Global prevalence of different levels of anxiety and stress symptoms in healthcare students: A meta-analysis and meta-regression

Abstract

Background: There are limited reviews to report the different levels of anxiety and stress symptoms among students studying nursing, pharmacy, and allied health. Objective: To calculate the global prevalence of different levels of anxiety and stress symptoms among healthcare students and examine the factors that affect the different levels of prevalence estimates. Methods: A three-step comprehensive search of 10 databases was conducted. Meta-analysis, subgroup analyses, and meta-regression were performed using the meta package in R software. The Newcastle-Ottawa Scale and Grading of Recommendations Assessments, Development and Evaluation criteria were utilised for the quality appraisal of included studies and the certainty of the evidence, respectively. Results: A total of 112 studies with 42,331 healthcare students across 43 countries were selected. The prevalences of unspecified, mild, moderate, severe, and extremely severe anxiety symptoms were 41% (95% CI: 33–50), 15% (95% CI: 12–19), 22% (95% CI: 19–26), 10% (95% CI: 8–13), 14% (95% CI: 11–17), respectively. The prevalences of unspecified, mild, moderate, severe, and extremely severe stress symptoms were 36% (95% CI: 25–47), 15% (95% CI: 12–18), 32% (95% CI: 25–40), 11% (95% CI: 8–15), 4% (95% CI: 2–5), respectively. A series of subgroup and meta-regression analyses identified geographic region, use of an instrument, type of healthcare students, sample size and study quality were significantly impacted prevalence estimates. Conclusion: Findings can contribute as evidence to raising awareness about different levels of anxiety and stress symptoms. Early screening and tailored preventive interventions can help eliminate the prevalence in healthcare students.