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Do social and environmental factors affect level of stress during COVID-19 among nursing students? Results from single center cross-sectional study in Malaysia

  • Siti Fatimah Sa’at ,
  • Annabelle Dimple Kharisha Gill ,
  • Bernard Jordan Damianus ,
  • Jeremy Dominic Saibun ,
  • Gill Lerrkey Ukim ,
  • Zulkhairul Naim bin Sidek Ahmad ,


Introduction: Stress in nursing students has been documented in many studies and this will lead to various health problems. However, there is scanty research assessing the level of stress among nursing students during Covid-19 in Malaysia.  Hence, this study aimed to assess the level of stress and its association with social and environmental factors amongst nursing students in Universiti Malaysia Sabah, Malaysia.

Methods: A cross-sectional study was conducted by random sampling among nursing students in Universiti Malaysia Sabah between March and May 2021. The primary outcome was stress symptoms, derived from the validated Perceived Stress Scale-10 (PSS) questionnaire. Socio-demographic, social, and environmental factors were also assessed. T-test was used to assess the associations between level of stress and social and environmental factors.

Results: A total of 115 responses were received with the mean (SD) age of the students being 20.5 (1.3) years old. Of all the students, 84.9% were female, 54.6% received financial support from National Higher Education Fund Corporation and 46.2% were in nursing Year 2 followed by the nursing year 1 (28.6%) and nursing year 3 (25.2%). The students in this study reported a higher level of stress. The students who reported most or all the time being trapped in a hostel (p<0.01), challenges of online classes (p=0.03), and catching up with class projects (p=0.03) had a higher level of stress compared to those who reported none or little or some of the factors.

Conclusion: This study showed that social and environmental factors may play a role in determining the stress level among nursing students. Hence, authorities should foster supporting strategies to lower student stress and tackles the unwanted consequences.


  1. Y B, Y S, S M, J S, L L. 2019-nCoV epidemic: address mental health care to empower society. Lancet (London, England)t. 2020;395(10224):e37–8.
  2. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) | CDC [Internet]. 2021. Available from:
  3. Worldometers. COVID Live Update. 2021.
  4. Li L, Hu H, Zhou H, He C, Fan L, Liu X, et al. Work stress, work motivation and their effects on job satisfaction in community health workers: a cross-sectional survey in China. BMJ Open,. 2014;4(6).
  5. Man MA, Toma C, Motoc NS, Necrelescu OL, Bondor CI, Chis AF, et al. Disease perception and coping with emotional distress during covid-19 pandemic: A survey among medical staff. Int J Environ Res Public Health. 2020;17(13):1–13.
  6. Rodríguez-Hidalgo AJ, Pantaleón Y, Dios I, Falla D. Fear of COVID-19, Stress, and Anxiety in University Undergraduate Students: A Predictive Model for Depression. Front Psychol. 2020;3041.
  7. Wang C, Zhao H. The Impact of COVID-19 on Anxiety in Chinese University Students. Front Psychol. 2020;22(1):15–22.
  8. Kalok A, Sharip S, Hafizz AMA, Zainuddin ZM, Shafiee MN. The Psychological Impact of Movement Restriction during the COVID-19 Outbreak on Clinical Undergraduates: A Cross-Sectional Study. Int J Environ Res Public Health. 2020;17(22):8522.
  9. Marelli S, Castelnuovo A, Somma A, Castronovo V, Mombelli S, Bottoni D, et al. Impact of COVID-19 lockdown on sleep quality in university students and administration staff. J Neurol. 2021;268(1).
  10. Changwon H, S., Smith A, Wang X, Sasangohar F. Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study. J Med Internet Res. 2020;22(9).
  11. Vestad L, Bru E, Virtanen TE, Stallard PN. Associations of social and emotional competencies, academic efficacy beliefs, and emotional distress among students in lower secondary school. Soc Psychol Educ. 2021;24(2):413–39.
  12. Pourhoseingholi MA, Vahedi M, Rahimzadeh M. Sample size calculation in medical studies. Gastroenterol Hepatol From Bed to Bench. 2013;6(1):14.
  13. Hamaideh SH, Al-Modallal H, Tanash M, Hamdan-Mansour A. Depression, anxiety and stress among undergraduate students during COVID-19 outbreak and “home-quarantine". Nurs Open. 2021;16(1):298–312.
  14. Aslan H, Pekince H. Nursing students’ views on the COVID‐19 pandemic and their percieved stress levels. Perspect Psychiatr Care. 2021;57(2):695–701.
  15. Shrestha N, Ghimire N, Khatry R, Maharjan R. Psychological Effect of COVID-19 among Nursing Students. Int J Heal Sci Res. 2021;11(5):29–9.
  16. Mattioli A V., Ballerini Puviani M, Nasi M, Farinetti A. COVID-19 pandemic: the effects of quarantine on cardiovascular risk. Eur J Clin Nutr. 2020;74(6):852–855.
  17. D M, M R, G S. Distance Learning-Related Stress Among Undergraduate Nursing Students During the COVID-19 Pandemic. J Nurs Educ. 2020;59(12):666–74.
  18. Thapa P, Bhandari SL, Pathak S. Nursing students’ attitude on the practice of e-learning: A cross-sectional survey amid COVID-19 in Nepal. PLoS One. 2021;16(6):e0253651.
  19. B S, Y F, A E, T H. Anxiety and coping strategies among nursing students during the covid-19 pandemic. Nurse Educ Pract. 2020;46:21–9.
  20. A F, S K. Transition in learning during COVID-19: Student nurse anxiety, stress, and resource support. Nurs Forum. 2021;56(2):298–304.

How to Cite

Sa’at , S. F., Gill , A. D. K. ., Damianus , B. J. ., Saibun, J. D. ., Ukim , G. L. ., & bin Sidek Ahmad, Z. N. . (2022). Do social and environmental factors affect level of stress during COVID-19 among nursing students? Results from single center cross-sectional study in Malaysia. Bali Medical Journal, 11(2), 934–938.




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Siti Fatimah Sa’at
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BMJ Journal

Annabelle Dimple Kharisha Gill
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Bernard Jordan Damianus
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Jeremy Dominic Saibun
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Gill Lerrkey Ukim
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Zulkhairul Naim bin Sidek Ahmad
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