Association between Psychological Status, Sleep Quality and Academic Performance among Nursing Undergraduates in a Sri Lankan State University

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.