Interventions for anxiety, burnout, and resilience in university students: a systematic review with implications for mental health nursing practice

Background: The mental health of students in higher education is an increasingly pressing global concern, with rising prevalence of anxiety and burnout. Mental health nurses are uniquely positioned on the front lines of this crisis within university health services. Aims: This systematic review synthesizes recent evidence on the risk factors for student anxiety and burnout to inform nursing assessment and evaluates the efficacy of interventions that can be delivered or facilitated by mental health nurses. Method: Following the PRISMA 2020 guidelines, a systematic search of PubMed, Scopus, Web of Science, PsycINFO, and ERIC was conducted for studies published between January 2010 and March 2024. The review was registered with PROSPERO ID CRD420261342279. Two independent reviewers performed screening, data extraction, and quality assessment. Results: Of the 2,150 identified records, 38 studies met the inclusion criteria. Key risk factors included academic pressure, financial stress, and social isolation. Resilience, bolstered by social support, was a significant buffer. Effective interventions included mindfulness-based programs, cognitive-behavioral therapy (CBT), and peer support programs, all core to advanced nursing practice. The review highlights the barrier of mental health stigma, which nurses can directly address through proactive engagement. Quality assessment indicated moderate to high quality across included studies, though geographic representation remains skewed toward high-income countries. Conclusions: Mental health nurses are essential in mitigating student anxiety and burnout through direct intervention, care coordination, and systemic advocacy. A multi-level approach that integrates nurse-led individual-level interventions with institutional changes is essential. Recommendations are provided for nursing education, practice, and leadership to enhance support for student populations.