Association of Health-Related Quality of Life and Depression Among Undergraduate Nursing Students

Depression greatly affects the health-related quality of life (QoL) in undergraduate nursing students and the prevalence of depression is extended day by day, as the nursing students have to face variety of problems and issue like health-related issue, poor QoL, diculty in focusing, feeling embraced and death anxiety because of their poor academic system and clinical performance. Objective: The purpose of the study is to determine the association of health-related quality of life and depression among undergraduate nursing students. Methods: This was observational study conducted on both female and male students at Shalimar Teaching Hospital, Lahore. A sample of 187 students was selected using non probability purposive sampling. Students were selected by using predened inclusion and exclusion criteria. After taking permission letter from the Hospital each student ll the Beck Depression Inventory and SF (36) questionnaire. Data was analyzed by using SPSS version-21.0. Mean and standard deviation were calculated for quantitative variables and data was presented in the form of frequency and percentage. Results: The result is evaluated by applying chi-square test which shows that there is strong association between physical health and depression because the (p<0.05) and p value is 0.00,there is no association between mental health and depression among undergraduate nursing students because the (p>0.05) and in the given result the p value is0.13. Conclusion: The study concluded that their association of health related quality of life and depression among undergraduate nursing student from the two variables of QoL, the physicalhealthisstronglyaffectedwithdepressionbutthementalhealthisnotaffectedwithdepres sion.

Depression greatly affects the health-related quality of life (QoL) in undergraduate nursing students and the prevalence of depression is extended day by day, as the nursing students have to face variety of problems and issue like health-related issue, poor QoL, di culty in focusing, feeling embraced and death anxiety because of their poor academic system and clinical performance. Objective: The purpose of the study is to determine the association of healthrelated quality of life and depression among undergraduate nursing students. Methods: This was observational study conducted on both female and male students at Shalimar Teaching Hospital, Lahore. A sample of 187 students was selected using non probability purposive sampling. Students were selected by using prede ned inclusion and exclusion criteria. After taking permission letter from the Hospital each student ll the Beck Depression Inventory and SF (36) questionnaire. Data was analyzed by using SPSS version-21.0. Mean and standard deviation were calculated for quantitative variables and data was presented in the form of frequency and percentage. Results: The result is evaluated by applying chi-square test which shows that there is strong association between physical health and depression because the (p<0.05) and p value is 0.00,there is no association between mental health and depression among undergraduate nursing students because the (p>0.05) and in the given result the p value is0.13. Conclusion: The study concluded that their association of health related quality of life and depression among undergraduate nursing student from the two variables of QoL, the physicalhealthisstronglyaffectedwithdepressionbutthementalhealthisnotaffectedwithdepres sion.
completely separation from social events, always stay alone [3]. A person who start taking stress from early stage and then continue this habit then he is must endangered to get psychiatric disorder which is depression [4]. Depression is a mental problem which is seen among medical students due to poor educational system and clinical performance [5]. Nursing is one of the profession that is full of stress which start from academic training and then after sometime the student reached such point when it is necessary to take decision that how to give proper care and attention to patient, so the lack of con dence and anxiety result into stress and depression in both nursing students and as well as nurses who work in practice. Because in this profession high level of understanding, perception, awareness and orientation is continuously required [6]. In nursing student due to high stress level there is disturbance in brain-storing ability, attentiveness as well as di culty in solving problem which decreased learning ability and educational performance [7]. College student learned higher level of ability to nd quick and clear way to overcome di culties and developed self-esteem, inspiration an academic resolution so less chance to become depressed, worried and feeling distress [8]. Nursing students during clinical practice face excessive anxiety producing factors. During clinical experience many emotions formed due to stress factor anxiety, nervous tension, depression, terror, irritation, displeasure, downheartedness, friendliness [9]. When the nursing students are in rst year of their course, there must be negative impact on the quality of life because depression [10]. Anxiety and depression always occur side by side due to depression 67% of college students affect with anxiety and for nursing student's anxiety is the major predictor of depression [11]. The nursing student experienced excessive stress because they work in clinical setting and nursing student also have to face the pain and illness of the patient and more over the academic stress is even higher than the clinical stress [12]. Nursing is a health related profession in which there is increased risk of suicide, as the nursing students have to face the stressful educational system [13]. The nursing is a four year program which include both clinical practice as well as theoretical classes and the students deal the stressful situations and get trained to manage the ill-condition and tolerate such situation in which the life end, in terms of nursing profession because of the job criteria and working setup the person get mentally disturb so after getting depressed the suicidal ideas arise in the mind [14]. College student learned higher level of ability to nd quick and clear way to overcome di culties and developed self-esteem, inspiration an academic resolution so less chance to become depressed, worried and feeling distress [15].

M E T H O D S
exclusion criteria. Age between 19-24 and both genders were included. The data was collected from under graduate nursing students and total 187 students participate in this study in which 162 are female and 25 are male. This study observed the association of health related quality of life and depression among undergraduate students so by using SF-36 Questionnaire the quality of life is check and the depression is evaluated by BDI-II. Prosperity-related individual ful llment (HRQOL) is an individual's or a social occasion's obvious physical and passionate well-being after some time. It fuses a wide extent of human experience, including working and unique responses of illness. Depression is a normal and certi able remedial infection that antagonistically impacts how you feel, the way where in you think and how you act. Fortunately, it is furthermore treatable. Wretchedness raises conclusion of ruckus and furthermore lost energy for activities once valued. It can incite a collection of enthusiastic and physical issues and can decrease a person's ability to work at home.

R E S U L T S
The frequency of the age of the responder is that the student with age of 19 was 59 (31.6%), the student with the age of 20 was 60 (32.1%), the student with the age of 21 was 37 (19.8%), the student with the age of 22 was 17 (10.2%), the student with the age of more than of 22 was 12(6.4%) ( Table  1).The result is evaluated by applying Pearson's chi-square test which shows that the association between depression and physical health is strong and because the (p<0.05) and p-value is 0.00, there is no association between mental health and depression among undergraduate nursing students as because the(p>0.05)and in the given result the p-value is 0.13.The frequency of the gender of the responder show female 162 (86.6%) and male 25 (13.4%). Frequency of beck depression in ventory is minimal 53(28.3%), mild 22.5(42%), moderate 22.5(42%) and severe 50(26.7%). conducted a research to analyse that the nursing students have to face mild, moderate and severe depression due to poor mental well-being as the it is mental health is affected due to limited academic strategies, insu cient knowledge of clinical practice and techniques how to deal the patients, so the nursing students required appropriate strategies to improve mental health, physical health which decrease the stress, depression and anxiety [15]. In the current study the result showed that the nursing students do not face depressive symptoms due to poor mental well-being as because there are proper academic strategies, clinical training and skills to deal the patient and on the other hand the nursing students required speci c interventions to improve the physical health which decrease the depressive symptoms [16]. According to the study in 2019, the online questionnaire was surveyed in 7000 students and the study showed that the mental health problems which occur due to depression will be lessen by providing social support to students as by giving appreciation to them their mental well-being is enhanced so basically family and friends are playing a leading role in improving the mental health or decreasing the depressive symptoms as well [17,20]. The domains physical functioning and mental health will be improved by social support; overall the quality of life is improved by this methodology [18,19]. In the current study, the result showed that mental well-being is not associated with depression as the students are appreciated, con dent and satis ed about their future and with their lives, if social support is provided then the mental health will be furthermore improved. But the physical functioning or physical health is strongly associated with depression so by giving social support or improving the strategies of educational program and adopt speci c methodology for the betterment clinical training. p-value (0.000).    In table 2, association between mental health and depression was analyzed. Pearson Chi-Square was used and showed no association (p-value 0.130). In table 4, association between physical functioning and depression was analyzed. Pearson Chi-Square was used and showed association (p-value0.000).

D I S C U S S I O N
According to another study in 2019, a questionnaire was C O N C L U S I O N

R E F E R E N C E S
The present study concluded that their association of health-related quality of life and depression among undergraduate nursing student by the help two variables of quality of life in which the physical health is directly affected with depression but the mental health is not affected with depression. So, there is no association shown between mental health and depression because the pvalue is (0.130) and on the other hand there is strong association between physical functioning and depression because the p-value is (0.000).