Abstract:
Background: Nursing undergraduates experience higher levels of stress due to academic and
clinical demands, impacting their sleep quality and academic performance. There are limited
evidences on the relationship between stress, sleep quality and academic performance among
nursing undergraduates in local context. This study provides insights for curriculum adjustment
and institutional support systems.
Objectives: To assess the association between psychological status, sleep quality and academic
performance among nursing undergraduates
Methods: A descriptive cross-sectional and correlational study was conducted among 200 nursing
undergraduates at the University of Colombo. A pre-tested validated self-administered
questionnaire consisting of three sections including, sociodemographic data, Depression, Anxiety
and Stress Scale, and Pittsburgh Sleep Quality Index, was used. Chi-square test, Spearman’s
correlation test, linear regression analysis, and multiple regression analysis were used. The Grade
Point Average (GPA) was obtained to assess the academic performance. The level of significance
was considered to be p<0.05.
Results: Response rate was 78% (200), with majority (65%) being females. Majority of the
respondents (40.0%) had a GPA of 2.00≤GPA<3.00. Extremely severe symptoms were prevalent
among the participants; depression (10.5%), anxiety (27.5%), and stress (4.0%). Majority of the
participants (65%) had poor sleep quality. Statistically significant associations were identified
between depression levels and satisfaction with nursing degree (p=0.048), anxiety levels, gender
(p=0.015), and religion (p=0.026). Multiple regression analysis revealed that stress was a
statistically significant negative predictor of academic performance (t = -2.345, p=0.020), even
though the overall model was not significant (R²=0.012, p=0.171).
Conclusions: Although the overall regression model was not statistically significant, stress was
identified as an individual factor significantly associated with lower academic performance. A
significant amount of the respondents experienced high levels of stress and poor sleep quality. The
results suggest that stress management strategies, and sleep hygiene education should be
incorporated into nursing curricula to promote wellbeing and academic outcomes.
