TABLE 1.
Characters of primary studies included in the meta‐analysis
| Author, year | Year a | Sampling method | Sample | Female (%) | Age M (SD)/Rang | Level | Country | Measure | Score method | Criteria of identification | QA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Abu Ruz et al. (2018) | NR | Nonrandom | 40 | NR | NR | Both | Jordan | HADS | 0–3 |
Mild: 8–10 Moderate: 11–14 Severe: 15–21 |
L‐M |
| Addonizio (2011) | 2010 | Nonrandom | 367 | 90.74% | 18–64 | Master | US | K10 | 1–5 |
Mild: 20–24 Moderate: 25–29 Severe: 30 and over |
M‐H |
| Ahuja and Kumar (2015) | 2013 | Nonrandom | 40 | 100.00% | 20–30 | Both | NR | HAM‐A | NR | NR | L |
| Aleena et al. (2020) | NR | Nonrandom | 400 | 50.00% | 23+ | Doctoral | China | DASS‐21 | 0–3 | NR | M‐H |
| Allen et al. (2022) | 2017 | Nonrandom | 2683 | 62.99% | 28/20–60 | Both | US | BAI | 0–3 |
Mild: 8–15 Moderate: 16–25 Severe: 26 and over |
M‐H |
| Almasri et al. (2022) | 2020 | Nonrandom | 308 | 45.13% | NR | Doctoral | US | GAD‐7 | NR | NR | L‐M |
| Al‐Shayea (2014) | 2013 | NR | 79 | 53.16% | 32/25–45 | Both | Saudi Arabia | DASS‐21 | 0–3 |
Mild: 8–9 Moderate: 10–14 Severe: 15–19 Extremely severe: 20 and over |
L‐M |
| Atkinson (2020) | 2019 | NR | 84 | 100.00% | NR | Both | Australia | DASS‐21 | 0–3 |
Mild: 8–9 Moderate: 10–14 Severe: 15–19 Extremely severe: 20 and over |
L‐M |
| Attia and Shata (2013) | 2013 | NR | 155 | 73.55% | 32.18(6.85)/ 22–52 | Both | Egypt | DASS‐21 | 0–3 | NR | L‐M |
| Balakrishnan et al. (2022) | 2020 | Nonrandom | 90 | 78.89% | 20–50 | Both | US | DASS‐21 | 0–3 |
Mild: 8–9 Moderate: 10–14 Severe: 15–19 Extremely severe: 20 and over |
L |
| Barreira et al. (2018) | 2017–2018 | Nonrandom | 510 | 34.71% | 20+ | Doctoral | US | GAD‐7 | 0–3 |
Mild: 5–9 Moderate: 10–14 Severe: 15 and over |
M‐H |
| Barton and Bulmer (2017) | 2010–2017 | Nonrandom | 4477 | 59.37% | 21+ | Both | US | PHQ‐9 | NR | NR | M‐H |
| Coakley et al. (2021) | 2020 | NR | 530 | NR | NR | Both | US | GAD‐7 | 0–3 |
Mild: 5–9 Moderate: 10–14 Severe: 15 and over |
M‐H |
| Cullinan et al. (2022) | 2018 | Nonrandom | 976 | NR | NR | Both | UK | DASS‐21 | 0–3 |
Mild to moderate: 8–14 Severe to extremely severe: 15 and over |
M‐H |
| Duan et al. (2022) | 2020–2021 | Nonrandom | 342 | NR | NR | Both | China | ZSAS | 1–4 |
Mild: 50–59 Moderate: 60–69 Severe: 70 and over |
M‐H |
| Eisenberg et al. (2007) | 2005 | Nonrandom | 1662 | 49.28% | 70% were 23–30 | Both | US | PHQ‐9 | NR | NR | L‐M |
| Ellison et al. (2020) | 2018 | NR | 59 | 81.36% | 25.48/23–36 | Doctoral | US | DASS‐21 | 0–3 | NR | L‐M |
| Evans et al. (2017) | NR | Nonrandom | 2279 | 70.38% | NR | 90% doctoral | 26 countries | GAD‐7 | NR | NR | L‐M |
| Fang et al. (2019) | 2018 | NR | 3669 | 57.62% | 22–28 | Master | China | GAD‐7 | NR | Positive symptom: 5 and over | L‐M |
| Garcia‐Williams et al. (2014) | 2010 and 2012 | Nonrandom | 301 | 77.08% | 27.98 (5.903)/18–63 | Both | US | PHQ‐9 | 0–3 | NR | L‐M |
| Ghogare et al. (2021) | 2020 | Nonrandom | 195 | 71.79% | 25–35 | Both | India | DASS‐21 | 0–3 |
Mild: 8–9 Moderate: 10–14 Severe: 15–19 Extremely severe: 20 and over |
L‐M |
| Hoying et al. (2020) | 2017–2018 | Nonrandom | 197 | NR | 24.5 (4.9) | Both | US | GAD‐7 | 0–3 |
Mild: 5–9 Moderate: 10–14 Severe: 15 and over |
L‐M |
| Jennifer et al. (2022) | 2020 | Nonrandom | 1916 | 85.80% | 20–45 | Both | US | DASS‐21 | NR | NR | L‐M |
| Jones‐White et al. (2022) | 2017–2018 | Random | 2582 | 55.46% | 18+ | Doctoral | US | GAD‐2 | 0–3 | Positive symptom: 3 and over | M‐H |
| Kowalczyk et al. (2021) | NR | NR | 528 | 55.49% | 26–30 | Doctoral | Poland | GHQ‐28 | 0–3 | Positive symptom: 28 and over | M‐H |
| Li et al. (2021) | 2020 | Random | 339 | 82.60% | 90% was 21–30 | Both | China | SCL‐90 | 1–5 | Positive symptom: subscale score over 2 | H |
| Liang et al. (2021) | 2020 | Nonrandom | 3137 | 78.29% | NR | Both | China | SAS | 1–4 |
Mild: 50–59 Moderate: 60–69 Severe: over 69 |
M‐H |
| Liu et al. (2019) | 2017 | Nonrandom | 325 | 60.31% | 31.1 (5.3)/ 23–47 | Doctoral | China | GAD‐7 | 0–3 |
Mild: 5–9 Moderate: 10–14 Severe: 15 and over |
M‐H |
| Liu et al. (2020) | 2017 | NR | 1625 | 54.15% | NR | Both | China | GAD‐7 | 0–3 | Positive symptom: 10 and over | M‐H |
| Madhan et al. (2012) | 2010 | Nonrandom | 330 | 44.85% | 26 (1.8)/ 24–34 | Master | India | DASS‐21 | 0–3 |
Mild: 8–9 Moderate: 10–14 Severe: 15–19 Extremely severe: 20 and over |
M‐H |
| Mazurek Melnyk et al. (2016) | 2014–2015 | Nonrandom | 91 | 65.93% | 25.43/21–51 | Both | US | GAD‐7 | 0–3 | NR | L |
| Milicev et al. (2021) | 2018–2019 | NR | 479 | 69.31% | 31.1 (9.1)/21–73 | Both | UK | GAD‐7 | 0–3 |
Mild: 5–9 Moderate: 10–14 Severe: 15 and over |
M‐H |
| Negi et al. (2019) | NR | NR | 76 | 50.00% | 21–35 | Both | India | DASS‐21 | 0–3 |
Mild: 8–9 Moderate: 10–14 Severe: 15–19 Extremely severe: 20 and over |
L‐M |
| Peng et al. (2022) | 2020–2021 | Nonrandom | 1410 | 73.48% | 23–26 | Both | China | GAD‐7 | 0–3 | Positive symptom: 10 and over | M‐H |
| Pervez et al. (2021) | 2019 and 2020 | NR | 113 | 49.56% | NR | Both | US | GAD‐7 | 0–3 |
Mild: 5–9 Moderate: 10–14 Severe: 15 and over |
L‐M |
| Ramadoss and Horn (2022) | 2021 | NR | 99 | 56.57% | NR | Doctoral | US | GAD‐2 | 0–3 | Positive symptom: 3 and over | L‐M |
| Rosenthal et al. (2021) | 2020 | NR | 222 | NR | 26–40 | Both | US | DASS‐21 | 0–3 | NR | L |
| Shadowen et al. (2019) | 2017 | Nonrandom | 344 | NR | NR | Both | US | BAI | 0–3 | Positive symptom: 19 and over | L‐M |
| Shete and Garkal (2015) | NR | NR | 50 | 66.00% | 23–34 | Both | India | DASS‐42 | 0–3 |
Mild: 8–9 Moderate: 10–14 Severe: 15–19 Extremely severe: 20 and over |
L |
| Talapko et al. (2021) | 2021 | Random | 370 | 84.32% | NR | Both | Croatia | DASS‐21 | 0–3 | NR | M‐H |
| Vuuren et al. (2021) | NR | NR | 108 | NR | NR | Both | South Africa | ZSAS | 0–3 |
Mild to moderate: 45–59 Severe: 60–74 Extremely severe: 75 and over |
L‐M |
| Wang et al. (2018) | 2017 | Random | 260 | 44.62% | NR | Both | China | SCL‐90 | 1–5 | Positive symptom: subscale score over 2 | H |
| Wang et al. (2020) | 2020 | Nonrandom | 375 | NR | NR | Master | China | GAD‐7 | 0–3 | Positive symptom: 5 and over | L‐M |
| Wu et al. (2022) | 2021 | NR | 1336 | 52.40% | 20+ | Both | China | ZSAS | 1–4 | Positive symptom: 50 and over | M‐H |
| Xiao et al. (2020) | 2020 | NR | 313 | NR | NR | Both | China | GAD‐7 | 0–3 |
Mild: 5–9 Moderate: 10–14 Severe: 15 and over |
M‐H |
| Yadav et al. (2021) | 2020 | Nonrandom | 409 | 83.13% | 22.10(2.928) | Both | Nepal | GAD‐7 | 0–3 |
Mild: 5–9 Moderate: 10–14 Severe: 15 and over |
M‐H |
| Zakeri et al. (2021) | 2020 | Nonrandom | 238 | 67.23% | NR | Doctoral | US | CCAPS‐62 | 0–4 |
Moderate: average sub scale‐score 1.22–1.89 Severe: average subscale score over 1.89 |
L‐M |
| Zhang et al. (2022) | 2021 | Random | 911 | 78.59% | NR | Both | China | ZSAS | 1–4 |
Mild: 50–59 Moderate: 60–69 Severe: 70 and over |
H |
| Zhou et al. (2018) | 2017 | Nonrandom | 1159 | 63.76% | NR | Both | China | SCL‐90 | 1–5 | Positive symptom: Subscale score over 2 | L‐M |
| Zhou et al. (2021) | 2020 | NR | 1080 | NR | NR | Both | China | GAD‐7 | 0–3 |
Mild: 5–9 Moderate: 10–14 Severe: 15 and over |
M‐H |
The end year of data collection.
NR: not report; QA: quality assessment; L: low quality (0–3 points); L‐M: low to medium quality (4–6 points); M‐H: medium to high quality (7–8 points); H: high quality (9–10 points); HADS: Hospital Anxiety and Depression Scale; K10: Kessler Psychological Distress Scale; HAM‐A: Hamilton Anxiety Scale; BAI: Beck Anxiety Inventory; DASS: Depression Anxiety and Stress Scale; GAD‐7: Generalized Anxiety Disorder 7‐item; PHQ: Patient Health Questionnaire; SAS: Self‐Rating Anxiety Scale; SCL‐90: Symptom Check List 90; CCAPS‐62: Counseling Center Assessment of Psychological Symptoms; ZSAS: Zung's Self‐Rating Anxiety Scale; GHQ‐28: General Health Questionnaires.