- Significant reductions in depression and anxiety over 12 months: depression 72% to 51.7%, anxiety 50.1% to 31.2% (P < 0.001).
- PTSD symptoms increased from 15.9% to 27.8%, indicating persistent post-traumatic stress despite improvements in depression and anxiety.
- Bidirectional longitudinal associations: T1 depression and anxiety predicted T2 PTSD, and T1 PTSD predicted T2 depression and anxiety, indicating reciprocal influence.
BMC Nurs. 2026 Jul 29;25(1):1020. doi: 10.1186/s12912-026-05035-7.
ABSTRACT
BACKGROUND: The COVID-19 pandemic has profoundly affected the mental health of nursing students, highlighting the importance of examining their mental health changes and recovery in the post-pandemic era.
OBJECTIVE: This study aimed to explore the mental health changes and longitudinal relationships among nursing students after the full removal of COVID-19 restrictions through a longitudinal study conducted from December 2022 (one month post-removal, T1) to November 2023 (12 months post-removal, T2).
METHODS: A total of 379 nursing undergraduates completed baseline and follow-up surveys, with all data collected using paper questionnaires. Descriptive statistics, paired sample T-tests, and Chi-square tests were used to analyze the data. Cross-lag analysis was used to investigate the longitudinal relationships between depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms.
RESULTS: The study demonstrated that scores for depression and anxiety symptoms significantly decreased over time, with prevalence decreasing from 72% to 50.1% at baseline to 51.7% and 31.2% at follow-up (P < 0.001). However, PTSD symptom scores unexpectedly showed an upward trend, with prevalence increasing from 15.9% at T1 to 27.8% at T2 (P < 0.001). In the cross-lagged model, depression (β = 0.61, P < 0.001) and anxiety (β = 0.67, P < 0.001) at T1 had significant cross-lag effects on PTSD symptoms at T2. Similarly, PTSD symptoms at T1 predicted subsequent depression (β = 0.33, P < 0.001) and anxiety (β = 0.33, P < 0.001) symptoms at T2.
CONCLUSION: The persistence of PTSD symptoms following the pandemic along with significant psychological stress, underscoring the need for targeted educational policies. Such policies should focus on enhancing post-disaster mental health recovery courses and fostering resilience among students.
CLINICAL TRIAL NUMBER: Not applicable.
PMID:42934627 | DOI:10.1186/s12912-026-05035-7
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