research topic for mental health nursing

📕 Studying HQ

35+ research topics on mental health nursing: fostering wellbeing in psychiatric care, carla johnson.

• August 24, 2023
• Essay Topics and Ideas

Mental health nursing is a critical pillar in nurturing the overall wellness of individuals grappling with psychiatric conditions. Aspiring nursing students, comprehending the nuances of mental health nursing is not only pivotal for your academic voyage but also your future professional practice. In this comprehensive guide, we delve profoundly into mental health nursing. We will explore a range of PICOT questions, propose ideas for evidence-based practice (EBP) projects, furnish you with capstone project ideas, offer a spectrum of research paper topics, present a compilation of research questions, and provide several essay topic concepts. All these facets are intended to equip you holistically for this indispensable domain.

What You'll Learn

Understanding the Essence of Mental Health Nursing

Mental health nursing entails the compassionate care and unwavering support extended to individuals traversing the challenges of mental health issues. The role of a mental health nurse transcends the confines of conventional medical care , encompassing therapeutic communication, emotional bolstering, and fostering an environment conducive to healing. Mental health nurses operate in a myriad of settings including hospitals, community health centers, and outpatient clinics, playing an instrumental role in shaping the lives of their patients.

PICOT Questions on Mental Health Nursing

• Population (P): Adults under psychiatric care ; Intervention (I): Integration of daily RS questionnaire; Comparison (C): Units without daily survey; Outcome (O): Decreased employment of restraint and seclusion; Time (T): 6 months. How does the incorporation of a daily RS (Restraint and Seclusion) questionnaire for adults in psychiatric care, compared to units lacking this daily survey, impact the reduction in the utilization of restraint and seclusion for 6 months?
• P: Adolescents with depressive disorders ; I: Implementation of mindfulness-based intervention; C: Standard therapeutic approach; O: Mitigation of depressive symptoms; T: 8 weeks. Among adolescents diagnosed with depressive disorders, what is the effect of incorporating a mindfulness-based intervention, compared to standard therapy, on alleviating depressive symptoms over an 8-week period?
• P: Elderly residents in long-term care facilities; I: Deployment of pet therapy ; C: Absence of pet therapy; O: Enhancement of mood and social interaction; T: 3 months. In elderly individuals residing within long-term care facilities, does the introduction of pet therapy, as opposed to its absence, result in a noticeable improvement in mood and social interaction over a course of 3 months?
• P: Individuals grappling with schizophrenia ; I: Integration of family psychoeducation; C: Standard care regimen; O: Diminished recurrence rate of episodes; T: 1 year. For individuals diagnosed with schizophrenia, does the inclusion of family psychoeducation within their treatment plan, when compared to standard care, lead to a reduction in the frequency of relapses over a 1-year period?
• P: Veterans afflicted with post-traumatic stress disorder (PTSD); I: Employment of virtual reality exposure therapy; C: Conventional therapeutic methods; O: Reduction in symptoms of PTSD; T: 10 sessions. In veterans struggling with post-traumatic stress disorder (PTSD), does the utilization of virtual reality exposure therapy result in a more pronounced reduction in PTSD symptoms, when contrasted with conventional therapy, across a span of 10 sessions?
• P: Children diagnosed with autism spectrum disorder (ASD); I: Incorporation of equine-assisted therapy; C: Standard interventions; O: Amplification of social skills; T: 12 weeks. Among children with autism spectrum disorder (ASD), does participation in equine-assisted therapy yield an advancement in social skills, in comparison to standard interventions, over a duration of 12 weeks?
• P: Inpatient populace with bipolar disorder ; I: Introduction of a mood tracking application; C: Conventional mood charting techniques; O: Attainment of superior mood stability; T: 6 months. Within inpatients diagnosed with bipolar disorder, does the utilization of a mood tracking application for monitoring moods contribute to enhanced mood stability in comparison to conventional mood charting over a span of 6 months?
• P: Individuals contending with eating disorders; I: Application of cognitive-behavioral therapy (CBT); C: Provision of supportive counseling; O: Reduction in maladaptive eating behaviors; T: 16 sessions. For individuals grappling with eating disorders, does the implementation of cognitive-behavioral therapy (CBT) yield a more substantial reduction in maladaptive eating behaviors, when contrasted with supportive counseling, over 16 sessions?
• P: Patients undergoing substance abuse treatment; I: Integration of music therapy; C: Absence of music therapy; O: Mitigation of anxiety and cravings; T: 8 weeks. Among patients undergoing substance abuse treatment, does engagement in music therapy contribute to a reduction in anxiety and cravings, in comparison to those without exposure to music therapy, over a duration of 8 weeks?
• P: Senior residents of assisted living facilities; I: Implementation of reminiscence therapy; C: Participation in routine activities; O: Elevation in cognitive functioning; T: 3 months.

In senior individuals residing in assisted living facilities, does involvement in reminiscence therapy lead to an improvement in cognitive functioning when juxtaposed with engagement in routine activities across a span of 3 months?

5 EBP Projects on Mental Health Nursing

• Appraising the Efficacy of Art Therapy in Alleviating Anxiety Among Schizophrenia Patients.
• Probing the Influence of Exercise Interventions on Bipolar Disorder Patients’ Depressive Symptoms.
• Unpacking Aromatherapy’s Role in Managing Agitation Among Dementia Patients.
• Evaluating Peer Support Groups’ Contribution to Borderline Personality Disorder Recovery.
• Analyzing Virtual Support Networks’ Role in Mitigating Adolescent Social Anxiety Isolation.

Engaging Capstone Projects on Mental Health Nursing

• Forging a Mental Health Awareness Campaign to Combat Stigma Surrounding Help-Seeking in High Schools.
• Devising an Inclusive Training Module for Nurses Enhancing Communication with Psychosis Patients.
• Crafting a Manual to Empower Families in Supporting Loved Ones with Obsessive-Compulsive Disorder (OCD).
• Establishing a Mindfulness Program for Psychiatric Hospital Personnel to Counter Burnout.
• Designing a Transitional Care Blueprint for Smooth Community Reintegration of Severe Mental Illness Patients Post-Hospitalization.

Research Paper Topics on Mental Health Nursing

• Examining the Role of Trauma-Informed Care in Enhancing Recovery for Domestic Violence Survivors with PTSD.
• Delving into the Nexus Between Childhood Trauma and the Emergence of Dissociative Identity Disorder.
• Surveying the Impact of Sleep Quality on College Students’ Mental Health : A Systematic Review.
• Assessing Telepsychiatry’s Efficacy in Extending Mental Health Services to Rural Regions.
• Navigating Cultural Competency in the Assessment and Treatment of Diverse Depression Patients.

Mental Health Nursing Research Questions

• How Does Early Intervention in Childhood Emotional Dysregulation Shape Mood Disorder Onset in Adulthood?
• What Are the Challenges to Adherence to Medication Among Schizophrenia Patients, and How Can Nursing Strategies Address Them?
• What Is the Impact of Mindfulness-Based Stress Reduction Initiatives on Psychiatric Nurses’ Stress Levels?
• What Factors Contribute to the Overrepresentation of Marginalized Individuals with Coexisting Mental Illness in the Criminal Justice System?
• What Are the Long-Term Effects of Electroconvulsive Therapy (ECT) on Memory and Cognitive Function in Severe Depression Patients?

Essay Topic Ideas & Examples

• Ethical Conundrums in Administering Electroconvulsive Therapy (ECT).
• Exploring the Nexus Between Trauma and Substance Abuse in Individuals with Dual Diagnoses.
• Nurses’ Role in Preventing Suicides: Assessing Risk and Providing Support.
• Cultural Proficiency in Mental Health Nursing: Catering to Multifaceted Patient Requirements.
• COVID-19’s Ripples on Healthcare Providers’ Mental Health: Coping Strategies Amid Challenges.

As you immerse yourself in the tapestry of mental health nursing, myriad opportunities unfold for your contributions to research, evidence-based practices, and compassionate patient care. These PICOT questions, EBP project suggestions, capstone project proposals, research paper topics, research questions, and essay themes constitute the foundation of your journey. Each endeavor you undertake to deepen your comprehension and skills in mental health nursing brings you closer to making a profound difference in the lives entrusted to your care. Should you need additional guidance when crafting essays, research papers, or any scholastic composition related to nursing and mental health, do not hesitate to seek professional aid. Our writing services are tailored to support your academic growth and triumph, ensuring your valuable contributions to mental health nursing are eloquently conveyed and impactful.

• What are the 4 principles of mental health nursing?

The four principles of mental health nursing are: therapeutic relationships, holistic care, patient-centeredness, and evidence-based practice. These principles guide nurses in providing comprehensive and effective care to individuals with mental health conditions.

• What is the role of a nurse in mental health treatment?

Nurses in mental health treatment play a pivotal role in assessing, planning, implementing, and evaluating care for patients with mental health issues. They provide therapeutic support, administer medications, conduct psychoeducation, and collaborate with the multidisciplinary team to promote recovery.

• What are the different types of mental health nurses?

Different types of mental health nurses include psychiatric-mental health nurses, advanced practice psychiatric nurses, child and adolescent mental health nurses, and geriatric mental health nurses. These specialized nurses cater to diverse patient populations and address specific mental health challenges.

• What are the 6 C’s in mental health nursing?

The 6 C’s in mental health nursing stand for Care, Compassion, Competence, Communication, Courage, and Commitment. These core values guide mental health nurses in delivering compassionate and effective care to individuals facing mental health issues.

Mental health nursing stands as a critical pillar in nurturing the overall wellness of individuals grappling with psychiatric conditions. Aspiring nursing students, comprehending the nuances of mental health nursing is not only pivotal for your academic voyage but also for your future professional practice. In this comprehensive guide, we delve profoundly into the realm of mental health nursing. We will explore a range of PICOT questions, propose ideas for evidence-based practice (EBP) projects, furnish you with capstone project ideas, offer a spectrum of research paper topics, present a compilation of research questions, and provide a plethora of essay topic concepts. All these facets are intended to equip you holistically for this indispensable domain.

Mental health nursing entails the compassionate care and unwavering support extended to individuals traversing the challenges of mental health issues. The role of a mental health nurse transcends the confines of conventional medical care, encompassing therapeutic communication, emotional bolstering, and fostering an environment conducive to healing. Mental health nurses operate in a myriad of settings including hospitals, community health centers, and outpatient clinics, playing an instrumental role in shaping the lives of their patients.

• Population (P): Adults under psychiatric care; Intervention (I): Integration of daily RS questionnaire; Comparison (C): Units without daily survey; Outcome (O): Decreased employment of restraint and seclusion; Time (T): 6 months. How does the incorporation of a daily RS (Restraint and Seclusion) questionnaire for adults in psychiatric care, compared to units lacking this daily survey, impact the reduction in the utilization of restraint and seclusion over a span of 6 months?
• P: Adolescents with depressive disorders; I: Implementation of mindfulness-based intervention; C: Standard therapeutic approach; O: Mitigation of depressive symptoms; T: 8 weeks. Among adolescents diagnosed with depressive disorders, what is the effect of incorporating a mindfulness-based intervention, in comparison to standard therapy, on the alleviation of depressive symptoms over an 8-week period?
• P: Elderly residents in long-term care facilities; I: Deployment of pet therapy; C: Absence of pet therapy; O: Enhancement of mood and social interaction; T: 3 months. In elderly individuals residing within long-term care facilities, does the introduction of pet therapy, as opposed to its absence, result in a noticeable improvement in mood and social interaction over a course of 3 months?
• P: Individuals grappling with schizophrenia; I: Integration of family psychoeducation; C: Standard care regimen; O: Diminished recurrence rate of episodes; T: 1 year. For individuals diagnosed with schizophrenia, does the inclusion of family psychoeducation within their treatment plan, when compared to standard care, lead to a reduction in the frequency of relapses over a 1-year period?
• P: Inpatient populace with bipolar disorder; I: Introduction of a mood tracking application; C: Conventional mood charting techniques; O: Attainment of superior mood stability; T: 6 months. Within inpatients diagnosed with bipolar disorder, does the utilization of a mood tracking application for monitoring moods contribute to enhanced mood stability in comparison to conventional mood charting over a span of 6 months?
• Surveying the Impact of Sleep Quality on College Students’ Mental Health: A Systematic Review.

As you immerse yourself in the tapestry of mental health nursing, myriad opportunities unfold for your contributions to research, evidence-based practices, and compassionate patient care. These PICOT questions, EBP project suggestions, capstone project proposals, research paper topics, research questions, and essay themes constitute the foundation of your journey. Each endeavor you undertake to deepen your comprehension and skills in mental health nursing brings you closer to making a profound difference in the lives entrusted to your care. Should you find yourself in need of additional guidance when crafting essays, research papers, or any scholastic composition related to nursing and mental health, do not hesitate to seek professional aid. Our writing services are tailored to support your academic growth and triumph, ensuring your valuable contributions to the realm of mental health nursing are eloquently conveyed and impactful.

Start by filling this short order form order.studyinghq.com

And then follow the progressive flow. 

Having an issue, chat with us here

Cathy, CS. 

New Concept ? Let a subject expert write your paper for You​

Have a subject expert write for you now, have a subject expert finish your paper for you, edit my paper for me, have an expert write your dissertation's chapter, popular topics.

Business StudyingHq Essay Topics and Ideas How to Guides Samples

• Nursing Solutions
• Study Guides
• Free Study Database for Essays
• Privacy Policy
• Writing Service 
• Discounts / Offers 

Study Hub: 

• Studying Blog
• Topic Ideas 
• How to Guides
• Business Studying 
• Nursing Studying 
• Literature and English Studying

Writing Tools  

• Citation Generator
• Topic Generator
• Paraphrasing Tool
• Conclusion Maker
• Research Title Generator
• Thesis Statement Generator
• Summarizing Tool
• Terms and Conditions
• Confidentiality Policy
• Cookies Policy
• Refund and Revision Policy

Our samples and other types of content are meant for research and reference purposes only. We are strongly against plagiarism and academic dishonesty. 

Contact Us:

📧 [email protected]

📞 +15512677917

2012-2024 © studyinghq.com. All rights reserved

Psychiatric-Mental Health Nursing Research Paper Topics

This page provides a comprehensive list of psychiatric-mental health nursing research paper topics , which serves as a crucial resource for nursing students assigned to write research papers. The field of psychiatric-mental health nursing is vast, encompassing a wide variety of topics related to mental health care. This extensive list has been carefully curated to include a diverse range of topics divided into ten distinct categories, making it easier for students to find a subject of interest and relevance to their studies. In addition to the list of topics, the page also includes a detailed article discussing the significance of psychiatric-mental health nursing and the various aspects it covers. Additionally, the page offers information on iResearchNet’s writing services, providing an opportunity for students to order custom-written research papers if needed. Ultimately, this page serves as a one-stop resource for students, aiding them in selecting a topic, understanding the importance of psychiatric-mental health nursing, and, if necessary, ordering a custom research paper.

100 Psychiatric-Mental Health Nursing Research Paper Topics

The field of psychiatric-mental health nursing is incredibly diverse, providing a wide range of research opportunities. Understanding the various aspects of psychiatric-mental health nursing is crucial for providing comprehensive care to patients with mental health issues. This section provides a comprehensive list of psychiatric-mental health nursing research paper topics, categorized into ten different areas of focus. These topics are carefully selected to cover the most pertinent issues and trends in the field, encouraging students to explore and contribute to the existing body of knowledge.

Academic Writing, Editing, Proofreading, And Problem Solving Services

Get 10% off with 24start discount code.

Understanding Mental Health Disorders

• The role of genetic factors in the development of schizophrenia.
• The impact of childhood trauma on adult mental health.
• The relationship between anxiety disorders and cardiovascular diseases.
• The link between depression and chronic pain.
• The effect of sleep disorders on mental health.
• The role of nutrition in managing mental health disorders.
• The impact of substance abuse on mental health.
• The relationship between personality disorders and criminal behavior.
• The role of social support in managing bipolar disorder.
• The impact of post-traumatic stress disorder on quality of life.

Psychopharmacology in Mental Health Nursing

• The effectiveness of antidepressants in managing major depressive disorder.
• The side effects of antipsychotic medications.
• The role of mood stabilizers in managing bipolar disorder.
• The impact of benzodiazepines on cognitive function.
• The effectiveness of non-pharmacological interventions in managing anxiety disorders.
• The role of psychostimulants in managing attention deficit hyperactivity disorder (ADHD).
• The impact of medication adherence on treatment outcomes in schizophrenia.
• The role of pharmacogenomics in personalized treatment of mental health disorders.
• The effectiveness of electroconvulsive therapy in treatment-resistant depression.
• The impact of polypharmacy on treatment outcomes in elderly patients with mental health disorders.

Therapeutic Communication in Mental Health Nursing

• The impact of therapeutic communication on patient outcomes in mental health care.
• The role of non-verbal communication in building therapeutic relationships with patients.
• The effectiveness of motivational interviewing in substance abuse treatment.
• The impact of active listening on patient satisfaction and adherence to treatment.
• The role of empathy in mental health nursing.
• The effectiveness of group therapy in managing social anxiety disorder.
• The impact of family therapy on the mental health of adolescents.
• The role of cognitive-behavioral therapy in managing depression.
• The effectiveness of dialectical behavior therapy in managing borderline personality disorder.
• The impact of psychoeducation on the management of schizophrenia.

Mental Health Promotion and Prevention

• The role of school-based mental health programs in preventing adolescent depression.
• The effectiveness of community-based mental health promotion programs.
• The impact of workplace mental health promotion programs on employee well-being.
• The role of physical activity in preventing mental health disorders.
• The effectiveness of mindfulness-based stress reduction in preventing anxiety and depression.
• The impact of social support on the prevention of mental health disorders.
• The role of early intervention programs in preventing the development of psychosis.
• The effectiveness of suicide prevention programs in reducing suicide rates.
• The impact of anti-stigma campaigns on public attitudes towards mental health.
• The role of primary care providers in mental health promotion and prevention.

Legal and Ethical Issues in Mental Health Nursing

• The impact of involuntary hospitalization on the mental health of patients.
• The role of advanced directives in mental health care.
• The effectiveness of mental health courts in reducing recidivism rates.
• The impact of confidentiality breaches on the therapeutic relationship.
• The role of informed consent in mental health care.
• The effectiveness of restraint and seclusion in managing aggressive behavior.
• The impact of medication refusal on treatment outcomes.
• The role of ethics committees in resolving ethical dilemmas in mental health care.
• The effectiveness of de-escalation techniques in managing aggressive behavior.
• The impact of legal and ethical issues on the role of the mental health nurse.

Mental Health Nursing Across the Lifespan

• The impact of developmental stages on the mental health of individuals.
• The role of mental health nursing in the care of children and adolescents.
• The effectiveness of mental health interventions for older adults.
• The impact of life transitions on mental health.
• The role of mental health nursing in the care of pregnant and postpartum women.
• The effectiveness of mental health interventions for individuals with intellectual disabilities.
• The impact of aging on mental health.
• The role of mental health nursing in the care of individuals with dementia.
• The effectiveness of mental health interventions for adolescents with eating disorders.
• The impact of end-of-life care on the mental health of patients and their families.

Cultural Competence in Mental Health Nursing

• The impact of cultural competence on patient satisfaction and outcomes in mental health care.
• The role of cultural competence in building therapeutic relationships with patients from diverse backgrounds.
• The effectiveness of culturally tailored interventions in managing mental health disorders.
• The impact of language barriers on access to mental health care.
• The role of cultural competence in the assessment and diagnosis of mental health disorders.
• The effectiveness of cultural competence training for mental health professionals.
• The impact of cultural beliefs and practices on mental health.
• The role of cultural competence in the prevention of mental health disorders.
• The effectiveness of culturally adapted cognitive-behavioral therapy in managing depression.
• The impact of cultural competence on the delivery of mental health services to immigrant and refugee populations.

Psychiatric-Mental Health Nursing in Various Settings

• The role of mental health nursing in primary care settings.
• The effectiveness of mental health nursing interventions in acute care settings.
• The impact of mental health nursing on patient outcomes in long-term care settings.
• The role of mental health nursing in community mental health services.
• The effectiveness of mental health nursing interventions in correctional facilities.
• The impact of mental health nursing on patient outcomes in home health care.
• The role of mental health nursing in school-based mental health services.
• The effectiveness of mental health nursing interventions in emergency departments.
• The impact of mental health nursing on patient outcomes in psychiatric hospitals.
• The role of mental health nursing in substance abuse treatment centers.

Technological Advances in Mental Health Nursing

• The impact of telepsychiatry on access to mental health care in rural areas.
• The role of electronic health records in improving the quality of mental health care.
• The effectiveness of online support groups in managing mental health disorders.
• The impact of mobile applications on medication adherence in patients with mental health disorders.
• The role of virtual reality in the treatment of phobias.
• The effectiveness of online cognitive-behavioral therapy in managing anxiety disorders.
• The impact of teletherapy on patient satisfaction and outcomes in mental health care.
• The role of technology in enhancing communication between mental health professionals and patients.
• The effectiveness of online psychoeducation in the management of bipolar disorder.
• The impact of technology on the role of the mental health nurse.

Emerging Trends in Psychiatric-Mental Health Nursing

• The impact of the COVID-19 pandemic on the mental health of healthcare workers.
• The role of psychiatric-mental health nurses in addressing the opioid crisis.
• The effectiveness of trauma-informed care in managing post-traumatic stress disorder.
• The impact of the integration of mental health and primary care services on patient outcomes.
• The role of psychiatric-mental health nurses in addressing the mental health needs of LGBTQ+ populations.
• The effectiveness of peer support in the management of mental health disorders.
• The impact of climate change on mental health.
• The role of psychiatric-mental health nurses in addressing the mental health needs of immigrant and refugee populations.
• The effectiveness of mindfulness-based interventions in managing stress and burnout among mental health professionals.
• The impact of social media on mental health.

The psychiatric-mental health nursing field offers a vast array of research opportunities, as evident from the extensive list of topics provided above. These topics encompass various aspects of mental health care, from understanding mental health disorders to exploring the ethical and legal considerations in psychiatric-mental health nursing. It is crucial for students and professionals in the field to engage in research to contribute to the advancement of knowledge and improvement of mental health care. This list of psychiatric-mental health nursing research paper topics serves as a starting point for students to explore and contribute to this vital field of nursing.

The Range of Psychiatric-Mental Health Nursing Research Paper Topics

Psychiatric-mental health nursing is a specialized field of nursing that is dedicated to promoting mental health through the assessment, diagnosis, and treatment of mental health disorders and conditions. This field of nursing is incredibly important, as mental health disorders are prevalent and can have a significant impact on individuals’ overall health and well-being. According to the World Health Organization, approximately one in four people in the world will be affected by mental or neurological disorders at some point in their lives. This staggering statistic underscores the critical need for skilled psychiatric-mental health nurses who can provide comprehensive and compassionate care to individuals with mental health needs.

The significance of psychiatric-mental health nursing is multifaceted. First and foremost, psychiatric-mental health nurses play a crucial role in providing care and support to individuals with mental health disorders. They are often the first point of contact for individuals seeking help for mental health issues and play a key role in the assessment and diagnosis of mental health disorders. Psychiatric-mental health nurses also develop and implement treatment plans, provide psychoeducation to patients and their families, and offer support and counseling. Additionally, they play a vital role in crisis intervention and the management of acute mental health episodes.

Furthermore, psychiatric-mental health nurses also play a critical role in promoting mental health and preventing mental health disorders. They work in a variety of settings, including community mental health centers, schools, and primary care clinics, where they provide mental health education and promote strategies for maintaining good mental health. Additionally, psychiatric-mental health nurses often work in interdisciplinary teams, collaborating with other healthcare professionals, such as psychiatrists, psychologists, and social workers, to provide comprehensive care to individuals with mental health needs.

Various aspects of psychiatric-mental health nursing offer a wide range of psychiatric-mental health nursing research paper topics. One critical area of focus is mental health assessment. This involves the evaluation of an individual’s mental health status through the use of various assessment tools and techniques. Research in this area might explore the validity and reliability of different mental health assessment tools, the impact of cultural differences on mental health assessment, or the development of new assessment tools and techniques.

Another important aspect of psychiatric-mental health nursing is treatment and intervention strategies. This encompasses a wide range of approaches, from psychopharmacology to psychotherapy to lifestyle interventions. Psychiatric-mental health nursing research paper topics in this area might include the effectiveness of different treatment approaches for specific mental health disorders, the impact of treatment adherence on treatment outcomes, or the development of new intervention strategies.

The role of the psychiatric-mental health nurse is another crucial aspect of this field. Psychiatric-mental health nurses have a unique set of skills and competencies that enable them to provide comprehensive care to individuals with mental health needs. Research topics in this area might explore the impact of nurse-patient relationships on treatment outcomes, the role of psychiatric-mental health nurses in interdisciplinary teams, or the development of new competencies and skills for psychiatric-mental health nurses.

In addition to these areas, there are many other aspects of psychiatric-mental health nursing that offer a wealth of research opportunities. For example, legal and ethical issues in psychiatric-mental health nursing, the role of technology in mental health care, and the mental health needs of specific populations, such as the elderly, children, or individuals with co-occurring disorders, are all important areas of focus.

Overall, the field of psychiatric-mental health nursing offers a wide range of research opportunities. From mental health assessment to treatment and intervention strategies to the role of the psychiatric-mental health nurse, there are numerous psychiatric-mental health nursing research paper topics to explore. Engaging in research in this field is crucial for the advancement of knowledge and the improvement of mental health care for individuals around the world.

In conclusion, psychiatric-mental health nursing is a vital field that plays a crucial role in promoting mental health and providing care and support to individuals with mental health needs. The various aspects of psychiatric-mental health nursing offer a wide range of psychiatric-mental health nursing research paper topics, from mental health assessment to treatment and intervention strategies to the role of the psychiatric-mental health nurse. Engaging in research in this field is essential for advancing knowledge and improving mental health care worldwide.

iResearchNet’s Custom Writing Services

iResearchNet is a leading provider of custom writing services, designed to assist students in achieving academic excellence. Our team of expert writers is committed to providing top-quality academic papers, tailored to meet your specific requirements. Whether you need help with a research paper, essay, dissertation, or any other academic assignment, iResearchNet is here to provide you with the support you need.

Features of iResearchNet’s Writing Services

• Expert Degree-Holding Writers: Our team consists of highly qualified writers, each holding a minimum of a Master’s degree in their respective fields. This ensures that your paper is written by an expert with a deep understanding of your subject matter.
• Custom Written Works: Each paper is crafted from scratch, according to your specific instructions. This ensures that your paper is unique, original, and tailored to your requirements.
• In-depth Research: Our writers conduct thorough research on each topic, using a variety of reliable sources. This ensures that your paper is well-researched, accurate, and comprehensive.
• Custom Formatting: Your paper will be formatted according to your preferred style guide, whether it is APA, MLA, Chicago/Turabian, or Harvard. This ensures that your paper meets the specific formatting requirements of your institution.
• Top Quality: We are committed to providing top-quality work. Each paper is carefully reviewed by our quality assurance team to ensure that it meets our high standards.
• Customized Solutions: We understand that each student has unique needs. Therefore, we offer customized solutions to meet your specific requirements. Whether you need a paper written from scratch, editing and proofreading services, or assistance with a specific part of your paper, we are here to help.
• Flexible Pricing: We offer flexible pricing options to suit your budget. Our prices are competitive, and we provide a detailed price quote upfront, with no hidden fees.
• Short Deadlines up to 3 hours: We understand that sometimes you may need your paper urgently. We offer short deadlines up to 3 hours for certain types of assignments.
• Timely Delivery: We are committed to delivering your paper on time, every time. You can count on us to meet your deadline.
• 24/7 Support: Our customer support team is available 24/7 to assist you with any questions or concerns you may have. You can contact us via phone, email, or live chat.
• Absolute Privacy: We respect your privacy and take all necessary measures to protect your personal information. Your personal details will never be shared with any third party.
• Easy Order Tracking: Our user-friendly online platform allows you to easily track the progress of your order. You can also communicate directly with your writer through our messaging system.
• Money-Back Guarantee: We are confident in the quality of our services. However, if you are not satisfied with the final product, we offer a money-back guarantee.

iResearchNet is committed to providing top-quality writing services to help students achieve academic success. Our expert degree-holding writers, custom written works, in-depth research, and custom formatting ensure that your paper is of the highest quality. Our customized solutions, flexible pricing, and short deadlines cater to your specific needs. With our timely delivery, 24/7 support, absolute privacy, easy order tracking, and money-back guarantee, you can have complete peace of mind when you choose iResearchNet for your academic writing needs.

Secure Your Success with iResearchNet

Are you feeling overwhelmed by the multitude of assignments and deadlines looming over your head? You are not alone. Many nursing students struggle to find the time and resources necessary to complete their psychiatric-mental health nursing research papers. That’s where iResearchNet comes in. We are here to provide you with top-quality, custom-written research papers that will not only help you to achieve your academic goals but also to deepen your understanding of psychiatric-mental health nursing.

Our team of expert writers is highly qualified and experienced in the field of psychiatric-mental health nursing. They are adept at conducting in-depth research and creating comprehensive, well-structured, and meticulously referenced research papers. When you order a custom research paper from iResearchNet, you can be confident that you are receiving a paper of the highest quality, tailored to your specific requirements and formatted according to your preferred style guide.

Submitting a high-quality research paper is crucial for your academic success. It demonstrates your understanding of the subject matter, your ability to conduct thorough research, and your skill in organizing and presenting information in a clear and coherent manner. A well-crafted research paper can significantly impact your final grade and your future career prospects in the field of psychiatric-mental health nursing. Don’t take chances with your academic and professional future. Trust iResearchNet to provide you with the top-quality research paper you need to succeed.

Take the First Step Towards Your Success

Don’t wait until the last minute to start your psychiatric-mental health nursing research paper. Take the first step towards your academic success by ordering a custom research paper from iResearchNet today. Our user-friendly online platform makes it easy to place your order, and our 24/7 customer support team is always here to assist you with any questions or concerns you may have. With our absolute privacy policy, you can be assured that your personal information will be kept confidential. And with our money-back guarantee, you can have complete peace of mind knowing that your satisfaction is our top priority. Invest in your future by choosing iResearchNet for your academic writing needs.

ORDER HIGH QUALITY CUSTOM PAPER

Mental Health Nursing Research Topics: Inspiring Ideas for Students

This article was written in collaboration with Christine T. and ChatGPT, our little helper developed by OpenAI.

Mental health nursing is an essential field that requires ongoing research to improve patient outcomes and enhance the overall quality of care. As a student in this field, you can contribute to this important work by conducting research projects.

One of the biggest challenges you may face when starting a research project is deciding on a topic. This article has compiled a list of relevant and inspiring mental health nursing research topics to help you get started.

Examples of Mental Health Nursing Research Topics

The effectiveness of mindfulness practices on mental health outcomes.

Mindfulness practices, such as meditation and yoga, have become increasingly popular in recent years as a way to reduce stress and improve overall well-being. Research has shown that these practices may also effectively treat mental health conditions such as depression and anxiety. As a mental health nursing student, you could investigate the impact of mindfulness practices on mental health outcomes.

• The impact of mindfulness practices on depression symptoms
• The effect of mindfulness on anxiety and stress reduction
• Mindfulness as a tool for coping with chronic pain
• The benefits of mindfulness for people with substance abuse disorders
• Mindfulness-based interventions for PTSD
• The role of mindfulness in promoting better sleep
• Comparing the effectiveness of different types of mindfulness practices on reducing anxiety symptoms
• Exploring the neurobiological mechanisms underlying the benefits of mindfulness meditation
• The impact of mindfulness practices on sleep quality and mental health
• Evaluating the long-term effects of regular mindfulness practices on emotional well-being
• Mindfulness interventions in schools and their effects on student mental health
• Mindfulness and eating disorders: effects on body image and eating behavior
• Mindfulness and anger management
• Mental health and gender inequality
• The effect of mindfulness on attention and focus
• Mindfulness as a strategy to enhance emotional intelligence
• Mindfulness and workplace stress
• Mindfulness and burnout in healthcare professionals
• The impact of mindfulness on cognitive function in older adults
• Mindfulness and self-compassion: effects on self-esteem and self-worth
• Mindfulness as a complement to medication for mental health treatment
• Mindfulness-based interventions for people with schizophrenia
• Mindfulness for children and adolescents with ADHD
• The effect of mindfulness on symptoms of bipolar disorder
• Mindfulness and social anxiety
• Mindfulness and parenting: effects on stress and well-being
• The impact of mindfulness on academic performance
• Mindfulness and addiction recovery: effects on relapse prevention
• Mindfulness and personality disorders
• Mindfulness and body image dissatisfaction
• Mindfulness and chronic illness: effects on quality of life
• Mindfulness for people with borderline personality disorder
• The impact of mindfulness on self-harm and suicidal ideation
• Mindfulness for people with eating disorders in recovery
• Mindfulness and resilience: effects on coping with adversity
• The drug abuse and associated disorders: an overview of the anti-drug policy and the need for policy change
• Mindfulness and self-compassion in cancer patients
• The effect of mindfulness on symptoms of OCD
• Mindfulness-based interventions for people with anxiety disorders
• Mindfulness and creativity: effects on artistic expression and well-being
• Mindfulness for people with chronic fatigue syndrome
• Mindfulness and pain management: effects on chronic pain
• Mindfulness and emotional regulation in people with autism
• Mindfulness for people with borderline intellectual functioning
• The effect of mindfulness on symptoms of postpartum depression
• Mindfulness and social connectedness: effects on loneliness and isolation
• Mindfulness and spirituality: effects on well-being and connection to something larger

Medical Studies Overwhelming?

Delegate Your Nursing Papers to the Pros!

Get 15% Discount

+ Plagiarism Report for FREE

The Role of Nutrition in Mental Health

Research has shown that diet and nutrition can significantly affect mental health outcomes. For example, certain nutrients, such as omega-3 fatty acids, have been linked to improved mood and cognitive function. As a mental health nursing student, you could explore the impact of nutrition on mental health outcomes and investigate the effectiveness of nutritional interventions in managing mental health conditions.

• The impact of nutrient deficiencies on mental health
• The role of omega-3 fatty acids in brain function and mental health
• The effect of vitamin D on mood and anxiety
• The connection between gut health and mental health
• The influence of caffeine on anxiety and sleep
• The effects of sugar on mental health and cognitive function
• The relationship between gut health, diet, and mood disorders
• Evaluating the effects of probiotics on mental health outcomes
• Impact of vitamin D deficiency on depressive symptoms
• Dietary interventions for managing ADHD symptoms in children
• The link between sugar intake and anxiety: a closer look
• The impact of nutrition on ADHD symptoms
• The role of antioxidants in protecting against oxidative stress and improving mental health
• The effects of probiotics on mental health and mood
• The connection between iron deficiency and depression
• The role of magnesium in anxiety and depression
• The impact of food allergies and intolerances on mental health
• The effect of B vitamins on cognitive function and mental health
• The influence of alcohol on mental health and well-being
• The role of nutrition in the prevention of dementia and cognitive decline
• The effects of caffeine withdrawal on mental health
• The connection between nutrition and schizophrenia symptoms
• The role of amino acids in brain function and mental health
• The effect of carbohydrates on mood and energy levels
• The impact of diet on sleep quality and quantity
• The influence of processed foods on mental health
• The role of nutrition in the treatment of eating disorders
• The connection between nutrition and bipolar disorder symptoms
• The effect of zinc on mental health and cognitive function
• The impact of phytochemicals on brain health and mental well-being
• The role of nutrition in the prevention and treatment of anxiety disorders
• The effects of dehydration on cognitive function and mood
• The connection between nutrition and ADHD medication effectiveness
• The role of nutrition in the prevention and treatment of depression
• The effect of amino acid supplementation on depression and anxiety
• The impact of low-carbohydrate diets on mental health and mood
• The influence of social and cultural factors on nutrition and mental health
• The role of nutrition in the management of stress and cortisol levels
• The effects of specific diets, such as the Mediterranean diet, on mental health outcomes
• The connection between nutrition and substance abuse recovery
• The role of nutrition in the prevention and treatment of postpartum depression
• The effect of omega-3 supplementation on cognitive function and memory
• The impact of vegetarian and vegan diets on mental health and well-being
• The connection between nutrition and Seasonal Affective Disorder (SAD)
• The role of nutrition in the prevention and treatment of Alzheimer’s disease

The Impact of Social Media on Mental Health

Social media has become integral to our daily lives, but research has also shown that it can hurt mental health. For example, excessive social media use has been linked to increased feelings of anxiety and depression. As a mental health nursing student, you could investigate the impact of social media on mental health outcomes and explore the effectiveness of interventions aimed at reducing the harmful effects of social media.

• The connection between social media use and depression
• The impact of social media on body image and self-esteem
• The effect of social media on sleep quality and quantity
• The relationship between social media addiction and mental health
• The influence of cyberbullying on mental health outcomes
• The role of social media in the development of anxiety disorders
• The effects of social media on interpersonal relationships and social skills
• The connection between social media use and suicide risk
• The correlation between social media usage patterns and self-esteem levels
• Effects of social media detox on mental health outcomes
• Evaluating the role of social media in the rise of body dysmorphia among teenagers
• The relationship between cyberbullying on social media platforms and depression
• Influence of social comparison on social media and its impact on mental health
• The impact of social media on attention span and focus
• The effect of social media on academic performance and stress
• The relationship between social media use and eating disorders
• The influence of social media on body dysmorphia
• The role of social media in the development of addiction and substance abuse disorders
• The effects of social media on the brain and cognition
• The connection between social media use and stress levels
• The impact of social media on political beliefs and mental health outcomes
• The effect of social media on self-compassion and self-care
• The relationship between social media use and personality disorders
• The influence of social media on social comparison and envy
• The role of social media in the development of Obsessive-Compulsive Disorder (OCD)
• The effects of social media on creativity and mental health
• The connection between social media use and addiction to video games
• The impact of social media on attention deficit and hyperactivity disorder (ADHD)
• The effect of social media on decision-making and impulsivity
• The relationship between social media use and loneliness
• The influence of social media on phobias and anxieties
• The role of social media in the development of trauma-related disorders
• The effects of social media on emotional regulation and mental health
• The connection between social media use and paranoia
• The impact of social media on cultural and societal attitudes toward mental health
• The effect of social media on post-traumatic stress disorder (PTSD)
• The relationship between social media use and narcissistic personality disorder
• The influence of social media on obsessive thoughts and compulsive behaviors
• The role of social media in the development of schizophrenia and other psychotic disorders
• The effects of social media on body-focused repetitive behaviors (BFRBs)
• The connection between social media use and self-harm behaviors
• The impact of social media on emotional contagion and mental health outcomes
• The effect of social media on emotional intelligence and empathy
• The relationship between social media use and phubbing (phone snubbing)
• The influence of social media on identity formation and mental health

The Effectiveness of Art Therapy in Treating Mental Health Conditions

Art therapy is a form of psychotherapy that uses creative expression to improve mental health outcomes. As a mental health nursing student, you could investigate the effectiveness of art therapy in treating mental health conditions such as depression, anxiety, and post-traumatic stress disorder.

• The role of art therapy in treating anxiety disorders
• The effectiveness of art therapy in managing depression
• Art therapy as a treatment for post-traumatic stress disorder (PTSD)
• Art therapy for improving social skills in individuals with autism spectrum disorders
• The anatomy and physiology of anxiety disorder: hereditary factors and statistical facts
• The benefits of art therapy in treating addiction and substance abuse disorders
• Art therapy for promoting self-expression and emotional regulation in children with ADHD
• Art therapy as a tool for managing PTSD symptoms in veterans
• The role of music therapy in improving mental health outcomes in dementia patients
• Exploring the benefits of dance therapy for individuals with mood disorders
• Evaluating the therapeutic effects of visual arts on children with behavioral disorders
• The impact of group art therapy sessions on building social skills in autistic individuals
• The effectiveness of art therapy in managing chronic pain and illness-related stress
• Art therapy for enhancing communication and reducing aggression in individuals with dementia
• The benefits of art therapy in managing symptoms of schizophrenia
• Art therapy as a treatment for borderline personality disorder
• The effectiveness of art therapy in improving body image and self-esteem
• The delicate dance: balancing art and science in the nursing profession
• Art therapy for reducing symptoms of obsessive-compulsive disorder (OCD)
• The role of art therapy in managing anger and aggression in individuals with intellectual disabilities
• Art therapy for promoting mindfulness and reducing stress in cancer patients
• The effectiveness of art therapy in managing symptoms of eating disorders
• Art therapy for improving cognitive functioning in individuals with traumatic brain injuries
• The benefits of art therapy in reducing symptoms of chronic fatigue syndrome
• Art therapy as a treatment for individuals with chronic pain and fibromyalgia
• The effectiveness of art therapy in improving sleep quality and quantity
• Art therapy for promoting relaxation and reducing anxiety in individuals with hypertension
• The role of art therapy in treating individuals with dissociative identity disorder
• Art therapy for enhancing creativity and promoting personal growth
• The benefits of art therapy in improving the overall quality of life in individuals with mental health conditions
• Art therapy as a treatment for individuals with multiple sclerosis
• The effectiveness of art therapy in managing symptoms of bipolar disorder
• Art therapy for improving social functioning and reducing isolation in individuals with schizophrenia
• The role of art therapy in promoting spirituality and reducing existential anxiety
• Nursing: a beautiful blend of art and science
• Art therapy for promoting self-compassion and self-care in individuals with chronic illness
• The benefits of art therapy in managing symptoms of attention deficit hyperactivity disorder (ADHD)
• Art therapy as a treatment for individuals with personality disorders
• The effectiveness of art therapy in reducing symptoms of agoraphobia
• Art therapy for promoting emotional resilience and coping skills in individuals with chronic pain
• The role of art therapy in managing symptoms of obsessive-compulsive personality disorder
• Art therapy for improving communication and reducing aggression in individuals with traumatic brain injuries
• The benefits of art therapy in promoting self-awareness and personal insight
• Art therapy as a treatment for individuals with gender identity disorder
• The effectiveness of art therapy in reducing symptoms of borderline intellectual functioning
• Art therapy for promoting emotional expression and reducing anxiety in individuals with speech disorders
• The role of art therapy in promoting cognitive flexibility and problem-solving skills
• Art therapy for improving body awareness and reducing symptoms of somatic disorders

The Impact of Trauma on Mental Health Outcomes

Trauma can profoundly impact mental health outcomes, and understanding the relationship between trauma and mental illness is essential for effective care. As a mental health nursing student, you could investigate the impact of trauma on mental health outcomes and explore the effectiveness of interventions to reduce the negative effects of trauma.

• The effects of childhood trauma on mental health in adulthood
• The impact of adverse childhood experiences (ACEs) on mental health outcomes
• The role of resilience in mitigating the effects of trauma on mental health
• The prevalence of trauma in marginalized populations and its impact on mental health
• The effects of trauma on brain development and mental health outcomes
• The impact of trauma on the development of post-traumatic stress disorder (PTSD)
• The relationship between trauma and substance use disorders
• The role of social support in mitigating the effects of trauma on mental health
• The effects of trauma on attachment and interpersonal relationships
• The impact of trauma on physical health outcomes
• Exploring the physiological changes in the brain after experiencing trauma
• Evaluating the effectiveness of EMDR therapy for trauma survivors
• The long-term mental health outcomes of childhood trauma
• Comparing the effects of single incident trauma vs. prolonged trauma on mental health
• The role of support groups in aiding trauma recovery
• The effects of trauma on cognitive functioning and memory
• The relationship between trauma and depression
• The impact of trauma on anxiety and anxiety disorders
• The role of trauma in the development of personality disorders
• The effects of trauma on sleep quality and quantity
• The relationship between trauma and self-esteem
• The impact of trauma on emotion regulation and impulsivity
• The effects of trauma on suicidal ideation and behavior
• The role of trauma in the development of dissociative disorders
• The impact of trauma on parenting and child-rearing practices
• The effects of trauma on sexual health and relationships
• The relationship between trauma and eating disorders
• The impact of trauma on social functioning and integration
• The effects of trauma on work productivity and employment outcomes
• The role of cultural factors in the experience and impact of trauma on mental health
• The effects of trauma on spirituality and faith-based coping mechanisms
• The relationship between trauma and anger management
• The impact of trauma on sexual and gender identity development
• The effects of trauma on executive functioning and decision-making abilities
• The role of trauma in the development of the obsessive-compulsive disorder (OCD)
• The impact of trauma on aging and geriatric mental health
• The effects of trauma on identity development and self-concept
• The relationship between trauma and borderline personality disorder (BPD)
• The impact of trauma on coping strategies and resilience
• The effects of trauma on healthcare utilization and healthcare outcomes
• The role of trauma in the development of anxiety and stress-related disorders
• The impact of trauma on social and emotional intelligence
• The effects of trauma on emotion recognition and empathy
• The relationship between trauma and bipolar disorder
• The role of trauma in the development of schizophrenia and other psychotic disorders

The Interdisciplinary Approach in Mental Health Nursing

Mental health nursing is not an isolated field. It thrives on interdisciplinary collaboration, where professionals from various disciplines come together to offer holistic care to patients. As the understanding of mental health broadens, it’s imperative for nursing students to recognize the value of interdisciplinary approaches in optimizing patient outcomes.

Benefits of an Interdisciplinary Approach:

• Holistic Care

Drawing expertise from fields like psychology, nutrition, social work, and even art therapy ensures a well-rounded approach to patient care.

• Enhanced Patient Outcomes

Collaborative efforts often lead to better patient outcomes as they address various facets of a patient’s well-being.

• Continued Learning

Interacting with professionals from diverse backgrounds provides an excellent opportunity for learning and professional growth.

Key Areas of Collaboration:

• Psychology and Psychiatry

Understanding the psychological underpinnings of mental disorders and collaborating with psychologists and psychiatrists is fundamental. It ensures that therapeutic interventions are complemented by appropriate medical treatments.

• Social Work

Social workers play a crucial role in patient rehabilitation, ensuring they have the necessary support systems in place, be it family counseling or community reintegration.

As the link between nutrition and mental health becomes increasingly evident, collaboration with nutritionists can guide dietary interventions to complement therapeutic strategies.

• Alternative Therapies

Fields like art therapy, music therapy, and even physical therapy offer alternative avenues for patient recovery. Understanding and collaborating with professionals from these fields can enhance patient care.

For nursing students, embracing the interdisciplinary approach is not just about improving patient care but also about enhancing their professional expertise. By understanding the broader landscape of mental health care, students prepare themselves for the diverse challenges and opportunities that lie ahead in their careers.

Choosing a research topic can be challenging, but with the right inspiration and guidance, you can find a relevant and inspiring topic with the right inspiration and guidance. These mental health nursing research topic ideas are just a starting point – there are countless other areas of research in this field that you can explore. With dedication and hard work, you can make a valuable contribution to the field of mental health nursing and help improve the lives of those struggling with mental illness.

📎 Related Articles

1. Top Nursing Argumentative Essay Topics: Engage in Thought-Provoking Debates 2. Top Nursing Topics for Discussion: Engaging Conversations for Healthcare Professionals 3. Key EBP Nursing Topics: Enhancing Patient Results through Evidence-Based Practice 4. Top Nursing Research Topics for Students and Professionals 5. Nursing Debate Topics: The Importance of Discussing and Debating Nursing Issues 6. Mental Health – Health Topics | Healthy Schools 7. NIMH » Health Topics 8. Mental Health Topics and Resources for Patients and Families 9. Exploring Controversial Issues in Nursing: Key Topics and Examples 10. Pediatric Nursing Research Topics for Students: A Comprehensive Guide

Table of content

Crafted with Care:

Nursing Essays!

Precision, Passion, & Professionalism in Every Page.

Online Nursing Essays

Top Quality Nursing Papers

Exploring Popular Mental Health Research Paper Topics

Mental health, a paramount aspect of overall human well-being, has recently gained considerable attention. Many individuals are diagnosed with mental illnesses at significant rates. Mental health research topics encompass a broad range of areas, from understanding the underlying causes of disorders to exploring treatment modalities and societal impacts. The insights drawn from these studies equip professionals to offer effective interventions and craft public health strategies. In this article, we’ll delve into some of the most pivotal and intriguing mental health issues under investigation by specialists.

What are Mental Health Research Topics?

Mental health research topics refer to the various subjects under the umbrella of mental health that researchers can explore, analyze, and draw conclusions from. These topics can range from specific disorders, such as depression or anxiety, to broader concepts, like the impact of societal norms on mental health or the role of technology in mental well-being. Data on mental health indicates that 10% of young women face eating disorders like anorexia nervosa, bulimia, and concerns about body image distortion.

What’s the Difference Between a Research Topic and a Research Question?

A research topic acts as a broad thematic umbrella, setting the study’s overall direction, like exploring ‘depression in teenagers.’ This general theme can encompass various facets, from causes and treatments to societal perceptions. In contrast, a research question, such as ‘How does social media usage impact depression levels in teenagers?’ provides a sharper, targeted inquiry, guiding specific research objectives. 

What Makes a Strong Mental Health Research Topic?

A robust mental health research topic is both current and relevant. It addresses gaps in existing knowledge, offers new perspectives, and has the potential to bring about meaningful change. Such a topic is backed by preliminary data, is feasible regarding research methodology, and resonates with the larger scientific and social community.

How to Find an Ideal Mental Health Research Topic?

Following a structured approach, one can narrow down a subject that aligns with their interests and contributes significantly to the field.

• Identify the mental health research area you’d like to concentrate on. Begin by outlining your interests. Whether it’s child psychology, geriatric mental health, or neurocognitive disorders, pinpointing a domain can offer direction.
• In the chosen research area, search and collect more research topic ideas. Scour journals, online databases, and relevant literature. Keep an eye on emerging trends and untouched areas.
• Brainstorm all the gathered ideas and eliminate topics with minimum or no research scope. A topic might sound intriguing, but it is essential to ensure it holds research potential.
• Choose one ideal mental health research topic from all the shortlisted topics. This should align with your passion, have ample research material, and be novel.
• Confirm the topic only if it matches the research paper writing guidelines your professor or university shared. Adherence to guidelines ensures your effort is acknowledged and validated.

Tips for Choosing a Mental Health Research Topic

The topic you opt for sets the tone for your entire research journey, influencing the hours you’ll spend reading, analyzing, and writing about it. Consider the following guidelines:

• Choose a topic that interests you: When you’re personally invested in a topic, the research transforms into a journey. A topic you’re enthusiastic about can motivate you during those inevitable rough patches in the research process. 
• Choose a fresh approach: Bringing a fresh perspective makes your research stand out and pushes the boundaries of existing knowledge, fostering growth in the field.
• Choose a topic that matters: Topics that resonate with societal issues or current events can attract a wider audience, increasing the potential impact of your findings. 
• Choose a topic that challenges you: It demands more effort, deeper analysis and might even push you out of your comfort zone. Overcoming obstacles can lead to personal and academic growth.
• Choose a manageable topic: Narrow your scope to ensure depth, providing a comprehensive view of a more specific issue. This ensures that you can produce a thorough and insightful piece of research.

List of Mental Health Research Topics and Ideas

This comprehensive list encompasses various domains within mental health, aiming to cater to diverse research interests.

Interesting Mental Health Research Topics

• Digital Age and Mental Well-being: Exploring the effects of continuous connectivity and social media on mental health.
• Neurological Basis of Anxiety Disorders: A deep dive into how the brain’s architecture and chemistry contribute to anxiety.
• Art Therapy for PTSD: Assessing the therapeutic potential of art in aiding recovery from traumatic experiences.
• Gut Health’s Link to Mental Wellness: Investigating the role of the gut-brain axis and the microbiome’s impact on mental health conditions.
• Remote Work and Its Psychological Implications: Analyzing the mental health challenges and benefits of the increasing shift towards remote working.
• Genetic Factors in Mental Illness: Studying the hereditary components that might predispose individuals to certain mental health conditions.
• Psychological Impact of Climate Change: Exploring the mental health outcomes of environmental shifts and natural disasters.
• Eastern vs. Western Mental Health Practices: Comparing and contrasting therapeutic methods from different cultural perspectives.
• Post-conflict Zones and Mental Health: Assessing the long-term psychological effects on populations living in areas previously or currently in conflict.
• Childhood Attachment and Adult Relationships: Investigating how early-life bonding experiences influence adult interpersonal dynamics.

Mental Illness Research Paper Topics

• The genetic factors influencing bipolar disorder.
• Exploring the physiological markers of anxiety disorders.
• The impact of culture and society on the definition of mental illnesses.
• The correlation between childhood abuse and adult schizophrenia.
• Evaluating the efficacy of various therapeutic interventions for obsessive-compulsive disorder.
• The intersection of physical health and mental illnesses.
• Mental illnesses among the elderly: overlooked and undertreated?
• How socioeconomic factors exacerbate the symptoms of major depressive disorder.
• Comorbidities: When mental illnesses don’t come alone.
• The challenges in diagnosing personality disorders.

Research Ideas on Mental Illness

• Investigating the microbiome-gut-brain axis and its implications for mental health.
• Role of mindfulness and meditation in managing mental illnesses.
• Impact of digital detoxes on general mental well-being.
• The stigmatization of mental illnesses in media portrayal.
• Assessing the mental health impacts of long-term remote work.
• Gender differences in experiencing and expressing symptoms of mental disorders.
• The potential benefits of integrating AI and tech in mental health diagnostics.
• The link between chronic pain and mental health deterioration.
• Examining resilience factors in individuals recovering from mental illnesses.
• Childhood nutrition and its relation to mental health outcomes.

Research Paper Topics on Mental Disorders

• Dissociative Identity Disorder: separating fact from fiction.
• Exploring the rise of tech-induced disorders, like ‘nomophobia.’
• The effects of climate change on global mental health.
• Neurological underpinnings of phobias and irrational fears.
• Delving into post-partum depression: More than just “baby blues.”
• Addressing sleep disorders in the digital age.
• The hidden mental health crisis among first responders.
• Investigating the triggers of psychosomatic disorders.
• Social media’s role in body dysmorphic disorder.
• Examining the spectrum of autism: understanding nuances.

Mental Health Nursing Research Topics

• Challenges faced by mental health nurses in acute psychiatric wards.
• The significance of therapeutic relationships in mental health care.
• Balancing empathy and professional detachment: a mental health nurse’s dilemma.
• Mental health nursing interventions for substance abuse patients.
• Strategies for handling aggressive behaviors in psychiatric patients.
• The role of continuous education in enhancing mental health nursing practices.
• Evaluating the mental well-being of nurses working in psychiatric units.
• The importance of cultural competence in mental health nursing.
• Implementing group therapy: strategies and challenges for nurses.
• Understanding the burnout phenomenon among mental health nurses.

New Mothers’ Mental Health Research Topics

• Evaluating post-partum depression’s impact on mother-infant bonding.
• Navigating the mental health challenges of high-risk pregnancies.
• The role of partner support in new mothers’ mental well-being.
• Addressing body image issues post-childbirth.
• The psychological impact of miscarriages and stillbirths.
• Role of lactation and breastfeeding in maternal mental health.
• Understanding the fears and anxieties of first-time mothers.
• The influence of hormonal fluctuations on post-partum mental states.
• Exploring societal pressures and their effect on new mothers’ self-esteem.
• Navigating the emotional landscape of adoption for new mothers.

Mental Health Research Topics on Music Therapy

• The neurological foundation of music therapy’s effectiveness.
• Exploring rhythm: How drumming alleviates symptoms of anxiety and stress.
• The role of music therapy in aiding Alzheimer’s and dementia patients.
• Evaluating the effects of different musical genres on mood regulation.
• Music therapy’s impact on children with developmental disorders.
• Singing as a therapeutic tool: benefits for respiratory and mental health.
• Assessing the efficacy of music therapy in post-traumatic stress disorder (PTSD) patients.
• Harmonizing emotions: music therapy’s role in emotional processing.
• The intersection of cultural music traditions and therapy practices.
• Music therapy’s potential in managing chronic pain and related mental strains.

Research Paper Topics on Mental Health Counseling

• The evolving landscape of virtual mental health counseling.
• Addressing the challenges of cross-cultural mental health counseling.
• The role of non-verbal cues in therapeutic settings.
• Cognitive-behavioral therapy vs. dialectical behavior therapy: Assessing applicability and outcomes.
• The ethics and dilemmas in mental health counseling: boundaries and relationships.
• Group therapy: dynamics, challenges, and benefits.
• Exploring the potential of animal-assisted therapy in mental health counseling.
• Techniques for handling resistance and denial in therapy.
• The impact of counselor’s self-care on therapeutic effectiveness.
• Integrating indigenous and holistic practices into modern counseling methods.

Research Ideas on Psychiatry

• Investigating the potential of psychedelic drugs in treating resistant depression.
• Neuroimaging in psychiatry: it’s potential in accurate diagnosis and treatment planning.
• Addressing the ethical concerns surrounding involuntary psychiatric treatments.
• The role of diet and nutrition in psychiatric interventions.
• Genetic markers and their potential in predicting psychiatric disorders.
• Examining the long-term effects of psychiatric medications.
• Understanding the psychiatric implications of chronic isolation.
• The challenges and dynamics of adolescent psychiatry.
• Integrating AI and big data in predicting and managing psychiatric conditions.
• Psychiatry in post-war zones: addressing the hidden mental health crisis.

Good Mental Health Research Paper Topics

• The influence of daily physical activity on mental well-being.
• Social connections and their intrinsic role in fostering good mental health.
• Examining the therapeutic effects of nature and outdoor activities.
• The importance of sleep hygiene in maintaining optimal mental health.
• Assessing the impact of positive affirmations and mindfulness practices.
• Delving into the world of nootropics: benefits and concerns.
• The role of a balanced diet in promoting mental health.
• Unplugging: the mental health benefits of digital detoxes.
• Volunteerism and its psychological rewards.
• The arts – painting, writing

Best Mental Health Research Topics

• Innovations in neuropsychology and their implications for mental health.
• Assessing the global impact of mental health awareness campaigns.
• The promising horizon of personalized mental health interventions.
• The undeniable connection between gut health and mental well-being.
• Addressing mental health disparities in marginalized communities.
• Evaluating the role of early interventions in preventing severe mental disorders.
• Exploring the link between creativity and mental health.
• Global perspectives on mental health: Cultural nuances and universal truths.
• The future of mental health: Technological advancements and challenges.
• Redefining mental health education in schools and communities.

Final Thoughts on Mental Health Research Topics

Mental health has been propelled to the forefront of global discussions. The emphasis has shifted from mere recognition to understanding, generalization to personalization, and treatment to prevention. Whether you’re an academic, practitioner, or someone with a personal connection to the topic, there’s no denying the impact and importance of continued exploration of mental health. As we march forward, armed with knowledge and empathy, we hope for a world where mental well-being is prioritized, understood, and accessible to all.

Are you ready to translate your passion and curiosity into a masterpiece? We’re here to help. Let our expert writers craft a top-tier paper tailored to your unique needs. With our assistance, you can ensure that your insights into mental health are presented with the depth, respect, and eloquence they deserve. Don’t compromise on your vision. Place your order today, and let us transform your research topic into a masterpiece!

Don’t wait until the last minute

Fill in your requirements and let our experts deliver your work asap.

• Research article
• Open access
• Published: 26 April 2019

Mental health nurses’ attitudes, experience, and knowledge regarding routine physical healthcare: systematic, integrative review of studies involving 7,549 nurses working in mental health settings

• Geoffrey L. Dickens   ORCID: orcid.org/0000-0002-8862-1527 1 , 2 ,
• Robin Ion 3 ,
• Cheryl Waters 1 ,
• Evan Atlantis 1 &
• Bronwyn Everett 1  

BMC Nursing volume  18 , Article number:  16 ( 2019 ) Cite this article

56k Accesses

13 Citations

20 Altmetric

Metrics details

There has been a recent growth in research addressing mental health nurses’ routine physical healthcare knowledge and attitudes. We aimed to systematically review the empirical evidence about i) mental health nurses’ knowledge, attitudes, and experiences of physical healthcare for mental health patients, and ii) the effectiveness of any interventions to improve these aspects of their work.

Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Multiple electronic databases were searched using comprehensive terms. Inclusion criteria: English language papers recounting empirical studies about: i) mental health nurses’ routine physical healthcare-related knowledge, skills, experience, attitudes, or training needs; and ii) the effectiveness of interventions to improve any outcome related to mental health nurses’ delivery of routine physical health care for mental health patients. Effect sizes from intervention studies were extracted or calculated where there was sufficient information. An integrative, narrative synthesis of study findings was conducted.

Fifty-one papers covering studies from 41 unique samples including 7549 mental health nurses in 14 countries met inclusion criteria. Forty-two (82.4%) papers were published since 2010. Eleven were intervention studies; 40 were cross-sectional. Observational and qualitative studies were generally of good quality and establish a baseline picture of the issue. Intervention studies were prone to bias due to lack of randomisation and control groups but produced some large effect sizes for targeted education innovations. Comparisons of international data from studies using the Physical Health Attitudes Scale for Mental Health Nursing revealed differences across the world which may have implications for different models of student nurse preparation.

Conclusions

Mental health nurses’ ability and increasing enthusiasm for routine physical healthcare has been highlighted in recent years. Contemporary literature provides a base for future research which must now concentrate on determining the effectiveness of nurse preparation for providing physical health care for people with mental disorder, determining the appropriate content for such preparation, and evaluating the effectiveness both in terms of nurse and patient- related outcomes. At the same time, developments are needed which are congruent with the needs and wants of patients.

Peer Review reports

People with a mental disorder diagnosis are at more than double the risk of all-cause mortality than the general population. Most at risk are those with psychosis, mood disorder and anxiety diagnoses. Median length of life lost by this group is 10.1 years greater for people with a diagnosis of mental disorder than for general population controls, but mortality rates are significantly higher in studies which include inpatients [ 1 ]. While risk of unnatural causes of death, notably suicide, are greatly increased in this group, it is death from natural causes that remains responsible for the vast majority of mortality. In people with schizophrenia, for example, cardiovascular disease accounts for about one third of all deaths and cancer for one in six, while other common causes are diabetes mellitus, COPD, influenza, and pneumonia [ 2 ]. A relatively high rate of tobacco smoking in this group is implicated in significant increased mortality [ 3 ], as is obesity [ 4 ], exposure to high levels of antipsychotic pharmacological treatment [ 5 ], and mental disorder itself [ 1 ].

Accordingly, the physical health of patients with mental disorder has been prioritised, becoming the focus of guidelines for practitioners in general [ 6 ] and for mental health nurses and other clinical professionals specifically [ 7 , 8 , 9 ]. However, while policies and guidelines are necessary prerequisites of change they must also be implemented in practice if they are to have a positive effect; one of the key barriers to change implementation for mental health nurses has been identified as lack of confidence, skills, and knowledge [ 10 ]. Robson and Haddad ([ 11 ]: p.74) identified that surprisingly ‘modest attention’ had been paid to the issue of such attitudes and knowledge among nurses related to their role in physical health care provision, and developed the Physical Health Assessment Scale for mental health nurses (PHASe) in order to further investigate the phenomenon. Since then, there has been a tangible and growing response among mental health nursing academics and practitioners. In recent years, published literature reviews have covered a decade of UK-only research on the role of mental health nurses in physical health care [ 12 ], patients’ and professionals’ perceptions of barriers to physical health care for people with serious mental illness [ 13 ], the focus and content of nurse-provided physical healthcare for mental health patients [ 14 ], and the physical health of people with severe mental illness [ 15 ]. There has also been an upsurge in the amount of related empirical research. However, to date, no one has systematically reviewed this growing literature about mental health nurses’ attitudes towards, or their related knowledge and experience about providing routine physical healthcare. Further, studies about the effectiveness of interventions designed to improve their delivery of or attitudes to routine physical healthcare have not been systematically appraised. This is surprising given the known links between nurses’ attitudes and their implementation of evidence-based practice [ 16 , 17 , 18 ] and the centrality of measuring nurses’ attitudes to physical health care delivery in recent mental health nursing research on the topic [ 11 , 19 , 20 ].

In this context we have conducted a systematic review to identify, appraise, and synthesise existing evidence from empirical research literature about i) mental health nurses’ experience of providing physical healthcare for patients and about their related knowledge, skills, educational preparation, and attitudes; ii) the effectiveness of any interventions aimed at improving or changing mental health nurse-related outcomes; and iii) to identify implications for the future provision of relevant training and education, for policy, research, and practice. The specific review question being addressed therefore is: what is known from the international, English language, empirical literature about mental health nurses’ skills, knowledge, attitudes, and experiences regarding provision of physical healthcare.

A systematic review of the literature following the relevant points of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [ 21 ].

Search strategy

Since the review scope encompassed questions about experience and effectiveness a dual literature search strategy was developed. For studies about mental health nurses’ experience of delivering physical healthcare a Population Exposure Outcome (PEO) format review question was developed (Population: mental health nurses; Exposure: physical healthcare provision for patients or related training; Outcomes: experiential, social, educational, knowledge, or attitudinal terms, see Additional file  1 : Table S1). For studies of the effectiveness of interventions to improve or change mental health nurse-related outcomes a Population Intervention Comparator Outcome (PICO) structure was implemented (Population: mental health nurses; Intervention: any intervention including physical health-related education, policy or guideline change; Comparator: any or none; Outcome: any) [ 22 ]. We searched five electronic databases: i) CINAHL, ii) PubMed, iii) MedLine, iv) Scopus, and v) ProQuest Dissertations and Theses using text words and MeSH terms. The references list of all included studies, together with those of relevant literature reviews, and the tables of contents of selected mental health nursing journals were hand searched. The search terms were informed by previous literature reviews on the subject of physical healthcare in mental health. The initial search was conducted in April 2018 and re-run in September 2018.

Inclusion and exclusion criteria

Inclusion criteria for studies were English language accounts of empirical research which investigated mental health nurses’ experience of providing physical health care or examined the effectiveness of any intervention that aimed to improve outcomes related to the provision of physical healthcare. Thus, studies of interventions aimed at changing nursing practice, behaviour, knowledge, attitudes, or experiences were eligible, but not those which solely attempted to determine the effect of an intervention on nurses in terms of patient outcomes. While improvement in patient care and outcomes is clearly the desirable endpoint of any intervention on nurses, previous reviews have indicated that no good quality studies exist [ 23 ]. Additionally, studies were only eligible for inclusion where the practitioners involved comprised or included mental health or psychiatric nurses or mental health nursing students, or registered nurses whose practice was within mental health services. Included studies could have used any design or methodological approach. As in previous reviews, studies solely about mental health nurses providing care for people with alcohol/ drug misuse, or mental disorder/substance misuse dual diagnosis were not eligible. Studies about mental health nurses and the provision of emergency physical care or of their experience of providing care for the seriously deteriorating physical health of a patient were omitted as this is the subject of a separate review (Dickens et al. submitted).

Data extraction

Information about the study title, author, publication year, data collection years, location (country), research objectives, aims or hypotheses, design, population, sample details and size, data sources, study variables (i.e. details of intervention) or other exposure, unit of analysis, and study findings were extracted from full text papers. Corresponding authors of included studies were contacted regarding any issues where clarification or additional data could aid the review.

Studies were categorised as interventional or observational. Intervention studies investigated the impact of an educational, policy, or practice intervention in terms of any mental health nurse- or nursing- related outcome, e.g., knowledge, attitudes, behaviour. Intervention studies were further sub-classified as simulation studies (as defined by Bland et al. ([ 24 ]: p.668) “a dynamic process involving the creation of a hypothetical opportunity that incorporates an authentic representation of reality, facilitates active student engagement and integrates the complexities of practical and theoretical learning with opportunity for repetition, feedback, evaluation and reflection”), traditional educational interventions (e.g., lectures, workshops, workbooks), or policy-level interventions (e.g., requiring nurses to follow some new policy or implement some new practice). Observational studies either described mental health nurse- or nursing- related outcomes and/or utilised case control designs to compare them with those of other occupational or professional groups and/or used qualitative methods.

Study quality appraisal

The likelihood of bias in intervention studies was assessed against criteria described by Thomas et al. [ 25 ] and encompassed assessment of the likelihood of selection bias in the obtained sample, study design, potential confounders, blinding, potential for bias in data collection from invalid instrumentation, and participant retention (see Additional file  2 : Table S2). Relevant items from the US Department of Health & Human Sciences NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies [ 26 ] were used to assess cross-sectional observational studies (see Additional file  3 : Table S3). Qualitative descriptive studies were assessed using the Critical Appraisal Skills Programme [ 27 ] tool (See Additional file  4 : Table S4). Multiple papers arising from single studies were quality assessed as a single entity. Study quality was initially undertaken independently by at least two of the team. A good level of inter-rater agreement was achieved (Cohen’s Kappa = 0.742 between pairs of raters). Disputed items were discussed by GD and CW and consensus achieved.

Study synthesis

The available total and subscale data from those studies that conducted data collection via the Physical Healthcare Attitude Scale for mental health nurses (PHASe [ 11 ]), the only scale used across more than two studies, was tabulated and compared across studies using unpaired t-tests in QuickCalcs GraphPad software. Where individual item mean and dispersion scores were unavailable estimates were calculated as follows: the mean mean (i.e., Σ means / n means) and the estimated standard deviation (the square root of the average of the variances [ 28 ]). Also, and where available, dichotomised data (‘Strongly agree’ or ‘agree’ responses versus all other responses) from the multiple studies using the 14-item PHASe scale investigating self-reported current involvement in aspects of physical healthcare was tabulated and subjected to Chi-squared analysis. Significant cross-study differences of means and proportions involved all subscale or item data for each study being compared with the corresponding subscale or item from the original study development sample, ‘the reference group’ [ 11 ].

Where available, effect sizes for correlational, interventional, or difference-related outcomes from studies were extracted or, where sufficient information presented, calculated. Where sufficient information was not presented we attempted to contact the corresponding author for clarification. Appropriate effect size statistics were calculated using an online resource [ 29 ]. All other information from study results was subject to a qualitative synthesis conducted by author 1 and subsequently refined and agreed by all of the authors.

Study settings and participants

The search strategy resulted in the inclusion of 41 study samples published in 51 papers (see Fig.  1 ) involving 7549 ( M [ SD ] = 200.5[374.1], Mdn =  47, range 2 to 1899) mental health nurses and n  = 213 mental health nursing students ( Mdn  = 33). Thirty-three samples included only nurses, of which 20 drew specifically on mental health nurses or nurses working in mental health settings only; eight samples were multidisciplinary. Four papers drew on two samples (i.e., two papers per study) while one sample featured in nine separate papers [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. Studies were conducted in the UK ( k  = 17), Australia ( k  = 9), US ( k  = 4), Canada ( k  = 2), Qatar, Hong Kong, Japan, Jordan, Belgium, Norway, Israel, Turkey, India, and Taiwan (all k  = 1); two studies were conducted internationally; first, in Qatar, Hong Kong, and Japan [ 19 ], and the US and Canada [ 39 ]. Studies were published between 1994 and 2018 ( Mdn year of publication 2016, only n  = 9 before 2010 and n  = 1 before 2000).

PRISMA study inclusion flowchart

Study design

Eleven studies evaluated an intervention; of these, 10 utilised pre- post AB designs and one adopted a randomised controlled trial design. Other studies used cross-sectional survey or qualitative designs. Intervention studies sometimes incorporated additional qualitative or descriptive elements.

Outcome measures

The most commonly used measure employed was the PHASe or some adaptation of it [ 11 ] in seven studies reported across eight papers [ 11 , 19 , 20 , 40 , 41 , 42 , 43 , 44 ]. The PHASe comprises four factors: 1. Nurses’ attitudes to physical health care; 2. Nurses’ confidence to provide physical health care; 3. Nurses’ perceived barriers in providing physical health care; and 4. Nurses’ attitude towards smoking. Contact with study corresponding authors (Bressington, Chee, Haddad) resulted in acquisition of additional PHASe total and subscale information that was not included in the respective published study papers. Two other outcomes tools were used in two studies each, these being the purpose-designed survey measure of Howard and Gamble [ 45 ] subsequently used by Terry and Cutter [ 46 ], and Happell’s [ 33 ] own questionnaire adapted for use by Clancy et al. [ 40 ]. Most studies used purpose-designed tools. Many reported sufficient information to allow confidence about their internal reliability and face/content validity but there was little information about their measurement reliability, criterion validity, or sensitivity to change (see Additional file  5 : Table S5). A small number of papers used existing validated measures [ 47 , 48 , 49 , 50 , 51 , 52 ] and these were generally the most robust tools (see Additional file  6 : Table S6).

Study quality

All K  = 7 qualitative studies were rated very highly in terms of their quality on a 10-point assessment ( Mdn  = 9, range 9–10). Cross-sectional observational studies met a median of four of seven quality criteria (range two to six; mean[SD] 4.43[1.33]). Four of these provided an a priori sample size calculation and there was a lack of valid outcome measures in nine of the 21 studies. Overall risk of bias for cross-sectional studies was judged to be low for nine studies, unclear for six and high for six. The quality of interventional studies was generally the poorest ( Mdn  = 5, range 2 to 7 of 10 indicators). Only two were judged to be at low risk of bias (see Additional file 2 : Tables S2, Additional file 3 : Table S3, Additional file 4 : Table S4, Additional file 5 : Table S5 and Additional file 6 : Table S6 for further details). Common omissions were, again, sample size justification, lack of repeat pre-baseline and follow up measures, and information about the representativeness of included samples.

Non-intervention studies

Studies examined physical healthcare in general ( k  = 24), sexual health ( k  = 4), smoking ( k  = 6), physical activity and healthy eating, nutrition - in particular the role of Omega-3 in diet, mild brain injury, and breastfeeding (all k  = 1; see Table  1 ).

With regards to studies using the PHASe, of all possible comparisons across studies (see Tables 2 and 3 ), the mean score of the study sample differed significantly from the reference sample [ 11 ] on 13 out of 21 (61.9%) subscale and three of four total score combinations (75.0%). Analysis revealed poorer attitudes compared to the reference sample on all three of the significantly poorer attitude scores on 10/17 (58.9%) subscale comparisons, and better attitudes on three (14.3%). However, the reference group only outperformed the other studies on two of the eight possible comparisons on the subscales ‘Physical Healthcare’ and ‘Confidence in Providing Physical Healthcare’ and was poorer for three comparisons. The PHASe total score difference was greatest (large effect size) between the reference sample and Chee et al’s [ 41 ] Australian sample (Cohens d  = 1.13) followed by Bressington et al’s [ 19 ] Japanese mental health nurse sub-sample ( d  = 0.72). For subscale scores, effect sizes for differences were also largest between the reference sample and that of Chee et al. [ 41 ]. Effect sizes were in favour of the reference sample on the attitudes to smoking and barriers to physical healthcare subscales ( d  = 1.48 and 1.78 respectively). Next largest were differences between Haddad et al’s [ 43 ] sample also on the barriers to healthcare ( d  = 0.93) and attitudes to smoking subscales ( d  = 1.01). On this occasion differences were in favour of Haddad et al’s [ 43 ] sample. Attitudes to smoking were more favourable than the reference sample in two studies, comparable in one and poorer in two.

Regarding the level of self-reported involvement in aspects of physical healthcare the proportion of respondents in PHASe-studies answering ‘strongly agree’ or ‘agree’ to 14 items revealed considerable cross-sample differences. Of 95 possible comparisons between the reference study and others, 70 (73.7%) differed significantly. Of these, 86.7% compared unfavourably with the UK reference study, 13.3% favourably). The number of items per sample differing from the reference sample ranged from 7 to 13 ( Mdn =  10). Japan [ 19 ] provided the only sample of mental health nurses whose responses compared favourably with the reference sample (7/10 significantly differing responses being more favourable in the Japanese sub-sample), while Ganiah et al’s [ 42 ] sample (0/11 favourable comparisons among significantly differing responses), Happell et al’s [ 30 ] (0/14 favourable comparisons), Chee et al’s [ 41 ] Australian sample (1/11 favourable comparisons), Haddad et al’s [ 43 ] UK sample (1/10 favourable comparisons) and Bressington et al’s [ 19 ] Hong Kong sample (2/12 favourable comparisons) all fared poorly. Items relating to checking GP-status, advising on exercise, weight management, healthy eating, contraception, and eyesight checks were all rated less favourably by at least two other samples (range 2 to 6, Mdn  = 4) and more favourably by none compared with the reference sample. Only the item about ensuring patients have had their general physical health assessed on first contact with mental health services was rated more favourably by two samples and less favourably by none compared with the reference sample. For all other items there were item-level variations with no clear pattern.

The remaining non-intervention studies provide a mixed and sometimes contradictory picture. First, in terms of reported use of physical health care skills, Osborn et al’s [ 47 ] study revealed that nurses working in mental health settings in one large hospital were less likely to use physical healthcare skills than colleagues in medical, oncology, maternity and surgical settings. Further, they reported using a smaller range of relevant skills. In Howard and Gamble’s [ 45 ] survey, nurses’ responses indicated a gap between their perceived responsibilities for physical healthcare and their practice. Elsewhere, compared with those responding on behalf of healthcare and educational organisations, nurses were less likely to endorse their role in physical healthcare provision [ 53 ] and they reported very low levels of endorsement of related skills training need [ 54 ]. However, for others in more recent studies, they displayed a clear commitment to the physical healthcare role [ 55 ], and said they want more training [ 31 , 56 ]. Further, nurses strongly endorsed their own role in physical health, sexual health, and substance abuse related care and were supported strongly by other healthcare professionals [ 40 ]. Across a series of linked surveys and qualitative studies, Happell et al. [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 57 ] reported associations between nurses’ positive evaluation of the physical healthcare role and practicing aspects of it more commonly. In studies of nurses and specific physical healthcare-related activities there was a suggestion that respondents’ own values or beliefs might be more influential in determining their health-giving or advising behaviour in relation to smoking cessation [ 50 , 58 ]. In relation to sexual health, both Dorsay and Forchuk [ 59 ] and Quinn et al. [ 60 ] have reported that nurses cite patient embarrassment as a reason for not asking patients about sexual side effects of antipsychotic medications. Lack of time, resources and knowledge were reported as barriers to providing advice and interventions regarding exercise and physical activity [ 61 ], Omega-3 [ 62 ]. Knowledge and attitudes to HIV/AIDS were generally good [ 63 ]. Finally, smoking-cessation training was associated with more smoking-cessation helping behaviour [ 64 ] though, counter-inuitively, training was negatively associated with attitudes to smoking cessation in a single study [ 65 ]. Further, Sharma et al’s [ 64 ] study compared the attitudes of mental health trained nurses and comprehensive/ generalist trained nurses working in mental health services: the most marked differences between the groups were on the smoking-related items with the former group expressing significantly more liberal views about smoking restrictions, more worrying attitudes about the benefits and utility of cigarette use as a therapeutic tool, and less confidence in the ability of mental health patients to quit smoking. This was particularly concerning in the study context which was about attitudes to physical healthcare with younger, first episode psychosis patients.

Intervention studies

Five studies focused on physical healthcare in general and six on specific issues (diabetes n =  3; sexual health, cardiometabolic health, obesity all n =  1). Ten evaluated an educational innovation, the exception being Happell et al. [ 35 ], who examined attitudes among nurses to the introduction of a specialist cardiometabolic health nurse role. Haddad et al. [ 43 ] examined the impact of the introduction of personal physical health care plans for patients on nurses’ physical healthcare attitudes alongside the delivery of a single educational session on physical healthcare assessment. The remaining nine studies evaluated educational interventions including three involving simulation and six involving didactic teaching, workshop-format or blended-learning approaches.

Simulation studies

Duration of interventions was 30 min [ 49 ] and1-day [ 66 ], while information was not provided by Wynn [ 52 ]. The mode of simulation delivery involved manikins [ 66 ], human actor as patient [ 66 ], software-based Human Person Simulator [ 52 ], and participant as ‘patient’ in which student participants wore a 15 kg bariatric empathy suit while undertaking everyday tasks in order to help them appreciate the experience of obesity [ 49 ]. Other simulations involved diabetes care [ 52 ], fractured leg in the context of a jump or fall in a patient with first episode psychosis, medical deterioration in the same patient following transfer to a psychiatric ward, and delirium [ 66 ]. Results indicated improved clinical judgement and reduced diabetes-related medical emergency reports [ 52 ], improved knowledge, attitudes, and confidence about physical healthcare [ 66 ], improved response to obese patients, characteristics of obese patients and supportive roles in caring for obese patients [ 49 ].

Non-simulation studie

Study duration ranged from a 2.5-h workshop on physical health [ 67 ] to a 20-credit bachelor’s degree level (equivalent to 200-h of taught and self-directed study and assessment completion) module on physical healthcare in mental health [ 46 ]. Non-simulation studies evaluated the introduction of personal health plans for patients in a low secure forensic unit together with a single educational session on physical health care for nursing staff [ 43 ]. Specific topics addressed included diabetes [ 68 , 69 ], health assessment [ 46 , 67 ], oral health, IM injectables [ 68 ], vital signs, blood readings, BMI measurement [ 46 ], and cardio-metabolic health [ 35 , 57 ].

In Sung et al’s [ 51 ] RCT, nurses were allocated in a random stratified design to attend 8 × 2-h session about sexual healthcare over a period of 4-w or no intervention. Significant effects were detected in the experimental group relative to the control group for improvements in related knowledge and in attitudes, but not in self-efficacy. The study involved nurses employed both in medical and psychiatric wards (stratified allocation from both) and there was no reported effect of ward-type on outcomes. Pretest- posttest design intervention studies targeted at diabetes found greatly improved clinical judgment in relation to diabetes care and reduced diabetes-related emergency referrals [ 52 ] and similarly impressive improved diabetes-related knowledge [ 69 , 70 ]. Improved attitudes to obesity, obese patients, and supportive roles in caring for obese individuals have been reported across a mixed group of participants and did not differ between mental health and other nurses [ 49 ]. and physical healthcare in general. Happell et al. [ 57 ] reported improved support for a specialist cardiometabolic nurse role following its introduction, however we find this conclusion is unwarranted since it is derived from statistical testing of 14-questionnaire items only one of which was found significant. Interventions aimed at physical healthcare in general found some impressive post- group improvements in knowledge [ 66 , 67 , 68 ], attitudes [ 66 ], and confidence [ 46 , 66 ].

We have conducted a systematic review of the empirical literature about mental health nurses and their attitudes towards, knowledge about, and experiences of physical health care for patients. We took a broad approach to searching the literature and included interventional and observational studies involving real or simulated situations. We included studies involving mental health nursing students and multidisciplinary professional groups in addition to those including only mental health nurses. We contacted study authors to gain additional information and, for the studies using the PHASe [ 11 ] and this elicited significant, previously unpublished information. While we applied no time limits to our comprehensive search we found studies only from as early as 1994, only nine from before 2000, and the median year of publication was 2016. This means that there has been a welcome increase, which we described as a ‘mini-explosion’ in the Introduction, in related empirical work in recent years. The total number of nurses involved in studies, 7549, makes this to our knowledge one of the largest amalgamations of evidence gathered directly from mental health nurses.

However, the overall methodological quality of studies was somewhat limited, particularly interventional studies to improve mental health nurses’ physical healthcare assessment practices and skills. Nevertheless, while many of the included studies examine mental health nurses, and nurses working in mental health settings, this group comprises a heterogeneous collection of individuals of vastly differing experience, preparation, knowledge, and roles. As a result, it is not too surprising that some less well-researched areas have thrown up starkly different results. However, there is consistent evidence that there is a strong association between mental health nurses’ reported attitudes and their reported involvement in physical health care [ 19 , 20 , 42 ]. Similarly, that the nurses who value physical health care also report that they deliver more of it [ 30 ] and those who talk to at least one other discipline about their patients’ physical health do so with multiple professional groups [ 33 ]. Accordingly, fewer resources could be expended on answering these sorts of associational questions in the future.

Our conclusion is that it is now time for a new phase for mental health nursing research related to physical healthcare: efforts must be redoubled to focus on developing and testing interventions to improve nurses’ attitudes, knowledge, and skills. We must ensure that new studies are well-designed and rigorously conducted. More specifically, further research is required to build knowledge about whether the supposed benefits arising from this relationship translate into objectively better practice and indeed better patient outcomes. This would strengthen the case for training to improve attitudes and provide some urgency to better understand what interventions might deliver that outcome. Further, it appears that mental health nurses well-recognise that they require further skills and knowledge related to physical health care across a wide range of areas [ 19 , 30 , 31 , 57 , 71 ]. However, ambivalence and reluctance remains about embracing the change needed to achieve this [ 61 ].

The PHASe was used across multiple studies which allowed for some international and setting-specific comparison of nurses’ attitudes. We found that nurses’ self-perceived practices and attitudes differed significantly between samples from across the world. This, of course, may well reflect different approaches to mental health nurse preparation; for example, in Australia, all pre-registration nurses undergo the same core programme whereas in the UK mental health nursing is a specialist branch of pre-registration training. Therefore, results from Chee et al’s [ 41 ] recent study are enlightening since they reveal equivalent attitudes to physical healthcare specifically, more confidence in delivering physical healthcare but poorer scores in relation to barriers to physical healthcare delivery and smoking cessation. Given the non-equivalence of results on the attitudes to smoking subscale between Chee et al. [ 41 ] and Wynaden et al. [ 44 ], both conducted in Western Australia by related research teams, there are questions about the extent to which results are sample specific. Larger scale, representative data collection in Australia and New Zealand could therefore add significantly to the debate about nurses’ preparation for physical healthcare skills under different preparation regimes. As the PHASe authors’ note, the tool has not been subjected to tests of its stability or criterion validity and improvements in evidence for this would add significantly to the ability to draw sound conclusions from research using the tool. Findings from Osborne et al’s [ 47 ] large hospital-wide survey indicate that the gap in the physical health-related skills addressed by the PHASe is real and of concern.

Apart from the PHASe the literature is peppered with outcomes tools designed for single studies and with little evidence of anything other than face validity and internal consistency. Is it possible, we must ask, that this reflects that researchers are asking the wrong questions i.e., focusing overly on mental health nurses’ attitudes and self-proclaimed knowledge and efficacy when what is now required is a more robust approach to examining their actual knowledge and performance and, crucially, their impact on patient outcomes. Little seems to have been added to the literature on this since Hardy et al. [ 23 ] found no studies to include in their systematic review. Further, Haddad et al’s [ 43 ] study in a low secure forensic setting found nurses scoring favourably on PHASe subscales about attitudes to physical healthcare and to smoking compared with non-forensic nurses in the reference sample, suggesting perhaps that in a setting where length of stay is considerably longer then nurses have more opportunity to engage with patients in this aspect of care. Notably, however, nurses in the same sample compared unfavourably with the reference sample in terms of perceived involvement in actual physical healthcare, a somewhat contradictory finding.

For intervention studies, effect sizes were generally largest, and were in fact sometimes startlingly large, where interventions were targeted and outcomes were knowledge based (e.g., educational studies). This is unsurprising since educational interventions are generally evaluated against criteria that are specifically and directly addressed in the intervention. Outcomes tended to be measured immediately following the training [ 46 , 52 ], but their long term retention is generally not known and neither is any practical beneficial change to practice. The apparent potency of these interventions requires further testing in randomized designs with appropriate follow-up periods.

Some study samples in the current review included non-nursing staff; though their occurrence and representativeness was too limited to allow robust conclusions to be drawn about the relative state of nurses’ knowledge and attitudes within the multidisciplinary team context. Given the current review explicitly focused on mental health nurses then further research exploring the multidisciplinary aspects of physical health care provision is warranted.

Mental health nurses’ ability to provide routine physical healthcare has been highlighted in recent years. Recent literature provides a starting point for future research which must now concentrate on determining the effectiveness of nurse preparation for providing physical health care for people with mental disorder, determining the appropriate content for such preparation, and evaluating the effectiveness both in terms of nurse and patient- related outcomes. At the same time, developments are needed which are congruent with the needs and wants of patients. Perhaps what the included studies best demonstrate is that mental health nurses seem to realise that physical health care is part of their role.

Abbreviations

Medical Subject Headings

Physical Health Attitudes Scale for mental health nurses

Population Intervention Comparator Outcome

Preferred Reporting Items for Systematic Reviews and Meta Analyses

Walker ER, McGee E, Druss BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiat. 2015;72(4):334–41. https://doi.org/10.1001/jamapsychiatry.2014.2502 .

Article   Google Scholar  

Olfson M, Gerhard T, Huang C. Premature mortality among adults with schizophrenia in the United States. JAMA Psychiat. 2015;72(12):1172–81. https://doi.org/10.1001/jamapsychiatry.2015.1737 .

Drope J, Liber AC, Cahn Z, Stoklosa M, Kennedy R, Douglas CE, Henson R, Drope J. Who's still smoking? Disparities in adult cigarette smoking prevalence in the United States. CA Cancer J Clin. 2018;68(2):106–15. https://doi.org/10.3322/caac.21444 .

Article   PubMed   Google Scholar  

Annamalai A, Kosir U, Tek C. Prevalence of obesity and diabetes in patients with schizophrenia. World J Diabetes. 2017;8(8):390–6. https://doi.org/10.4239/wjd.v8.i8.390 .

Article   PubMed   PubMed Central   Google Scholar  

Tomiainen M, Mittendorfer-Rutz E, Bjӧrkenstam C, Suvisaari J, Alexanderson K, Tiihonen J. Antipsychotic treatment and mortality in schizophrenia. Schizophr Bull. 2016;41(3):656–63. https://doi.org/10.1093/schbul/sbu164 .

World Health Organisation. Guidelines for the management of physical health conditions in adults with severe mental disorders. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO

Google Scholar  

New South Wales Government. Physical Health Care of Mental Health Consumers. North Sydney: NSW Ministry of Health; 2017. Accessed 29 Jan 2019: https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/GL2017_019.pdf

Nursing, Midwifery and Allied Health Professions Policy Unit. Improving the physical health of people with mental health problems: Actions for mental health nurses. London: Department of Health; 2016. Accessed 4 Jan 2019 at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/532253/JRA_Physical_Health_revised.pdf

Royal Australian and New Zealand College of Psychiatrists. Keeping Body and Mind Together: Improving the physical health and life expectancy of people with serious mental illness. Melbourne: Victoria; 2015. Accessed 29 Jan 2019 at: https://www.ranzcp.org/files/resources/reports/ranzcp-keeping-body-and-mind-together.aspx

Department of Health. From values to action: the chief nursing Officer’s review of mental health nursing. London: DOH; 2006.

Robson D, Haddad M. Mental health nurses' attitudes towards the physical health care of people with severe and enduring mental illness: the development of a measurement tool. Int J Nurs Stud. 2012;49(1):72–83. https://doi.org/10.1016/j.ijnurstu.2011.07.011 .

Blythe J, White J. Role of the mental health nurse towards physical health care in serious mental illness: an integrative review of 10 years of UK literature. Int J Ment Health Nurs. 2012;21(3):193–201. https://doi.org/10.1111/j.1447-0349.2011.00792.x .

Happell B, Scott D, Platania-Phung C. Perceptions of barriers to physical health care for people with serious mental illness: a review of the international literature. Issues Ment Health Nurs. 2012;33(11):752–61. https://doi.org/10.3109/01612840.2012.708099 .

Happell B, Platania-Phung C, Scott D. A systematic review of nurse physical healthcare for consumers utilizing mental health services. J Psychiatr Ment Health Nurs. 2014;21(1):11–22. https://doi.org/10.1111/jpm.12041 .

Article   CAS   PubMed   Google Scholar  

Collins E, Tranter S, Irvine F. The physical health of the seriously mentally ill: an overview of the literature. J Psychiatr Ment Health Nurs. 2012;19(7):638–46. https://doi.org/10.1111/j.1365-2850.2011.01831.x .

Estabrooks CA, Floyd JA, Scott-Findlay S, O’Leary KA, Gushta M. Individual determinants of research utilization: a systematic review. J Adv Nurs. 2003;43(5):506–20. https://doi.org/10.1046/j.1365-2648.2003.02748.x .

Melnyk BM, Fineout-Overholt E, Feinstein NF, Li H, Wilcox L, Kraus R. Nurses’ perceived knowledge, beliefs, skills and needs regarding evidence-based practice: implications for accelerating the paradigm shift. Worldviews Evid-Based Nurs. 2004;1(4):185193. https://doi.org/10.1111/j.1524-475X.2004.04024.x .

Varnell G, Haas B, Duke G, Hudson K. Effect of an educational intervention on attitudes toward and implementation of evidence-based practice. Worldviews Evid-Based Nurs. 2008;5(4):172–81. https://doi.org/10.1111/j.1741-6787.2008.00124.x .

Bressington D, Badnapurkar A, Inoue S, Ma HY, Chien WT, Nelson D, Gray R. Physical health care for people with severe mental illness. Int J Environ Res Public Health. 2018;15(343). https://doi.org/10.3390/ijerph15020343 .

Robson D, Haddad M, Gray R, Gournay K. Mental health nursing and physical health care: a cross-sectional study of nurses' attitudes, practice, and perceived training needs for the physical health care of people with severe mental illness. Int J Ment Health Nurs. 2013;22(5):409–17. https://doi.org/10.1111/j.1447-0349.2012.00883.x .

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097 .

Munn Z, Srtern C, Aromataris E, Lockwood C, Jordan Z. What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences. BMC Med Res Methodol. 2018;18(5):1–9. https://doi.org/10.1186/s12874-017-0468-4 .

Hardy S, White J, Deane K, Gray R. Educating healthcare professionals to act on the physical health needs of people with serious mental illness: a systematic search for evidence. J Psychiatr Ment Health Nurs. 2011;18(8):721–7. https://doi.org/10.1111/j.13652850.2011.01722.x .

Bland AJ, Topping A, Wood B. A concept analysis of simulation as a learning strategy in the education of undergraduate nursing students. Nurse Educ Today. 2011;31:664–70. https://doi.org/10.1016/j.nedt.2010.10.013 .

Thomas BH, Ciliska D, Dobbins M, Micucci S. A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. Worldviews Evid-Based Nurs. 2004;1(3):176–84. https://doi.org/10.1111/j.1524-475X.2004.04006.x .

NIH National Heart, Lung and Blood Institute (n.d.). Study Quality Assessment Tools: Quality Assessment Tool for Observational Cohort and Cross Sectional Studies. Accessed 28 Apr 2018: https://www.nhlbi.nih.gov/health-pro/guidelines/in-develop/cardiovascular-risk-reduction/tools

Critical Appraisal Skills Programme (n.d.). CASP checklist: 10 questions to help you make sense of qualitative research. Oxford: CASP. Available at: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Qualitative-Checklist-2018.pdf . Accessed 16 Apr 2019.

Campbell MJ. Statistics at square one (9th edition) T.D.V. Swinscow [revised by M.J. Campbell]: University of Southampton: BMJ publishing group; 1997. Accessed 14 Jun 2018: https://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one/

Wilson, D.B. (n.d.). Practical meta-analysis effect size calculator. Accessed 11 Mar 2019 https://campbellcollaboration.org/escalc/html/EffectSizeCalculator-SMD-main.php .

Happell B, Platania-Phung C, Scott D. Are nurses in mental health services providing physical health care for people with serious mental illness? An Australian perspective. Issues Ment Health Nurs. 2013;34(3):198–207. https://doi.org/10.3109/01612840.2012.733907 .

Happell B, Platania-Phung C, Scott D. Physical health care for people with mental illness: training needs for nurses. Nurse Educ Today. 2013;33:396–401. https://doi.org/10.1016/j.nedt.2013.01.015 .

Happell B, Platania-Phung C, Scott D. Proposed nurse-led initiatives in improving physical health of people with serious mental illness: a survey of nurses in mental health. J Clin Nurs. 2013;23:1018–29. https://doi.org/10.1111/jocn.12371 .

Happell B, Platania-Phung C, Scott D, Nankivell J. Communication with colleagues: frequency of collaboration regarding physical health of consumers with mental illness. Perspect Psychiatr Care. 2014;50(1):33–43. https://doi.org/10.1111/ppc.12021 .

Happell B, Platania-Phung C, Scott D. What determines whether nurses provide physical health care to consumers with serious mental illness? Arch Psychiatr Nurs. 2014;28:87–93. https://doi.org/10.1016/j.apnu.2013.11.001 .

Happell B, Platania-Phung C, Scott D, Stanton R. Predictors of nurse support for the introduction of the cardiometabolic health nurse in the Australian mental health sector. Perspect Psychiatr Care. 2015;51(3):162–70. https://doi.org/10.1111/ppc.12077 .

Happell B, Platania-Phung C. Cardiovascular health promotion and consumers with mental illness in Australia. Issues Ment Health Nurs. 2015;36:286–93. https://doi.org/10.3109/01612840.2014.981770 .

Happell B, Platania-Phung C, Stanton R, Millar F. Exploring the views of nurses on the cardiometabolic health nurse in mental health services in Australia. Issues Ment Health Nurs. 2015;36:135–44. https://doi.org/10.3109/01612840.2014.901449 .

Happell B, Platania-Phung C, Scott D, Hanley C. Access to dental care and dental ill-health of people with serious mental illness: views of nurses working in mental health settings in Australia. Aust J Prim Health. 2015;21(1):32–7. https://doi.org/10.1071/PY13044 .

Klein TA, Graves JM. A comparison of psychiatric and non-psychiatric nurse practitioner knowledge and management recommendations regarding adolescent mild traumatic brain injury. J Am Psychiatr Nurses Assoc. 2017;23(1):37–49. https://doi.org/10.1177/1078390316668992 .

Clancy R, Lewin TJ, Bowman JA, Kelly BJ, Mullen AD, Flanagan K, Hazelton MJ. Providing physical health care for people accessing mental health services: clinicians’ perceptions of their role. Int J Ment Health Nurs. 2018;28(1):256–67. https://doi.org/10.1111/inm.12529 .

Chee G, Wynaden D, Heslop K. The provision of physical health care by nurses to young people with first episode psychosis: a cross-sectional study. J Psychiatr Ment Health Nurs. 2018;25(7):411–22.

Ganiah AN, Al-Hussami M, Alhadidi M. Mental health nurses’ attitudes and practice toward physical health care in Jordan. Community Ment Health J. 2017;53(6):725–35. https://doi.org/10.1007/s10597-017-0143-6 .

Haddad M, Llewellyn-Jones S, Yarnold S, Simpson A. Improving the physical health of people with severe mental illness in a low secure forensic unit: an uncontrolled evaluation study of staff training and physical health care plans. Int J Ment Health Nurs. 2016;25(6):554–65. https://doi.org/10.1111/inm.12246 .

Wynaden D, Heslop B, Heslop K, Barr L, Lim E, Chee GL, Murdock J. The chasm of care: where does the mental health nursing responsibility lie for the physical health care of people with severe mental illness? Int J Ment Health Nurs. 2016;25(6):516–25. https://doi.org/10.1111/inm.12242 .

Howard L, Gamble C. Supporting mental health nurses to address the physical health needs of people with serious mental illness in acute inpatient care settings. J Psychiatr Ment Health Nurs. 2010;18(2):105112. https://doi.org/10.1111/j.1365-2850.2010.01642.x .

Terry J, Cutter J. Does education improve mental health practitioners' confidence in meeting the physical health needs of mental health service users? A mixed methods pilot study. Issues Ment Health Nurs. 2013;34(4):249–55. https://doi.org/10.3109/01612840.2012.740768 .

Osborn S, Douglas C, Reid C, Jones L, Gardner G. The primacy of vital signs – acute care nurses’ and midwives’ use of physical assessment skills: a cross sectional study. Int J Nurs Stud. 2015;52:952–62 https://doi.org/10.1016/j.ijnurstu.2015.01.014 .

Artzi-Medvedik R, Chertok IRA, Romem Y. Nurses' attitudes towards breastfeeding among women with schizophrenia in southern Israel. J Psychiatr Ment Health Nurs. 19(8):702–8. https://doi.org/10.1111/j.1365-2850.2011.01846.x .

Hunter J, Rawlings-Anderson K, Lindsay T, Bowden T, Aitken LM. Exploring student nurses' attitudes towards those who are obese and whether these attitudes change following a simulated activity. Nurse Educ Today. 2018;65:225–31. https://doi.org/10.1016/j.nedt.2018.03.013 .

Magor-Blatch LE, Rugendyke AR. Going smoke-free: attitudes of mental health professionals to policy change. J Psychiatr Ment Health Nurs. 2016;23(5):290–302. https://doi.org/10.1111/jpm.12309 .

Sung SC, Jiang HH, Chen RR, Chao JK. Bridging the gap in sexual healthcare in nursing practice: implementing a sexual healthcare training programme to improve outcomes. J Clin Nurs. 2016;25:19–20. https://doi.org/10.1111/jocn.13441 2989-3000.

Wynn SD. Improving the quality of care of veterans with diabetes: a simulation intervention for psychiatric nurses. J Psychosoc Nurs Ment Health Serv. 2011;49(2):38–45. https://doi.org/10.3928/02793695-20110111-01 .

Brimblecombe N, Tingle A, Tunmore R, Murrells T. Implementing holistic practices in mental health nursing: a national consultation. Int J Nurs Stud. 2007;44(3):339–48. https://doi.org/10.1016/j.ijnurstu.2006.07.021 .

Delaney KR, Hamera E, Drew BL. Health advanced practice nursing: the adequacy of educational preparation: voices of our graduates. J Am Psychiatr Nurses Assoc. 2009;15(6):383–92. https://doi.org/10.1177/1078390309353070 .

Mwebe H. Physical health monitoring in mental health settings: a study exploring mental health nurses' views of their role. J Clin Nurs. 2017;26(19/20):3067–78. https://doi.org/10.1111/jocn.13653 .

Çelik Ince S, Partlak Günüşen N, Serçe Ö. The opinions of Turkish mental health nurses on physical health care for individuals with mental illness: a qualitative study. J Psychiatr Ment Health Nurs. 2018;25(4):245–57.

Happell B, Stanton R, Hoey W, Scott D. Reduced ambivalence to the role of the cardiometabolic health nurse following a 6-month trial. Perspect Psychiatr Care. 2015;51(2):80–5. https://doi.org/10.1111/ppc.12066 .

Sharp DL, Blaakman SW, Cole RE, Evinger JS. Report from a national tobacco dependence survey of psychiatric nurses. J Am Psychiatr Nurses Assoc. 2009;15(3):172–81. https://doi.org/10.1177/1078390309336746 .

Dorsay JP, Forchuk C. Assessment of the sexuality needs of individuals with psychiatric disability. J Psychiatr Ment Health Nurs. 2009;1(2):93–7. https://doi.org/10.1111/j.1365-2850.1994.tb00025.x .

Quinn C, Platania-Phung C, Bale C, Happell B, Hughes E. Understanding the current sexual health service provision for mental health consumers by nurses in mental health settings: findings from a survey in Australia and England. Int J Ment Health Nurs. 2018;27(5):1522–34. https://doi.org/10.1111/inm.12452 .

Verhaege N, De Maeseneer J, Maes L, Van Heeringen C, Annemans L. Health promotion in mental health care: perceptions from patients and mental health nurses. J Clin Nurs. 2013;22(11–12):1569–78. https://doi.org/10.1111/jocn.12076 .

Johannessen B, Skagestad I, Bergkaasa AM. Food as medicine in psychiatric care: which profession should be responsible for imparting knowledge and use of omega-3 fatty acids in psychiatry. Complement Ther Clin Pract. 2011;17(2):107–12. https://doi.org/10.1016/j.ctcp.2010.08.001 .

Hughes E, Gray R. HIV prevention for people with serious mental illness: a survey of mental health workers' attitudes, knowledge and practice. J Clin Nurs. 2009;18(4):591–600. https://doi.org/10.1111/j.1365-2702.2007.02227.x .

Sharma R, Meurk C, Bell S, Ford P, Gartner C. Australian mental health care practitioners’ practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness. Int J Ment Health Nurs. 2018;27:247–57. https://doi.org/10.1111/inm.12314 .

Parel JT, Khakha DC, Balhara YPS. Do psychiatric nurses have favourable knowledge and attitude towards tobacco prevention among their patients? A cross-sectional study from national capital of India. Asian J Nurs Educ Res. 2018;8(1):01–4. https://doi.org/10.5958/2349-2996.2018.00001.0 .

Fernando A, Attoe C, Jaye P, Cross S, Pathan J, Wessely S. Improving interprofessional approaches to physical and psychiatric comorbidities through simulation. Clin Simul Nurs. 2017;13(4):186193. https://doi.org/10.1016/j.ecns.2016.12.004 .

White J, Hemingway S, Stephenson J. Training mental health nurses to assess the physical health needs of mental health service users: a pre- and post-test analysis. Perspect Psychiatr Care. 2014;50(4):243–50. https://doi.org/10.1111/ppc.12048 .

Hemingway S, Clifton A, Stephenson J, Edward KL. Facilitating knowledge of mental health nurses to undertake physical health interventions: a pre-test/post-test evaluation. J Nurs Manag. 2014;22(3):383–93. https://doi.org/10.1111/jonm.12220 .

Hemingway S, Stephenson J, Trotter F, Clifton A, Holdich P. Increasing the health literacy of learning disability and mental health nurses in physical care skills: a pre and post-test evaluation of a workshop on diabetes care. Nurse Educ Pract. 2015;15(1):30–7. https://doi.org/10.1016/j.nepr.2014.08.003 .

Hemingway S, Trotter F, Stephenson J, Holdich P. Diabetes: Increasing the knowledge base of mental health nurses. Br J Nurs. 2013;22(17):991–5. https://doi.org/10.12968/bjon.2013.22.17.991 .

Nash M. Physical care skills: a training needs analysis of inpatient and community mental health nurses. Ment Health Pract. 2005;9(4):20–3. https://doi.org/10.7748/mhp2005.12.9.4.20.c1896 .

Happell B, Scott D, Nankivell J, Platania-Phung C. Nurses’ views on training needs to increase provision of primary care for consumers with serious mental illness. Perspect Psychiatr Care. 2013;49:210–7. https://doi.org/10.1111/j.1744-6163.2012.00351.x .

Happell B, Scott D, Nankivell J, Platania-Phung C. Screening physical health? Yes! But…: nurses’ views on physical health screening in mental health care. J Clin Nurs. 2013;22:2286–97. https://doi.org/10.1111/j.1365-2702.2012.04325.x .

Birks M, Cant R, James A, Chung C, Davis J. The use of physical assessment skills by registered nurses in Australia: issues for nursing education. Collegian. 2012;20:27–33. https://doi.org/10.1016/j.colegn.2012.02.004 .

Giddens JF. A survey of physical assessment techniques performed by RNs: lessons for nursing education. J Nurs Educ. 2007;46:83–7.

PubMed   Google Scholar  

Douglas C, Osborne S, Reid C, Batch M, Hollingdrake O, Gardner G. What factors influence nurses’ assessment practices? Development of the barriers to nurses’ use of physical assessment scale. J Adv Nurs. 2014;70:2683–94. https://doi.org/10.1111/jan.12408 .

Phelan M, Stradins L, Amin D, Isadore R, Hitrov C, Doyle A, Inglis R. The physical health check: a tool for mental health workers. J Ment Health. 2004;13(3):277–85. https://doi.org/10.1080/09638230410001700907 .

Shuel F, White J, Jones M, Gray R. Using the serious mental illness health improvement profile [HIP] to identify physical problems in a cohort of community patients: a pragmatic case series evaluation. Int J Nurs Stud. 2010;47(2):136–45. https://doi.org/10.1016/j.ijnurstu.2009.06.003 .

Freed GL, Clark SJ, Sorensen J, Lohr JA, Cefalo R, Curtis P. National assessment of physicians’ breastfeeding knowledge, attitudes, training, and experience. JAMA. 1995;273:472–6.

Corrigan P, Markowitz FE, Watson A, Rowan D, Kubiak MA. An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav. 2003;44(2):162–79.

Shore TH, Tashchian A, Adams JS. Development and validation of a scale measuring attitudes toward smoking. J Soc Psychol. 2000;140(5):615–23.

Nash M. Mental health nurses' diabetes care skills - a training needs analysis. Br J Nurs. 2009;18(10):626–30. https://doi.org/10.12968/bjon.2009.18.10.42472 .

Quinn C, Happell B, Browne G. Opportunity lost? Psychiatric medications and problems with sexual function: a role for nurses in mental health. J Clin Nurs. 2011;21:415–23. https://doi.org/10.1111/j.1365-2702.2011.03908.x .

Ford P, Tran P, Keen B, Gartner C. Survey of Australian oral health practitioners and their smoking cessation practices. Aust Dent J. 2015;60:43–51.

Morris C, Waxmonsky J, May M, Giese A, Martin L. Smoking cessation for persons with mental illness: a toolkit for mental health providers: University pf Colorado Denver, CO; 2009. Accessed 19 Mar 2019: https://www.integration.samhsa.gov/Smoking_Cessation_for_Persons_with_MI.pdf

Watson L, Oberle K, Deutscher D. Development and psychometric testing of the Nurses' attitudes toward obesity and obese patients scale (NATOOPS). Res Nurs Health. 2008;31(6):586–93. https://doi.org/10.1002/nur.20292 .

Lasater K. Clinical judgment development: using simulation to create an assessment rubric. J Nurs Educ. 2007;46(11):496–503. https://doi.org/10.1097/NND.0000000000000209 .

Download references

Acknowledgements

The study was partly funded as part of the CUBIC Capability, Capacity and Cultural Change project funded by Nursing and Midwifery Office (NaMO) New South Wales

‘The funding body played no part in the in the design of the study, collection, analysis, interpretation of data, and in writing the manuscript.’

Availability of data and materials

All data generated or analysed during this study are included in this published article [and its supplementary information files] and, where applicable data sharing is not applicable to this article as no datasets were generated or analysed during the current study.

Author information

Authors and affiliations.

Professor Mental Health Nursing, Centre for Applied Nursing Research (CANR), Western Sydney University, Sydney, Australia

Geoffrey L. Dickens, Cheryl Waters, Evan Atlantis & Bronwyn Everett

South West Sydney Local Health District, Sydney, Australia

Geoffrey L. Dickens

Division of Mental Health Nursing and Counselling, Abertay University, Dundee, Scotland

You can also search for this author in PubMed   Google Scholar

Contributions

GLD conceived of and designed the study. GLD, RI, CW, EA, BE contributed to acquisition of data, analysis and interpretation of data. GLD, RI, CW, EA, BE contributed to drafting the manuscript or revising it critically for important intellectual content. GLD, RI, CW, EA, BE gave final approval of the version to be published. GLD, RI, CW, EA, BE agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Geoffrey L. Dickens .

Ethics declarations

Ethics approval and consent to participate.

Not applicable.

Consent for publication

Competing interests.

The authors declare they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Additional files

Additional file 1:.

Table S1. Example PICO-style electronic literature search. Example literature search (DOCX 13 kb)

Additional file 2:

Table S2. Controlled intervention evaluation study quality assessment. Study Quality Assessment (controlled intervention study) (DOCX 13 kb)

Additional file 3:

Table S3. Cross-sectional, observational studies quality assessment (adapted from National Heart, Lung, and Blood Institute [ 26 ]. Study Quality Assessment (Cross-sectional and observational studies) (DOCX 16 kb)

Additional file 4:

Table S4. Longitudinal uncontrolled intervention study quality assessment. Study Quality Assessment (uncontrolled intervention studies) (DOCX 14 kb)

Additional file 5:

Table S5. Qualitative study quality assessment. Study Quality Assessment. (Qualitative studies) (DOCX 14 kb)

Additional file 6:

Table S6. Outcome measure content and quality assessment. Quality assessment of outcomes measures used in studies. (DOCX 25 kb)

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Cite this article.

Dickens, G.L., Ion, R., Waters, C. et al. Mental health nurses’ attitudes, experience, and knowledge regarding routine physical healthcare: systematic, integrative review of studies involving 7,549 nurses working in mental health settings. BMC Nurs 18 , 16 (2019). https://doi.org/10.1186/s12912-019-0339-x

Download citation

Received : 30 October 2018

Accepted : 01 April 2019

Published : 26 April 2019

DOI : https://doi.org/10.1186/s12912-019-0339-x

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Mental health nurses
• Emergency medicine
• Deteriorating patient
• Educational interventions

BMC Nursing

ISSN: 1472-6955

• General enquiries: [email protected]

Best Nursing Research Topics for Students

What is a nursing research paper.

• What They Include
• Choosing a Topic
• Best Nursing Research Topics
• Research Paper Writing Tips

Writing a research paper is a massive task that involves careful organization, critical analysis, and a lot of time. Some nursing students are natural writers, while others struggle to select a nursing research topic, let alone write about it.

If you're a nursing student who dreads writing research papers, this article may help ease your anxiety. We'll cover everything you need to know about writing nursing school research papers and the top topics for nursing research.  

Continue reading to make your paper-writing jitters a thing of the past.

A nursing research paper is a work of academic writing composed by a nurse or nursing student. The paper may present information on a specific topic or answer a question.

During LPN/LVN and RN programs, most papers you write focus on learning to use research databases, evaluate appropriate resources, and format your writing with APA style. You'll then synthesize your research information to answer a question or analyze a topic.

BSN , MSN , Ph.D., and DNP programs also write nursing research papers. Students in these programs may also participate in conducting original research studies.

Writing papers during your academic program improves and develops many skills, including the ability to:

• Select nursing topics for research
• Conduct effective research
• Analyze published academic literature
• Format and cite sources
• Synthesize data
• Organize and articulate findings

About Nursing Research Papers

When do nursing students write research papers.

You may need to write a research paper for any of the nursing courses you take. Research papers help develop critical thinking and communication skills. They allow you to learn how to conduct research and critically review publications.

That said, not every class will require in-depth, 10-20-page papers. The more advanced your degree path, the more you can expect to write and conduct research. If you're in an associate or bachelor's program, you'll probably write a few papers each semester or term.

Do Nursing Students Conduct Original Research?

Most of the time, you won't be designing, conducting, and evaluating new research. Instead, your projects will focus on learning the research process and the scientific method. You'll achieve these objectives by evaluating existing nursing literature and sources and defending a thesis.

However, many nursing faculty members do conduct original research. So, you may get opportunities to participate in, and publish, research articles.

Example Research Project Scenario:

In your maternal child nursing class, the professor assigns the class a research paper regarding developmentally appropriate nursing interventions for the pediatric population. While that may sound specific, you have almost endless opportunities to narrow down the focus of your writing. 

You could choose pain intervention measures in toddlers. Conversely, you can research the effects of prolonged hospitalization on adolescents' social-emotional development.

What Does a Nursing Research Paper Include?

Your professor should provide a thorough guideline of the scope of the paper. In general, an undergraduate nursing research paper will consist of:

Introduction : A brief overview of the research question/thesis statement your paper will discuss. You can include why the topic is relevant.

Body : This section presents your research findings and allows you to synthesize the information and data you collected. You'll have a chance to articulate your evaluation and answer your research question. The length of this section depends on your assignment.

Conclusion : A brief review of the information and analysis you presented throughout the body of the paper. This section is a recap of your paper and another chance to reassert your thesis.

The best advice is to follow your instructor's rubric and guidelines. Remember to ask for help whenever needed, and avoid overcomplicating the assignment!

How to Choose a Nursing Research Topic

The sheer volume of prospective nursing research topics can become overwhelming for students. Additionally, you may get the misconception that all the 'good' research ideas are exhausted. However, a personal approach may help you narrow down a research topic and find a unique angle.

Writing your research paper about a topic you value or connect with makes the task easier. Additionally, you should consider the material's breadth. Topics with plenty of existing literature will make developing a research question and thesis smoother.

Finally, feel free to shift gears if necessary, especially if you're still early in the research process. If you start down one path and have trouble finding published information, ask your professor if you can choose another topic.

The Best Research Topics for Nursing Students

You have endless subject choices for nursing research papers. This non-exhaustive list just scratches the surface of some of the best nursing research topics.

1. Clinical Nursing Research Topics

• Analyze the use of telehealth/virtual nursing to reduce inpatient nurse duties.
• Discuss the impact of evidence-based respiratory interventions on patient outcomes in critical care settings.
• Explore the effectiveness of pain management protocols in pediatric patients.

2. Community Health Nursing Research Topics

• Assess the impact of nurse-led diabetes education in Type II Diabetics.
• Analyze the relationship between socioeconomic status and access to healthcare services.

3. Nurse Education Research Topics

• Review the effectiveness of simulation-based learning to improve nursing students' clinical skills.
• Identify methods that best prepare pre-licensure students for clinical practice.
• Investigate factors that influence nurses to pursue advanced degrees.
• Evaluate education methods that enhance cultural competence among nurses.
• Describe the role of mindfulness interventions in reducing stress and burnout among nurses.

4. Mental Health Nursing Research Topics

• Explore patient outcomes related to nurse staffing levels in acute behavioral health settings.
• Assess the effectiveness of mental health education among emergency room nurses .
• Explore de-escalation techniques that result in improved patient outcomes.
• Review the effectiveness of therapeutic communication in improving patient outcomes.

5. Pediatric Nursing Research Topics

• Assess the impact of parental involvement in pediatric asthma treatment adherence.
• Explore challenges related to chronic illness management in pediatric patients.
• Review the role of play therapy and other therapeutic interventions that alleviate anxiety among hospitalized children.

6. The Nursing Profession Research Topics

• Analyze the effects of short staffing on nurse burnout .
• Evaluate factors that facilitate resiliency among nursing professionals.
• Examine predictors of nurse dissatisfaction and burnout.
• Posit how nursing theories influence modern nursing practice.

Tips for Writing a Nursing Research Paper

The best nursing research advice we can provide is to follow your professor's rubric and instructions. However, here are a few study tips for nursing students to make paper writing less painful:

Avoid procrastination: Everyone says it, but few follow this advice. You can significantly lower your stress levels if you avoid procrastinating and start working on your project immediately.

Plan Ahead: Break down the writing process into smaller sections, especially if it seems overwhelming. Give yourself time for each step in the process.

Research: Use your resources and ask for help from the librarian or instructor. The rest should come together quickly once you find high-quality studies to analyze.

Outline: Create an outline to help you organize your thoughts. Then, you can plug in information throughout the research process. 

Clear Language: Use plain language as much as possible to get your point across. Jargon is inevitable when writing academic nursing papers, but keep it to a minimum.

Cite Properly: Accurately cite all sources using the appropriate citation style. Nursing research papers will almost always implement APA style. Check out the resources below for some excellent reference management options.

Revise and Edit: Once you finish your first draft, put it away for one to two hours or, preferably, a whole day. Once you've placed some space between you and your paper, read through and edit for clarity, coherence, and grammatical errors. Reading your essay out loud is an excellent way to check for the 'flow' of the paper.

Helpful Nursing Research Writing Resources:

Purdue OWL (Online writing lab) has a robust APA guide covering everything you need about APA style and rules.

Grammarly helps you edit grammar, spelling, and punctuation. Upgrading to a paid plan will get you plagiarism detection, formatting, and engagement suggestions. This tool is excellent to help you simplify complicated sentences.

Mendeley is a free reference management software. It stores, organizes, and cites references. It has a Microsoft plug-in that inserts and correctly formats APA citations.

Don't let nursing research papers scare you away from starting nursing school or furthering your education. Their purpose is to develop skills you'll need to be an effective nurse: critical thinking, communication, and the ability to review published information critically.

Choose a great topic and follow your teacher's instructions; you'll finish that paper in no time.

Joleen Sams is a certified Family Nurse Practitioner based in the Kansas City metro area. During her 10-year RN career, Joleen worked in NICU, inpatient pediatrics, and regulatory compliance. Since graduating with her MSN-FNP in 2019, she has worked in urgent care and nursing administration. Connect with Joleen on LinkedIn or see more of her writing on her website.

Plus, get exclusive access to discounts for nurses, stay informed on the latest nurse news, and learn how to take the next steps in your career.

By clicking “Join Now”, you agree to receive email newsletters and special offers from Nurse.org. We will not sell or distribute your email address to any third party, and you may unsubscribe at any time by using the unsubscribe link, found at the bottom of every email.

ORIGINAL RESEARCH article

Mental health of nursing students amid coronavirus disease 2019 pandemic.

• 1 School of Nursing, Henan Technical Institute, Zhengzhou, China
• 2 Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

The coronavirus disease 2019 (COVID-19) pandemic is a global disaster, and recent studies have shown its association with increasing mental health problems such as post-traumatic stress disorder (PTSD), depression, anxiety, and stress. Nursing students, especially nursing interns, may be shunned, harassed, and even blamed as potential COVID-19 spreaders, though they were an important reserve force against COVID-19 and other diseases. Of note, the psychological influences of COVID-19 on nursing students remained unclear. The aim of this study was to evaluate the mental health of nursing students during the COVID-19 pandemic. A cross-sectional online survey was conducted on nursing students in a vocational college from April 12 to 23, 2020. The Impact of Event Scale–Revised, 21-item Depression, Anxiety and Stress Scale, and Pittsburgh Sleep Quality Index were used to assess the degree of symptoms of PTSD, depression, anxiety, stress, and insomnia, respectively. Multivariable logistic regression analysis was performed to determine the potential risk factors for the psychological symptoms. A total of 1,780 college nursing students were asked to participate in this online survey, with 1,532 complete responses. In total, 682 (44.5%) college nursing students reported having PTSD, 358 (22.8%) students reported insomnia, and few students reported depression ( n = 45, 2.9%), anxiety ( n = 44, 2.9%), and stress ( n = 17, 1.1%) symptoms. As compared with junior, female, and rural nursing students, the senior, male, and urban nursing students had higher rates of PTSD, depression, anxiety, stress, respectively, whereas male nursing students had a higher insomnia rate. Multivariable analysis showed that senior nursing students had higher risks of PTSD, depression, anxiety; being male was associated with higher risks of PTSD, depression, anxiety, stress, and insomnia; and urban nursing students had higher risks of PTSD, depression, anxiety, and stress. In summary, a considerable number of nursing students reported mental symptoms of PTSD and insomnia, though few reported mental symptoms of depression, anxiety, and stress. Furthermore, senior, male, and urban nursing students are at risk for developing mental symptoms. Appropriate psychological interventions should be implemented to assure the mental health of nursing students.

Introduction

The coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China on December 8, 2019, and it has rapidly spread all over the world ( Pan et al., 2020 ). This pandemic has been a global disaster, greatly influencing social lives, economics, mental conditions, and health security, and it seemed that there was no end to this disaster ( Firth et al., 2020 ; Pfefferbaum and North, 2020 ). As of June 4, 2021 (the moment of writing), WHO reported 171,782,908 confirmed cases of COVID-19 globally, with 3,698,621 deaths ( World Health Organization, 2021 ).

To limit the spread of this outbreak, a series of important and effective public-health measures were implemented in China and in many other countries, such as mass vaccination, lockdowns, maintaining social distancing, wearing masks, hand hygiene, population surveillance, abundant COVID-19 tests, rigorous contacts tracing, mandatory quarantine for confirmed or suspected cases with COVID-19 infection and their close contacts, and the building of makeshift hospitals ( Budd et al., 2020 ; Firth et al., 2020 ; Pan et al., 2020 ; Ruktanonchai et al., 2020 ). Despite the initiation of these public-health measures, cases continued to rise. Many infected patients had returned to China from other countries, and imported infections as well as asymptomatic cases were the main challenges in China ( Chen et al., 2020 ). In order to curb the spread of COVID-19, Chinese students had experienced prolonged school suspensions and subsequent online education at home.

During the initial stage of the COVID-19 epidemic, the results of a survey conducted among the general population in China had shown that more than half of the respondents (53.8%) rated the psychological impact of the COVID-19 epidemic as moderate to severe ( Wang X. et al., 2020 ). With the increasing mental health burden amid the COVID-19 pandemic, it became crucial and necessary to enhance mental health assessments and support so as to maintain public mental health, and the Chinese National Health Commission has issued guidelines for emergency psychological crisis intervention and established psychological assistance hotlines ( Lai et al., 2020 ; Wang Y. et al., 2020 ). Many mental healthcare workers have been bravely and voluntarily involved in providing frontline or online psychological care (e.g., WeChat, TikTok, Weibo, and hotlines) to patients with COVID-19 as well as to the general population ( Wang Y. et al., 2020 ). These mental health services might improve the mental resilience and reduce the incidence of psychological diseases. However, several people have not requested for mental health assistance due to the fear of discrimination and stigmatization, despite having severe psychological symptoms ( Lyndon et al., 2019 ; Javed et al., 2021 ).

Healthcare workers, including nurses, played very important roles in fighting the COVID-19 pandemic and have made invaluable contributions. Many nurses were brave and heroic, working at the frontlines to treat patients with COVID-19 pneumonia despite the very high risk of infection ( Hartmann et al., 2020 ; Hughes et al., 2020 ). Recent studies have shown that healthcare workers such as frontline nurses, especially women, experienced a large psychological burden which manifested as symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and insomnia ( Lai et al., 2020 ).

Some studies had shown that the psychological consequences of the COVID-19 epidemic on college students could be serious. Chinese college students suffered from symptoms of PTSD, stress, anxiety, and depression in the early stage of the COVID-19 pandemic ( Li H. Y. et al., 2020 ; Tang et al., 2020 ; Zhang et al., 2020 ). In addition, medical students may suffer from more stress than non-medical students following the COVID-19 outbreak ( Ye et al., 2020 ).

Nursing students are a new and important reserve force against COVID-19 and other diseases. In China, nursing students in general are required to receive 3–5 years of a college education. They also need to undergo clinical training as interns in the hospital during their previous year. Later, some nursing students continue further studies, whereas most nursing students begin working as formal clinical nurses after graduation.

At the early beginning of the COVID-19 epidemic, though WHO was informed of a cluster of pneumonia of unknown cause in Wuhan city on December 31, 2019 ( World Health Organization, 2020 ), much remained unknown except for patients with COVID-19 were infected by direct exposure at the seafood market ( The Lancet, 2020b ), and Chinese nursing students were still learning at schools or hospitals during this period. On January 20, 2020, the eminent SARS specialist Zhong Nanshan announced that 14 medical workers had been infected by one virus carrier and confirmed that COVID-19 could spread from human to human ( Nature, 2020 ). Also on January 20, the Chinese president and government announced the COVID-19 outbreak and it should be resolutely contained ( Nature, 2020 ). At this time, most junior nursing students had been back home to celebrate Chinese New Year, but nursing seniors (interns) still remained in their clinical training in the hospital. Massive actions including all sectors from business to factories and to schools were taken the next day to curb the COVID-19 epidemic ( Chen and Yu, 2020 ). As of January 23, 2020, a total of 835 confirmed cases (549 from Hubei Province and 286 in 32 provinces, municipalities, and special administrative regions in China) were detected; in order to contain the COVID-19 spread, Wuhan City was locked down, and soon followed by many other areas in China ( The Lancet, 2020b ; Wang et al., 2020a , b ). Of note, as cases increased, medical workers were recognized as a high-risk group to acquire the COVID-19 infection. As of February 11, 2020, a total of 72,314 COVID-19 cases were reported in mainland China, with 3,019 medical workers (1,716 were confirmed) ( Epidemiology Working Group for NCIP Epidemic Response Chinese Center for Disease Control Prevention, 2020 ). Since senior nursing students needed to work as interns in the hospital before Spring Festival, they were considered as medical workers by the general population. The public, including friends and relatives, had a fear of getting COVID-19 infection, so as to the medical workers such as nurses even nursing students were shunned, harassed, and even blamed as potential COVID-19 spreaders by some people ( Bagcchi, 2020 ; Koh, 2020 ; Abdulah et al., 2021 ). Besides, the nursing students who worked in the hospital were also anxious about the chance of getting the COVID-19 infection and passing the infection to their families ( The Lancet, 2020a ). Nursing students experienced extreme psychological stress and a range of feelings such as excitement, doubt, and helplessness after the COVID-19 outbreak ( Huang et al., 2020 ).

To date, it is still unclear whether the COVID-19 pandemic and the subsequent quarantine and online education could give rise to mental health symptoms among college nursing students. According to the official website, from April 12 to 23, 2020, there were 1,273 COVID-19-confirmed patients in the Henan Province (with no new increases), and confirmed cases in China increased from 83,597 to 84,303 (moving into mitigation stage), whereas confirmed cases all over the world rapidly increased from 1,713,517 to 2,548,755 ( World Health Organization, 2021 ). During this period, we conducted a survey that focused on the mental health (including symptoms of PTSD, depression, anxiety, stress, and insomnia) among nursing students studying in Henan Technical Institute, a comprehensive vocational college with a 3-year nursing college education with almost 2,200 nursing students located in Zhengzhou, Henan Province, China, in order to provide evidence for the formation of specific and effective mental health interventions for nursing students.

Materials and Methods

Study design and participants.

A cross-sectional online survey regarding the mental health of college nursing students was conducted from April 12 to 23, 2020 according to the principles of the Declaration of Helsinki. Most nursing students ( n = 1,780) in Henan Technical Institute were asked to voluntarily participate in this study by their teachers via QQ groups (a widely used instant messaging and social platform, Tencent Inc., Shenzhen, China), and all the participants were informed that they had the right to terminate their participation in the study anytime they desired. All these students received online education at home in order to avoid infection with COVID-19, hence the survey was completed via an online platform (SurveyStar, a professional online survey, examination, and voting platform, Changsha Ranxing Information Technology Co., LTD, Shanghai, China), especially WeChat/Weixin (a widely used communication and social platform in China, Tencent Inc., Shenzhen, China), using a cellphone or computer. The questions of this survey could be revisited and answered using the same WeChat account, but they could not be corrected or answered again once these were submitted. Students who responded were divided into two groups according to their year level: 1,135 were junior nursing students (grades 1 and 2) and 397 were senior nursing interns (grade 3).

Participation in this study was anonymous and the personal information of participants was kept confidential. This study protocol was approved by the Ethics Committee of Henan Technical Institute.

Measurements

The mental health conditions of nursing students amid the COVID-19 pandemic were evaluated through an online structured questionnaire. The 22-item Impact of Event Scale–Revised (IES-R) ( Christianson and Marren, 2012 ), 21-item Depression, Anxiety, and Stress Scale (DASS-21) ( Lovibond and Lovibond, 1995 ; Henry and Crawford, 2005 ), and Pittsburgh Sleep Quality Index (PSQI) ( Buysse et al., 1989 ) were used to assess the symptoms of PTSD, depression, anxiety, stress, and insomnia among college nursing students, respectively. IES-R included intrusion (items of IES-R 1, 2, 3, 6, 9, 14, 16, 20), avoidance (items 5, 7, 8, 11, 12, 13, 17, 22), and hyperarousal (items 4, 10, 15, 18, 19, 21) subscales, with five choices including not at all (score 0), a little bit (score 1), moderately (score 2), quite a bit (score 3), and extremely (score 4). The severity of PTSD symptoms was evaluated by the sum of the intrusion and avoidance subscales ( Christianson and Marren, 2012 ). The DASS-21 included depression (items of DASS 3, 5, 10, 13, 16, 17, 21), anxiety (items 2, 4, 7, 9, 15, 19, 20), and stress (items 6, 8, 11, 12, 14, 18) subscales, with four responses including do not apply to me at all (score 0), apply to me to some degree or some of the time (score 1), apply to me a considerable degree or a good part of the time (score 2), and apply to me very much or most of the time (score 3). The final score of each subscale was equal to the sum of its items and then multiplied by two, as the DASS-21 was a short form version of the 42-item DASS ( Lovibond and Lovibond, 1995 ; Henry and Crawford, 2005 ). The PSQI evaluated seven components of sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleeping medication, and daytime dysfunction. The score ranged from 0 to 3 for each component, and the PSQI score was equal to the sum of the seven component scores ( Buysse et al., 1989 ). The detailed questions and scoring methods are shown in Supplementary Material . The scales above have been shown to have excellent reliability and validity in previous studies ( Yohannes et al., 2019 ; Chew et al., 2020 ; Lai et al., 2020 ; Xiao et al., 2020 ).

The scores of the above scales were graded as follows: scores on the IES-R (sum of intrusion and avoidance subscale scores) were classified as normal (0–8), mild (9–25), moderate (26–43), and severe (44–64) PTSD ( Christianson and Marren, 2012 ; Lai et al., 2020 ). For the DASS-21 depression subscales, participants were classified as being normal (0–9) or having mild (10–13), moderate (14–20), severe (21–27), or extremely severe (28–42) depression. For the DASS-21 anxiety subscale, classifications included normal (0–7), mild (8–9), moderate (10–14), severe (15–19), and extremely severe (20–42) anxiety. For the DASS-21 stress subscale, classifications included normal (0–14), mild (15–18), moderate (19–25), severe (26–33), and extremely severe (34–42) stress ( Lovibond and Lovibond, 1995 ; Henry and Crawford, 2005 ; Yohannes et al., 2019 ; Chew et al., 2020 ). Finally, the PSQI included categories such as normal (0–5), mild (6–10), moderate (11–15), and severe (16–21) insomnia ( Buysse et al., 1989 ; Xiao et al., 2020 ).

In addition, the educational and living conditions of nursing students during the COVID-19 pandemic were also inquired about in this survey. There were three questions related to their education: (1) attitude toward online education, with four responses including very satisfactory, satisfactory, average, or unsatisfactory; (2) mental states during online learning, with three responses including better, as usual, or worse; and (3) attitude toward going back to school, with two responses including expected and not expected. There were five questions related to their living conditions: (1) family economic income (higher, as usual, or lower); (2) body weight (increased, unchanged, or decreased); (3) quality of life (good, average, or bad); (4) attention to COVID-19 (always, usually, sometimes, or almost never); and (5) attitude toward being a frontline nurse (sure, maybe, maybe not, or impossible).

Demographic data such as gender (male or female), educational status (junior or senior), and place of residence (urban or rural) were collected in the survey. The COVID-19 status of the nursing students and their families was also investigated.

Statistical Methods

All statistical tests were performed using SPSS software (version 22.0, SPSS, IBM Corporation, Armonk, New York). Scores of measurement scales had a skewed distribution, and these were presented as medians and interquartile ranges (IQR). A non-parametric Mann–Whitney U -test was used to compare the differences between the two groups. Categorical variables, such as the severity classifications of PTSD, depression, anxiety, stress, and insomnia symptoms, were presented as numbers and percentages, and group differences were assessed using the Mann–Whitney U -test of ranked data.

Multivariable logistic regression analysis was applied to evaluate the influences of educational status, gender, and location on PTSD, depression, anxiety, stress, and insomnia symptoms, and their associations were demonstrated as OR with a 95% CI.

A P < 0.05 was considered significant, and all tests were two-tailed.

Demographic Characteristics

In this study, a total of 1,780 college nursing students were asked to fulfill the online survey (the count included QQ groups of teachers who asked their students and sent the link to the survey), and we received 1,532 complete responses, with a response rate of 86.1%. Among these 1,532 nursing students, the average age was 19.95 (SD, 1.24) years, 397 (25.9%) were senior interns, 1,135 (74.1%) were juniors, 666 (43.5%) came from an urban area, 866 (56.5%) came from a rural area, and 1,400 (91.4%) lived in the Henan Province. The majority of respondents were females ( n = 1,351, 88.2%), with 181 (11.8%) males. There were no confirmed or suspected COVID-19 infected cases in this research according to self-reports and official data from the school.

The Educational and Living Conditions Influenced by COVID-19

Table 1 presents the educational and living conditions of respondents. As for educational condition, many college nursing students were satisfied with their current online education (satisfactory, n = 1,036, 67.6%; very satisfactory, n = 234, 15.3%). However, only 164 (10.7%) respondents reported having better mental states during online learning, whereas many students ( n = 883, 57.6%) reported worsening mental states and 1,359 (88.7%) students expected to go back to school. As for their living condition, 1,261 (82.3%) suffered a loss in their family income, 265 (17.3%) reported the same economic income as usual, and only 6 (0.4%) reported a higher economic income. Surprisingly, only 52 (3.4%) students thought they had a poor quality of life. Furthermore, 675 (44.1%) students had gained weight. Of the 1,532 respondents, 696 (45.4%) reported that they usually paid attention to the COVID-19 pandemic, and 633 (41.3%) reported always paying close attention to COVID-19. Finally, an overwhelming majority of students had a positive attitude ( n = 1,504, 98.2%) toward becoming frontline nurses against COVID-19 in the future.

Table 1 . Educational and living conditions of all and subgroup participants.

On comparing junior and senior nursing students, senior nursing students (interns) reported having better mental states during the online learning period (worse, 51.9 vs. 59.6%, P < 0.01) but worse family economic incomes (lower, 86.6 vs. 80.8%, P < 0.01). They also paid more attention to COVID-19 (always and usually, 90.4 vs. 85.5%, P < 0.01) and were more willing to become frontline nurses against COVID-19 (sure, 73.8 vs. 66.1%, P < 0.01). When compared with female nursing students, male nursing students also reported paying more attention to COVID-19 (always and usually, 89.5 vs. 86.3%, P < 0.01) and being more willing toward becoming frontline nurses against COVID-19 (sure, 78.5 vs. 66.7%, P < 0.01). However, they reported worse mental states during the online learning period (worse, 65.2 vs. 56.6%, P < 0.05). There were no significant differences in changes in family economic income according to sex. With respect to the rate of nursing students who expected to go back to school, this was higher among males than females (95 vs. 87.9%, P < 0.01), but there was no significant difference between senior and junior nursing students. There were no significant differences between junior and senior nursing students in terms of their degree of satisfaction with online education, changes in body weight, and quality of life.

With regard to rural and urban nursing students, urban nursing students reported better family economic incomes (lower, 79.1 vs. 84.8%, P < 0.01) and they paid more attention to COVID-19 (always and usually, 88.6 vs. 85.3%, P < 0.05) as compared with rural nursing students; however, there were no significant differences in all other educational and living indexes.

Mental Health Outcomes

As shown in Table 2 , the median (IQR) score of IES-R for PTSD was 7 (3–14), the median (IQR) scores of DASS-21 for depression, anxiety, and stress were 0 (0–2), 0 (0–2), and 1 (0–3), respectively, and the median (IQR) score of PSQI for insomnia was 3 (2–5). As shown in Table 3 and Figure 1 , a considerable number of college nursing students ( n = 682, 44.5%) reported having symptoms of PTSD, few students reported symptoms of depression ( n = 45, 2.9%), anxiety, ( n = 44, 2.9%), and stress ( n = 17, 1.1%), whereas the number of students with insomnia ( n = 358, 22.8%) was also considerable. Among these students, only a few experienced symptoms of severe PTSD ( n = 5, 0.3%), depression ( n = 2, 0.1%), anxiety ( n = 3, 0.2%), stress ( n = 1, 0.1%), and insomnia ( n = 2, 0.1%).

Table 2 . Scores of PTSD, depression, anxiety, stress, and insomnia.

Table 3 . Severity Classifications of PTSD, depression, anxiety, stress, and insomnia symptoms.

Figure 1 . Severity classifications of post-traumatic stress disorder, depression, anxiety, stress, and insomnia in nursing students.

Moreover, the results of subgroup analysis indicated that as compared with juniors and female nursing students, senior interns and male nursing students reported higher scores of PTSD [senior 9 (3–15) vs. junior 7 (3–14), P < 0.01; male 11 (3–16) vs. female 7 (3–14), P < 0.01], depression [senior 1 (0–4) vs. junior 0 (0–2), P < 0.01; male 1 (0–5) vs. female 0 (0–2), P < 0.01], anxiety [senior 0 (0–3) vs. junior 0 (0–1), P < 0.05; male 0 (0–3) vs. female 0 (0–2), P < 0.01], and stress [senior 1 (0–5) vs. junior 0 (0–3), P < 0.01; male 1 (0–5) vs. female 0 (0–3), P < 0.01]. As compared with rural nursing students, urban nursing students also reported higher scores of PTSD [8 (3–15) vs. 7 (3–13), P < 0.05], anxiety [0 (0–2) vs. 0 (0–1), P < 0.05], stress [1 (0–4) vs. 0 (0–3), P < 0.05], and depression [0 (0–3) vs. rural 0 (0–2), P = 0.072]. Accordingly, as compared with junior, female, and rural nursing students, these senior, male, and urban nursing students had higher incidences of symptoms of PTSD (senior 50.9% vs. junior 42.3%, P < 0.01; male 54.7% vs. female 43.2%, P < 0.01; urban 48.9% vs. rural 41.1%, P < 0.01), depression (senior 5.5% vs. junior 2.0%, P < 0.01; male 6.1% vs. female 2.5%, P < 0.01; urban 4.2% vs. rural 2.0%, P < 0.05), anxiety (senior 5.5% vs. junior 1.9%, P < 0.01; male 6.6% vs. female 2.4%, P < 0.01; urban 4.1% vs. rural 2.0%, P < 0.05), and stress (senior 2.0% vs. junior 0.8%, P < 0.05; male 2.8% vs. female 0.9%, P < 0.05; urban 1.8% vs. rural 0.6%, P < 0.05). Furthermore, male nursing students had higher PSQI scores [3 (2–6) vs. 3 (2–5), P < 0.05] and rates of insomnia (31.5 vs. 23.3%, P < 0.05) when compared with female nursing students. The detailed mental health outcomes are also shown in Tables 2 , 3 .

Risk Factors for Mental Health of Nursing Students

The results of multivariable logistic regression analysis are presented in Table 4 . As compared with junior nursing students, senior nursing students (interns) had a higher risk of PTSD (OR = 1.406; 95% CI, 1.116–1.771; P = 0.004), depression (OR = 2.790; 95% CI, 1.529–5.093; P = 0.001), and anxiety (OR = 2.950; 95% CI, 1.604–5.425; P < 0.001). As compared with female nursing students, male nursing students had higher risks of PTSD (OR = 1.631; 95% CI, 1.192–2.233; P = 0.002), depression (OR = 2.676; 95% CI, 1.318–5.431; P = 0.006), anxiety (OR = 3.144; 95% CI, 1.572–6.286; P = 0.001), stress (OR = 3.352; 95% CI, 1.158–9.702; P = 0.026), and insomnia (OR = 1.478; 95% CI, 1.048–2.084; P = 0.026). As compared with rural nursing students, urban nursing students had higher risks of PTSD (OR = 1.362; 95% CI, 1.110–1.672; P = 0.003), depression (OR = 2.091; 95% CI, 1.129–3.874; P = 0.019), anxiety (OR = 2.010; 95% CI, 1.079–3.743; P = 0.028), and stress (OR = 3.031; 95% CI, 1.057–8.693; P = 0.039).

Table 4 . Logistic regression analysis for PTSD, depression, anxiety, stress, and insomnia risk factors.

In this study, we conducted a survey to evaluate the mental health condition of college nursing students amid the COVID-19 pandemic. Measurement scales including IES-R, DASS-21, and PSQI were used to assess the symptoms of PTSD, depression, anxiety and stress, and insomnia, respectively. We found that among the college nursing students, 44.5% presented with symptoms of PTSD, 2.9% with depression, 2.9% with anxiety, 1.1% with stress, and 22.8% presented with symptoms of insomnia. Fortunately, few nursing students experienced severe symptoms of PTSD (0.3%), depression (0.1%), anxiety (0.2%), stress (0.1%), and insomnia (0.1%). Additionally, as compared with junior, female, and rural nursing students, senior (interns), male, and urban nursing students had higher occurrence rates of PTSD, depression, anxiety, and stress, and male nursing students had a higher rate of insomnia. Surprisingly, the results showed that an overwhelming majority of students had a positive attitude (98.2%) about becoming frontline nurses against COVID-19 despite the high risk of contagion.

At present, there is still no definitive treatment for COVID-19, we do not know how long this will last, and the future remains unpredictable. The psychological impact of the COVID-19 pandemic is extensive and profound, as it has led to psychological symptoms such as fear, irritability, uncertainty, PTSD, depression, anxiety, stress, and insomnia among people all over the world. Lockdowns, economic losses, and the lack of masks and alcohol-based disinfectants further aggravated feelings of social isolation, loneliness, and the above negative psychological symptoms and even gave rise to delirium, self-harm, and suicide ( Ettman et al., 2020 ; Twenge and Joiner, 2020 ). A large-scale online survey showed that the rates of mental health symptoms among the general Chinese population from February 28 to March 11, 2020 showed that 27.9% had symptoms of depression, 31.6% had symptoms of anxiety, 29.2% had symptoms of insomnia, and 24.4% experienced acute stress ( Shi et al., 2020 ). Another large web-based survey conducted in the United States from June 24 to 30, 2020 indicated that 26.3, 24.3, and 25.5% of the adult respondents presented with symptoms of PTSD, depression, and anxiety, respectively, and 10.7% respondents (8.9% females and 12.6% males) had seriously considered suicide in the previous 30 days ( Czeisler et al., 2020 ).

Previous studies have indicated that healthcare workers had high levels of stress, depression, and anxiety. Furthermore, healthcare workers, especially nurses who were directly exposed to COVID-19 due to circumstances such as serving in isolation wards or emergency departments had higher levels of adverse psychiatric outcomes ( Azoulay et al., 2020 ; Lai et al., 2020 ; Si et al., 2020 ). For instance, a survey regarding the mental health of healthcare workers in China revealed that the rates of PTSD, depression, anxiety, and insomnia were 71.5, 50.4, 44.6, and 34.0%, respectively, among all the participants, whereas these values were 74.5, 53.5, 47.1, and 38.2% among nurses, respectively ( Lai et al., 2020 ). These findings were more severe than the results of this study.

Some recent studies revealed that students also experienced adverse mental symptoms after the COVID-19 outbreak, and the mental effects of COVID-19 may differ among countries and areas due to discrepancies in the COVID-19 infection and anti-epidemic conditions. First, a cross-sectional study regarding the psychological effects of the COVID-19 outbreak and lockdown among students (76.8%) and workers (23.2%) in a university in Spain which was severely affected by the COVID-19 pandemic showed that 87.5, 48.1, 35.2, and 40.3% of the respondents presented with symptoms of PTSD, depression, anxiety, and stress, respectively, with students having higher scores of depression, anxiety, and stress ( Odriozola-Gonzalez et al., 2020 ). Next, a survey conducted in Texas A&M University, USA which was also severely affected by the COVID-19 pandemic showed that 80.6 and 71.8% of respondents reported symptoms of depression and anxiety, respectively ( Wang X. et al., 2020 ). Furthermore, a survey about the impact of the COVID-19 pandemic on the mental health of home-quarantined students in Bangladesh showed that 69.3, 46.9, 33.3, and 28.5% of respondents reported having symptoms of PTSD, depression, anxiety, and stress, respectively ( Khan et al., 2020 ). Finally, a large cross-sectional survey conducted among college students in Guangdong Province, China which aimed to assess the psychological impact of the COVID-19 outbreak showed that 50.9% respondents had abnormal IES scores, 0.5% reported poor mental health, and 3.2% reported poor sleep quality ( Li X. et al., 2020 ).

As for nursing students, a recently published survey conducted from March 8 to 24, 2020 in China showed that the prevalence of anxiety, depression, and PTSD were 34.97, 40.22, and 14.97%, respectively ( Li et al., 2021 ). Additionally, a multicenter cross-sectional study conducted from April 30 to May 14, 2020 in three European countries (Spain, Greece, and Albania) indicated that 67.5% nursing students experienced mild to severe depression, and the rates of depression differed among countries (Spain, 86%; Greece, 59.5% and Albania, 58.9%) ( Patelarou et al., 2021 ). In this study, although the incidence rates of anxiety and depression were lower than that of the above studies, about half (44.5%) of the respondents reported symptoms of PTSD, whereas about a quarter (22.8%) reported symptoms of insomnia. Therefore, the psychological impact of the COVID-19 pandemic on nursing students is considerable, and special psychological guidance, support, and interventions should be implemented to assure their mental health.

Based on the above studies, we could conclude that the incidences of mental symptoms might be greater in areas with a high risk of COVID-19 or during high-risk periods. However, these results may be influenced by the use of different scales to evaluate the same symptoms. For example, depression was assessed using the Patient Health Questionnaire 9 (PHQ-9) in the above two studies; however, we used the DASS-21 to assess depression in this study.

In this study, senior and urban nursing students indicated higher levels of mental symptoms. Senior nursing students (interns) had started working under their clinical practice which required them to come into contact with all kinds of patients. As they would become clinical staff nurses soon, their feelings about the COVID-19 contagion might be more intuitive and deeper than junior nursing students which may have caused them to experience more symptoms of PTSD, depression, anxiety, and stress, even though all of them were required by the education department to study at home. In addition, their worries regarding their clinical skills and further education or employment may contribute to their higher levels of mental symptoms. Due to the dense population and convenient transportation in urban areas (about 2 h from Wuhan city to Zhengzhou city by high-speed train), the spread of COVID-19 was more severe in urban areas compared with rural areas, which may have resulted in the higher incidence of mental symptoms among urban nursing students.

Unexpectedly, compared with female nursing students, male nursing students reported higher incidences of symptoms of PTSD, depression, anxiety, and stress in this study, which was different from previous studies about healthcare workers ( Lai et al., 2020 ). Possible reasons for this inconsistency are listed as follows. First, the respondents in this study were far from the areas with a high-risk of COVID-19 and were relatively safe at home. Second, male nursing students paid more attention to the COVID-19 outbreak (always, 50.8 vs. 40.0% among females). Finally, male nursing students had higher rates of insomnia (31.5 vs. 23.3%).

As more severe mental symptoms of PTSD, depression, anxiety, and stress were found in senior, urban, and male nursing students, governments, schools, and teachers should pay more attention to students with these risk factors. More frontline or online mental health counseling and support should be provided for these students to promote their mental health. First, senior nursing students should be educated more regarding COVID-19 prevention and treatment, and governments and schools should guarantee their chances of clinical practice and employment. Second, as for junior nursing students, it is important to educate them regarding COVID-19, and strengthening their professional identity, ideals, and faith may help prevent them from experiencing more severe psychological symptoms. Third, there are fewer male nursing students in China, and even though it is easier for them to get jobs compared with female nursing students, they had poor professional feelings of self-identity, responsibility, honor, and pride; thus, they may require special attention and more relevant education. Furthermore, nursing students from urban cities which had a higher risk of COVID-19 infection require more education regarding the prevention and control of COVID-19 infection, such as maintaining social distancing, wearing masks, and hand hygiene, and the government should provide them with timely, updated, and accurate official information regarding COVID-19.

In this study, a considerable number of nursing students reported having symptoms of PTSD and insomnia, whereas few nursing students reported mental symptoms of depression, anxiety, and stress. Furthermore, senior, male, and urban nursing students may be at risk for more severe mental symptoms. As nursing students are an important reserve force against the COVID-19 pandemic, special psychological interventions should be implemented to assure their mental health.

Limitations

There were several limitations in our study. First, this study had an online cross-sectional design. Second, we only investigated the nursing students from one college in Henan Province, China, so the findings may differ among other colleges, areas, or populations such as students belonging to other disciplines. Furthermore, as fewer respondents reported symptoms of depression, anxiety, and stress, the sample may have been insufficient for the subgroup analysis. Finally, we did not assess the effects of psychiatric and physical disorders of respondents, which might affect the results. Based on the above limitations, further studies regarding the mental health of nursing students should be conducted in the future.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Author Contributions

FH, JG, and FW conceived and designed the experiments. JG wrote the original draft. JG, FW, and SG performed data collection, analysis, and interpretation. FH reviewed and edited the manuscript. All authors contributed to this study and approved the final version of the manuscript.

This study was supported by Henan Provincial Science and Technology Research Projects (Grant Nos. 182102310476 and 212102310799), Youth Foundation of The First Affiliated Hospital of Zhengzhou University (Grant No. YNQN2017109), and Medical Education Research Project of Health Commission of Henan Province (Grant No. Wjlx2020234).

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Acknowledgments

We would like to thank the teachers of Weihong Li, Tingting Qu, Xing Meng, and nursing students who participated in this study. We would also like to thank the reviewers for their insightful comments, and Editage ( www.editage.cn ) for English language editing.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.699558/full#supplementary-material

Abdulah, D. M., Mohammedsadiq, H. A., and Liamputtong, P. (2021). Experiences of nurses amidst giving care to COVID-19 patients in clinical settings in Iraqi Kurdistan: a qualitative descriptive study. J. Clin. Nurs . doi: 10.1111/jocn.15909. [Epub ahead of print].

PubMed Abstract | CrossRef Full Text | Google Scholar

Azoulay, E., Cariou, A., Bruneel, F., Demoule, A., Kouatchet, A., Reuter, D., et al. (2020). Symptoms of anxiety, depression and peritraumatic dissociation in critical care clinicians managing COVID-19 patients: a cross-sectional Study. Am. J. Respir. Crit. Care Med . 202, 1388–1398. doi: 10.1164/rccm.202006-2568OC

CrossRef Full Text | Google Scholar

Bagcchi, S. (2020). Stigma during the COVID-19 pandemic. Lancet Infect. Dis . 20:782. doi: 10.1016/S1473-3099(20)30498-9

Budd, J., Miller, B., Manning, E., Lampos, V., Zhuang, M., Edelstein, M., et al. (2020). Digital technologies in the public-health response to COVID-19. Nat. Med . 26, 1183–1192. doi: 10.1038/s41591-020-1011-4

Buysse, D. J., Reynolds, C. F. III., Monk, T. H., Berman, S. R., and Kupfer, D. J. (1989). The pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry. Res . 28, 193–213. doi: 10.1016/0165-1781(89)90047-4

Chen, L., Cai, J., Lin, Q., Xiang, B., and Ren, T. (2020). Imported COVID-19 cases pose new challenges for China. J. Infect . 80:e43–e44. doi: 10.1016/j.jinf.2020.03.048

Chen, X., and Yu, B. (2020). First two months of the 2019 Coronavirus Disease (COVID-19) epidemic in China: real-time surveillance and evaluation with a second derivative model. Glob. Health Res. Policy 5:7. doi: 10.1186/s41256-020-00137-4

Chew, N., Lee, G., Tan, B., Jing, M., Goh, Y., Ngiam, N., et al. (2020). A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav. Immun . 88, 559–565. doi: 10.1016/j.bbi.2020.04.049

Christianson, S., and Marren, J. (2012). The Impact of Event Scale - Revised (IES-R). Medsurg. Nurs . 21, 321–322. doi: 10.1007/s11800-008-0132-2

Czeisler, M., Lane, R., Petrosky, E., Wiley, J., Christensen, A., Njai, R., et al. (2020). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic–United States, June 24-30, 2020. MMWR. Morb. Mortal. Wkly. Rep . 69, 1049–1057. doi: 10.15585/mmwr.mm6932a1

Epidemiology Working Group for NCIP Epidemic Response and Chinese Center for Disease Control and Prevention (2020). The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Chin. J. Epidemiol . 41, 145–151. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003

Ettman, C., Abdalla, S., Cohen, G., Sampson, L., Vivier, P., and Galea, S. (2020). Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic. JAMA Netw. Open 3:e2019686. doi: 10.1001/jamanetworkopen.2020.19686

Firth, J., Hellewell, J., Klepac, P., Kissler, S., Kucharski, A., and Spurgin, L. (2020). Using a real-world network to model localized COVID-19 control strategies. Nat. Med . 26, 1616–1622. doi: 10.1038/s41591-020-1036-8

Hartmann, S., Rubin, Z., Sato, H., OYong, K., Terashita, D., and Balter, S. (2020). Coronavirus 2019 (COVID-19) Infections among healthcare workers, Los Angeles County, February–May 2020. Clin. Infect. Dis. ciaa1200. doi: 10.1093/cid/ciaa1200. [Epub ahead of print].

Henry, J. D., and Crawford, J. R. (2005). The short-form version of the depression anxiety stress scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br. J. Clin. Psychol . 44, 227–239. doi: 10.1348/014466505X29657

Huang, L., Lei, W., Xu, F., Liu, H., and Yu, L. (2020). Emotional responses and coping strategies in nurses and nursing students during Covid-19 outbreak: a comparative study. PLoS. ONE 15:e0237303. doi: 10.1371/journal.pone.0237303

Hughes, M., Groenewold, M., Lessem, S., Xu, K., Ussery, E., Wiegand, R., et al. (2020). Update: characteristics of health care personnel with COVID-19 - United States, February 12-July 16, 2020. MMWR Morb. Mortal. Wkly. Rep . 69, 1364–1368. doi: 10.15585/mmwr.mm6938a3

Javed, A., Lee, C., Zakaria, H., Buenaventura, R. D., Cetkovich-Bakmas, M., Duailibi, K., et al. (2021). Reducing the stigma of mental health disorders with a focus on low- and middle-income countries. Asian J. Psychiatry 58:102601. doi: 10.1016/j.ajp.2021.102601

Khan, A., Sultana, M., Hossain, S., Hasan, M., Ahmed, H., and Sikder, M. (2020). The impact of COVID-19 pandemic on mental health & wellbeing among home-quarantined Bangladeshi students: a cross-sectional pilot study. J. Affect. Disord . 277, 121–128. doi: 10.1016/j.jad.2020.07.135

Koh, D. (2020). Occupational risks for COVID-19 infection. Occup. Med. 70, 3–5. doi: 10.1093/occmed/kqaa036

Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., et al. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw. Open 3:e203976. doi: 10.1001/jamanetworkopen.2020.3976

Li, D., Zou, L., Zhang, Z., Zhang, P., Zhang, J., Fu, W., et al. (2021). The psychological effect of COVID-19 on home-quarantined nursing students in China. Front. Psychiatry 12:652296. doi: 10.3389/fpsyt.2021.652296

Li, H. Y., Cao, H., Leung, D. Y. P., and Mak, Y. W. (2020). The Psychological impacts of a COVID-19 outbreak on college students in China: a longitudinal study. Int. J. Environ. Res. Public Health 17:3933. doi: 10.3390/ijerph17113933

Li, X., Lv, S., Liu, L., Chen, R., Chen, J., Liang, S., et al. (2020). COVID-19 in Guangdong: immediate perceptions and psychological impact on 304,167 college students. Front. Psychol . 11:2024. doi: 10.3389/fpsyg.2020.02024

Lovibond, P. F., and Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav. Res. Ther . 33, 335–343. doi: 10.1016/0005-7967(94)00075-u

Lyndon, A. E., Crowe, A., Wuensch, K. L., McCammon, S. L., and Davis, K. B. (2019). College students' stigmatization of people with mental illness: familiarity, implicit person theory, and attribution. J. Ment. Health 28, 255–259. doi: 10.1080/09638237.2016.1244722

Nature (2020). Stop the Wuhan virus. Nature 577:450. doi: 10.1038/d41586-020-00153-x

PubMed Abstract | CrossRef Full Text

Odriozola-Gonzalez, P., Planchuelo-Gomez, A., Irurtia, M. J., and Luis-Garcia, R. D. (2020). Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish University. Psychiatry Res . 290:113108. doi: 10.1016/j.psychres.2020.113108

Pan, A., Liu, L., Wang, C., Guo, H., Hao, X., Wang, Q., et al. (2020). Association of public health interventions with the epidemiology of the COVID-19 outbreak in Wuhan, China. JAMA 323, 1915–1923. doi: 10.1001/jama.2020.6130

Patelarou, A., Mechili, E. A., Galanis, P., Zografakis-Sfakianakis, M., Konstantinidis, T., Saliaj, A., et al. (2021). Nursing students, mental health status during COVID-19 quarantine: evidence from three European countries. J. Ment. Health 30, 164–169. doi: 10.1080/09638237.2021.1875420

Pfefferbaum, B., and North, C. (2020). Mental health and the Covid-19 pandemic. N. Engl. J. Med . 383, 510–512. doi: 10.1056/NEJMp2008017

Ruktanonchai, N., Floyd, J., Lai, S., Ruktanonchai, C., Sadilek, A., Rente-Lourenco, P., et al. (2020). Assessing the impact of coordinated COVID-19 exit strategies across Europe. Science 369, 1465–1470. doi: 10.1126/science.abc5096

Shi, L., Lu, Z., Que, J., Huang, X., Liu, L., Ran, M., et al. (2020). Prevalence of and risk factors associated with mental health symptoms among the general population in China during the coronavirus disease 2019 pandemic. JAMA. Netw. Open 3:e2014053. doi: 10.1001/jamanetworkopen.2020.14053

Si, M., Su, X., Jiang, Y., Wang, W., Gu, X., Ma, L., et al. (2020). Psychological impact of COVID-19 on medical care workers in China. Infect. Dis. Poverty 9:113. doi: 10.1186/s40249-020-00724-0

Tang, W., Hu, T., Hu, B., Jin, C., Wang, G., Xie, C., et al. (2020). Prevalence and correlates of PTSD and depressive symptoms one month after the outbreak of the COVID-19 epidemic in a sample of home-quarantined Chinese university students. J. Affect. Disord . 274, 1–7. doi: 10.1016/j.jad.2020.05.009

The Lancet (2020a). COVID-19: protecting health-care workers. Lancet 395:922. doi: 10.1016/S0140-6736(20)30644-9

The Lancet (2020b). Emerging understandings of 2019-nCoV. Lancet 395:311. doi: 10.1016/S0140-6736(20)30186-0

Twenge, J., and Joiner, T. U. S. (2020). Census Bureau-assessed prevalence of anxiety and depressive symptoms in 2019 and during the 2020 COVID-19 pandemic. Depress. Anxiety 37, 954–956. doi: 10.1002/da.23077

Wang, C., Horby, P. W., Hayden, F. G., and Gao, G. F. (2020a). A novel coronavirus outbreak of global health concern. Lancet 395, 470–473. doi: 10.1016/S0140-6736(20)30185-9

Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., et al. (2020b). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health 17:1729. doi: 10.3390/ijerph17051729

Wang, X., Hegde, S., Son, C., Keller, B., Smith, A., and Sasangohar, F. (2020). Investigating mental health of US college students during the COVID-19 pandemic: cross-sectional survey study. J. Med. Internet Res . 22:e22817. doi: 10.2196/22817

Wang, Y., Zhao, X., Feng, Q., Liu, L., Yao, Y., and Shi, J. (2020). Psychological assistance during the coronavirus disease 2019 outbreak in China. J. Health Psychol . 25, 733–737. doi: 10.1177/1359105320919177

World Health Organization (2020). Pneumonia of Unknown Cause – China. World Health Organization . Available online at: https://www.who.int/emergencies/disease-outbreak-news/item/2020-DON229

PubMed Abstract

World Health Organization (2021). Novel Coronavirus (COVID-19) Situation . Available online at: https://covid19.who.int/ (accessed June 4, 2021).

Xiao, H., Zhang, Y., Kong, D., Li, S., and Yang, N. (2020). The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Med. Sci. Monit . 26:e923549. doi: 10.12659/MSM.923549

Ye, W., Ye, X., Liu, Y., Liu, Q., Vafaei, S., Gao, Y., et al. (2020). Effect of the novel coronavirus pneumonia pandemic on medical students' psychological stress and its influencing factors. Front. Psychol . 11:548506. doi: 10.3389/fpsyg.2020.548506

Yohannes, A., Dryden, S., and Hanania, N. (2019). Validity and responsiveness of the depression anxiety stress scales-21 (DASS-21) in COPD. Chest 155, 1166–1177. doi: 10.1016/j.chest.2018.12.010

Zhang, Y., Zhang, H., Ma, X., and Di, Q. (2020). Mental health problems during the COVID-19 pandemics and the mitigation effects of exercise: a longitudinal study of college students in China. Int. J. Environ. Res. Public Health 17:3722. doi: 10.3390/ijerph17103722

Keywords: mental health, PTSD, depression, anxiety, stress, nursing students, COVID-19

Citation: Gao J, Wang F, Guo S and Hu F (2021) Mental Health of Nursing Students amid Coronavirus Disease 2019 Pandemic. Front. Psychol. 12:699558. doi: 10.3389/fpsyg.2021.699558

Received: 23 April 2021; Accepted: 12 July 2021; Published: 12 August 2021.

Reviewed by:

Copyright © 2021 Gao, Wang, Guo and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Fudong Hu, hufudong2005@126.com

† These authors have contributed equally to this work and share first authorship

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Research Topics & Ideas: Nursing

50+ Nursing Research Topic Ideas To Fast-Track Your Project

Finding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you’ve landed on this post, chances are you’re looking for a nursing-related research topic , but aren’t sure where to start. Here, we’ll explore a variety of nursing-related research ideas and topic thought-starters, including general nursing, medical-surgical nursing, pediatric nursing, obstetrics and gynaecological nursing, ICU and mental health nursing.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the nursing domain. This is the starting point, but to develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. In it, we cover the process of writing a dissertation or thesis from start to end. Be sure to also sign up for our free webinar that explores how to find a high-quality research topic. 

Overview: Nursing Research Topics

• General nursing-related topics
• Medical-surgical nursing
• Pediatric nursing
• Obstetrics and gynaecological nursing
• ICU nursing
• Mental health nursing

General Nursing Research Topics & Ideas

• The impact of cultural competence on patient care in the UK
• The importance of evidence-based practice in nursing for patients with HIV/AIDS
• The effects of workplace stress on nurse well-being and performance
• The role of nurse-patient communication for patients transitioning from adolescent to adult care
• The impact of technology on nursing practice and patient outcomes
• The importance of interdisciplinary collaboration in healthcare for the rehabilitation of patients post-surgery
• The effects of fatigue on nurse performance in the emergency room
• The impact of nurse staffing levels on patient outcomes in rural areas
• The effectiveness of nurse-led interventions in managing chronic conditions: a case study of diabetes
• The impact of patient-centred care on health outcomes for the elderly
• The importance of patient safety in nursing: bedside nurse vigilance
• The effects of empathy and compassion in critical care nursing
• The role of nursing in disaster preparedness and response: a case study of the Haiti earthquake of 2021
• The impact of the level of nursing education on patient outcomes
• The importance of ethical considerations in frail care nursing practice

Topics & Ideas: Medical-Surgical Nursing

• The impact of bedside care on patient outcomes in medical-surgical units
• The role of the nurse in managing post-operative patient pain
• The effects of nurse-patient ratios on patient outcomes in medical-surgical units
• A systematic review of different approaches to patient education in medical-surgical units
• The relationship between nurse-patient communication and patient satisfaction in medical-surgical units: perspectives and recommendations to improving patient satisfaction

Topics & Ideas: Pediatrics Nursing

• The impact of family-centered care on pediatric patient outcomes with sickle cell anemia
• The role of nursing interventions in promoting developmental and behavioral health in pediatric patients
• The effects of play therapy on anxiety and pain in pediatric patients during hospitilisation
• A systematic review of different approaches to pain management in pediatric cancer patients
• The relationship between parent involvement and post-operative patient outcomes in pediatric units

Ideas: Obstetrics and Gynecological Nursing

• The impact of nurse-led prenatal care on maternal and fetal outcomes in African American communities
• The role of the nurse in promoting sexual and reproductive health for women in the UK
• The effects of midwifery care on maternal satisfaction of primiparous women and birth outcomes
• A comparative study of different approaches to childbirth education for expectant mothers and partners: perceptions of control
• The relationship between lactation support and breastfeeding success of primiparous women

Topics & Ideas: ICU Nursing

• The impact of nursing interventions on patient outcomes in intensive care units in a developing country
• The role of the nurse in managing palliative and end-of-life care in the ICU
• The effects of family presence on patient outcomes and satisfaction in the ICU: A systematic review of the literature
• A comparative study of different approaches to pain management for trauma patients in the ICU
• The relationship between nurse-patient communication and geriatric patient outcomes in ICU

Topics & Ideas: Mental Health Nursing

• The impact of nurse-led therapy on adolescent patient outcomes in mental health settings
• The role of the nurse in promoting recovery and resiliency in mental health patients through group interventions
• The effects of mindfulness-based interventions on stress and anxiety in mental health patients: A systematic literature review
• A comparative study of the role of nurses in applying different approaches to patient education in mental health settings
• The association between nurse-patient therapeutic alliance and patient outcomes in mental health settings

Nursing Dissertation & Theses

While the ideas we’ve presented above are a decent starting point for finding a nursing-related research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various nursing-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

• Nursing Workload and Interventions of Licensed Nurses in Nursing Homes: An Observational Time and Motion Study (Kang, 2021)
• Missed Nursing Care: Accounting for Education, Experience, and Job Satisfaction in Registered Nurses (Bechard, 2021)
• Examining Predictors of Attitudes and Knowledge of Registered Nurses and Nursing Students in Tennessee toward Pregnant and Perinatal Women with a Substance Use Disorder (Patrylo, 2021)
• A Program Evaluation of the Organizational Readiness for Pathway to Excellence at Two Community Hospitals  (Behling, 2021)
• The Impact of Covid-19 Pandemic Policy Decisions on the Wellbeing of Nursing Home Residents in Missouri (White, 2022)
• Battling A Parallel Pandemic: An Evaluation of Sustainable System-Level Nursing Support in Response To COVID-19 (Gifford, 2022)
• Holistic Nursing Process Maps: a Tool for Student Nurses to Operationalize the Nursing Process to Increase Clinical Reasoning (Reyes, 2022)
• Satisfaction and Work-Life Balance in Undergraduate Nursing Faculty: A Mixed-Methods Study (Crawford, 2021)
• The Effect of Mindfulness Meditation on the Stress, Anxiety, Mindfulness, and Self-Compassion Levels of Nursing Students (Heinrich, 2022)
• Effectiveness of Simulation-Based Case Studies in Undergraduate Nursing Students (Becnel, 2022)
• A Telehealth Simulation Experiment: Exploring Prebriefing (Owen, 2022)
• Perceptions of Lateral Violence Among Vocational Nursing Students, Associate Degree Nursing Students, and Bachelor’s Degree Nursing Students (Martha, 2022)
• Nurse Educators’ Description of Ethics from a Disciplinary Perspective: A Qualitative Descriptive Research Study (Cuchetti, 2022)
• A Literature Review of the Relationship Between Oral Health and Pneumonia Risk in the Geriatric Nursing Home Population (Swift, 2021)

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. This is an important thing to keep in mind as you develop your own research topic. That is to say, to create a top-notch research topic, you must be precise and target a specific context with specific variables of interest . In other words, you need to identify a clear, well-justified research gap.

Get 1-On-1 Help

If you’re still feeling a bit unsure about how to find a research topic for your nursing dissertation, thesis or research project, check out our private coaching services below.

You Might Also Like:

To learn from the GRAD Coach is a lofty goal for me. I am unable to express my gratitude for your teaching style. I need assistance with my thesis as a master’s in nursing candidate. Please assist me.

Submit a Comment Cancel reply

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

• Print Friendly

• How it works

Useful Links

How much will your dissertation cost?

Have an expert academic write your dissertation paper!

Dissertation Services

Get unlimited topic ideas and a dissertation plan for just £45.00

Order topics and plan

Get 1 free topic in your area of study with aim and justification

Yes I want the free topic

Mental Health Nursing Dissertation Topics

Published by Owen Ingram at January 3rd, 2023 , Revised On August 16, 2023

Are you passionate about helping others, especially those facing mental health challenges? If this is the case for you, then mental health nursing is a career choice you may want to pursue.

It can be challenging to work in the field of mental health nursing. The final year of the nursing undergraduate programme can be especially stressful because it involves completing a dissertation paper on a unique and interesting topic . Get a better understanding of mental health nursing, how it works, and how it can improve healthcare!

Similarly, Masters and PhD students of nursing and medicine must complete a research proposal and a thesis paper on a topic that really adds value to the research areas.

What Is Mental Health Nursing?

Nursing in mental health focuses on preventing, treating, and rehabilitating behavioural, emotional, and mental disorders. Nursing professionals work with patients to improve their emotional well-being by overcoming mental stress. Patients with mental illness or disorders are also guided throughout their recovery.

There are many different types of mental health nurses who work in hospitals, clinics, private practices, and residential facilities. As part of their responsibilities, they assess symptoms, administer medications, provide supportive care, collaborate with family members, and educate others about mental illness. Their treatment plans also involve psychologists, psychiatrists, social workers, and other professionals.

Taking care of your patient’s mental health and making a difference in their lives is your responsibility as a mental health nurse.

Related Links

• Evidence-based Practice Nursing Dissertation Topics
• Child Health Nursing Dissertation Topics
• Adult Nursing Dissertation Topics
• Critical Care Nursing Dissertation Topics
• Dementia Nursing Dissertation Topics
• Midwifery Dissertation Topics
• Palliative Care Nursing Dissertation Topics
• Nursing Dissertation Topics
• Coronavirus (COVID-19) Nursing Dissertation Topics

Topic-1: Cognitive and emotional well-being

Research Aim: Finding out different ways to improve the cognitive and emotional well-being of people to solve the common mental health problems in the surrounding.

Topic-2: Eliminating mental illnesses

Research Aim: Encouraging better mental health by diagnosing the symptoms of mental health issues in the early stage to prevent severe circumstances later.

Topic-3: Providing specialized treatments

Research Aim: From anxiety, depression, and disorders to other mental health complexities, providing solutions to all types of mental health disorders, including pre-traumatic and post-traumatic issues.

Topic-4: Bipolar disorder

Research Aim: Explaining the symptoms, treatments, and procedures to soothe the common and impulsive mental health issues with solid behavior modification treatments.

Topic-5: Borderline personality disorder

Research Aim: Understanding the common borderline personality disorders and their effects on the mental health condition of different patients. Also, studying the unstable relationships with friends, family, and other associations and ways to improve it.

Topic-6: Dissociative disorders

Research Aim: Reviewing all the common causes of dissociative disorders and the primary care management to assess and intervene in different causes of the problem.

Topic-7: Disruptive and impulse-control disorders

Research Aim: Studying all the disruptive and impulsive-control disorders and their impact on the intermittent explosive condition and anti-social behavior of a person.

Topic-8: Attention deficit hyperactivity disorder

Research Aim: A brief overview of ADHD to control the attention span of a person through different effective techniques and procedures.

Topic-9: Psychosocial mental health nursing

Research Aim: Studying theories to understand human nature better and the process of normal development based on their physical and mental health.

Topic-10: Mental health and psychiatric nursing

Research Aim: Exploring different types of mental illnesses and their treatments used to soothe the hyperactive condition of the patient.

Topic-11: Mental health educating

Research Aim: Educating everyone about the basic mental health problems and preventive measures to administer the condition of patients and to meet their varying mental health needs.

Topic-12: Providing different levels and quality of care to every patient

Research Aim: Studying the needs of every patient and providing care to solve different mental illnesses in a variety of ways helps tackle the problem calmly.

Topic-13: National and local mental health programs

Research Aim: Introducing different national and local mental health programs. Explaining their role in spreading awareness on the importance of mental health for individuals from different backgrounds.

Topic-14: Mental health checkups

Research Aim: Conveying the need for mental health checkups for individuals of all ages suffering from anxiety, stress, frustration, and other mental health issues.

Topic-15: Schizophrenia

Research Aim: Understanding the feelings of a patient suffering from schizophrenia and identifying its symptoms to curate the best and proper treatment for the stress cause.

Topic-16: Suicide prevention

Research Aim: Spreading awareness on suicide prevention, especially for young and adults with the help of telephone and physical counselling. Finding the causes of suicide in professional spaces to get rid of the suicidal thoughts as early as possible.

I/O Example

The number of people encountering poor mental health and related issues in their day-to-day lives is increasing, making mental health nursing a growing field in the healthcare industry. Those who are willing to work hard, be creative, and take risks in handling such patients can find many opportunities in this field.

Nurses in mental health are required to hold a bachelor’s degree, preferably a master’s degree. They also obtain additional training on dealing with people suffering from depression and different anxiety disorders.

According to the Bureau of Labor Statistics, mental health nurses’ demand will grow by 15% between 2014 and 2024. The need for nurses who specialize in this field will increase because of this growth rate.

Like other nursing jobs, mental health nursing pay depends on experience and education. The average salary for this career is $91,298 per year. According to a survey, salaries for mental health nurses can range from $71,485 to $129,837 per year, depending on their experience and education level.

There are still many challenges and rewards associated with a career in mental health nursing. Bringing peace to the lives of diverse people is a major part of the job. A flood of opportunities is always flowing your way as the field is constantly evolving. Take some time to research all of the nursing degree programs available before you make a decision.

Free Dissertation Topic

Phone Number

Academic Level Select Academic Level Undergraduate Graduate PHD

Academic Subject

Area of Research

Frequently Asked Questions

How to find mental health nursing dissertation topics.

For mental health nursing dissertation topics:

• Research recent issues in mental health care.
• Explore treatment approaches or therapies.
• Examine stigma and advocacy.
• Focus on specific populations or disorders.
• Consult professionals for insights.
• Select a topic that resonates with you and contributes to the field.

You May Also Like

Here is a list of Linguistic dissertation topics to help you choose the one studies any one as per your requirements.

Auditing dissertation study provides professionals and students with a variety of chances to improve quality in healthcare and commercial organizations.

If you are looking for a dissertation topic, you can find one here. We have listed some of the best dissertation topics on graphic design. Choose one and get started immediately!

USEFUL LINKS

LEARNING RESOURCES

COMPANY DETAILS

• How It Works

• 1.866.411.2159
• Online Master’s Degrees Overview
• Master’s in Applied Behavior Analysis
• Online Master of Science in Product Management
• Online Master of Science in Nursing
• Online Master of Social Work
• Online Doctoral Degrees Overview
• Online BSN to Doctor of Nursing Practice
• Online MSN to Doctor of Nursing Practice
• Online Certificate Programs Overview
• Online ABA Certificate
• Online Introduction to Product Management Certificate
• Online Nursing Certificate Programs
• About Regis College
• Corporate Partners Tuition Discount
• Federal Employee Program
• Military & Veterans Tuition Discount Program
• Faculty Directory

Evidence-Based Practice in Nursing for Mental Health Nurses

March 8, 2023

View all blog posts under Articles | View all blog posts under Doctor of Nursing Practice | View all blog posts under Master of Science in Nursing

The nursing profession has long taken the lead in practicing evidence-based care. Evidence-based care relies on nurses’ clinical expertise, critical thinking, and research knowledge. Nurses use this skill set to support patient care decisions and as a lens through which to view patient outcomes.

Evidence-based practice in nursing may be even more crucial for mental health nurse practitioners . Mental and behavioral health disorders are complex, as patients may suffer from two or more diagnoses. Additionally, patients may be homeless or incarcerated, making treatment even more difficult.

An advanced degree program that supplies a rigorous background in evidence-based practice is essential for any nurse planning a career in mental and behavioral health.

What Are Evidence-Based Mental Health Services?

Evidence-based mental health services recognize that patients don’t just need therapeutic care; they may also suffer from loss of housing and income, among other basic needs. They may live in high-crime areas and are more likely to be incarcerated. Evidence-based mental health services often combine psychiatric and therapeutic treatment with services that include helping patients find housing, employment, and other support.

The following are some examples of evidence-based practices and treatments supported by SAMHSA. Mental health nurses engaged in evidence-based nursing practice may employ these treatments to support individuals dealing with mental and behavioral health issues.

Assertive Community Treatment (ACT)

Assertive community treatment seeks to provide behavioral health services in the community setting. The framework serves conditions such as schizophrenia, bipolar disorder, and depression. ACT services seek to maintain outpatient treatments and ensure regular, ongoing therapies.

Using the framework, various health care practitioners provide services such as assistance with activities of daily living (ADL), help managing family responsibilities, and support in securing important needs such as food and housing.

Integrated Treatment for Co-Occurring Disorders

Integrated treatment delivers dual treatments for patients diagnosed with behavioral health and substance abuse disorders. By combining the two services, patients usually have a better chance of making a full, long-term recovery.

Practitioners provide patients with services and resources such as case management, outreach, housing, and employment assistance. The framework aids the high-risk dual diagnoses population, who are more likely to relapse and resume substance use, suffer from poor health, or face homelessness.

 Illness Management and Recovery (IMR)

Illness management and recovery is an evidence-based psychiatric treatment framework for patients with a severe mental illness, such as schizophrenia. It’s designed to allow patients to participate actively in their own recoveries. During ongoing weekly sessions, behavioral health practitioners help patients develop treatment plans and identify goals. This may encompass teaching recovery methodologies, behavioral health facts, and stress management techniques.

Practitioners also teach patients how to build and maintain social support networks, reduce the chances of resuming drug use, and use prescribed medications effectively. The teaching techniques of this framework might also include cognitive behavioral therapy and motivational sessions.

Permanent Supportive Housing

Homelessness is a complex challenge in treating people with mental health and substance use disorders. Not only can homelessness worsen a patient’s mental health condition, but it also makes them physically vulnerable to violence, disease, and incarceration. According to SAMHSA, the longer a person experiences homelessness, the harder it is to get them the treatment they need. The agency recommends moving people to permanent housing, with additional support services including therapy, treatment, financial support, and training services, without requiring transitional steps such as getting sober first.

Screening for Postpartum Depression

A study in BMC Psychiatry found nearly 20% of mothers experience postpartum depression, which can impact the health of the mother and the child. Screening and treating pregnant mothers for perinatal depression (depression during pregnancy) can help reduce instances of postpartum depression and in some cases improve the physical and mental health of babies.

Additional Treatments for Mental and Behavioral Health

Many mental health treatment practices are evidence-based and numerous studies have reinforced their effectiveness. Some of the most common evidence-based techniques for treating mental health, behavioral health, and substance use include:

• Cognitive behavioral therapy (CBT) , helps patients change patterns of behavior.
• Dialectical behavior therapy (DBT) , is based on CBT practices, while also focusing on emotion regulation and mindfulness, among other techniques. It is shown to be effective in treating various mental health disorders.
• Motivational interviewing , uses open questions, affirmations, reflection, and summarizing to help people overcome substance use disorders.

Some therapies are not considered evidence-based, even though they may be popular and effective, such as:

• 12-step programs : Alcoholics Anonymous (AA) pioneered the 12-step process. Some aspects of 12-step programs can be very effective in helping individuals deal with substance use.
• Talk therapy : A traditional form of therapy, talk therapy is widely used on its own and in conjunction with other treatments.

The Role of Doctors of Nursing Practice (DNPs) in Evidence-Based Practice

In the United States, more Doctor of Nursing Practice (DNP) programs are emerging to fill the anticipated shortage of health care talent. The nation needs these professionals to fill the service gaps faced by underserved populations in settings such as rural communities, schools, prisons, and urgent care facilities.

DNP-educated nurses are well-positioned to bring the evidence-based nursing practice to the communities they serve. With their background in research and clinical practice, they can lead the establishment of evidence-based plans and criteria at hospitals, clinics, and government agencies.

Become a Leader in Evidence-Based Nursing

Are you eager to become a leader in the field of mental health nursing? The Regis College online MSN to Doctor of Nursing Practice program offers an excellent foundation in evidence-based nursing practice, equipping you with the tools to embrace the exciting challenges of delivering best-in-class mental and behavioral health services. The curriculum includes classes in advanced research, informatics and statistics, cultural perspectives in health care, and more. Explore your options and take your first steps to make a difference in nursing.

Recommended Reading

What Is a Psychiatric Mental Health Nurse Practitioner?

How Nurse Practitioners Can Become Community Advocates

10 Best Practices to Promote Cultural Awareness in the Nursing Profession

Behavioral Health Resources, “PACT: Program for Assertive Community Treatment”

BMC Psychiatry , “Screening Programs for Common Maternal Mental Health Disorders Among Perinatal Women: Report of the Systematic Review of Evidence”

Frontiers in Psychiatry, “Effects of Illness Management and Recovery: A Multicenter Randomized Controlled Trial”

Psychology Today , “From Evidence-Based Practice to Practice-Based Evidence”

THERAPlatform, “ Evidence-Based Practices for Mental Health”

Substance Abuse and Mental Health Services Administration, “ About the Evidence-Based Practices Resource Center”

Substance Abuse and Mental Health Services Administration, “The Case for Screening and Treatment of Co-Occurring Disorders”

Substance Abuse and Mental Health Services Administration. “Homelessness Resources: Housing and Shelter”

U.S. Department of Health & Human Services, “Mental Health Myths and Facts”

Let’s move forward

Wherever you are in your career and wherever you want to be, look to Regis for a direct path, no matter your education level. Fill out the form to learn more about our program options or get started on your application today.

Transforming the understanding and treatment of mental illnesses.

Información en español

Celebrating 75 Years! Learn More >>

• Science News
• Meetings and Events
• Social Media
• Press Resources
• Email Updates
• Innovation Speaker Series

Workshop: Neurofeedback Intervention Development: Opportunities and Challenges

Date and time.

This workshop will convene researchers and federal officials to review the state of the science for neurofeedback (NF) intervention development for mental disorders, with an emphasis on real time fMRI approaches. The program will highlight recent developments in both early treatment development and later efficacy and effectiveness trials, as well as regulatory issues relevant to the approval and implementation of device-based interventions like NF. Panel presentations and discussion will aid in identifying new opportunities and challenges for NF development. The workshop is free and open to the scientific community and the public.

Sponsored by

National Institute of Mental Health, Division of Translational Research (DTR) .

Registration

This workshop is free, but registration is required.  

If you have questions about this workshop or need reasonable accommodations, please email Chris Sarampote . Requests need to be made five business days before the event.

• See us on facebook
• See us on twitter
• See us on youtube
• See us on linkedin
• See us on instagram

Two key brain systems are central to psychosis, Stanford Medicine-led study finds

When the brain has trouble filtering incoming information and predicting what’s likely to happen, psychosis can result, Stanford Medicine-led research shows.

April 11, 2024 - By Erin Digitale

People with psychosis have trouble filtering relevant information (mesh funnel) and predicting rewarding events (broken crystal ball), creating a complex inner world. Emily Moskal

Inside the brains of people with psychosis, two key systems are malfunctioning: a “filter” that directs attention toward important external events and internal thoughts, and a “predictor” composed of pathways that anticipate rewards.

Dysfunction of these systems makes it difficult to know what’s real, manifesting as hallucinations and delusions. 

The findings come from a Stanford Medicine-led study , published April 11 in  Molecular Psychiatry , that used brain scan data from children, teens and young adults with psychosis. The results confirm an existing theory of how breaks with reality occur.

“This work provides a good model for understanding the development and progression of schizophrenia, which is a challenging problem,” said lead author  Kaustubh Supekar , PhD, clinical associate professor of psychiatry and behavioral sciences.

The findings, observed in individuals with a rare genetic disease called 22q11.2 deletion syndrome who experience psychosis as well as in those with psychosis of unknown origin, advance scientists’ understanding of the underlying brain mechanisms and theoretical frameworks related to psychosis.

During psychosis, patients experience hallucinations, such as hearing voices, and hold delusional beliefs, such as thinking that people who are not real exist. Psychosis can occur on its own and isa hallmark of certain serious mental illnesses, including bipolar disorder and schizophrenia. Schizophrenia is also characterized by social withdrawal, disorganized thinking and speech, and a reduction in energy and motivation.

It is challenging to study how schizophrenia begins in the brain. The condition usually emerges in teens or young adults, most of whom soon begin taking antipsychotic medications to ease their symptoms. When researchers analyze brain scans from people with established schizophrenia, they cannot distinguish the effects of the disease from the effects of the medications. They also do not know how schizophrenia changes the brain as the disease progresses. 

To get an early view of the disease process, the Stanford Medicine team studied young people aged 6 to 39 with 22q11.2 deletion syndrome, a genetic condition with a 30% risk for psychosis, schizophrenia or both. 

Kaustubh Supekar

Brain function in 22q11.2 patients who have psychosis is similar to that in people with psychosis of unknown origin, they found. And these brain patterns matched what the researchers had previously theorized was generating psychosis symptoms.

“The brain patterns we identified support our theoretical models of how cognitive control systems malfunction in psychosis,” said senior study author  Vinod Menon , PhD, the Rachael L. and Walter F. Nichols, MD, Professor; a professor of psychiatry and behavioral sciences; and director of the  Stanford Cognitive and Systems Neuroscience Laboratory .

Thoughts that are not linked to reality can capture the brain’s cognitive control networks, he said. “This process derails the normal functioning of cognitive control, allowing intrusive thoughts to dominate, culminating in symptoms we recognize as psychosis.”

Cerebral sorting  

Normally, the brain’s cognitive filtering system — aka the salience network — works behind the scenes to selectively direct our attention to important internal thoughts and external events. With its help, we can dismiss irrational thoughts and unimportant events and focus on what’s real and meaningful to us, such as paying attention to traffic so we avoid a collision.

The ventral striatum, a small brain region, and associated brain pathways driven by dopamine, play an important role in predicting what will be rewarding or important. 

For the study, the researchers assembled as much functional MRI brain-scan data as possible from young people with 22q11.2 deletion syndrome, totaling 101 individuals scanned at three different universities. (The study also included brain scans from several comparison groups without 22q11.2 deletion syndrome: 120 people with early idiopathic psychosis, 101 people with autism, 123 with attention deficit/hyperactivity disorder and 411 healthy controls.) 

The genetic condition, characterized by deletion of part of the 22nd chromosome, affects 1 in every 2,000 to 4,000 people. In addition to the 30% risk of schizophrenia or psychosis, people with the syndrome can also have autism or attention deficit hyperactivity disorder, which is why these conditions were included in the comparison groups.

The researchers used a type of machine learning algorithm called a spatiotemporal deep neural network to characterize patterns of brain function in all patients with 22q11.2 deletion syndrome compared with healthy subjects. With a cohort of patients whose brains were scanned at the University of California, Los Angeles, they developed an algorithmic model that distinguished brain scans from people with 22q11.2 deletion syndrome versus those without it. The model predicted the syndrome with greater than 94% accuracy. They validated the model in additional groups of people with or without the genetic syndrome who had received brain scans at UC Davis and Pontificia Universidad Católica de Chile, showing that in these independent groups, the model sorted brain scans with 84% to 90% accuracy.

The researchers then used the model to investigate which brain features play the biggest role in psychosis. Prior studies of psychosis had not given consistent results, likely because their sample sizes were too small. 

Vinod Menon

Comparing brain scans from 22q11.2 deletion syndrome patients who had and did not have psychosis, the researchers showed that the brain areas contributing most to psychosis are the anterior insula (a key part of the salience network or “filter”) and the ventral striatum (the “reward predictor”); this was true for different cohorts of patients.

In comparing the brain features of people with 22q11.2 deletion syndrome and psychosis against people with psychosis of unknown origin, the model found significant overlap, indicating that these brain features are characteristic of psychosis in general.

A second mathematical model, trained to distinguish all subjects with 22q11.2 deletion syndrome and psychosis from those who have the genetic syndrome but without psychosis, selected brain scans from people with idiopathic psychosis with 77.5% accuracy, again supporting the idea that the brain’s filtering and predicting centers are key to psychosis.

Furthermore, this model was specific to psychosis: It could not classify people with idiopathic autism or ADHD.

“It was quite exciting to trace our steps back to our initial question — ‘What are the dysfunctional brain systems in schizophrenia?’ — and to discover similar patterns in this context,” Menon said. “At the neural level, the characteristics differentiating individuals with psychosis in 22q11.2 deletion syndrome are mirroring the pathways we’ve pinpointed in schizophrenia. This parallel reinforces our understanding of psychosis as a condition with identifiable and consistent brain signatures.” However, these brain signatures were not seen in people with the genetic syndrome but no psychosis, holding clues to future directions for research, he added.

Applications for treatment or prevention

In addition to supporting the scientists’ theory about how psychosis occurs, the findings have implications for understanding the condition — and possibly preventing it.

“One of my goals is to prevent or delay development of schizophrenia,” Supekar said. The fact that the new findings are consistent with the team’s prior research on which brain centers contribute most to schizophrenia in adults suggests there may be a way to prevent it, he said. “In schizophrenia, by the time of diagnosis, a lot of damage has already occurred in the brain, and it can be very difficult to change the course of the disease.”

“What we saw is that, early on, functional interactions among brain regions within the same brain systems are abnormal,” he added. “The abnormalities do not start when you are in your 20s; they are evident even when you are 7 or 8.”

Our discoveries underscore the importance of approaching people with psychosis with compassion.

The researchers plan to use existing treatments, such as transcranial magnetic stimulation or focused ultrasound, targeted at these brain centers in young people at risk of psychosis, such as those with 22q11.2 deletion syndrome or with two parents who have schizophrenia, to see if they prevent or delay the onset of the condition or lessen symptoms once they appear. 

The results also suggest that using functional MRI to monitor brain activity at the key centers could help scientists investigate how existing antipsychotic medications are working. 

Although it’s still puzzling why someone becomes untethered from reality — given how risky it seems for one’s well-being — the “how” is now understandable, Supekar said. “From a mechanistic point of view, it makes sense,” he said.

“Our discoveries underscore the importance of approaching people with psychosis with compassion,” Menon said, adding that his team hopes their work not only advances scientific understanding but also inspires a cultural shift toward empathy and support for those experiencing psychosis. 

“I recently had the privilege of engaging with individuals from our department’s early psychosis treatment group,” he said. “Their message was a clear and powerful: ‘We share more similarities than differences. Like anyone, we experience our own highs and lows.’ Their words were a heartfelt appeal for greater empathy and understanding toward those living with this condition. It was a call to view psychosis through a lens of empathy and solidarity.”

Researchers contributed to the study from UCLA, Clinica Alemana Universidad del Desarrollo, Pontificia Universidad Católica de Chile, the University of Oxford and UC Davis.

The study was funded by the Stanford Maternal and Child Health Research Institute’s Uytengsu-Hamilton 22q11 Neuropsychiatry Research Program, FONDEYCT (the National Fund for Scientific and Technological Development of the government of Chile), ANID-Chile (the Chilean National Agency for Research and Development) and the U.S. National Institutes of Health (grants AG072114, MH121069, MH085953 and MH101779).

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu .

Artificial intelligence

Exploring ways AI is applied to health care

Nurse's Research Highlights Importance of Maternal Wellness

by Carolina Zimbron

Mental health is a significant issue in America. One rural Ohio mom is using her research to help others through various mental health struggles. 

Dr. Marcia Williams , assistant professor of nursing at Cedarville University, presented her research on the importance of postpartum maternal mental health at the Eastern Nursing Research conference in Boston, Massachusetts on Friday, April 5. 

Seeking to fill the resource void on postpartum mental health, Williams began a yearlong mixed method study that looked at the type of mental health care women prefer postpartum and the stigma that comes from depression during their pregnancy.  

“What I found in my research is that women have significant health care barriers during their pregnancies,” Williams said. “The greatest barrier is a lack of childcare during medical appointments, but I also learned the women prefer to care for any mental health issues in an informal process using a self-care approach.” 

From the beginning of her research, Williams was concerned about the effects untreated mild or moderate perinatal depression can have on women and their families. 

“I was a labor and delivery nurse and one of the big things that I learned from taking care of moms was that maternal mental health doesn’t only affect the mother, it also affects the child,” Williams said. “The months following birth are when bonding occurs between mom and the child, so if the mom is not feeling well, that bond can be disrupted, as well as the care to her family.”  

From her research and experience as a nurse, Williams understands that moms are foundational to their families. Therefore, caring for the health and mental health of moms is essential for the family unit. Williams has devoted her professional life to health care and recently completed her doctoral degree in nursing from the University of Utah. Her undergraduate degree in nursing and master’s degree in nursing -  family nurse practitioner , were earned at Cedarville University. 

Her love for Cedarville University and its mission is the reason Williams has devoted her professional career to teaching Cedarville students and working in the Dayton region.  

"Cedarville taught me how to be a nurse and to view medical care from a biblical perspective, so teaching from this perspective and preparing our future nurses is important to me.”

- Dr. Marcia Williams

Not only has her research helped Ohio moms, but her preparation for this conference has also helped her teach students how to prepare this kind of presentation. “Right now, I am teaching them how to create their own research posters, which they will be presenting soon at Cedarville's annual Scholar Symposium,” Williams said. 

Williams is excited to use her newly developed skills as a researcher in the classroom. “I want to equip students with the ability to practice with excellence, teach with confidence and improve care through research,” she said. 

Located in southwest Ohio,  Cedarville University  is a Baptist university with  undergraduate  programs in arts, sciences, and professional programs, and  graduate  programs. With an enrollment of 5,456 students in 175 areas of study, Cedarville is one of the largest private universities in Ohio and is recognized nationally for its authentic Christian community, rigorous academic programs, and high graduation and retention rates. For more information about the University, visit  cedarville.edu . 

Share This Article

Interested in cedarville, are you looking for an expert.

Cedarville University is known throughout the country for its faculty experts who speak into national and international topics. You can find the expert you are seeking by searching our "Media Experts Guide" for detailed profiles and contact information.

Media Experts Guide »

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Wiley - PMC COVID-19 Collection

Analysis of mental health effects among nurses working during the COVID ‐19 pandemic: A systematic review

Cristina garcía‐vivar.

1 Department of Health Sciences, Public University of Navarre (UPNA), Pamplona Spain

2 IdiSNA, Navarra Institute for Health Research, Pamplona Spain

Irati Rodríguez‐Matesanz

3 Primary Care Research Group, BioDonostia Health Research Institute, IIS Biodonostia, Donostia – San Sebastián Spain

Leticia San Martín‐Rodríguez

Nelia soto‐ruiz, marta ferraz‐torres, paula escalada‐hernández, associated data.

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

Accessible Summary

What is known on the subject.

• Working on the frontline during the pandemic has had a negative impact on the mental health of health professionals. A significant proportion experienced anxiety, insomnia, posttraumatic stress or depression.

What the paper adds to existing knowledge?

• Analysis and synthesis of the evidence of the impact of the COVID‐19 pandemic on the mental health of nurses based on their work context. There exists a gap in the literature as no studies were found that analysed the effects on nurses' mental health according to the level of care they worked in (hospital–primary care–nursing home).

What are the implications for practice?

• There is an urgent need to assess and respond to the impact of COVID‐19 on the physical and mental well‐being of nurses, and to monitor international policies for the improvement of nurses' working conditions.

Introduction

Health professionals have suffered negative consequences during the COVID‐19 pandemic. No review has specifically addressed the impact of the pandemic on the mental health of nurses exclusively according to the work context.

To analyse the impact of the COVID‐19 pandemic on the mental health of nurses who have worked in hospitals, primary care centres and social health centres.

PubMed, CINAHL, PsychINFO and Cochrane databases were searched (Prospero number: CRD42021249513). Out of 706 papers, 31 studies (2020–2021) were included in the systematic review. A qualitative synthesis method was used to analyse the data.

Most studies were conducted in hospitals or frontline settings. The prevalence of moderate‐to‐severe symptoms was for anxiety 29.55%, depression 38.79%, posttraumatic stress disorder 29.8%, and insomnia 40.66%.

This review highlights the mental health effects among nurses working in acute hospital settings. It also evidences a data gap on mental health effects among nurses working in primary health care and in nursing homes.

Implications for practice

In the post phase of the pandemic, there is an urgent need to assess and respond to the impact on the mental well‐being of nurses, and to monitor international policies for the improvement of nurses’ working conditions.

1. INTRODUCTION

When the World Health Organization (WHO) declared on 11 March 2020, a global health pandemic due to COVID‐19, no one expected that we would be faced with a global health emergency and more than 6.2 million deaths (World Health Organization,  2022 ). Nor did healthcare professionals, and nurses in particular, figure that they would be confronted with a new disease that caused many severe cases of acute respiratory syndrome and pneumonia, and that involved lack of supplies and intensive care unit beds in hospitals, and many people dying prematurely, and in some cases unable to be cared for (Lai et al.,  2020 ). Many nurses had to be transferred to ICUs and special units due to staff shortages but with the aggravating factor of having no training in intensive care and no experience in caring for critically ill patients (Stayt et al.,  2022 ). In addition to this work scenario, many health providers were contaminated, hospitalized, and died from SARS‐CoV‐2 coronavirus (International Council of Nurses,  2021 ) with an estimation of more than 115,000 deaths (World Health Organization,  2021 ).

Consequently, approximately one‐third of health professionals, including nurses, have experienced negative effects such as anxiety, insomnia, posttraumatic stress or depression (de Kock et al.,  2021 ; Pappa et al.,  2020 ). These health outcomes seem to worsen in the presence of some factors, such as being a woman, being a nurse, or working on the front line (Lai et al.,  2020 ). For this reason, it is not surprising that nurses are one of the groups most affected by the pandemic. The nursing profession is associated with a high burden of care due to the global lack of nurses during the pandemic, and their involvement at all levels of care imparts a great level of responsibility and overload across time (Fry‐Bowers & Rushton,  2021 ). The International Council of Nurses (ICN) also warns about the negative effects of the pandemic on nurses, reiterating that there was a shortage of professionals and a high level of burnout and abandonment before the pandemic, which has only accentuated these issues (International Council of Nurses,  2021 ).

Many studies have focussed on the impact of the pandemic on the mental health of nurses in the context of hospitalization units and intensive care units where work overload and lack of beds and human resources for care were common (Greenberg et al.,  2021 ; Hackett,  2020 ; Shen et al.,  2020 ). Notably, in two other health sectors substantially affected by the pandemic, primary care centres and social health centres or nursing homes, nurses are the pillars of care (Fallon et al.,  2020 ). The pandemic itself has evolved through nurses' different work environments. Social health centres and nursing homes (i.e. aged care facilities) were, at first, the most affected because of lack of supplies for the care of institutionalized elderly people who were at greater risk of being infected by COVID‐19 because they were more vulnerable due to age‐related pathologies and the environment where they lived (Riello et al.,  2020 ). Subsequently, across time, the context of primary care has become associated with work overload, becoming the centre of care for chronic patients whose follow‐up has been altered by the pandemic, individuals newly diagnosed with COVID‐19, and individuals with persistent COVID‐19 symptoms after infection (Knight & Vancheeswaran,  2021 ). Therefore, as the pandemic has continued, the primary care workforce has become more affected (Aranda‐Reneo et al.,  2021 ).

Although there is evidence of the impact of the pandemic on health professionals who have worked in hospitals and, to a lesser extent, in social health centres and primary care centres, to date, no review has been found through a quick database search that specifically addressed the impact of the pandemic on the mental health of nurses exclusively, nor the level of care at which nurses perform their professional duties during the pandemic. A worldwide inclusive response should include a focus on the mental health impact on nurses who have worked in different levels of health care. Therefore, herein, we analyse the impact of the COVID‐19 pandemic on the mental health of nurses based on their work context.

This systematic review aimed to answer the following question: What is the impact of the COVID‐19 pandemic on the mental health of nurses working in different health contexts during the pandemic?

The main objective of the review was to analyse the impact of the COVID‐19 pandemic on the mental health of nurses who have worked in hospitals, primary care centres and social health centres. The secondary objectives were (1) to identify the prevalence of anxiety, depression, sleep disorder and posttraumatic stress in nurses who have worked during the COVID‐19 pandemic and (2) to compare the effects of the pandemic on the mental health of nurses based on level of care (primary care, secondary and tertiary care).

3.1. Study design

A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines (Page et al.,  2021 ). Given the nature of the studies included, meta‐analysis was not possible to perform.

The protocol is registered in the PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42021249513).

The conceptual framework for the impact of traumatic events was used in this study. Three defining features of traumatic events include negative valence, lack of controllability and suddenness (Bisson,  2009 ) as was the case with the COVID‐19 pandemic. Responses to the traumatic event comprise depression, anxiety, insomnia and difficulties in interpersonal relationships, among others (Bisson,  2009 ).

3.2. Eligibility criteria

We aimed to include any potentially relevant research on the topic of interest; therefore, the inclusion criteria were as follows: (1) observational studies carried out in any setting (primary care centres, hospitals and nursing homes); and (2) studies that measured the levels of mental health burden in terms of anxiety, depression, posttraumatic stress disorder (PTSD) and/or insomnia in nurses who worked during the COVID‐19 pandemic, as these are some of the most prevalent burdens reported by previous studies (Carmassi et al.,  2020 ; Sahebi et al.,  2021 ). The following exclusion criteria were applied: (1) literature reviews, qualitative studies, editorials and grey literature; (2) studies that analysed the mental health of nurses but not related to the COVID‐19 pandemic; and (3) studies that analysed the mental health of other healthcare workers (HCWs) and/or students without separating their results from nurses' results.

In this review, nurses were defined as healthcare professionals with the skills and knowledge to assess, implement and evaluate nursing care plans and interventions independently (International Council of Nurses,  2022 ). The variables analysed in this review were those most frequent in the studies under consideration. According to the Diagnostic and Statistical Manual of Mental Disorders in its 5th Edition (also known as the DSM‐5), anxiety includes disorders that share features of excessive fear and anxiety and related behavioural disturbances; depression is a mood disorder in which those who suffer from depression experience persistent feelings of sadness and hopelessness and lose interest in activities they once enjoyed; PTSD refers to persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others and to experience a persistent negative emotional state (e.g. fear, horror, anger, guilt or shame); and insomnia refers to dissatisfaction with sleep quantity or quality, associated with one or more symptoms such as difficulty initiating sleep and/or maintaining sleep (American Psychiatric Association,  2013 ). There are many screening tools to determine an individual's level of anxiety, depression, PTSD and insomnia.

3.3. Search strategy

Searches were performed in the following electronic databases: Pub, CINAHL, PsychINFO and Cochrane. The Population, Intervention, Context and Outcomes (PICO; Schardt et al., 2007 ) framework was used to develop the research question and select search terms. The Medical Subject Headings (MeSH) browser was also used by the research team under the guidance of a librarian to generate and refine search terms, which are presented in Table  1 .

Search terms

Searches were performed during August and September 2021. The following search limits were imposed: English, French, German, Portuguese and Spanish languages (because the authors of this review are fluent in these languages) and the years 2020 and 2021.

3.4. Study selection

The article selection process was carried out in three phases using COVIDENCE, a virtual platform for performing systematic reviews. After the automatic elimination of duplicate articles, an author was responsible for the first round of screening by reading the titles and abstracts. Subsequently, the complete texts were read simultaneously by two authors and selected following the established criteria. Using the COVIDENCE platform, those articles in which there was no consensus were automatically detected, and discrepancies were resolved in a meeting with a third researcher. No major discrepancies were found.

Many articles were excluded for the following reasons: patient population—studies that did not analyse the outcomes of nurses separately; outcomes—studies that did not analyse one or more of the target outcomes of this review (i.e. anxiety, depression, PTSD and insomnia); unclear setting—studies that did not specify the setting where the nurses were working; study design—studies whose design did not meet the inclusion criteria specified above; methods—studies that showed poor methodology or a high risk of bias (i.e. not specifying how they contacted the participants, no specific ethics approval or funding sources); withdrawn paper—studies no longer available when assessed for eligibility; intervention—studies that focused on performing an intervention without first assessing the prevalence rates of the goal outcomes; no full text—studies whose full text was not available, neither online nor after contacting the authors; and language other than the selected one—studies whose full text was not in one of the languages specified previously.

The PRISMA flow diagram (Page et al.,  2021 ) in Figure  1 outlines the systematic search and screening process. The search yielded 706 papers, from which 625 studies remained after duplicates were removed. Of these, 426 articles were excluded because they did not meet the inclusion criteria; the remaining 199 articles were assessed for eligibility. Of these, 125 articles were excluded for different reasons. Ultimately, a total of 31 studies met the inclusion criteria and were included in this review (Figure  1 ).

PRISMA flow diagram

3.5. Data extraction

All team members agreed to use a data extraction template from the COVIDENCE platform. The template included the main characteristics of the studies that were relevant for this review: year, country, number of participants (nurses), level of care, variables studied (anxiety, depression, PTSD and/or insomnia), instruments used to measure each variable, main results and other results of interest.

3.6. Quality appraisal

The quality of included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist for analytical cross‐sectional studies, an 8‐point assessment tool (Joanna Briggs Institute,  2021 ). The studies obtained high scores, with 19 studies (61.3%) scoring 8 out of 8 and 12 studies (38.7%) scoring 7 out of 8 (see Table  2 ).

General characteristics and quality appraisal of the included studies

3.7. Data synthesis

Following systematic review guidelines (Page et al.,  2021 ), the literature was synthesized using descriptive synthesis that presented the characteristics of the included studies and the prevalence of the selected variables, i.e. anxiety, depression, insomnia and/or PTSD experienced by nurses working during the COVID‐19 pandemic.

4.1. Study characteristics

The general characteristics of the studies are presented in Table  2 . Most of the studies were conducted in China (16), followed by Italy (3) and Turkey (3). The remaining studies were conducted in Saudi Arabia, the Philippines, South Korea, Iran, Canada, Belgium, the Netherlands, Germany and France.

Most studies were conducted in hospitals or frontline settings, with only one study being conducted in a primary care setting (Selçuk Tosun et al.,  2021 ); none of the included studies were conducted in nursing homes.

Most of the included studies aimed to describe or measure the impact of the COVID‐19 pandemic on the mental burden of nurses. In addition, the studies researched possible associated factors that contributed to the results.

In relation to the designs of the included articles, quantitative cross‐sectional descriptive studies were the most common ( n  = 30), with one being a mixed methodology study (Crowe et al.,  2021 ), for which only the quantitative data were used for this review.

Concerning the sampling, the number of nurses included in the studies ranged from N  = 90 to N  = 3228 (average = 816.36 nurses). The population consisted mainly of nurses working in hospital settings during the COVID‐19 pandemic in different countries. No notable differences were found in sociodemographic factors among the included studies, with most participants being middle‐aged (35–50 years) females.

Concerning the data collection period, most studies analysed the impact of COVID‐19 on nurses working during the first wave in each respective country, roughly encompassing the period from January 2020 until May 2020. Of the 31 studies included in this review, 25 were performed during that time frame. Four studies (Balay‐odao et al.,  2021 ; Chen et al.,  2021 ; Gül & Kılıç,  2021 ; Selçuk Tosun et al.,  2021 ) were performed during 2020, from June to August, and only two studies (Doo et al.,  2021 ; Heesakkers et al.,  2021 ) were carried out in the last third of 2020, from September until the end of the year. Studies that were conducted across two periods were classified based on the period during which most of the study took place (from January to May 2020, which was the first wave of the pandemic). There was no single study identified in this review that collected data during 2021.

4.2. Studied variables and instruments used

Anxiety was the most prevalent studied variable, being studied in 28 out of the 31 studies. Depression was a variable in 21 studies, PTSD was a variable in eight studies, and last, insomnia was a variable in five studies. Table  3 shows the prevalence of the four mental health variables analysed in the included studies. The results for these variables were reported in different formats among studies. Some studies presented the overall prevalence of mild‐to‐severe symptoms, and others detailed the prevalence of symptoms based on intensity (normal, mild, moderate and severe) (see Table  3 ).

Prevalence of the mental health outcomes analysed in the studies

A variety of instruments (see Table  4 ) were used in the included studies to measure anxiety, depression, PTSD and insomnia.

Instruments used to measure the mental health variables analysed in the studies

4.3. Anxiety

The included studies used seven specific instruments to measure anxiety (see Table  4 ) and two other scales (Depression, Anxiety and Stress Scale‐21 (DASS‐21); and Hospital Anxiety and Depression Scale (HADS)) that combined anxiety with other variables such as depression and stress.

The prevalence of anxiety symptoms ranged from 3% to 99.6% (average, 42.64%) for studies that presented their results with percentages. The prevalence of moderate‐to‐severe anxiety symptoms was 29.55%. The lowest scores were found for operating room nurses in China (data collected from January to March 2020) (Lian et al.,  2021 ). The highest scores were found for hospital workers in Italy during the first wave (data collected from February to April 2020) (Simonetti et al.,  2021 ).

Among the studies with the lowest rates of anxiety, two studies reported a prevalence of less than 20%. Zheng, Zhou, Qiu, et al. ( 2021 ), who conducted a study in a hospital setting in China from January to February 2020, reported a prevalence of anxiety of 18.1% (14.3% mild, 2.9% moderate and 0.9% severe), and a study with data collected in German hospitals reported an overall prevalence of anxiety of 19% in nurses (Morawa et al.,  2021 ).

Regarding the highest prevalence rates, a study conducted in Italy with COVID hospital nurses during April and May 2020 reported a prevalence of anxiety symptoms of 77.6% (26.9% mild; 24.7% moderate; and 26% severe) (Naldi et al.,  2021 ). Another study conducted in Iran in April 2020 reported a prevalence of overall anxiety symptoms of 73.5% among hospital workers (Pouralizadeh et al.,  2020 ). Last, Gül and Kılıç ( 2021 ), who conducted a study in Turkey during July and August 2020 with operating room workers, reported a prevalence of anxiety symptoms of 71.9% among nurses (30.2% mild; 24.5% moderate; and 17.2% severe).

Intermediate prevalences (30%–40%) were found in Chinese studies in COVID and non‐COVID treating hospitals (He et al.,  2021 ; Hu et al.,  2020 ; Xiong et al.,  2020 ). In these studies, moderate‐to‐severe levels of anxiety were established between 8.5% and 14.3%. In addition, a study conducted in a primary care setting in Turkey from August to September 2020 (second wave of the pandemic) reported state and trait anxiety scores that were above average [48.71 ± 11.07 & 46.89 ± 7.94, respectively], indicating a moderate level of anxiety among nurses and midwives (Selçuk Tosun et al.,  2021 ). Another study in a Turkish hospital reported the mean total of the Self‐Rating Anxiety Scale (SAS) score of 51.51 ± 9.94, indicating a high level of anxiety among nurses (Bahadir‐Yilmaz & Yüksel,  2020 ). In contrast, a study from Wuhan reported a SAS score of 31.79 ± 3.32 (Mo et al.,  2021 ), indicating a lower level of anxiety experienced by Chinese nurses.

4.4. Depression

To measure depression, four instruments were used: the Patient Health Questionnaire‐9 (PHQ‐9), Self‐Rating Depression Scale (SDS), Depression, Anxiety and Stress Scale‐21 items (DASS‐21) and Hospital Anxiety and Depression Scale (HADS).

From the studies included in this review, the average prevalence of mild‐to‐severe depression symptoms was 38.79%, and the average prevalence of moderate‐to‐severe depression was 22.9%. The lowest depression rates were reported by Sun et al. ( 2021 ) at a COVID‐19 hospital in China, with a prevalence of mild or moderate depressive symptoms of 7.1% and no severe or extremely severe symptoms. The highest rates were reported by Pouralizadeh et al. ( 2020 ), with an overall prevalence of 71% (33.6% mild; 30.7% moderate; and 6.8% severe depression) during the first wave of COVID (April 2020) at a hospital in Iran.

Other studies with low prevalence rates included a study conducted in a paediatric hospital in China during the beginning of the first wave (January to February 2020) of the pandemic, with a depression symptom prevalence of 15.4% (7% mild; 6.3% moderate; 1% severe; and 1.1% extremely severe) (Zheng, Zhou, Qiu, et al.,  2021 ). Heesakkers et al. ( 2021 ), in an ICU setting in the Netherlands in 2020, reported an overall prevalence of depressive symptoms of 18.6% among nurses.

The following studies reported the highest depression prevalence rates: a study conducted in an ICU setting in Canada in May 2020 (56.9% overall and 42.2% moderate‐to‐severe) (Crowe et al.,  2021 ); a study conducted in October 2020 with COVID hospital workers in South Korea (65.7% overall and 29.7% mild, 18.8% moderate, 7.8% moderate–severe and 9.4% severe) (Doo et al.,  2021 ); and a study conducted in a hospital setting in China in March 2020 (54.65% mild to severe depression) (Zhan et al.,  2020 ). Three other studies reported a prevalence of depressive symptoms greater than 50% among nurses (Cai et al.,  2020 ; Tiete et al.,  2021 ; Wang et al.,  2021 ).

Four studies were carried out in China in hospital settings during February and March 2020 and reported intermediate levels of depression between 22% and 44%, with moderate‐to‐severe levels being between 6% and 16% (An et al.,  2020 ; He et al.,  2021 ; Hu et al.,  2020 ; Xiong et al.,  2020 ).

4.5. Posttraumatic stress disorder ( PTSD )

To measure PTSD, the included studies used four instruments: Impact of the Event Scale—Revised (IES‐R), Self‐reporting PTSD scale—Civilian (PCL‐C), Impact of the Event Scale‐6 (IES‐6) and Peritraumatic Dissociative Experiences Questionnaire (PDEQ).

The average prevalence of PTSD was 39.06%, ranging from 5.6% to 73.4%. In addition, the prevalence of moderate‐to‐severe symptoms was 29.8%. The highest rates were found by Crowe et al. ( 2021 ) in an ICU setting in Canada, with 73.4% of the nurses reporting symptoms, including 37.6% showing significant PTSD symptoms (Crowe et al.,  2021 ). The second highest rates were reported by Lasalvia et al. ( 2020 ) for a hospital setting in Italy from April to May 2020, with a prevalence of severe PTSD symptomatology of 65% among nurses. Another Italian study conducted in a COVID hospital during the first wave of the pandemic (April to May 2020) reported that 64.2% of the nurses exhibited PTSD symptoms, with 37.3% corresponding to moderate‐to‐severe symptomatology (Naldi et al.,  2021 ).

A study conducted in February 2020 with hospital workers in China reported a prevalence of 41.8%, with moderate‐to‐severe PTSD accounting for 10.7% (Juan et al.,  2020 ). A French study investigated the prevalence of PTSD among ICU nurses from April to May 2020 and found that 34% showed symptoms compatible with the disorder (Azoulay et al.,  2020 ). A study conducted with hospital workers in China during January and February 2020 reported a prevalence of 26% during an acute COVID‐19 outbreak and a prevalence of 19.3% during a stable period of the pandemic (Cai et al.,  2020 ). A study conducted by Heesakkers et al. ( 2021 ) in the Netherlands from August to September 2020 also investigated PTSD rates among ICU nurses and found a prevalence of 22.2%.

The remaining study, and the one with the lowest rates, was conducted in a hospital setting in China during the first wave of the pandemic, reporting a prevalence of clinically significant PTSD of 5.6% (Leng et al.,  2021 ).

4.6. Insomnia

To measure insomnia, the following three instruments were used: Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS).

All the studies that analysed the prevalence of insomnia among nurses ( n  = 5) were carried out in a hospital setting during the first wave of the pandemic, with an average prevalence of 53.60% (40.66% for moderate‐to‐severe symptoms) for studies that presented their results as percentages.

Of the five studies, an Italian study carried out by Simonetti et al. ( 2021 ) reported the worst outcomes, with 75.72% of nurses reporting poor sleep quality (data collected from February to April 2020). A study conducted in Belgium found an overall prevalence of moderate and severe symptoms of 72.4% and 36.1%, respectively (Tiete et al.,  2021 ). Furthermore, a study conducted in China by Shen et al. ( 2020 ) found a prevalence of sleep disturbances of 41.5%. A study conducted from January to February 2020 by Cai et al. ( 2020 ) in China found that 38.5% of nurses exhibited sleep disturbances. In a study by Wang et al. ( 2021 ), the mean PSQI score was 6.0, indicating poor sleep quality among nurses.

5. DISCUSSION

This review found high rates of anxiety, depression, PTSD and insomnia among nurses who worked during the COVID‐19 pandemic. Depression was the least prevalent disorder, with a prevalence of 38.79%, with a similar prevalence of PTSD (39.06%). Similarly, the overall prevalence of anxiety was 42.64%. The most impaired aspect of nurses' wellness was insomnia, with a prevalence of 53.6% in the few studies that analysed this outcome.

Overall, the studies conducted in China seemed to have lower rates of all outcomes, whereas studies conducted in Western countries, especially those conducted in Italy, one of the countries that was hit the hardest during the first wave of the pandemic, showed increased rates of the disorders studied by this review (Lasalvia et al.,  2020 ; Simonetti et al.,  2021 ). Among the selected studies, there were no studies from the USA, Latin American countries or other European countries, such as Spain or the United Kingdom, where the pandemic has had a great impact (World Health Organization,  2022 ). The latest journalistic news from these contexts reflects similar or even higher levels of impact on mental health among nurses, considering the pressure exerted on their health systems (Cafe,  2021 ; Diario de Navarra,  2021 ).

The few studies that were conducted in specific settings, such as operating rooms (Gül & Kılıç,  2021 ; Lian et al.,  2021 ) or women's and children's hospitals (He et al.,  2021 ), also seemed to have lower prevalence rates than did studies conducted in inpatient hospital settings and/or with adult populations.

The results obtained from this review on the mental health of nurses who have worked during the COVID‐19 pandemic are similar to the data reported by an umbrella review of meta‐analyses on the impact among different HCWs on the prevalence of anxiety (24.94%) and depression (24.83%) (Sahebi et al.,  2021 ). For sleep disturbances, a meta‐analysis on the subject indicated that the prevalence of insomnia among HCWs on the frontline of the COVID‐19 pandemic was approximately 38% (Serrano‐Ripoll et al.,  2021 ), consistent with the prevalence found among nurses in this review. In contrast, in a meta‐analysis, Saragih et al. ( 2021 ) reported prevalence rates higher than those found in our review for posttraumatic stress disorder (49%), anxiety (40%) and depression (37%) among HCWs during the COVID‐19 pandemic. According to the authors, among the different HCWs, nurses exhibited the highest levels of affectation for all variables due to their workplace conditions, being female, and having limited access to personal protective equipment.

One of the specific aims of this review was to compare the mental health of nurses by the level of care (primary care, secondary care and tertiary care). However, this was not possible in this review because the evidence found in the primary care setting and community health centres and nursing homes was poor. Only one study was carried out in a primary care setting; the study was conducted in Turkey during the second wave of the pandemic and showed moderate levels (state [48.71 (± 11.07)] and trait [46.89 (± 7.94)]) of anxiety among nurses and midwives in this setting (Selçuk Tosun et al.,  2021 ). No other psychological variables were analysed in that study, and solution‐focussed thinking skills were suggested as possible means to improve anxiety outcomes (Selçuk Tosun et al.,  2021 ). No studies were found regarding anxiety, depression, PTSD and/or insomnia among nurses who worked in nursing homes during the COVID‐19 pandemic. This lack of data points to an urgent need for research into the mental health of nurses responsible for caring for older people in community care homes because the impact of the pandemic on nursing homes has been significant (Davidson & Szanton,  2020 ).

Furthermore, even though most of the studies were conducted during the first wave of the pandemic (from March to May 2020), those that were carried out during subsequent waves showed similar outcomes, either demonstrating that different regions have been hit harder by the pandemic during different periods or highlighting the continuity of the pandemic and the subsequent impact on the mental health of nurses. It is expected that with the ongoing waves of the pandemic, resulting in further work overload, the mental impact on nurses will worsen.

Concerning the instruments used, a certain level of variability can be observed (see Table  4 ). To assess anxiety, nine different tools were used among the 31 studies analysed; notably, this variable was evaluated in most included studies ( n  = 28). The most frequently used instruments were the Self‐Rating Anxiety Scale (SAS) and the Depression, Anxiety and Stress Scale‐21 (DASS‐21), which are widely used for clinical and research purposes at the international level and have good psychometric properties (Dunstan & Scott,  2018 ; Lee,  2020 ). In the study by Labrague and De los Santos ( 2020 ), the COVID‐19 Anxiety Scale was used; this scale was designed by Lee ( 2020 ) to assess anxiety caused by COVID‐19. Regarding depression, in addition to the DASS‐21 already mentioned, most studies that evaluated depression used the Patient Health Questionnaire‐9 (PHQ‐9), which is extensively used as a screening tool, showing adequate psychometric properties (Costantini et al.,  2021 ). In the eight studies that assessed PTSD, four different scales were used; the most used was the Impact of the Event Scale—Revised (IES‐R). This scale has been widely used to assess the effects of the COVID‐19 pandemic both among the general population (Cénat et al.,  2021 ) and among HCWs (Carmassi et al.,  2020 ). To measure insomnia, among the five studies that evaluated it, there were three different tools.

5.1. Strengths and limitations of this review

In this review, a comprehensive search was conducted in the main health and nursing databases; the retrieved studies were published in various languages (English, French, German, Portuguese and Spanish) and across an extended time range, from the onset of the COVID‐19 pandemic, i.e. January 2020 to September 2021, resulting in a high number of articles identified for this review. Other strengths of this review are the high level of rigour of the included studies when considering only those studies that presented all the items of the critical appraisal tools used based on the design of each study; the high number of participants included in this review; and the analysis of the four main variables (anxiety, depression, PTSD and insomnia) among nurses. Furthermore, this review presents the measurement of the “direct” and “acute” impacts of a health emergency. Finally, the results of this review are considered a strength because they allow us to provide recommendations for practice and research. In any health service, we recommend assessing the impact of COVID‐19 on the mental well‐being of nurses and monitoring international policies for the improvement of nurses' working conditions. In terms of research, future studies are needed that include the assessment of the mental health of nurses working in different healthcare settings (hospitals, primary care, nursing homes, etc.).

Nevertheless, this review also has some limitations that need to be considered. Despite the large number of articles found, not having included grey literature may have left out publications of interest. One major limitation of this review is that the specific aim of comparing the mental health of nurses by level of care (primary care, secondary care and tertiary care) could not be addressed, as the included studies focussed primarily on hospital nurses, with only one study conducted in primary care and none conducted in a nursing home setting. In addition, most articles measured the mental health of professionals during the first wave (January–May 2020), with little data for successive waves and no data for 2021. This may have occurred because study results take time to be published, especially in the past year, when there has been a considerable increase in submissions to scientific journals and a lack of available reviewers due to the pandemic. Therefore, we recommend that future reviews should include studies from more healthcare settings and studies that present data collected during different waves of the pandemic. Importantly, most studies included in this review were conducted in China and reported lower prevalence rates for the variables studied, thus lowering the overall prevalence of the outcomes, i.e. the impact of the pandemic on the mental health of nurses. Another limitation of this review is the variety of instruments used in the included studies, a fact that should be considered when comparing and interpreting the results of the studies. Finally, given the nature of the studies included and the diversity of instruments used to measure the selected variables, it was not possible to carry out the meta‐analysis of this review.

6. CONCLUSION

This review highlights the mental health effects among nurses working in different parts of the world during the COVID‐19 pandemic. It also highlights a gap in the literature: no studies were found that analyse the mental health of nurses by care level, such as primary care; such nurses are key to the management and care of citizens during the pandemic and have had to adapt to an avalanche of new cases of COVID‐19. Especially striking is the lack of studies with nurses who work in nursing homes, considering that this setting has been substantially affected by COVID‐19. Future studies are needed to address these gaps and provide a holistic view of the experiences of working during the COVID‐19 pandemic and its negative impact on nurses' mental health.

7. RELEVANCE STATEMENT

No review has specifically addressed the impact of the pandemic on the mental health of nurses exclusively, nor the level of care at which nurses perform their professional duties.

AUTHOR CONTRIBUTIONS

Cristina Garcia‐Vivar, Irati Rodriguez‐Matesanz, Leticia San Martin‐Rodriguez, Paula Escalada‐Hernandez, Nelia Soto‐Ruiz, and Marta Ferraz‐Torres—Made substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data; or the creation of new software used in the work. Cristina Garcia‐Vivar, Irati Rodriguez‐Matesanz, Leticia San Martin‐Rodriguez, Paula Escalada‐Hernandez, Nelia Soto‐Ruiz, and Marta Ferraz‐Torres—Drafted the work or revised it critically for important intellectual content. Cristina Garcia‐Vivar, Irati Rodriguez‐Matesanz, Leticia San Martin‐Rodriguez, Paula Escalada‐Hernandez, Nelia Soto‐Ruiz, and Marta Ferraz‐Torres—Approved the version to be published. Cristina Garcia‐Vivar, Leticia San Martin‐Rodriguez, Irati Rodriguez‐Matesanz, Paula Escalada‐Hernandez, Nelia Soto‐Ruiz, and Marta Ferraz‐Torres—Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

FUNDING INFORMATION

This study was supported by the Department of Health of the Government of Navarre (Spain) in the call for research related to Health Sciences and SARS‐CoV‐2 pandemic, 2020. [Date, December 2021; Grant number 0011–3638–2020‐000005].

Supporting information

Appendix S1

ACKNOWLEDGEMENT

This study was supported by the Department of Health of the Government of Navarre (Spain) in the call for research related to Health Sciences and SARS‐CoV‐2 pandemic, 2020. [Date, December 2021; Grant number 0011‐3638‐2020‐000005]. We thank the American Journal Experts for translating and editing this paper. Open access funding provided by the Universidad Pública de Navarra.

García‐Vivar, C. , Rodríguez‐Matesanz, I. , San Martín‐Rodríguez, L. , Soto‐Ruiz, N. , Ferraz‐Torres, M. , & Escalada‐Hernández, P. (2022). Analysis of mental health effects among nurses working during the COVID‐19 pandemic: A systematic review . Journal of Psychiatric and Mental Health Nursing , 00 , 1–15. 10.1111/jpm.12880 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

DATA AVAILABILITY STATEMENT

• American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association. [ Google Scholar ]
• An, Y. , Yang, Y. , Wang, A. , Li, Y. , Zhang, Q. , Cheung, T. , Ungvari, G. S. , Qin, M. Z. , An, F. R. , & Xiang, Y. T. (2020). Prevalence of depression and its impact on quality of life among frontline nurses in emergency departments during the COVID‐19 outbreak . Journal of Affective Disorders , 276 , 312–315. 10.1016/J.JAD.2020.06.047 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Aranda‐Reneo, I. , Pedraz‐Marcos, A. , & Pulido‐Fuentes, M. (2021). Management of burnout among the staff of primary care centres in Spain during the pandemic caused by the SARS‐CoV‐2 . Human Resources for Health , 19 ( 1 ), 133. 10.1186/s12960-021-00679-9 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Azoulay, E. , Cariou, A. , Bruneel, F. , Demoule, A. , Kouatchet, A. , Reuter, D. , Souppart, V. , Combes, A. , Klouche, K. , Argaud, L. , Barbier, F. , Jourdain, M. , Reignier, J. , Papazian, L. , Guidet, B. , Geri, G. , Resche‐Rigon, M. , Guisset, O. , Labbe, V. , … Kentish‐Barnes, N. (2020). Symptoms of anxiety, depression, and peritraumatic dissociation in critical care clinicians managing patients with COVID‐19 a cross‐sectional study . American Journal of Respiratory and Critical Care Medicine , 202 ( 10 ), 1388–1398. 10.1164/RCCM.202006-2568OC/SUPPL_FILE/DISCLOSURES.PDF [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bahadir‐Yilmaz, E. , & Yüksel, A. (2020). State anxiety levels of nurses providing care to patients with COVID‐19 in Turkey . Perspectives in Psychiatric Care , 57 ( 3 ), 1088–1094. 10.1111/PPC.12661 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Balay‐odao, E. M. , Alquwez, N. , Inocian, E. P. , & Alotaibi, R. S. (2021). Hospital preparedness, resilience, and psychological burden among clinical nurses in addressing the COVID‐19 crisis in Riyadh, Saudi Arabia . Frontiers in Public Health , 8 , 573932. 10.3389/FPUBH.2020.573932 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bisson, J. I. (2009). Psychological and social theories of post‐traumatic stress disorder . Psychiatry , 8 ( 8 ), 290–292. 10.1016/j.mppsy.2009.05.003 [ CrossRef ] [ Google Scholar ]
• Cafe, R. (2021). Nurses' mental health: “Most people in the NHS, they are sad.” BBC News . https://www.bbc.com/news/uk‐england‐london‐59104738
• Cai, Z. , Cui, Q. , Liu, Z. , Li, J. , Gong, X. , Liu, J. , Wan, Z. , Yuan, X. , Li, X. , Chen, C. , & Wang, G. (2020). Nurses endured high risks of psychological problems under the epidemic of COVID‐19 in a longitudinal study in Wuhan China . Journal of Psychiatric Research , 131 , 132–137. 10.1016/J.JPSYCHIRES.2020.09.007 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Carmassi, C. , Foghi, C. , Dell'Oste, V. , Cordone, A. , Bertelloni, C. A. , Bui, E. , & Dell'Osso, L. (2020). PTSD symptoms in healthcare workers facing the three coronavirus outbreaks: What can we expect after the COVID‐19 pandemic . Psychiatry Research , 292 , 113312. 10.1016/j.psychres.2020.113312 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cénat, J. M. , Blais‐Rochette, C. , Kokou‐Kpolou, C. K. , Noorishad, P.‐G. , Mukunzi, J. N. , McIntee, S.‐E. , Dalexis, R. D. , Goulet, M.‐A. , & Labelle, P. R. (2021). Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID‐19 pandemic: A systematic review and meta‐analysis . Psychiatry Research , 295 , 113599. 10.1016/j.psychres.2020.113599 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chen, X. , Arber, A. , Gao, J. , Zhang, L. , Ji, M. , Wang, D. , Wu, J. , & Du, J. (2021). The mental health status among nurses from low‐risk areas under normalized COVID‐19 pandemic prevention and control in China: A cross‐sectional study . International Journal of Mental Health Nursing , 30 ( 4 ), 975–987. 10.1111/INM.12852 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Costantini, L. , Pasquarella, C. , Odone, A. , Colucci, M. E. , Costanza, A. , Serafini, G. , Aguglia, A. , Belvederi Murri, M. , Brakoulias, V. , Amore, M. , Ghaemi, S. N. , & Amerio, A. (2021). Screening for depression in primary care with Patient Health Questionnaire‐9 (PHQ‐9): A systematic review . Journal of Affective Disorders , 279 , 473–483. 10.1016/j.jad.2020.09.131 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Crowe, S. , Howard, A. F. , Vanderspank‐Wright, B. , Gillis, P. , McLeod, F. , Penner, C. , & Haljan, G. (2021). The effect of COVID‐19 pandemic on the mental health of Canadian critical care nurses providing patient care during the early phase pandemic: A mixed method study . Intensive & Critical Care Nursing , 63 , 102999. 10.1016/J.ICCN.2020.102999 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Davidson, P. M. , & Szanton, S. L. (2020). Nursing homes and COVID‐19: We can and should do better . Journal of Clinical Nursing , 29 ( 15–16 ), 2758–2759. 10.1111/jocn.15297 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• de Kock, J. H. , Latham, H. A. , Leslie, S. J. , Grindle, M. , Munoz, S.‐A. , Ellis, L. , Polson, R. , & O'Malley, C. M. (2021). A rapid review of the impact of COVID‐19 on the mental health of healthcare workers: Implications for supporting psychological well‐being . BMC Public Health , 21 ( 1 ), 104. 10.1186/s12889-020-10070-3 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Diario de Navarra . (2021). The mental health of two‐thirds of nurses in Navarra has been affected after their work during the pandemic (Spanish) . https://www.diariodenavarra.es/noticias/navarra/2021/12/28/salud‐mental‐dos‐tercios‐enfermeras‐navarras‐visto‐afectada‐trabajo‐pandemia‐512301‐300.html
• Doo, E. Y. , Kim, M. , Lee, S. , Lee, S. Y. , & Lee, K. Y. (2021). Influence of anxiety and resilience on depression among hospital nurses: A comparison of nurses working with confirmed and suspected patients in the COVID‐19 and non‐COVID‐19 units . Journal of Clinical Nursing , 30 ( 13–14 ), 1990–2000. 10.1111/JOCN.15752 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Dunstan, D. A. , & Scott, N. (2018). Assigning clinical significance and symptom severity using the Zung scales: Levels of misclassification arising from confusion between Index and Raw scores . Depression Research and Treatment , 2018 , 1–13. 10.1155/2018/9250972 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Fallon, A. , Dukelow, T. , Kennelly, S. P. , & O'Neill, D. (2020). COVID‐19 in nursing homes . QJM: An International Journal of Medicine , 113 ( 6 ), 391–392. 10.1093/qjmed/hcaa136 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Fry‐Bowers, E. K. , & Rushton, C. H. (2021). Who will be there to care if there are no more nurses? The Hastings Center; https://www.thehastingscenter.org/who‐will‐be‐there‐to‐care‐if‐there‐are‐no‐more‐nurse/ [ Google Scholar ]
• Greenberg, N. , Weston, D. , Hall, C. , Caulfield, T. , Williamson, V. , & Fong, K. (2021). Mental health of staff working in intensive care during Covid‐19 . Occupational Medicine , 71 ( 2 ), 62–67. 10.1093/occmed/kqaa220 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Gül, Ş. , & Kılıç, S. T. (2021). Determining anxiety levels and related factors in operating room nurses during the COVID‐19 pandemic: A descriptive study . Journal of Nursing Management , 29 ( 7 ), 1934–1945. 10.1111/JONM.13332 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hackett, K. (2020). Concerns over ICU nurses' mental health as admissions rise . Emergency Nurse , 28 ( 6 ), 6. 10.7748/en.28.6.6.s3 [ CrossRef ] [ Google Scholar ]
• He, Q. , Ren, J. , Wang, G. , Zhang, J. , Xiang, J. , & He, D. (2021). Psychological effects of the COVID‐19 outbreak on nurses working in tertiary women's and children's hospitals from Sichuan, China: A cross‐sectional study . International Journal of Disaster Risk Reduction: IJDRR , 58 , 102188. 10.1016/J.IJDRR.2021.102188 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Heesakkers, H. , Zegers, M. , van Mol, M. M. C. , & van den Boogaard, M. (2021). The impact of the first COVID‐19 surge on the mental well‐being of ICU nurses: A nationwide survey study . Intensive & Critical Care Nursing , 65 , 103034. 10.1016/J.ICCN.2021.103034 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hu, D. , Kong, Y. , Li, W. , Han, Q. , Zhang, X. , Zhu, L. X. , Wan, S. W. , Liu, Z. , Shen, Q. , Yang, J. , He, H. G. , & Zhu, J. (2020). Frontline nurses' burnout, anxiety, depression, and fear statuses and their associated factors during the COVID‐19 outbreak in Wuhan, China: A large‐scale cross‐sectional study . EClinicalMedicine , 24 , 100424. 10.1016/J.ECLINM.2020.100424 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• International Council of Nurses . (2021). ICN says 115,000 healthcare worker deaths from COVID‐19 exposes collective failure of leaders to protect global workforce . News. https://www.icn.ch/news/icn‐says‐115000‐healthcare‐worker‐deaths‐covid‐19‐exposes‐collective‐failure‐leaders‐protect
• International Council of Nurses . (2022). Nursing definitions . https://www.icn.ch/nursing‐policy/nursing‐definitions
• Joanna Briggs Institute . (2021). Critical appraisal tools . https://jbi.global/critical‐appraisal‐tools
• Juan, Y. , Yuanyuan, C. , Qiuxiang, Y. , Cong, L. , Xiaofeng, L. , Yundong, Z. , Jing, C. , Peifeng, Q. , Yan, L. , Xiaojiao, X. , & Yujie, L. (2020). Psychological distress surveillance and related impact analysis of hospital staff during the COVID‐19 epidemic in Chongqing, China . Comprehensive Psychiatry , 103 , 152198. 10.1016/J.COMPPSYCH.2020.152198 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Knight, M. , & Vancheeswaran, R. (2021). Post‐acute covid‐19 in primary care . BMJ , 375 , n3080. 10.1136/bmj.n3080 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Labrague, L. J. , & De los Santos, J. A. A. (2020). COVID‐19 anxiety among front‐line nurses: Predictive role of organisational support, personal resilience and social support . Journal of Nursing Management , 28 ( 7 ), 1653–1661. 10.1111/JONM.13121 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lai, J. , Ma, S. , Wang, Y. , Cai, Z. , Hu, J. , Wei, N. , Wu, J. , Du, H. , Chen, T. , Li, R. , Tan, H. , Kang, L. , Yao, L. , Huang, M. , Wang, H. , Wang, G. , Liu, Z. , & Hu, S. (2020). Factors associated with mental health outcomes among health care workers exposed to Coronavirus disease 2019 . JAMA Network Open , 3 ( 3 ), e203976. 10.1001/jamanetworkopen.2020.3976 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lasalvia, A. , Bonetto, C. , Porru, S. , Carta, A. , Tardivo, S. , Bovo, C. , Ruggeri, M. , & Amaddeo, F. (2020). Psychological impact of COVID‐19 pandemic on healthcare workers in a highly burdened area of north‐east Italy . Epidemiology and Psychiatric Sciences , 30 , e1. 10.1017/S2045796020001158 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lee, S. A. (2020). Coronavirus Anxiety Scale: A brief mental health screener for COVID‐19 related anxiety . Death Studies , 44 ( 7 ), 393–401. 10.1080/07481187.2020.1748481 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Leng, M. , Wei, L. , Shi, X. , Cao, G. , Wei, Y. , Xu, H. , Zhang, X. , Zhang, W. , Xing, S. , & Wei, H. (2021). Mental distress and influencing factors in nurses caring for patients with COVID‐19 . Nursing in Critical Care , 26 ( 2 ), 94–101. 10.1111/NICC.12528 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lian, A. , Jin, D. , Zhang, T. , & Wu, Y. (2021). Investigation on psychological state of occupational exposure of medical staff in operation room under novel coronavirus . Saudi Journal of Biological Sciences , 28 ( 5 ), 2726–2732. 10.1016/J.SJBS.2021.02.080 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Mo, Y. , Deng, L. , Zhang, L. , Lang, Q. , Pang, H. , Liao, C. , Wang, N. , Tao, P. , & Huang, H. (2021). Anxiety of nurses to support Wuhan in fighting against COVID‐19 Epidemic and its Correlation With Work Stress and Self‐efficacy . Journal of Clinical Nursing , 30 ( 3–4 ), 397–405. 10.1111/JOCN.15549 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Morawa, E. , Schug, C. , Geiser, F. , Beschoner, P. , Jerg‐Bretzke, L. , Albus, C. , Weidner, K. , Hiebel, N. , Borho, A. , & Erim, Y. (2021). Psychosocial burden and working conditions during the COVID‐19 pandemic in Germany: The VOICE survey among 3678 health care workers in hospitals . Journal of Psychosomatic Research , 144 , 110415. 10.1016/J.JPSYCHORES.2021.110415 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Naldi, A. , Vallelonga, F. , Di Liberto, A. , Cavallo, R. , Agnesone, M. , Gonella, M. , Sauta, M. D. , Lochner, P. , Tondo, G. , Bragazzi, N. L. , Botto, R. , & Leombruni, P. (2021). COVID‐19 pandemic‐related anxiety, distress and burnout: prevalence and associated factors in healthcare workers of North‐West Italy . BJPsych Open , 7 ( 1 ), e27. 10.1192/BJO.2020.161 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Page, M. J. , McKenzie, J. E. , Bossuyt, P. M. , Boutron, I. , Hoffmann, T. C. , Mulrow, C. D. , Shamseer, L. , Tetzlaff, J. M. , Akl, E. A. , Brennan, S. E. , Chou, R. , Glanville, J. , Grimshaw, J. M. , Hróbjartsson, A. , Lalu, M. M. , Li, T. , Loder, E. W. , Mayo‐Wilson, E. , McDonald, S. , … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews . BMJ , 372 , 71. 10.1136/bmj.n71 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pappa, S. , Ntella, V. , Giannakas, T. , Giannakoulis, V. G. , Papoutsi, E. , & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID‐19 pandemic: A systematic review and meta‐analysis . Brain, Behavior, and Immunity , 88 , 901–907. 10.1016/j.bbi.2020.05.026 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pouralizadeh, M. , Bostani, Z. , Maroufizadeh, S. , Ghanbari, A. , Khoshbakht, M. , Alavi, S. A. , & Ashrafi, S. (2020). Anxiety and depression and the related factors in nurses of Guilan University of Medical Sciences hospitals during COVID‐19: A web‐based cross‐sectional study . International Journal of Africa Nursing Sciences , 13 , 100233. 10.1016/J.IJANS.2020.100233 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Riello, M. , Purgato, M. , Bove, C. , MacTaggart, D. , & Rusconi, E. (2020). Prevalence of post‐traumatic symptomatology and anxiety among residential nursing and care home workers following the first COVID‐19 outbreak in Northern Italy . Royal Society Open Science , 7 ( 9 ), 200880. 10.1098/rsos.200880 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Sahebi, A. , Nejati‐Zarnaqi, B. , Moayedi, S. , Yousefi, K. , Torres, M. , & Golitaleb, M. (2021). The prevalence of anxiety and depression among healthcare workers during the COVID‐19 pandemic: An umbrella review of meta‐analyses . Progress in Neuro‐Psychopharmacology and Biological Psychiatry , 107 , 110247. 10.1016/j.pnpbp.2021.110247 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Saragih, I. D. , Tonapa, S. I. , Saragih, I. S. , Advani, S. , Batubara, S. O. , Suarilah, I. , & Lin, C.‐J. (2021). Global prevalence of mental health problems among healthcare workers during the Covid‐19 pandemic: A systematic review and meta‐analysis . International Journal of Nursing Studies , 121 , 104002. 10.1016/j.ijnurstu.2021.104002 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Schardt, C. , Adams, M. B. , Owens, T. , Keitz, S. , & Fontelo, P. (2007). Utilization of the PICO framework to improve searching PubMed for clinical questions . BMC medical informatics and decision making , 7 ( 1 ), 1–6. 10.1186/1472-6947-7-16 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Selçuk Tosun, A. , Akgül Gündoğdu, N. , & Taş, F. (2021). Anxiety levels and solution‐focused thinking skills of nurses and midwives working in primary care during the COVID‐19 pandemic: A descriptive correlational study . Journal of Nursing Management , 29 ( 7 ), 1946–1955. 10.1111/JONM.13334 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Serrano‐Ripoll, M. J. , Zamanillo‐Campos, R. , Castro, A. , Fiol‐Deroque, M. A. , & Ricci‐Cabello, I. (2021). Insomnia and sleep quality in healthcare workers fighting against Covid‐19: A systematic review of the literature and meta‐analysis . Actas Espanolas de Psiquiatria , 49 ( 4 ), 155–179. https://www.actaspsiquiatria.es/repositorio//23/132/ENG/23‐132‐ENG‐155‐179‐292610.pdf [ PubMed ] [ Google Scholar ]
• Shen, X. , Zou, X. , Zhong, X. , Yan, J. , & Li, L. (2020). Psychological stress of ICU nurses in the time of COVID‐19 . Critical Care , 24 ( 1 ), 200. 10.1186/s13054-020-02926-2 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Simonetti, V. , Durante, A. , Ambrosca, R. , Arcadi, P. , Graziano, G. , Pucciarelli, G. , Simeone, S. , Vellone, E. , Alvaro, R. , & Cicolini, G. (2021). Anxiety, sleep disorders and self‐efficacy among nurses during COVID‐19 pandemic: A large cross‐sectional study . Journal of Clinical Nursing , 30 ( 9–10 ), 1360–1371. 10.1111/JOCN.15685 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Stayt, L. C. , Merriman, C. , Bench, S. , Price, A. , Vollam, S. , Walthall, H. , Credland, N. , Gerber, K. , & Calovski, V. (2022). Doing the best we can': Registered Nurses' experiences and perceptions of patient safety in intensive care during COVID‐19 . Journal of Advanced Nursing , 78 , 3371–3384. 10.1111/jan.15419 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Sun, H. , Wang, S. , Wang, W. , Han, G. , Liu, Z. , Wu, Q. , & Pang, X. (2021). Correlation between emotional intelligence and negative emotions of front‐line nurses during the COVID‐19 epidemic: A cross‐sectional study . Journal of Clinical Nursing , 30 ( 3–4 ), 385–396. 10.1111/JOCN.15548 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Tiete, J. , Guatteri, M. , Lachaux, A. , Matossian, A. , Hougardy, J. M. , Loas, G. , & Rotsaert, M. (2021). Mental health outcomes in healthcare workers in COVID‐19 and non‐COVID‐19 care units: A cross‐sectional survey in Belgium . Frontiers in Psychology , 11 , 612241. 10.3389/FPSYG.2020.612241 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Wang, H. , Dai, X. , Yao, Z. , Zhu, X. , Jiang, Y. , Li, J. , & Han, B. (2021). The prevalence and risk factors for depressive symptoms in frontline nurses under COVID‐19 pandemic based on a large cross‐sectional study using the propensity score‐matched method . BMC Psychiatry , 21 ( 1 ), 152. 10.1186/S12888-021-03143-Z [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• World Health Organization . (2021). Health and care worker deaths during COVID‐19 . https://www.who.int/news/item/20‐10‐2021‐health‐and‐care‐worker‐deaths‐during‐covid‐19
• World Health Organization . (2022). WHO Coronavirus (COVID‐19) Dashboard . https://covid19.who.int/?adgroupsurvey=%7Badgroupsurvey%7D&gclid=CjwKCAiA5t‐OBhByEiwAhR‐hm1XnIr4UmhCy2oOmjWDaS9L‐SNxK_Jib57F_wLW‐yZ‐ycFBELB_v8hoCgN0QAvD_BwE
• Xiong, H. , Yi, S. , & Lin, Y. (2020). The psychological status and self‐efficacy of nurses during COVID‐19 outbreak: A cross‐sectional survey . Inquiry: A Journal of Medical Care Organization, Provision and Financing , 57 , 5‐21. 10.1177/0046958020957114 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Zhan, Y. X. , Zhao, S. Y. , Yuan, J. , Liu, H. , Liu, Y. F. , Gui, L. L. , Zheng, H. , Zhou, Y. M. , Qiu, L. H. , Chen, J. H. , Yu, J. H. , & Li, S. Y. (2020). Prevalence and influencing factors on fatigue of first‐line nurses combating with COVID‐19 in China: A descriptive cross‐sectional study . Current Medical Science , 40 ( 4 ), 625–635. 10.1007/S11596-020-2226-9 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Zheng, R. , Zhou, Y. , Fu, Y. , Xiang, Q. , Cheng, F. , Chen, H. , Xu, H. , Fu, L. , Wu, X. , Feng, M. , Ye, L. , Tian, Y. , Deng, R. , Liu, S. , Jiang, Y. , Yu, C. , & Li, J. (2021). Prevalence and associated factors of depression and anxiety among nurses during the outbreak of COVID‐19 in China: A cross‐sectional study . International Journal of Nursing Studies , 114 , 103809. 10.1016/J.IJNURSTU.2020.103809 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Zheng, R. , Zhou, Y. , Qiu, M. , Yan, Y. , Yue, J. , Yu, L. , Lei, X. , Tu, D. , & Hu, Y. (2021). Prevalence and associated factors of depression, anxiety, and stress among Hubei pediatric nurses during COVID‐19 pandemic . Comprehensive Psychiatry , 104 , 152217. 10.1016/J.COMPPSYCH.2020.152217 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

Study helps explain why childhood maltreatment continues to impact on mental and physical health into adulthood

Childhood maltreatment can continue to have an impact long into adulthood because of how it effects an individual's risk of poor physical health and traumatic experiences many years later, a new study has found.

Individuals who experienced maltreatment in childhood -- such as emotional, physical and sexual abuse, or emotional and physical neglect -- are more likely to develop mental illness throughout their entire life, but it is not yet well understood why this risk persists many decades after maltreatment first took place.

In a study published in Proceedings of the National Academy of Sciences , scientists from the University of Cambridge and Leiden University found that adult brains continue to be affected by childhood maltreatment in adulthood because these experiences make individuals more likely to experience obesity, inflammation and traumatic events, all of which are risk factors for poor health and wellbeing, which in turn also affect brain structure and therefore brain health.

The researchers examined MRI brain scans from approximately 21,000 adult participants aged 40 to 70 years in UK Biobank, as well as information on body mass index (an indicator of metabolic health), CRP (a blood marker of inflammation) and experiences of childhood maltreatment and adult trauma.

Sofia Orellana, a PhD student at the Department of Psychiatry and Darwin College, University of Cambridge, said: "We've known for some time that people who experience abuse or neglect as a child can continue to experience mental health problems long into adulthood and that their experiences can also cause long term problems for the brain, the immune system and the metabolic system, which ultimately controls the health of your heart or your propensity to diabetes for instance. What hasn't been clear is how all these effects interact or reinforce each other."

Using a type of statistical modelling that allowed them to determine how these interactions work, the researchers confirmed that experiencing childhood maltreatment made individuals more likely to have an increased body mass index (or obesity) and experience greater rates of trauma in adulthood. Individuals with a history of maltreatment tended to show signs of dysfunction in their immune systems, and the researchers showed that this dysfunction is the product of obesity and repeated exposure to traumatic events.

Next, the researchers expanded their models to include MRI measures of the adult's brains and were able to show that widespread increases and decreases in brain thickness and volume associated with greater body mass index, inflammation and trauma were attributable to childhood maltreatment having made these factors more likely in the first place. These changes in brain structure likely mean that some form of physical damage is occurring to brain cells, affecting how they work and function.

Although there is more to do to understand how these effects operate at a cellular level in the brain, the researchers believe that their findings advance our understanding of how adverse events in childhood can contribute to life-long increased risk of brain and mind health disorders.

Professor Ed Bullmore from the Department of Psychiatry and an Honorary Fellow at Downing College, Cambridge, said: "Now that we have a better understanding of why childhood maltreatment has long term effects, we can potentially look for biomarkers -- biological red flags -- that indicate whether an individual is at increased risk of continuing problems. This could help us target early on those who most need help, and hopefully aid them in breaking this chain of ill health."

The research was supported by MQ: Transforming Mental Health, the Royal Society, Medical Research Council, National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre, the NIHR Applied Research Collaboration East of England, Girton College and Darwin College.

• Mental Health Research
• Chronic Illness
• Diseases and Conditions
• Medical Topics
• Mental Health
• Disorders and Syndromes
• Child Development
• Post-traumatic stress disorder
• Environmental impact assessment
• Adolescence
• Child abuse
• Substance abuse
• Personalized medicine

Story Source:

Materials provided by University of Cambridge . The original text of this story is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License . Note: Content may be edited for style and length.

Journal Reference :

• Orellana, SC et al. Childhood maltreatment influences adult brain structure through its effects on immune, metabolic and psychosocial factors. . PNAS , 2024 DOI: 10.1073/pnas.230470412

Cite This Page :

Explore More

• Quantum Effects in Electron Waves
• Star Trek's Holodeck Recreated Using ChatGPT
• Cloud Engineering to Mitigate Global Warming
• Detecting Delayed Concussion Recovery
• Genes for Strong Muscles: Healthy Long Life
• Brightest Gamma-Ray Burst
• Stellar Winds of Three Sun-Like Stars Detected
• Fences Causing Genetic Problems for Mammals
• Ozone Removes Mating Barriers Between Fly ...
• Parkinson's: New Theory On Origins and Spread

Trending Topics

Strange & offbeat.