Exploring the Relationship between Balneotherapy and Anxiety in University Students: An Uncontrolled Study

Background: The mental health of college students is a growing concern. According to the World Health Organization, one in eight people globally suffered from mental disorders in 2019. College students face various emotional challenges, including academic stress and peer pressure. In Spain, 49.5% of university students, particularly those in health sciences, experienced moderate to severe anxiety. While balneotherapy has shown therapeutic benefits, research on its impact on anxiety among college students is still lacking. The general objective of this research was to determine the efficacy of balneotherapy in reducing self-perceived anxiety among nursing students, and to identify potential moderating or interacting variables in this relationship. Methods: Uncontrolled study with pre- and post-measurement. The study included second-year nursing students enrolled in the 2023/2024 academic year. Non-probability convenience sampling was used. Sociodemographic data were collected, and the State-Trait Anxiety Inventory scale was used to assess self-perceived anxiety. The balneotherapy intervention consisted of a 20-minute session in a thermal pool with a circuit of jets. Data were collected before and after the intervention. The analysis included descriptive statistics and the Mann-Whitney U test for pre- and post-intervention differences. Additionally, a linear regression was conducted to identify moderating variables, with evaluation of residual linearity and independence using the Durbin-Watson statistic. Results: The study involved 125 university students, with a majority of women (76.8%) and the majority (88%) between 18 and 24 years old. Of the participants, 56% reported previous experience with anxiety, while 89.6% had not tried balneotherapy, and 64.8% had not engaged in relaxation therapies. The scale demonstrated high internal consistency, with Cronbach's alpha coefficients of 0.913 and 0.886 before and after the intervention, respectively. Following balneotherapy, the average anxiety score decreased by 9.05 points (p<0.01), and the prevalence of anxiety decreased from 12% to 1.6% (p=0.002). In the linear regression analysis, both pre-intervention anxiety scores and prior treatment for anxiety emerged as significant predictors (p<0.001), jointly explaining 45.2% of the variance. Conclusions: The study shows that balneotherapy significantly reduces anxiety among university nursing students, as indicated by improvements in anxiety scales and a decrease in the prevalence of anxiety. Prior anxiety and prior treatment emerge as crucial predictors of the response to balneotherapy. However, further studies with larger samples and long-term follow-up are warranted to substantiate these findings.