical software SPSS version 21 and Microsoft Excel 2013. One hundred and twenty-five students were included in the study. The mean age of students was 20.26years with females more than males 92 (73.6%) and 33 (26.4%), respectively. Anxiety was positive in 56 (45.0%) and depression in 90 (72.0%) students. Gender (p=0.002) and alcohol (p=0.023) were significantly associated to depression. Anxiety had no significant association with any of these factors but for number of siblings with p=0.008. The both conditions had a negative effect on learning with a prevalence of 29.6%. Majority of nursing students were found to be both anxious and depressed. A good number of them had anxiety and more than two thirds of them had depression. About one third of the students showed negative learning ability as a result of anxiety and depression. Therefore, the need to effect the counseling center, to enable intensive counseling interventions in this susceptible group should be considered our prime objective.

CHAPTER ONE

INTRODUCTION

1.0 Background

In the field of mental health, depression and anxiety are very pertinent disorders whose effects cannot be over emphasized. Depression is a general mental disorder characterized by a switch or distortion in mood, which in turn has a significant effect on human activities (18). Competency in nursing practice is dependent on the type of training undergone by the nurse as a student; as such a lot of factors contribute to a student nurse’s ability to acquire knowledge and skills. ”Anxiety, depression, stress, hostility, and aggressiveness are among the problems prevalent among young university students. Depression is a serious health issue and a considerable reason for restlessness among students. It affects their live during the critical learning and social development process ” (2).

Many nursing students experience anxiety and stress, they are therefore highly susceptible to falling into depression during their stay in nursing school; this contributes a lot to their performance. Depression is said to be one of the main contributors to global burden of diseases and affects people in all communities and professions across the world. Today, it is being estimated that depression has affected over 350 million people (1). A survey conducted by the World Mental Health in 17 countries reviewed that an average of 1 in 20 people had an episode of depression in the previous years. Disorders related to depression often start at a young age; it is recurrent and reduces people’s ability to function efficiently, as such depression is a leading cause of disability worldwide considering  year lost as a result of disability. Hence, the demand for addressing depression and other mental health condition is increasing globally, of which nursing as a profession should not be left out (1).

In a study carried out comparing 558 undergraduate students of computer sciences, law, nursing, and letters, it was observed that minor mental disorders were prevalent among nursing students. The most frequent psychosomatic disorders were tension, psychological stress, and low performance (8). It is known that these changes contribute to a low performance and bring serious consequences to such students’ health state and probably affect their learning ability (9). A relative analytical study conducted between nursing, medical, obstetrics, child care, and medical technology courses proved that the courses and individual conditions to carry out exercises result to a more significant effect among nursing students(8). The nursing student is immersed in the teaching-learning process, which might be threatening or challenging, but is also particularly important, for being related to one’s professional preparation(7,10).The adaptation to the teaching-learning process along the course is a constant concern students have (11). Many writers have authenticated other origins of stress in the midst of nursing students; examples include academic demands related to the workload increase, steady exams (12-13), and detailed demand of competent reports and papers (13), are a cradle of stress for students. Other causes of stress are connected to interpersonal and intra-personal relationships, which can be attributed to making of new friends, and working with people they do not know (14-15), problems with professors who can sometimes be demanding, intimidating and strict (15), limited time to perform several roles related to family, work, and college (11), as well as financial problems, which are pertinent nowadays (11-16). In addition to classroom learning, nursing students have to acquire skills in laboratories and clinical settings, and undergo extensive evaluation processes consisting of theory and practical examinations that lead to a complex learning environment. Evidence indicates that there is an inverse relationship between stress and lack of professional knowledge and skills, poor patient care and clinical performance among nursing students (29). These factors go a long way to consequent these students’ ability to acquire knowledge effectively.

The educational environment of health sciences is recognized as stressful and usually has negative impacts on educational performance and feeling of well-being in students; as such, there is a growing anxiety toward the emotional distress in health science students. Depression is a common experience among students, since one out of every seven students suffers from depression (2). During the education period, nursing students do not only have the common problems of other students, but also deal with particular problems of their field of study including high mental and emotional pressures of the hospital and emergency unit, confronting with patients’ problems, and their academic period. Therefore, they are exposed to a higher risk of mental health problems (2).

The WHO sat down in a Call for Action at the 54th World Health Assembly in 2001 to talk about mental health as a rising issue of tremendous importance. “I have great pleasure in presenting this publication which reflects our determined efforts to put mental health right at the core of the global health and development agendas…” as said by ex-director of the WHO, Gro Harlem Brundtland. WHO during this conference laid emphasis on the importance of improving mental health in most countries (3). This then calls to mind the capital importance of taking mental health issues very serious most especially when it has to do with health care providers. Stress during school training period can lead to problems later in professional life compromising patient care (4). Stress has been reportedly associated with anxiety, depression and psychological symptoms possibly having a negative impact on students’ academic performance (5, 6). The lifetime prevalence of depression, anxiety and stress among adolescents and young adults around the world is currently estimated to range from 5% to 70% (7).

In 2009, the American College Health Association-National College Health Assessment (ACHA-NCHA) carried out a nationwide survey of college students in their 2nd and 4th year in institutions; it was found that nearly 30 percent of college students reported feeling saying “so depressed that it was difficult to function” at some point in time in their previous year.

 

1.1 Problem Statement

Many nursing students suffer from anxiety and probably depression when exposed to difficult academic tasks; also different students respond differently to situations; as a result anxiety and depression may go a long way to affect their learning abilities. In a study carried out in Niger Delta State University Nigeria to investigate the effect of anxiety on academic performance, it was revealed that a significant relationship existed between students’ performance and level of anxiety (52). In another study carried out in Iran it was found that nursing students experienced a series of stressors due to many factors which can be attributed to academic and personal sources of stress while in nursing school (14). A cross sectional descriptive study was done among baccalaureate nursing students in Mansoura University Eygpt to investigate stress, anxiety and depression within the students. It was also found that 27.9% of these students suffered from depression (17), Anxiety and depression are pointed factors in the study of nursing that cannot be left out. Regardless of the countless studies carried out in Cameroon on psychological disorders with depression and anxiety being at high number, there is still no main study pinpointing the prevalence and effects of these disorders towards learning in our nursing milieu. Health personnel could be exposed to a considerable amount of stress alongside depression and anxiety making it more pertinent. With evidence in the background proving it significant presence and effects on learning in the nursing department, this study will help provide necessary information on the prevalence and effects of these conditions in our nursing community and come out with appropriate measures if positive towards these disorders.

 

1.2 Significance Of Study

Determining the prevalence and effects of anxiety and depression on nursing students’ learning ability in a community where mental health is increasingly becoming an issue, would help us know to what extent nursing students will be needing support throughout their training period, and this will go a long way to help themselves and their patients affected by these disorders throughout their practice.

Identifying the risk factors of these disorders and its effects on learning would help in the setting of appropriate measures to see to it that nursing students are closely followed up. Measures such as opening of counseling and support institutions in various nursing departments could be established.

This study will create some level of awareness among nursing students at FHS University of Buea on the problem being explored hence, helping them prepare themselves to coping with the conditions.

Health is not only a state of physical wellbeing, as such the mental or psychological aspect should not be less considered.

 

1.3 Research Goal

The goal of this study is to investigate the personal and socio-demographic factors associated with anxiety and depression and how these disorders affect student’s learning abilities in our nursing milieu in Cameroon by providing data on the prevalence and socio-demographic factors associated with anxiety and depression  and the  effect(s) of these conditions on learning amongst nursing students.

 

1.4 Objective(S)

1.4.1 General Objective

To determine the risk factors and prevalence of anxiety and depression among nursing students at FHS and the effect(s) of these conditions on students’ learning ability.

1.4.2 Specific Objectives

1. To identify the socio-demographic, academic and personal risk factors associated with anxiety and depression at the Department of Nursing FHS University of Buea.
2. To determine the prevalence of students affected by these conditions at the Department of Nursing FHS University of Buea.
3. To verify the effect(s) of these conditions on learning ability among