Does climate change stress and anxiety increase premenstrual syndrome symptoms in nursing students?

Background: Nursing students are future nurses. They are more susceptible to the physiological and psychological implications of climate change because of their participation in climate activities. Aim: To assess the relationships among nursing students' climate change awareness, climate change-related stress and eco-anxiety; and the associations between their climate change-related stress and their eco-anxiety and premenstrual syndrome. Methods: A cross-sectional correlational study was conducted on a convenience sample of 400 female nursing students at Matrouh University via self-report questionnaires about climate change knowledge and awareness, perceived stress, eco-anxiety and premenstrual syndrome. The data were collected from January 2022 to June 2025. Hierarchical multiple regression analysis was performed to analyze the effects of the mediating and moderating variables. Results: Nursing students demonstrated satisfactory levels of knowledge and high levels of awareness of climate change. High climate change awareness among nursing students was coupled with moderate (53.2%) to severe (28.6%) climate change-related stress, whereas 54.9% of the students experienced moderate (46.2%) to severe (8.7%) levels of eco-anxiety. Regression analysis revealed that the relationship between nursing students' climate change-related stress and eco-anxiety was moderated via climate change awareness as a moderating factor. Eco-anxiety played a mediating role in the relationship between climate change-related stress and premenstrual syndrome among nursing students. Conclusion: Nursing students suffer from mental stress related to climate change, including climate change-related stress and eco-anxiety, due to increased climate change awareness. Climate change-related stress and eco-anxiety increased the prevalence of premenstrual syndrome among nursing students.

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