Post-traumatic stress disorder in nursing students on the frontline during the first Covid-19 wave: a cross-sectional survey

To describe the prevalence of PTSD symptoms and their associated factors in nursing students 1 month after the peak of the first COVID-19 wave in France. On-line cross-sectional survey. Nursing school students throughout France. Respondents to the survey conducted between 12 May and 12 July 2020 completed the Impact of Event Scale-Revised (IES-R). Scores ≥ 24 indicate PTSD symptoms of concern. Factors independently associated with scores ≥ 24 were identified by multivariable logistic regression. Of the 4282 respondents (91.3% were females, 77.4% were aged 18–25 years), 1032 (24.1%) reported a prior traumatic event and 1569 (36.6%) had IES-R scores ≥ 24, indicating PTSD symptoms of concern. By multivariable analysis, variables associated with an IES-R score ≥ 24 included pre-existing vulnerabilities (prior traumatic event, psychological support, and psychotropic treatment), working conditions (COVID-19 unit rotation, rotation as full-time registered nurse, team integration issues, out-of-scope tasks, not feeling valued and limited access to protective equipment), management of patients with COVID-19-related life-threatening emergencies, pandemic-related emotional distress (feelings of incompetence and vulnerability, fear of getting infected and infecting relatives), and pandemic-related anxieties (isolation from family, news anxiety, anxiety about missed nursing classes). The ability to rest and recover was the only variable associated with a lower risk of a score ≥ 24. PTSD symptoms of concern were common in nursing students during the first COVID-19 wave. Several factors independently associated with PTSD symptoms are amenable to improvement. Opportunities to rest and recover must be provided (study registered on ClinicalTrials.gov, NCT04402229).