Prevalence of imposter syndrome and its association with depression, stress, and anxiety among nursing students: a multi-center cross-sectional study

Abstract

Objective To examine the prevalence of imposter syndrome among nursing students and its association with depression, stress, and anxiety. Methods A multi-center cross-sectional survey was conducted with 1572 nursing students randomly selected from three universities across Egypt. The study was conducted over 3 months, from the beginning of January to the end of March, during the academic year 2023/2024. Clance Imposter Phenomenon Scale and Depression Anxiety Stress Scale-21 were used for data collection. Results A significant proportion of nursing students experience moderate to highly severe levels of depression, anxiety, and stress. Around a quarter of students had moderate depression, 22.6% had moderate anxiety, and 14.9% had severe anxiety. Additionally, 13.3% of participants experienced severe stress, with only 3.8% experiencing highly severe stress. The study also found that 46.3% of students experienced moderate imposter syndrome, with 33% having frequent imposter levels and 6.2% scoring intense imposter on the scale. Furthermore, imposter syndrome was positively correlated with depression, anxiety, and stress, and the total score of the Depression Anxiety Stress Scale (r = 0.639, p < 0.001). The stepwise linear regression analysis explained that 45.0% of the variance in students' depression, anxiety, and stress was due to imposter syndrome and other sociodemographic covariates. Conclusion This study highlighted the relationship between imposter syndrome, depression, anxiety, and stress among nursing students. Specifically, female students in higher academic years, with lower grade point averages, living in urban areas, with lower family incomes, and not participating in hobbies are more prone to depression, anxiety, and stress. Nursing implications These findings underscore the need for a holistic approach to managing the complex nature of mental health among nursing students. Incorporating education and resources on self-care and stress management techniques into nursing training programs is imperative for addressing the implications of imposter syndrome in nursing practice. Equipping nursing students with these essential skills can enhance their resilience, foster a healthier work environment, and ultimately improve patient care outcomes.