Assessing COVID-19-Related Psychological Distress: Validation of the AMICO Scale in Spanish Nursing University Students

<b>Background</b>: The COVID-19 pandemic had a significant impact on nursing students by intertwining academic demands with health concerns, a situation that had effects on their emotional well-being and academic engagement. Factors such as sociodemographic characteristics and health status determined their experiences. Understanding these dynamics is crucial, especially in the context of the Spanish health and education systems. The present study aimed to adapt and assess the psychometric properties of the AMICO scale in the context of nursing students in Spain. <b>Methods</b>: Cross-sectional descriptive study. The study was carried out in University Nursing Centers in Spain using a non-probabilistic snowball sampling method. The total sample consisted of 1197 nursing students. Sociodemographic variables were included, as well as questions related to general health and some more specific questions about COVID-19. For the reliability study, Cronbach's alpha was calculated. An exploratory factor analysis using principal components and varimax rotation was applied, excluding items with loadings below 0.05. <b>Results</b>: In this study, 1197 nursing students residing in Spain participated, of whom 85% were female, with a mean age of 22.35 years. Despite 73.9% of the students being isolated due to exposure to COVID-19, they rated their general health positively (7.86). Females reported higher levels of anxiety. The AMICO scale revealed significant differences according to gender, health, and vaccination history, showing high reliability (Cronbach's alpha = 0.913). <b>Conclusions</b>: The two-factor structure of the AMICO scale was validated, confirming its suitability for assessing anxiety and fear among nursing students in Spain. The study revealed significant emotional distress during the COVID-19 pandemic, particularly among women, high-risk individuals, and those fully vaccinated. These findings accentuate the need for higher education institutions to implement targeted mental health interventions during public health emergencies. Future longitudinal research should examine the evolving psychological impact of such crises and the mitigating roles of quality of life, sleep, and physical activity.