Background and Objective: Mental health among students in higher education remains a major public health concern, affecting well-being and academic performance. This survey research, conducted between December ۲۰۲۳ and January ۲۰۲۴, aimed to determine the academic
stress and its related factors among ۴۱۵ students in ۱st to ۴th study years at Nakhon Si Thammarat Rajabhat University, Thailand.Materials and Methods: Participants were recruited using proportionate convenience sampling across faculties. The data were gathered through a structured questionnaire that consisted of five parts, including health literacy, health-related behaviors,
stress management behaviors, and
stress tests. Mean differences were compared using independent samples t-tests and one-way analyses of variance. Associations between variables were tested using Pearson correlation analysis. Multiple linear regression and structural equation modeling were used to examine factors associated with stress. Result: The results revealed that about ۷۰% students showed
stress levels above the normal range. Furthermore, ۱۳.۷۳% of the students had
stress at the highest severity level. Female students had significantly higher
stress than males (p-value<.۰۵), and fourth-year students exhibited significantly higher
stress levels than first- and second-year students (p-value<.۰۰۱). In addition, Science and Technology students experienced significantly less
stress than other students (p-value=.۰۰۴). Health literacy, health-related behavior, and
stress management behavior were found to be significantly negatively correlated with stress. The findings were consistent with a potential mediating role of
stress management in the association between health literacy and
stress with health literacy showing significant indirect association with
stress through
stress management behaviors (p-value<.۰۰۱).Conclusion: These results revealed the importance of health literacy, health-related behavior, and
stress management promotions among academic students to reduce stress. Interventions should be considered for specific student subgroups, including by sex, academic year, and faculty, to address those who might be at greater risk of stress.