The relationship between future anxiety and awareness of global climate change in nursing students

Introduction

Climate change is associated with increased frequency and severity of extreme weather events and poses various threats to human health, including mental health. It is known that natural disaster-like events induced by climate change may cause mental disorders such as PTSD, depression, anxiety and substance abuse (Clayton, 2020). Negative mental health outcomes associated with climate change include direct experiences as well as associated negative emotional outcomes, even without a specific personal experience (Clayton, 2020; Clayton & Karazsia, 2020). 29% of Americans have stated that they are concerned about global warming and 49% have thought that they will be personally harmed for this problem (Leiserowitz et al., 2018). 20% to 40% of Europeans have reached the threshold of being ‘very concerned’ about climate change (Steentjes et al., 2017). Healthcare professionals who have a higher awareness of climate change may also have higher levels of anxiety compared to the general population. In a study by Fertelli, it was reported that nurses had a moderate level of awareness and anxiety about climate change. In addition, as their scores of climate change awareness increased, their anxiety scores also increased (Fertelli, 2023). The results of a study conducted with nursing students revealed that students who had knowledge about climate change and its effects on health had higher anxiety scores (Mat et al., 2023).

Another anxiety of university students is future anxiety that is defined as the state of perceiving personalised uncertainties and negative expectations covering a wide timeframe as an extreme danger and being uneasy. Future anxiety is a cognitive condition rather than an affective condition. Numerous factors such as hopelessness, perceived stress, and life satisfaction may cause university students to experience anxiety about the future (Geylani & Yıldız, 2022). A comparative study on future anxiety reported that nursing students had higher score of future anxiety compared to the education faculty students (Rabei et al., 2020). It is thought that nursing students’ awareness of climate change may be associated with their level of future anxiety.

In the literature, there are studies examining individually future anxiety and awareness of climate change in nursing students (Mat et al., 2023; Rabei et al., 2020). However, no study examining two concepts together in this population has been found. Investigating future anxiety and awareness of global climate change in nursing students, who can be considered as a risk group for higher anxiety, is thought to be guiding for future interventional studies and contribute to the literature.

Participants and methods

Results

The mean age of the participants was 20.91 ± 2.40, 73.6% were female, 96.7% were single, 46.1% had an income less than their expenses, 47.3% were the first-year students and 60.9% were living in the city. Of the students, 96.1% stated that they were sensitive to the environment, 70.3% followed the news about the environment, 67.9% stated that the Nursing Education Programme was inadequate in terms of sustainability and 55.2% stated that nurses could transfer sustainability principles into practice (Table 1).

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Table 1.

Descriptive characteristics of the nursing students (n = 330).

Socio-demographic characteristics	n	%
	M ± SD
Age	20.91±2.40
Gender
Female	243	73.6
Male	87	26.4
Marital status
Married	11	3.3
Single	319	96.7
Income level
Income less than expenses	152	46.1
Income equal to expenses	150	45.5
Income more than expenses	28	8.4
University year
1st year	156	47.3
2nd year	55	16.7
3rd year	62	18.8
4th year	57	17.2
Place of residence
City	201	60.9
District	74	22.4
Village or town	55	16.7
Being sensitive to the environment
Yes	317	96.1
No	13	3.9
Warning people about the environment
Yes	288	87.3
No	42	12.7
Following environment news
Yes	232	70.3
No	98	29.7
Adequacy of the nursing education programme on sustainability
Yes	106	32.1
No	224	67.9
Adequacy of nurses’ transfer of sustainability principles into practice
Yes	182	55.2
No	148	44.8

The lowest score, highest score, and mean score of the participants on the ASUSGCC were 1, 5, and 3.43 ± 0.88, respectively. They had a moderate level of awareness about global climate change (Table 2).

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Table 2.

ASUSGCC and FASUS total mean scores of the nursing students (n = 330).

Scales	Min-max score	M ± SD
Total mean score of ASUSGCC	1–5	3.43 ± 0.88
Total mean score of FASUS	19–95	61.39 ± 12.98

The lowest score, highest score, and mean score of the participants on the FASUS were 19, 95, and 61.39 ± 12.98, respectively. The FASUS total mean score suggested that university students had moderate levels of future anxiety (Table 2).

There was a statistically significant positive weak correlation between the participants’ ASUSGCC and FASUS total mean scores (p < .05). As their level of awareness towards climate change elevated, their level of future anxiety increased (Table 3).

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Table 3.

The correlation between ASUSGCC and FASUS total mean scores of the nursing students.

ASUSGCC
FASUS	R	0.345
	P	.001

Note. Pearson’s correlation test, p < .05 is significant.

A linear stepwise regression model was used to determine the actual factors affecting awareness on climate change. The results of the regression analysis indicated that the factors of being sensitive to the environment and future anxiety had an effect on awareness of climate change at the rates of 6% and 17%, respectively (p < .05). Total score of future anxiety had the highest effect on awareness of climate change (17%) (Table 4).

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Table 4.

Regression analysis on effects of the descriptive characteristics and future anxiety on climatic change awareness.

Awareness about global climate change
	β	F	R 2	t	p
Future anxiety	.274	2.242	0.173	1.034	.001
Age	.022	0.162	−0.03	0.896	.371
Gender	.133	0.594	0.002	1.230	.217
Marital status	.424	0.670	0.002	1.429	.154
Income level	.120	1.254	0.001	1.660	.098
University year	−.036	0.123	0.003	−0.769	.442
Place of residence	.033	0.479	0.002	0.545	.586
Being sensitive to the environment	−.661	2.739	0.065	−2.289	.023
Warning people about the environment	−.035	1.310	0.001	−0.216	.829
Following environment news	−.149	0.498	0.003	−1.403	.162
Adequacy of the nursing education programme on sustainability	−.085	1.593	0.005	−0.784	.435
Adequacy of nurses’ transfer of sustainability principles into practice	.054	0.198	0.001	0.514	.608

Discussion

The findings of the present study were discussed in line with the literature.

The present study revealed that the students had a moderate level of awareness about global climate change. A study by Fertelli reported that nurses had a moderate level of awareness of climate change (Fertelli, 2023). In a study conducted with nurses to examine awareness about climate change and health, it was found that the participants had a moderate level of awareness about the effects of climate change on health (Schenk et al., 2021). A study conducted with nursing students on global warming, climate change and the role of public health nurses reported that 87.7% of the students knew the main cause of climate change and they had awareness on this issue (Ergin et al., 2021). In another study conducted by Luque-Alcaraz et al., with nurses, most of the participants had a moderate level of environmental awareness (Luque-Alcaraz et al., 2024). A study on climate change reported that about half of Pakistani nurses were aware of this issue (Buriro et al., 2018). In a study investigating the concepts of awareness, concern and hope on climate change in nursing students, it was found that nursing students had a high level of awareness about climate change (Tümer et al., 2024). The findings of the study are compatible with the literature. It is thought that the inclusion of environmental health, public health and sustainability measures in the nursing education curriculum will have an effect on this awareness.

Considering the FASUS total mean score of the participants, it can be asserted that they had a moderate level of future anxiety. A study conducted with nursing students to investigate the effect of future anxiety on career optimism in nursing reported that students’ future anxiety was at a moderate level (Karaman & Karatepe, 2024). In a comparative study on future anxiety, the researchers stated that the future anxiety score of nursing students was higher than the score of education faculty students (Rabei et al., 2020). Nursing students encounter with critical situations during their education process and have to care for people who are struggling for life. In addition, the globe and Turkiye alike have seen several major disasters (COVID-19 pandemic and February 6 earthquakes) in recent years. In all these disasters, healthcare professionals have been at the forefront due to their social responsibilities. The city where this study was conducted is 1 of 11 cities that suffered drastically from both COVID-19 pandemic and the February 6 earthquakes. That in turn may have caused students to experience many different emotions and thoughts at once. Not only were they victims of those events, their expectations and responsibilities about being future healthcare professionals may cause them to feel self-doubt and anxiety. It is estimated that such situations increase their anxiety about the future.

In the study, it was determined that as the participants’ level of awareness of climate change elevated, their level of future anxiety elevated. A study examining the concepts of awareness, anxiety and hope associated with climate change among nurses reported that as the climate change awareness scores of nurses increased, their anxiety scores also increased (Fertelli, 2023). The results of a study conducted with nursing students revealed that students who had knowledge about climate change and its effects on health had higher anxiety scores (Mat et al., 2023). In their study including nursing students, Tamer et al., found that awareness of climate change increased the related anxiety. It can be asserted that the awareness of nursing students, who can professionally witness the impact of global climate change on the environment and human health, brought along anxiety about this issue. This anxiety may have also increased their anxiety about the future. It is thought that the students’ future anxiety stemmed from their ability to foresee the possible individual harms of climate change as well as their concerns about the profession.

Conclusion and recommendations

Consequently, it was determined that the students had a moderate level of awareness about global climate change and future anxiety. In addition, as their awareness of climate change increased, their future anxiety levels elevated. Having awareness about climate change is one of the important aspects of nursing and thus nursing education. Initiatives to increase awareness of climate change (training programmes, awareness campaigns) can mobilise nursing students and encourage them to fight against climate change. Although their awareness of this issue increases their anxieties about the future, it will enable them to take professional and personal measures in this regard.