The Impact of Academic Workload and Perceived Stress on Anxiety and Depression among Nursing Students: A Cross-Sectional Study

Depressive and anxiety disorders are significant global mental health concerns. In higher education, academic workload and stress make students particularly vulnerable to these disorders, especially in nursing, where training requirements are high. This study investigates the impact of academic workload and perceived stress on the prevalence of anxiety and depression among nursing students at the Higher Institute of Nursing Professions and Health Techniques (HINPHT) in Taza City, Morocco, using a quantitative correlational design involving a sample of 294 students. Data were collected using a self-administered questionnaire structured into three sections: 1) sociodemographic characteristics (gender, age, marital status, specialty, semester of study), 2) assessment of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) and 3) assessment of perceived stress through the Perceived Stress Scale (PSS-10). The academic workload was calculated from the program description of the theoretical and practical modules in each semester and specialty, excluding personal work. Data were analyzed using IBM SPSS Statistics software through univariate, bivariate, and multivariate analyses to determine relationships between variables. The results of the multivariate analysis, using ordinal logistic regression, revealed that academic workload had a statistically significant but minimal effect on anxiety (p-value = 0.039; AOR = 1.004) but no significant effect on depression (p-value = 0.933). Perceived stress, on the other hand, emerged as a major predictive factor for both anxiety (p-value < 0.001; AOR = 1.234) and depression (p- value < 0.001; AOR = 1.157). Considering these results, recommendations include adjusting the academic workload to align with students' skills and needs, implementing stress management strategies, providing psychological support through listening services, and creating a less stressful theoretical and clinical learning environment to safeguard the mental well-being of nursing students.