skip to main content

Association Between Source of Social Support and Depression Among Nursing Students During the COVID-19 Pandemic

Dedi Kurniawan orcid  -  Department of Mental Health Nursing, Kepanjen School of Health Sciences, Indonesia
*Akbar Satria Fitriawan orcid scopus  -  Department of Nursing, Faculty of Health Sciences, Universitas Respati Yogyakarta, Indonesia
Wiwit Ananda Wahyu Setyaningsih orcid scopus  -  Department of Anatomy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
Apri Nur Wulandari  -  Department of Maternity Nursing, Notokusumo School of Health Sciences, Indonesia
Eriyono Budi Wijoyo  -  Department of Mental Health Nursing, Faculty of Health Sciences, Universitas Muhammadiyah Tangerang, Indonesia
Erni Samutri  -  Department of Maternity Nursing, Faculty of Health Sciences, Universitas Alma Ata, Indonesia
Gatot Suparmanto  -  Department of Basic Nursing, Faculty of Health Sciences, Universitas Kusuma Husada, Indonesia
Bayu Fandhi Achmad  -  Department of Emergency Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
Listyana Natalia Retnaningsih  -  Department of Nursing Management, Faculty of Health Sciences, Universitas Respati Yogyakarta, Indonesia
Putri Eka Sudiarti  -  Department of Pediatric Nursing, Faculty of Health Sciences, Universitas Pahlawan Tuanku Tambusai, Indonesia
Open Access Copyright (c) 2024 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: Nursing students have a higher risk of depression due to their already high academic burden, social isolation, pandemic loneliness, abrupt online learning, and financial difficulties during the COVID-19 pandemic lockdown. Although the disruption of social network patterns during the pandemic has been observed in previous studies, it is still not fully understood which source of social support is associated with depression among nursing students. 

Purpose: This study aimed to assess the correlations between sources of social support and depression among nursing students during the COVID-19 pandemic lockdown.

Methods: An online cross-sectional study was conducted between May-September 2021. Nursing students (n=734) from seven universities across four provinces in Indonesia were recruited as participants using convenience sampling methods. Data were obtained through online questionnaires consisting of the Multidimensional Scale of Perceived Social Support (MSPSS) to assess social support, and the Patient Health Questionnaire-9 (PHQ-9) to assess depression. Spearman-Rank correlation tests were used to examine the correlations between sources of social support and depression.    

Results: Most of the nursing students (85.1%) were female with a mean age of 19.94 years (SD=1.42). Many nursing students (n=313; 42.6%) experienced depression. Most of the students (n=465; 63.4%) perceived high family support, moderate friends (n=415; 56.5%) and significant others' support (n=437; 59.5%). Of the three sources of social support (family, friends, and significant others), only family support had a significant inverse correlation with depression (Rho=-0.492, p<0.001).

Conclusion: Family support had a significant inverse and moderate correlation with depression among nursing students during the COVID-19 pandemic. Our findings provided information to nursing educators to incorporate a strategy to maintain robust family support and regular depression assessments as part of the online learning curriculum. Therefore, it can be used to ameliorate depression among nursing students.

Fulltext
Keywords: COVID-19, depression, Indonesia, nursing students, social support

Article Metrics:

  1. Abu Ruz, M. E., Al-Akash, H. Y., & Jarrah, S. (2018). Persistent (anxiety and depression) affected academic achievement and absenteeism in nursing students. The Open Nursing Journal, 12(1), 171–179. https://doi.org/10.2174/1874434601812010171
  2. Achmad, B.F., Fitriawan, A.S., Kurniawan, D., Chen, H.M. (2023). Mediating effect of self-esteem on the relationship between academic self-efficacy and depression symptoms among nursing students participating in blended learning. Heliyon, 9(11), e22526. https://doi.org/10.1016/j.heliyon.2023.e22526
  3. Achmad, B.F., Fitriawan, A.S., Kurniawan, D., Kafil, R.F., Retnaningsih, L.N., Setyaningsih, W.A.W. (2021). Perceived Barriers in Online Learning among Nursing Students during the COVID-19 Pandemic in Indonesia. Open Access Maced J Med Sci, 9(G), 203-10. https://doi.org/10.3889/oamjms.2021.7183
  4. Alsubaie, M. M., Stain, H. J., Webster, L. A. D., & Wadman, R. (2019). The role of sources of social support on depression and quality of life for university students. International Journal of Adolescence and Youth, 24(4), 484–496. https://doi.org/10.1080/02673843.2019.1568887
  5. Al-Zawaadi, A., Hesso, I., Kayyali, R. (2021). Mental Health Among School-Going Adolescents in Greater London: A Cross-Sectional Study. Front Psychiatry, 12, 592624. https://doi.org/10.3389/fpsyt.2021.592624
  6. Amoah, P. A. (2019). The relationship among functional health literacy, self-rated health, and social support among younger and older adults in Ghana. International Journal of Environmental Research and Public Health, 16(17), 3188. https://doi.org/10.3390/ijerph16173188
  7. Bokszczanin, A., Palace, M., Brown, W., Gladysh, O., Tripathi, R., & Shree, D. (2023). Depression, Perceived Risk of COVID-19, Loneliness, and Perceived Social Support from Friends Among University Students in Poland, UK, and India. Psychology research and behavior management, 16, 651–663. https://doi.org/10.2147/PRBM.S380318
  8. Cahuas, A., Marenus, M.W., Kumaravel, V., Murray, A., Friedman, K., Ottensoser, H., Chen, W. (2023). Perceived social support and COVID-19 impact on quality of life in college students: an observational study. Ann Med, 55(1), 136-145. https://doi.org/10.1080/07853890.2022.2154943
  9. Camara, M., Bacigalupe, G., & Padilla, P. (2017). The role of social support in adolescents: are you helping me or stressing me out? International Journal of Adolescence and Youth, 22(2), 123–136. https://doi.org/10.1080/02673843.2013.875480
  10. Coventry, W. L., Gillespie, N. A., Heath, A. C., & Martin, N. G. (2004). Perceived social support in a large community sample - Age and sex differences. Social Psychiatry and Psychiatric Epidemiology, 39(8), 625–636. https://doi.org/10.1007/s00127-004-0795-8
  11. Elmer, T., Mepham, K., & Stadtfeld, C. (2020). Students under lockdown: Comparisons of students’ social networks and mental health before and during the COVID-19 crisis in Switzerland. PLoS ONE, 15(7), e0236337. https://doi.org/10.1371/journal.pone.0236337
  12. Esmaeelzadeh, S., Moraros, J., Thorpe, L., & Bird, Y. (2018). The association between depression, anxiety and substance use among Canadian post-secondary students. Neuropsychiatric Disease and Treatment, 14, 3241–3251. https://doi.org/10.2147/NDT.S187419
  13. Facioli, A. M., Barros, Â. F., Melo, M. C., Ogliari, I. C. M., & Custódio, R. J. de M. (2020). Depression among nursing students and its association with academic life. Revista Brasileira de Enfermagem, 73(1), e20180173. https://doi.org/10.1590/0034-7167-2018-0173
  14. Fitriawan, A.S., Kurniawan, D., Nailufar, Y., Retnaningsih, L.N., Achmad, B.F, & Setyaningsih, W.A.W. (2023). Association between self-efficacy and psychological distress with readiness for online learning among nursing students. Malaysian Journal of Medicine and Health Sciences, 19(1), 125–134. https://doi.org/10.47836/mjmhs19.1.18
  15. Fitriawan, A.S., Setyaningsih, W.A.W., Samutri, E., Kurniawan, D., Deviantony, F., Suparmanto, G., Achmad, B.F., & Wijoyo, E.B. (2023). Predictors of Adherence to Personal Preventive Behaviors Among Nursing Students Based on Health Belief Model: Cross Sectional Study During the Second Wave of COVID-19 Pandemic in Indonesia. Malaysian Journal of Medicine and Health Sciences, 19(4), 237-246. https://doi.org/10.47836/mjmhs19.4.35
  16. Fitriawan, A.S., Setyaningsih, W.A.W., Wulandari, A.N., Samutri, E., Achmad, B.F., Budiyati, G.A., Nailufar, Y., & Retnaningsih, L.N. (2023). Prevalence and predictors of suicidality among nursing students in Indonesia. Kontakt, 25(1), 10-17. https://doi.org/10.32725/kont.2023.009
  17. Guerrero-Muñoz, D., Salazar, D., Constain, V., Perez, A., Pineda-Cañar, C. A., & García-Perdomo, H. A. (2021). Association between family functionality and depression: A systematic review and meta-analysis. Korean Journal of Family Medicine, 42(2), 172–180. https://doi.org/10.4082/kjfm.19.0166
  18. Hager, N. M., Judah, M. R., & Milam, A. L. (2022). Loneliness and Depression in College Students During the COVID-19 Pandemic: the Role of Boredom and Repetitive Negative Thinking. International journal of cognitive therapy, 15(2), 134–152. https://doi.org/10.1007/s41811-022-00135-z
  19. Hailey, V., Fisher, A., Hamer, M., & Fancourt, D. (2023). Perceived social support and sustained physical activity during the COVID-19 pandemic. International Journal of Behavioral Medicine, 30(5),651-662. https://doi.org/10.1007/s12529-022-10125-2
  20. Hock, R. S., Or, F., Kolappa, K., Burkey, M. D., Surkan, P. J., & Eaton, W. W. (2012). A new resolution for global mental health. Lancet, 379(9824): 1367–1368. https://doi.org/10.1016/S0140
  21. Huang, X., Hu, N., Yao, Z., & Peng, B. (2022). Family functioning and adolescent depression: A moderated mediation model of self-esteem and peer relationships. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.962147
  22. Hung, M. S. Y., Ng, W. W. M., & Choi, E. K. Y. (2022). The impacts of the COVID-19 pandemic on Hong Kong nursing students’ mental health and quality of life. International Journal of Environmental Research and Public Health, 19(22). https://doi.org/10.3390/ijerph192215117
  23. Kamen, C., Cosgrove, V., McKellar, J., Cronkite, R., & Moos, R. (2011). Family support and depressive symptoms: A 23-year follow-up. Journal of Clinical Psychology, 67(3), 215–223. https://doi.org/10.1002/jclp.20765
  24. Karaca, A., Yildirim, N., Cangur, S., Acikgoz, F., & Akkus, D. (2019). Relationship between mental health of nursing students and coping, self-esteem and social support. Nurse Education Today, 76, 44–50. https://doi.org/10.1016/j.nedt.2019.01.029
  25. Kim, K., Jeong, H., & Lee, J. (2022). COVID-19 related fear, risk perceptions, and behavioral changes according to level of depression among nursing students. International Journal of Environmental Research and Public Health, 19(8). https://doi.org/10.3390/ijerph19084814
  26. Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9 validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613, https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  27. Kugbey, N., Osei-Boadi, S., & Atefoe, E. A. (2015). The Influence of Social Support on the Levels of Depression, Anxiety and Stress among Students in Ghana. Journal of Education and Practice, 6(25), 135-140
  28. Kulcar, V., Bork-Hüffer, T., & Schneider, A. M. (2022). Getting through the crisis together: Do Friendships contribute to university students’ resilience during the COVID-19 pandemic?. Frontiers in Psychology, 13, 880646. https://doi.org/10.3389/fpsyg.2022.880646
  29. Kwak, E., Park, S., & Ko, J. W. (2022). The effects of academic stress and upward comparison on depression in nursing students during COVID-19. Healthcare (Basel), 10(10), 2091. https://doi.org/10.3390/healthcare10102091
  30. Laksmita, O. D., Chung, M. H., Liao, Y. M., & Chang, P. C. (2020). Multidimensional scale of perceived social support in indonesian adolescent disaster survivors: A psychometric evaluation. PLoS ONE, 15(3), e0229958. https://doi.org/10.1371/journal.pone.0229958
  31. Lee, M., Na, H. M., Kim, B., Kim, S. Y., Park, J., & Choi, J. Y. (2021). Mediating effects of achievement emotions between peer support and learning satisfaction in graduate nursing students. Nurse Education in Practice, 52, 103003. https://doi.org/10.1016/j.nepr.2021.103003
  32. Li, F., Luo, S., Mu, W., Li, Y., Ye, L., Zheng, X., Xu, B., Ding, Y., Ling, P., Zhou, M., & Chen, X. (2021). Effects of sources of social support and resilience on the mental health of different age groups during the COVID-19 pandemic. BMC Psychiatry, 21(1), 16. https://doi.org/10.1186/s12888-020-03012-1
  33. Li, S., & Xu, Q. (2022). Family support as a protective factor for attitudes toward social distancing and in preserving positive mental health during the COVID-19 pandemic. Journal of Health Psychology, 27(4), 858–867. https://doi.org/10.1177/1359105320971697
  34. Lim, G. Y., Tam, W. W., Lu, Y., Ho, C. S., Zhang, M. W., & Ho, R. C. (2018). Prevalence of Depression in the Community from 30 Countries between 1994 and 2014. Scientific Reports, 8(1), 2861. https://doi.org/10.1038/s41598-018-21243-x
  35. Liu, Y., Hu, J., & Liu, J. (2022). Social Support and Depressive Symptoms Among Adolescents During the COVID-19 Pandemic: The Mediating Roles of Loneliness and Meaning in Life. Frontiers in public health, 10, 916898. https://doi.org/10.3389/fpubh.2022.916898
  36. Mai, Y., Wu, Y. J., & Huang, Y. (2021). What type of social support is important for student resilience during COVID-19? A latent profile analysis. Frontiers in Psychology, 12, 646145. https://doi.org/10.3389/fpsyg.2021.646145
  37. Manczak, E. M., Skerrett, K. A., Gabriel, L. B., Ryan, K. A., & Langenecker, S. A. (2018). Family support: A possible buffer against disruptive events for individuals with and without remitted depression. Journal of Family Psychology, 32(7), 926–935. https://doi.org/10.1037/fam0000451
  38. Mcdermott, R. C., Fruh, S. M., Williams, S., Hauff, C., Graves, R. J., Melnyk, B. M., & Hall, H. R. (2020). Nursing students’ resilience, depression, well-being, and academic distress: Testing a moderated mediation model. Journal of Advanced Nursing, 76(12), 3385–3397. https://doi.org/10.1111/jan.14531
  39. Moraes, S. M. A. B., Barbosa, V. F. B., Alexandre, A. C. S., Santos, S. C. Dos, Guimarães, F. J., & Veras, J. L. de A. (2021). Risk of suicide among nursing students. Revista Brasileira de Enfermagem, 74(6), e20200867. https://doi.org/10.1590/0034-7167-2020-0867
  40. Mustanski, B., Newcomb, M. E., & Garofalo, R. (2011). Mental health of lesbian, gay, and bisexual youths: A developmental resiliency perspective. Journal of Gay and Lesbian Social Services, 23(2), 204–225. https://doi.org/10.1080/10538720.2011.561474
  41. Ng, C. W. M., How, C. H., & Ng, Y. P. (2016). Major depression in primary care: Making the diagnosis. Singapore Medical Journal, 57(11), 591–597. https://doi.org/10.11622/smedj.2016174
  42. Njim, T., Mbanga, C., Mouemba, D., Makebe, H., Toukam, L., Kika, B., & Mulango, I. (2020). Determinants of depression among nursing students in Cameroon: A cross-sectional analysis. BMC Nursing, 19(1), 2-6. https://doi.org/10.1186/s12912-020-00424-y
  43. Orsolini, L., Latini, R., Pompili, M., Serafini, G., Volpe, U., Vellante, F., Fornaro, M., Valchera, A., Tomasetti, C., Fraticelli, S., Alessandrini, M., La Rovere, R., Trotta, S., Martinotti, G., Di Giannantonio, M., & De Berardis, D. (2020). Understanding the complex of suicide in depression: From research to clinics. Psychiatry Investigation, 17(3), 207-221. https://doi.org/10.30773/pi.2019.0171
  44. Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan, C. A., Charney, D., & Southwick, D. (2007). Social support and resilience to stress: From neurobiology to clinical practice. Psychiatry (Edgmont), 4(5), 35-40
  45. Padmanabhanunni, A., Pretorius, T. B., & Isaacs, S. A. (2023). We Are Not Islands: The Role of Social Support in the Relationship between Perceived Stress during the COVID-19 Pandemic and Psychological Distress. International journal of environmental research and public health, 20(4), 3179. https://doi.org/10.3390/ijerph20043179
  46. Perret, L. C., Ki, M., Commisso, M., Chon, D., Scardera, S., Kim, W., Fuhrer, R., Gariépy, G., Ouellet-Morin, I., & Geoffroy, M. C. (2021). Perceived friend support buffers against symptoms of depression in peer victimized adolescents: Evidence from a population-based cohort in South Korea. Journal of Affective Disorders, 291, 24–31. https://doi.org/10.1016/j.jad.2021.04.078
  47. Putri, W. C., & Nursanti, A. (2020). The relationship between peer social support and academic resilience of young adult migrant students in Jakarta. International Journal of Education, 13(2), 122–130. https://doi.org/10.17509/ije.v13i2.24547
  48. Remes, O., Mendes, JF., Templeton, P. (2021). Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature. Brain Sci, 11(12), 1633. doi: 10.3390/brainsci11121633
  49. Rutkowska, A., Cieślik, B., Tomaszczyk, A., & Szczepańska-Gieracha, J. (2022). Mental Health Conditions Among E-Learning Students During the COVID-19 Pandemic. Frontiers in public health, 10, 871934. https://doi.org/10.3389/fpubh.2022.871934
  50. Sakai, M., Nakanishi, M., Yu, Z., Takagi, G., Toshi, K., Wakashima, K., & Yoshii, H. (2022). Depression and anxiety among nursing students during the COVID-19 pandemic in Tohoku region, Japan: A cross-sectional survey. Japan Journal of Nursing Science, 19(3). https://doi.org/10.1111/jjns.12483
  51. Samrock, S., Kline, K., & Randall, A. K. (2021). Buffering against depressive symptoms: Associations between self-compassion, perceived family support and age for transgender and nonbinary individuals. International Journal of Environmental Research and Public Health, 18(15), 7938. https://doi.org/10.3390/ijerph18157938
  52. Setia, M.S. (2016). Methodology Series Module 3: Cross-sectional Studies. Indian J Dermatol, 61(3), 261-4. https://doi.org/10.4103/0019-5154.182410
  53. Sun, Y., Lin, SY., Chung, K.K.H. (2020). University Students' Perceived Peer Support and Experienced Depressive Symptoms during the COVID-19 Pandemic: The Mediating Role of Emotional Well-Being. Int J Environ Res Public Health, 17(24), 9308. https://doi.org/10.3390/ijerph17249308
  54. Stewart, W. F., Ricci, J. A., Chee, E., Hahn, S. R., & Morganstein, D. (2003). Cost of lost productive work time among us workers with depression. Jama-J Am Med Assoc, 289(23), 3135–3144. https://doi.org/10.1001/jama.289.23.3135
  55. Tenda, E.D., Asaf, M.M., Pradipta, A., Kumaheri, M.A., Susanto, A.P. (2021). The COVID-19 surge in Indonesia: what we learned and what to expect. Breathe, 17, 210146. doi: 10.1183/20734735.0146-2021
  56. Tin, S.T., Sidik, S.M., Rampal, L., & Ibrahim, N. (2015). Prevalence and predictors of suicidality among medical students in a public university. Medical Journal of Malaysia, 70(1), 1–15
  57. Tung, Y. J., Lo, K. K. H., Ho, R. C. M., & Tam, W. S. W. (2018). Prevalence of depression among nursing students: A systematic review and meta-analysis. Nurse Education Today, 63, 119-129. https://doi.org/10.1016/j.nedt.2018.01.009
  58. van der Linden, A. (2019). Cross-Cultural Validation of the Patient Health Questionnaire (PHQ-9) in Bahasa Indonesia to Measure Depression among People Affected by Leprosy in Central Java, Indonesia. Amsterdam, Netherland: Master of Medicine, Vrije Universiteit Amsterdam
  59. Wang, Y.-N., Yuan, Z.-J., Leng, W.-C., Xia, L.-Y., Wang, R.-X., Li, Z.-Z., Zhou, Y.-J., & Zhang, X.-Y. (2021). Role of perceived family support in psychological distress for pregnant women during the COVID-19 pandemic. World Journal of Psychiatry, 11(7), 365–374. https://doi.org/10.5498/wjp.v11.i7.365
  60. Wise, A. E., Smith, B. C., Armelie, A. P., Boarts, J. M., & Delahanty, D. L. (2019). Age moderates the relationship between source of social support and mental health in racial minority lesbian, gay, and bisexual youth. Journal of Health Psychology, 24(7), 888–897. https://doi.org/10.1177/1359105316686667
  61. Yao, Y., Lin, M., Ni, J., & Ni, J. (2023). Hope Buffers the Effect of Fear of COVID-19 on Depression among College Students: Insomnia as a Mediator. International journal of environmental research and public health, 20(4), 3245. https://doi.org/10.3390/ijerph20043245
  62. Zeng, Y., Wang, G., Xie, C., Hu, X., & Reinhardt, J. D. (2019). Prevalence and correlates of depression, anxiety and symptoms of stress in vocational college nursing students from Sichuan, China: a cross-sectional study. Psychology, Health and Medicine, 24(7), 798-811. https://doi.org/10.1080/13548506.2019.1574358
  63. Zhou, L., Sukpasjaroen, K., Wu, Y., Gao, L., Chankoson, T., & Cai, E. (2022). Perceived social support promotes nursing students’ psychological wellbeing: Explained with self-compassion and professional self-concept. Frontiers in Psychology, 13, 835134. https://doi.org/10.3389/fpsyg.2022.835134
  64. Zhou, X. (2020). Managing psychological distress in children and adolescents following the COVID-19 epidemic: A cooperative approach. Psychological Trauma: Theory, Research, Practice, and Policy, 12, S76–S78. https://doi.org/10.1037/tra0000754
  65. Zimet, G.D., Powel, S.S., Farley, G.K., Werkman, S., Berkoff, K.A. (1990). Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess, 55(3-4), 610-7. https://doi.org/10.1080/00223891.1990.9674095
  66. Zysberg, L., & Zisberg, A. (2022). Days of worry: Emotional intelligence and social support mediate worry in the COVID-19 pandemic. Journal of Health Psychology, 27(2), 268–277. https://doi.org/10.1177/1359105320949935

Last update:

No citation recorded.

Last update: 2024-10-11 17:33:39

No citation recorded.