**1. Introduction**

The coronavirus disease 2019 (COVID-19) pandemic is the latest global health disaster of the century with high morbidity and mortality rates. In December 2019, a new infectious respiratory disease appeared in Wuhan, China. The World Health Organization (WHO) named the disease "COVID-19" after confirming its pandemic level potential. According to WHO, on 18 April 2020, the current outbreak of COVID-19 had affected over 2,164,111 people, and more than 146,198 deaths had been confirmed in more than 200 countries worldwide [1]. COVID-19 is one of the fastest spreading viral infections, which WHO declared a pandemic after affirming the high infectious levels. The disease spread from person to person through infected air droplets released through coughing or sneezing. Additionally, people spread the virus through physical contact, such as greetings or touching infected surfaces. Countries have sought vaccines and treatment protocols for COVID-19 vaccines and treatments amidst the implementation of various containment measures worldwide to combat the disease. Such containment measures have included the closure of public places, schools, universities, imposing curfews, and other physical distancing measures, such as the cancelation of large events [2].

The COVID-19 pandemic has forced political leaders and universities to take drastic measures to safeguard citizens' and students' lives. As many universities have suspended classroom teaching and switched to online teaching, the lives of students have changed

**Citation:** Majrashi, A.; Khalil, A.; Nagshabandi, E.A.; Majrashi, A. Stressors and Coping Strategies among Nursing Students during the COVID-19 Pandemic: Scoping Review. *Nurs. Rep.* **2021**, *11*, 444–459. https://doi.org/10.3390/ nursrep11020042

Academic Editors: Richard Gray and Sonia Udod

Received: 16 April 2021 Accepted: 27 May 2021 Published: 3 June 2021

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completely and students have become prone to developing stressors, such as fear about physical health, family, and a loss of control related to the change in the educational environment [3].

Stress refers to a "situation in which internal demands, external demands, or both, are appraised as taxing or exceeding the adaptive or coping resources of an individual or group" [4]. Nursing students can suffer from a high level of stress during their education program. Specifically, there are two significant sources of stress among nursing students, academic and clinical stressors. The stressors related to academia include heavy assignments, examinations, and workloads. Other sources of stress related to the clinical area for nursing students include a lack of professional nursing skills and unfamiliarity with patients' diagnoses, medical history, or treatment [4].

The specific stressors related to the impact of COVID-19 among nursing students are stress from COVID-19 infection and a lack of preventive measures in clinical training [1]. This period has been undoubtedly stressful for learners; with classes moving online, nursing students face difficulties, such as being unable to concentrate and having difficulties participating, writing assignments, taking exams, and meeting the deadlines of academic assignments [5].

Coping strategies are stabilizing methods for helping individuals maintain psychological adaption during stressful events [6]. Coping strategies are classified as problem-based or emotion-based coping. The problem-solving approach is the most common coping strategy employed by nursing students to adjust to stressors, while an avoidance approach is the coping behavior least used by nursing students [4]. Nursing students use strong resilience, as one of the coping strategies during COVID-19 has been strong resilience. The learners have used humor, which studies associate with lower to moderate anxiety levels. Additionally, other coping strategies, such as mental disengagement, have led to high levels of anxiety [7]. This study sought to unearth the specific stressors and coping strategies employed by nursing students in universities during the COVID-19 pandemic.

#### *Aim of the Study*

This scoping review aimed to explore the relevant evidence related to stressors and coping strategies among nursing students during the COVID-19 pandemic.

#### **2. Materials and Methods**

A scoping review methodology was used to map the relevant evidence and synthesize the findings. The 6 steps of scoping review by Pérez et al. [8] guided the study. The steps involved the identification of the research question, determining the keywords, inclusion and exclusion criteria, searching the databases for the relevant studies, the study selection, charting the data, collecting, and summarizing the findings.
