Diploma In Nursing Research Articles

Final year nursing students in Nigeria; How knowledgeable and prepared are they to offer medical care to patients with chronic kidney disease?

Background:Nurses play an important role in the management of chronic kidney disease (CKD) patients at primary, secondary, and tertiary levels of care. In other to perform their functions, it is pertinent that they have a good understanding of kidney functions and CKD. We do not know if the current educational curriculum prepares them adequately for this role.Aim:To assess the knowledge level of kidney functions and diseases among final year nursing students in Abia State Nigeria.Materials and Methods:This was a cross sectional study involving final year diploma and Bachelor of nursing (B. Nursing) students who were randomly chosen. Structured, self-administered questionnaire containing 18 items was the tool for data collection. A score of one was given for each correctly answered question on functions of the kidney, symptoms, signs, causes, and complications of CKD. A score of 50% and above was regarded as good knowledge.Results:Two hundred questionnaires were distributed, but 186 were returned (response rate of 93%). Male:female ratio was 1:14.5. One hundred and seventeen (62.9%) knew the correct definition of CKD, but only 69 (37.1%) knew the normal range of glomerular filtration rate. Eighty-one percent had good knowledge of kidney functions while 39 (21%) had good knowledge of CKD. Overall, 42 (22.6%) had good knowledge of kidney functions and CKD. Students who rotated through the dialysis unit during their clinical posting had higher mean knowledge score than others (P = 0.03). There was no significant difference in the mean knowledge scores of the diploma and B. Nursing students (P = 0.76).Conclusion:The majority of the final year students had poor knowledge of CKD. There is need to expand the current teaching curriculum so as to increase the knowledge of these future nurses on the basic concepts of CKD to improve outcomes of patient management.

A mental health nursing transition program for enrolled nurses at a forensic mental health hospital

Objective: There are difficulties in recruiting enrolled nurses to mental health positions. A six month program was developed with the aim to bridge possible knowledge gaps for enrolled nurses, and to provide them practical support to consolidate skills and knowledge for nursing in a forensic mental health hospital. Setting: The setting was a 116 bed secure forensic mental health hospital in the state of Victoria, Australia. Subjects: Nine enrolled nurses who had completed a Diploma of Nursing, were recruited into the program. Primary argument: There is a national decrease in enrolled nursing supply, and a paucity of data exploring the training needs of enrolled nurses transitioning from the Diploma to a mental health nursing role. Nursing programs are required to assist enrolled nurses with the knowledge and skills, and support required to effectively make their transition into mental health nursing. Conclusion: The results demonstrate the importance in providing a program to assist enrolled nurses transition to mental health and that the mental health course requirements within the Diploma of Nursing and placement length may not be adequate in preparing enrolled nurses for direct entry to mental health nursing. Providing a structured transition program for a group of enrolled nurses is a useful strategy to improve knowledge, skills, and retention.

NURSE MANAGERS’ EXPERIENCES WITH NURSES CARRYING OUT COMPULSORY COMMUNITY SERVICE

The South African Nursing Council promulgated the compulsory community service (CCS) policy, in regulation R765 of 2007, for nurses of the four-year diploma or degree in nursing. The implementation of the CCS policy takes place at public health institutions. There have been no studies to date on how nurse managers experience this process of the CCS policy implementation. The findings of the study will inform future changes to the policy, such as guidelines for nurse managers on how to handle community nurse practitioners (CNPs) that are placed in their institutions. This study explores the experiences of nurse managers with nurses who are placed at their institutions to carry out compulsory community service. Descriptive qualitative design was used to gather data from nurse managers using individual interviews and data were analysed using Tesch’s content analysis. The main categories that were identified were: valuing the CNPs, role modelling behaviours, benefiting from mentoring, dealing with challenges and following the process. The community nurse practitioners were valued by two groups of nurse managers. Support and professional development were provided on an ad hoc basis, leading to inconsistencies in their management. The following are recommended: the guidelines of the CCS policy to provide structured guidelines for the development of the CNPs during the CCS year; mentorship for the CNPs that is evaluated at regular intervals through formalised reports; and a scope of practice for the CNPs.

Scholarship in nursing: Degree-prepared nurses versus diploma-prepared nurses

Background: The nursing profession needs nurses with a higher level of education and not merely more nurses to enhance patient outcomes. To improve quality patient care the nursing discipline needs to be advanced through theory development and knowledge generation, thus graduate nurses. Nursing scholarship cannot be limited to nurse academics, but is the responsibility of every nurse. Although the world is looking towards combating the decline in nursing numbers with better educated nurses, South Africa is planning to address the problem with more lower qualified nurses.Aim: The aim of this study being reported here was to establish whether degree-prepared nurses in South-Africa partake more often in scholarly activities than diploma-prepared nurses.Method: A cross-sectional descriptive design was used. The population was all professional nurses registered with the South African Nursing Council who obtained either a four year degree or four year diploma in nursing. Data were gathered from 479 respondents, using aself-administrative questionnaire.Results: Three times more nursing educators (n = 19) achieved a degree as first qualification than their colleagues (n = 6) who achieved a diploma as first qualification. All but one (n = 18) nursing educators who obtained a degree as first qualification are educators in the private sector that include both universities as well as nursing colleges of private hospital groups. Data further revealed that most nurse educators and those in managerial positions were degree prepared. More degree prepared nurses than diploma prepared nurses were actively involved in scholarly activities such as research (30,5% compared to 25,5%) andimplementing best practice guidelines (62,2% compared to 55,9%).Conclusion: The global nursing crisis, nor the nursing profession, will benefit by only training more nurses. The profession and the health care sector need more degree prepared nurses to improve scholarship in nursing.

Scholarship in nursing: Degree-prepared nurses versus diploma-prepared nurses

BackgroundThe nursing profession needs nurses with a higher level of education and not merely more nurses to enhance patient outcomes. To improve quality patient care the nursing discipline needs to be advanced through theory development and knowledge generation, thus graduate nurses. Nursing scholarship cannot be limited to nurse academics, but is the responsibility of every nurse.Although the world is looking towards combating the decline in nursing numbers with better educated nurses, South Africa is planning to address the problem with more lower qualified nurses. AimThe aim of this study being reported here was to establish whether degree-prepared nurses in South-Africa partake more often in scholarly activities than diploma-prepared nurses. MethodA cross-sectional descriptive design was used. The population was all professional nurses registered with the South African Nursing Council who obtained either a four year degree or four year diploma in nursing. Data were gathered from 479 respondents, using a self-administrative questionnaire. ResultsThree times more nursing educators (n = 19) achieved a degree as first qualification than their colleagues (n = 6) who achieved a diploma as first qualification. All but one (n = 18) nursing educators who obtained a degree as first qualification are educators in the private sector that include both universities as well as nursing colleges of private hospital groups.Data further revealed that most nurse educators and those in managerial positions were degree prepared. More degree prepared nurses than diploma prepared nurses were actively involved in scholarly activities such as research (30,5% compared to 25,5%) and implementing best practice guidelines (62,2% compared to 55,9%). ConclusionThe global nursing crisis, nor the nursing profession, will benefit by only training more nurses. The profession and the health care sector need more degree prepared nurses to improve scholarship in nursing.

Assessing the Knowledge of Nurses Regarding Hypertension Management Who are Working in National Institute of Cardiovascular Diseases and Hospital in Bangladesh

Hypertension is a chronic disease, which progresses silently and leads to many complications affecting major body organs. Hypertensive patient’s awareness may be developed on the various aspects regarding disease and self-caremanagement through the health care providers. Nurses knowledge regarding hypertension plays an important role in the ability to the management of hypertension Patients [Kaur et al., 2007]. This descriptive type of cross-sectional study was conducted to assess the Nurses knowledge regarding hypertension in National Institute of Cardiovascular Diseases, (NICVD), Sher-E-Bangla Nagar, Dhaka, Bangladesh. Sample size was selected 60 nurses through purposive sampling technique. Data were collected by using the self-administer questionnaire through maintaining face to face interview of the respondents. Data analysis procedure was done by using statistical approaches. Analyzing demographic information, it has found, most of the nurses are from older age group with majority of them belong to secondary level education, significant proportion of them have done diploma in nursing. In terms of awareness, largest number of respondents has very good knowledge on concept of hypertension. They have also fairly known about management and prevention ofhypertension. However, they have limitation in knowing causes and symptom of hypertension. In addition, they have quite poor knowledge how to control hypertension. From this study, it is concluded that, hospital management require instigating different training opportunities and learning session so that nurses would have improve their knowledge.

New fast-track nursing diploma offered to redress 'skills shortage'.

A new fast-track diploma course has been launched as an alternative route into nursing for students without traditional qualifications.

Employee Turnover and Employee Performance: A Study among Nurses

This descriptive research study has been undertaken in private multispeciality hospitals, Tirunelveli City, Tamil Nadu to examine the perception of nurses towards the impact of employee turnover on employee performance. The study has sampled 60 nurses qualified with Diploma in General Nursing and Midwifery (DGNM) and Bachelor in Nursing (B.Sc Nursing) courses using judgement sampling technique. Primary data have been collected through a constructed questionnaire. Secondary data have been collected from books, journals, projects and journals. Percentage method has been applied to analyse profile of the respondents. The study has administered mean and standard deviation to understand perception of nurses towards impact of employee turnover on performance of the existing nurses. The results of the study has found that more workload for the existing employees, inability to leave the duty on time, health issues, inadequate care for the patients, conflict and dispute among the coworkers, stress, inability to take decisions on time and inability to segregate biomedical wastes are the foremost impact of employee turnover on performance of existing employees.

Assessment of the Level of Knowledge and Practice on Intravenous Cannulization among Staff Nurses of Selected Tertiary Care Hospital in Dhaka City

Intravenous (IV) cannulization is common invasive procedure used in clinical practice of hospital. Intravenous cannulization is the methods of insertion of a flexible plastic device with a stylet available, inserted to the vein to administer medications, fluids of blood transfusions. The Objective of the study was to find out the level of knowledge and practice on intravenous cannulization among staff nurses of selected Tertiary Care Hospital in the Dhaka city. The study was descriptive type of cross-sectional in nature. The main study was conducted from March-August 2013 in Dhaka Medical College Hospital, Bangabandhu Sheikh Mujib Medical University, Delta Medical College Hospital, Dhaka, Bangladesh. The instruments used for the study were self-administrated questionnaire and observational checklist. A total of 290 staff nurses who met the inclusion criteria were selected from different units of hospital by using simple random sampling technique. Mean age of the respondents was 32.11±5.3 years. The majority of respondents were female (87.2%). Maximum, 94% of respondents were completed upto Diploma in Nursing. Among the respondents, 18.3%, 50%, 24.3% and 6.9% had expressed one type of IV cannula, two types of IV cannula, three types of IV cannula and 6.9% four types of IV cannula. A majority of 49.7 % had found Good knowledge level followed by 25.5% had average knowledge, 21.7% had excellent knowledge and 3.1% had poor knowledge. About 53.8 % had found poor knowledge level followed by 39.3% had average knowledge and 5.9% ad Good knowledge, whereas only 1.0% had excellent knowledge regarding indication and contraindication on IV cannulization. About 2.67% respondents had Excellent, 12% had Good, 73.33 % had Average Practice and 12% had poor practice.

Using clinical reasoning and simulation-based education to ‘flip’ the Enrolled Nurse curriculum

Objective: This paper describes the development and implementation of an innovative Diploma of Nursing curriculum for preparing Enrolled Nursing students for acute care nursing practice. Setting: Vocational Education and Training at the Health Education and Research Centre in Hobart, Tasmania. Subjects: Vocational Education and Training students enrolled in the Diploma of Nursing (Enrolled-Division 2 Nursing) (HLT51612). Primary Argument: The increasing complexity and acuity of contemporary practice environments requires a nursing workforce that is flexible and competent. In 2013 nurse educators developed an innovative approach to offering the national standardised Diploma of Nursing course that integrates three key pedagogical approaches: the ‘flipped classroom’, simulation-based learning and the Clinical Reasoning Cycle. Conclusion: By ‘flipping the curriculum’ students are provided with opportunities to develop and extend their clinical reasoning skills as they respond to both routine and unpredictable ‘patient’ scenarios in the safety of a simulation environment. These simulated clinical learning experiences are designed to challenge students to ‘think like a nurse’ while actively engaging in the provision of safe and effective ‘patient’ care.

THE HISTORY OF SPANISH NURSING (1953-1980): INTRODUCTORY NOTES

ABSTRACT A historical-social documentary study aiming to analyze the history of Nursing in Spain, in the period 1953 - 1980. Undertaken between September and December 2014 through consultations with archive services, newspapers, legislation, specialized journals and academic works. This historical period corresponds to the unification of the teaching of practitioners, midwives and nurses (1953) and to the approval of the standards of the title of Sanitary Technical Assistant with Diploma in Nursing (1980). Thematic analysis was used for understanding the meanings and thus to (re-)construct part of this history. The empirical material revealed that the Real Escuela de Enfermeras de Santa Isabel de Hungria is considered the pioneer within the anglo-saxon model, that Spanish Nursing results from the fusion of three professions (practitioners, midwives and nurses) and training separated by sex was striking. Finally, it is concluded that the trajectory of Spanish Nursing towards the level of a graduate profession was long and arduous.

Coping Strategies for Stress: A Comparative Study among Nurses Working in Multi-and Single-Speciality Hospitals

This survey-based qualitative descriptive research has been undertaken in Tirunelveli city, Tamilnadu to understand and differentiate coping strategies being followed by nurses working in both multi-speciality and single-speciality hospitals to deal with stress and to examine the relationship between demographic variables and coping strategies. The structured format of coping strategies established by Folkman and Lazarus has been used in this study to analyse and differentiate coping styles of nurses. It has been analysed under five dimensions namely positive and action focused coping, wishful thinking and positive reappraisal, distancing, escape and avoidance and seeking social support coping. The study has sampled 120 (60 from multi-speciality hospitals and 60 from single-speciality hospitals) nurses qualified with Diploma in General Nursing and Midwifery and Bachelor of Science in Nursing courses. Mean, standard deviation and coefficient of variation have been used to rank and differentiate the dimensions of coping strategies. Kruskal–Wallis test has been administered to examine the relationship between coping strategies and demographic variables. The result indicates that there is no marked differences in the perception of the nurses working in both kinds of organisation towards majority of the coping strategies discussed under five dimensions of the Folkman and Lazarus coping strategies. The perception level of majority of the respondents working in both kinds of hospitals has been at medium level towards all coping strategies.

Webquest and Comics in the Formation of Human Resources in Nursing.

Objective To describe the process of constructing and implementation of Webquest as pedagogical strategy as guiding the study about the pedagogical concepts using Comic. Method The first stage of the study was outlined applied research of technological production. The second stage was characterized as research exploratory, descriptive documentary for the analysis of Comic. in the teaching diploma in Nursing of EEUSP in 2013. Results The proposed Webquest was implemented, resulting in 18 Comic. All Pedagogical Concepts studied were addressed; used the software indicated and the power point, the plots developed in different scenarios and most Comic contemplated mandatory items. Conclusion The use of different technological resources provide learning, by mobilizing multiple potentialities, abilities and interests of students, favoring the construction of collective and collaborative learning, strengthening important and necessary features in training that will influence the human resource profile in tune with the aspirations of the labor market.

Abstract: Use of E-Learning to Advance Nursing Education in Rwanda

Background: Most nursing care in Rwanda is provided by high school trained nurses. As of 2011, there were 6,970 nurses in Rwanda with 90% trained at the high school level. The Ministry of Health has set the goal of upgrading high school trained nurses to a diploma by 2020. To assist in educating nurses and advancing their education, E-Learning (distance education) has been adopted as a model to support this education initiative. Description: This is a description of the E-Learning Advanced Nursing Diploma program which was launched in 2012 to educate nurses trained at a high school level, to a nursing diploma. The goal was to develop a more skilled and educated nursing workforce. Electronic learning (E-Learning) uses the internet as a medium for interaction between students and teachers. The curriculum model used has 40% of the curriculum delivered in a face to face environment, and 60% delivered through self-directed learning within the Moodle Learning Management System. As much of the Rwandan population (80%) lives in rural areas, distance education can allow many nurses to obtain further education that was not available in the past. This increased education is critical to increase the competency levels of nurses and consequently the quality of the healthcare delivered. Lessons learned: Over 800 nurses have commenced the program. There have been many challenges to implementing e-learning. These include a) Unstable Learning Management System, b) Inconsistent internet connectivity, c) Varying levels of informational technology literacy d) Language difficulties, and e) Altering faculty workloads and responsibilities with the new mode of education. Conclusions: As it is early in the implementation of this innovative project, outcomes are limited. The first cohort of students (298) have completed the program and are preparing to write their licensure examinations. Program evaluation is a priority for the next year to determine the strengths of the program and areas for improvement. Keywords: e-learning, distance education, online learning, nursing, curriculum

Knowledge of Psychiatric Nurses About the Potentially Lethal Side-Effects of Clozapine

Clozapine is an antipsychotic with superior efficacy in treatment refractory patients, and has unique anti-suicidal properties and a low propensity to cause extrapyramidal side-effects. Despite these advantages, clozapine utilization is low. This can in part be explained by a number of potentially lethal side effects of clozapine. Next to psychiatrists nurses play a crucial role in the long-term management of patients with schizophrenia. It is therefore important that nurses know, inform and monitor patients about the specific side-effects of clozapine. A recent study of psychiatrists published in 2011 has shown that there was a gap in the knowledge about side-effects of clozapine. The knowledge about side-effects of clozapine in nurses has never been studied. This cross-sectional study evaluated the knowledge base regarding the safety of clozapine, and its potential mediators, of psychiatric nurses in 3 psychiatric hospitals in Belgium with a specifically developed questionnaire based on the literature and expert opinion (3 clozapine experts). A total of 85 nurses completed the questionnaire. The mean total score was 6.1 of a potential maximum score of 18. Only 3 of the 18 multiple choice knowledge questions were answered correctly by more than 50% of nurses. Only 24.9% of participants passed the test (>50% correct answers). Nurses working on psychosis units were more likely to pass the test (xx.y% vs yy.z%, p=0.0124). There was a trend that nurses with a lower nursing diploma were more likely to fail the test (p=0.0561). Our study clearly identifies a large gap in the basic knowledge of psychiatric nurses about clozapine and its side-effects. Knowledge could be increased by more emphasis on the topic in nurse's training curricula as well as targeted onsite training. Only 23.5% of participants indicate that there was sufficient information in their basic nursing training.

Challenges experienced by nurse educators on the delivery of content laden curriculum at a nursing college in Gauteng

Objective : Nursing education is characterised by content laden curriculum which results in superficial coverage of content by most nurse educators in order to get the curriculum finished. The aim of this study was to explore and describe the challenges experienced by nurse educators on the delivery of content laden curriculum at a nursing college in Gauteng. Methods : A purposive sampling was used to select 20 nurse educators who teach a four-year comprehensive nursing diploma at a nursing college in Gauteng. The data were collected through audio-taped, in-depth, semi-structured individual interviews until data saturation was reached. The study was enriched with field notes that were taken to increase the credibility of data collected. Data were analysed by the researcher and an independent coder using Tesch’s protocol of qualitative data analysis. Trustworthiness was ensured through the use of Lincoln and Guba’s four principles. Results : The findings revealed that the challenges experienced by nurse educators during delivery of content laden curriculum were large classes, academically underprepared learner nurses, lack of learner nurses’ prior knowledge and learner nurses’ negative attitude towards nursing. Following these findings, the implications of the results were discussed and recommendations were made that can be used to facilitate effective delivery of the content laden curriculum. Conclusions : The findings from this study suggest that the need to cover the learning content should not supersede effective teaching and meaningful learning for the development of higher-order thinking skills in learner nurses.

Mapping Nursing Pathways

Articulated education pathways between the vocational education training sector and universities provide opportunities for students wishing to progress to higher qualifications. Enrolled nurses seeking to advance their career in nursing can choose to enter baccalaureate degree programs through such alternative entry routes. Awarding of credit for prior studies is dependent on accurate assessment of the existing qualification against that which is sought. This study employed a modified Delphi method to inform the development of an evidence-based, structured approach to mapping the pathway from the nationally consistent training package of the Diploma of Nursing to the diversity of baccalaureate nursing programs across Australia. The findings of this study reflect the practical nature of the role of the enrolled nurse, particularly the greater emphasis placed on direct care activities as opposed to those related to professional development and the generation and use of evidence. These findings provide a valuable summative overview of the relationship between the Diploma of Nursing and the expectations of the registered nurse role.

Developing Post-Operative Nursing Care Standards for Patient's Undergoing Cystectomy for Cancer Patients

Abstract Aims: To assess nurses knowledge and practice regarding cystectomy patients and develop postoperative nursing care standards for patients undergoing cystectomy at South Egypt Cancer Institute. Subject & Methods Descriptive research design was utilized in this study. Sample: A convenient sample of (60) nurses male and female working in surgical oncology department. The tools were utilized for data collection includes the following: Nurse's knowledge questionnaire, Nurses practice observation checklist, and Construction of standard of nursing care: Post-operative nursing care standards. Results: The majority of nurses are female (86.7%), more than half of nurses their age ranged from 20 >30 years (71.7%), and had diploma of nursing (70.0%). The majority of nurses are married (80.0%) and no had attended training programs (80.0%, 95.0 % respectively). More than two third of nurses (55.0%) years of experience from 5-10 years. Conclusions: Nurses` knowledge and practice regarding postoperative nursing care standards for patients undergoing cystectomy in surgical oncology department at South Egypt Cancer Institute are inadequate that necessitate developing nursing care standards for such group of patients. Recommendation: Nurses are needs for in-service training programs and refreshing courses to improve their knowledge which will reflect into their practice regarding postoperative nursing care standards while working with patients.

Oral health in nursing students at Kilimanjaro Christian Medical Centre teaching hospital in Moshi, Tanzania.

BackgroundThis study aimed to determine the prevalence and severity of dental caries, oral hygiene levels and assessment of the oral health knowledge and practices of nursing students at Kilimanjaro Christian Medical Centre teaching hospital in Moshi, Tanzania.MethodsA cross-sectional survey was done on 217 student nurse population at Kilimanjaro Christian Medical Centre Teaching Hospital in Moshi, Tanzania in 2014. Ethical approval was obtained from the Kilimanjaro Christian Medical University College Ethical Committee. A questionnaire probing on socio-demographic characteristics, knowledge and practices on selected oral health issues was administered to the students. Students were also examined for oral hygiene and dental caries using Simplified Oral Hygiene Index (OHI-S) and WHO 1997 recommended method respectively.ResultsThere were 214 (98.6%) respondents aged between 18 and 53 years (mean age was 27.2 SD ± 7.35 years). About 72% of the respondents were in the young age group (below 31 years), 63.1% were pursuing Diploma in Nursing while the rest were pursuing Bachelor of Science in Nursing. Although oral health knowledge of the respondents was generally poor, more students pursuing Bachelor of Science in Nursing had significant adequate oral health knowledge than those who were pursuing Diploma in Nursing (p = 0.05). Population Oral Hygiene Index- Simplified was 0.41 meaning good oral hygiene in the current population. Overall, caries prevalence was 40.2%. The mean population DMFT was 1.34 (SD ± 2.44). The decay component was 0.53 (SD ± 1.29), whereas the missing component was 0.67 (SD ±1.34) and filled component was 0.14 (SD ± 0.69). Significantly more students in the older age group had more missing and filled teeth than their counterparts in the young age group (p ≤0.05).ConclusionMajority of the students in this population had good oral hygiene and a very low DMFT. There was poor basic oral health knowledge and poor recall visit to dental personnel. Curriculum development in these school programmes should strengthen or encompass comprehensive oral health education components. This will empower nursing professional with basic oral health knowledge and promotive oral health behaviors and hence to disseminate to the clients.

Stress and Health: A Comparative Study among Nurses

This survey based descriptive research has been undertaken in Tirunelveli District, Tamil Nadu as a comparative study to identify and differentiate sources of stress and its impact on health of nurses working in four core departments namely intensive care unit, operation theatre, emergency department and ward. Sources of stress have been identified under three dimensions namely physical environment and welfare facilities related stressors, discrimination and harassment related stressors and attitude towards work related stressors. The study has sampled 360 nurses qualified with Diploma in General nursing and Midwifery and Bachelor of Science in nursing courses from 45 general types of private hospitals using a stratified sampling technique. Weighted average method has been applied to analyse sources of stress. Mean, standard deviation and coefficient of variation have been used to understand perception of nurses working in four core departments towards sources of stress. Kruskal-Wallis test has been administered to examine the relationship between sources of stress and demographic variables. Multiple regression models have been used to know relationship between sources of stress and health. The result indicated that all three dimensions of stressors have been perceived at medium level by majority of the nurses. The result also found that among three dimensions of stress or physical environment and welfare facilities related stressors has occupied the first place followed by attitude towards work related stressors and discrimination and sexual harassment related stressors. The study has given suitable suggestions to overcome the stress.