Date of Award

Fall 2022

Degree Type



College of Nursing

Director of Thesis

Michael D. Wirth, MSPH, PhD, FACE

First Reader

Robin M. Dawson, PhD, RN, CPNP-PC

Second Reader

Robin M. Dawson, PhD, RN, CPNP-PC


Stress, anxiety, and depression are noticeably prevalent in the nursing student population. There is a great deal of pressure placed on nursing students for high academic achievement and performance in the clinical settings. For many nursing students, the coronavirus disease 2019 (COVID-19) pandemic exacerbated existing or created new mental health struggles. Despite the severity of this problem, there is a great hesitancy for students to seek treatment because of the stigma around mental health diagnoses. With this in mind, strength training is an effective mode of exercise for improving symptoms of anxiety and depression, indicating that it would be a beneficial lifestyle modification for those that suffer from mental health problems. The purpose of this theory-informed, sequential explanatory mixed methods study was to gauge the experience of mental health issues amongst University of South Carolina undergraduate nursing students and the prevalence of exercise as a coping strategy. To understand these topics, nursing students (n=109) completed a survey and a subset (n=10) of the sample participated in one-on-one, digitally recorded interviews. The General Anxiety Disorder-7 and Patient Health Questionnaire-9 assessed the level of anxiety and depressive symptoms in the sample, respectively. Additional questions were asked about the impact of nursing school and the COVID-19 pandemic on their levels of anxiety and depression. The participants reported what type of exercise they engage in; participants that engage in strength training were asked whether it has an impact on their mental health. To assess the relationship between type of exercise and anxiety and depressive symptoms, correlation, analysis of variance, and t-tests were used. The qualitative interviews were transcribed, coded for themes, and organized by constructs of the Theoretical Domains Framework (TDF). Upon completion, the results of the study revealed that engagement in strength training exercise is statistically significantly (p

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