Academic Stress in Undergraduate Nursing Education: An Integrative Review

Abstract

This integrative review examines the nature, prevalence, and implications of academic stress among undergraduate nursing students, drawing on peer-reviewed evidence published between 2021 and 2025. Academic stress levels in nursing students are consistently among the highest in higher education, attributed to intensive theoretical coursework, emotionally demanding clinical placements, financial pressures, and insufficient institutional support. A narrative review methodology was employed, utilising research from major health sciences databases. Inclusion criteria encompassed peer-reviewed empirical studies and systematic reviews published within the specified timeframe, focusing on undergraduate nursing students globally. The findings indicate that 65 to 80 per cent of nursing students experience moderate to high stress, with significant rates of anxiety, depression, and burnout reported annually. Inadequate stress management is associated with lower academic achievement, increased program attrition, poor physical health, and diminished professional readiness, with downstream effects on early nursing practice and patient safety. Common adaptive coping behaviours include mindfulness, social support, and time management, while maladaptive strategies such as emotional suppression and substance use are also prevalent. Institutional interventions such as curriculum redesign, faculty development, proactive psychological care, and high-quality clinical supervision demonstrate measurable effectiveness. Nursing education systems are urged to prioritise preventative approaches to student wellbeing, positioning resilience-building as a central component of professional preparation.