Exploration of Mental Health and Stress Among Nursing Interns Through a Chatbot: A Single-Group Pilot Study.

Journal: Nurse educator
Published Date: Jan 15, 2026

Abstract

BACKGROUND: Nursing interns face early clinical distress; chatbot-based mental health tools show promise, although evidence of their feasibility and educational value remains insufficient. PURPOSE: To evaluate the application feasibility and effectiveness of the Xiao Ling Assistant Chatbot (X-LAC) for addressing mental health challenges, monitoring stress, and detecting early warning signals of psychological distress among nursing students participating in a clinical internship. METHODS: A 4-week single-group study with 61 nursing interns tested X-LAC's daily chatbot-based support and keyword-triggered alerts; pre/post mental health and stress were assessed. RESULTS: Well-being improved (12-20); suicidal ideation declined (10-4). The chatbot flagged 16 high-risk expressions per 100 messages, notably so tired and under pressure; 60.6% reported internship distress. CONCLUSION: Chatbot support shows promise for clinical training, reducing stress and enabling early detection. Integrating artificial intelligence for risk prediction is warranted while retaining human oversight for critical cases.

Authors

  • Ya-Wen Kuo
    Author Affiliations: Professor (Kuo), Undergraduate Nursing Student (Lin), Postdoctoral Research Fellow (Hsu), Assistant Professor (Liu), Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Puzi, Chiayi County, Taiwan; Associate Professor (Hou), Department of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan; Professor (Fetzer), Department of Nursing, College of Health and Human Services, University of New Hampshire, Durham, New Hampshire; Professor (Kuo), Attending Neurologist (Lee), Department of Neurology, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan; Physician and Associate Professor (Lee), Department of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Wen-Li Hou
  • Susan Fetzer
  • Yi-Na Lin
  • Hsiu-Fan Hsu
  • Mei-Chun Liu
  • Jiann-Der Lee
    Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan and College of Medicine, Chang Gung University, Taoyuan, Taiwan.

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