Stress In Nursing Students Research Articles

A longitudinal study of stress and self-esteem in student nurses

It is well recognised that nurse education/training can be a stressful experience and that self-esteem is an important predictor of stress. BACKGROUND/LITERATURE: While there are a significant number of studies showing levels and contributors to stress among students. There is little evidence of how these levels change over time. The aim of the study was to investigate nursing students' experiences of stress and levels of self-esteem during three years of their undergraduate nursing programme. Participants completed the stress in nurse education questionnaire and the culture free self-esteem inventory at various time points in the study, and a demographic questionnaire at baseline. The students who took part in the study commenced their nurse training in September 2002. This study has demonstrated that levels of self reported stress and "general" self-esteem are significantly different at different stages the nurse training process. Self reported stress were at the highest at the beginning of the third year and these were significantly higher when compared to stress reported at any other time point. Self-esteem levels were lowest at the end of training. Trying to obtain data only at single time point during nurse education/training is inadequate as this research has shown that there is indeed variation in student psychological well being across the academic year.

The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea

This study examined the effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. A nonequivalent, control group, pre-posttest design was used. A convenience sample of 41 nursing students were randomly assigned to experimental (n=21) and control groups (n=20). Stress was measured with the PWI-SF (5-point) developed by Chang. Anxiety was measured with Spieberger's state anxiety inventory. Depression was measured with the Beck depression inventory. The experimental group attended 90-min sessions for eight weeks. No intervention was administered to the control group. Nine participants were excluded from the analysis because they did not complete the study due to personal circumstances, resulting in 16 participants in each group for the final analysis. Results for the two groups showed (1) a significant difference in stress scores (F=6.145, p=0.020), (2) a significant difference in anxiety scores (F=6.985, p=0.013), and (3) no significant difference in depression scores (t=1.986, p=0.056). A stress coping program based on mindfulness meditation was an effective intervention for nursing students to decrease their stress and anxiety, and could be used to manage stress in student nurses. In the future, long-term studies should be pursued to standardize and detail the program, with particular emphasis on studies to confirm the effects of the program in patients with diseases, such as cancer.

Experience of stress in psychiatric nursing students in Ireland

The aim of this study was to explore the experience of stress among psychiatric nursing students undertaking their 'internship' or final year of a four-year degree course. A questionnaire was administered to all 28 students in the intern year in conjunction with the 28-item version of the General Health Questionnaire. Semi-structured interviews were subsequently undertaken with four volunteers from a range of clinical locations. Approximately 48% of respondents reported levels of stress above the threshold score as described by Goldberg (1978), indicating levels of distress unlikely to remit without intervention. Interview data suggested that the main sources of stress during the intern year were associated with relationships in the clinical environment; clinical workload; matching competence and responsibility; and simultaneous clinical and academic demands. The findings should be interpreted with caution and understood within the context of the dynamic nature of nurse education in Ireland. However, the issues raised demand further enquiry to examine the structure of educational programmes, the nature of the work and the organisational culture in which the work is carried out.

Mental health nursing students differ from other nursing students: Some observations from a study on stress and coping

The study reported here is taken from a wider investigation into stress among preregistration nursing students, undertaken in the nursing department of a large university in northern England. British nursing is divided into four specialties or 'branches': adult, mental health, children's, and learning disability nursing, and the aim of the study was to explore interbranch differences among the students in terms of the sources of stress they identify, the levels of stress they experience, and the ways in which they cope. A cross-sectional survey of all nursing students on the department's roll (n = 1362), using a range of self-report measures bound together in a 'questionnaire pack', was undertaken. The questionnaire pack contained formal measures of sources of stress (Student Nurse Stress Index), stress (specifically, psychological distress) (General Health Questionnaire) and coping (Coping Inventory for Stressful Situations), as well as a set of questions that enabled data on a range of pertinent variables, including the nursing branch being pursued, to be collected. The findings revealed that mental health nurses were notably different from the other three branches in terms of the quantity and characteristics of the sources of stress they faced, the levels of stress they experienced, and the ways in which they coped. These differences were largely advantageous to the students' well-being and speculations are made as to whether the concept of 'hardiness'- especially its focus on a sense of being in control - plays a role in explaining the findings.

A comparative, longitudinal study of stress in student nurses in five countries: Albania, Brunei, the Czech Republic, Malta and Wales

Stress amongst nursing students is a global issue. There is an absence of published international comparative studies which investigate this and so this paper sets out to explore the sources of stress among nursing students throughout their course of study and to determine whether they were more stressed by academic or clinical factors across five different countries (Albania, Brunei, the Czech Republic, Malta and Wales). Although each country, within this study, has a unique culture, a cross-cultural comparison can be made in an attempt to better understand stress in the student nursing population. The study was undertaking using a descriptive quantitative design using the Stress in Nurse Education Questionnaire with 1707 nursing students across the five countries. The mean score for the total sample for all the items on the stress scale was 52.3 (SD 17.1). The sample from Wales had the lowest mean score and those in Brunei had the highest. Students in Brunei and Malta were more stressed by the academic elements of the course than by the clinical elements. Whereas for those students in the Czech Republic For students in Wales and in Albania - Korçe there were no differences in stress experienced between the academic and clinical elements of the course. The results indicated that there were no significant differences in total stress scores by year of study for students in Albania - Tirana, Albania-Korçe, Malta and Wales. In Brunei however, ANOVA revealed that there were significant differences in total stress scores by year of study. Further analysis revealed that students in year 3 scored higher on the overall scale than students in year 1. The individual item on the stress scale with highest mean in the Albania - Korçe and the Albania-Tirana sample was "The death of a patient" whilst the Bruneian sample, Maltese sample and Welsh sample opted for "Revising for and sitting examinations" and the Czech sample chose: "Continuous pressure to meet deadlines for assessments". This study has succeeded as the first of its kind to compare and contrast levels and sources of stress amongst an international sample. The findings indicate that student nurses worldwide do share much in common while still retaining individual cultural features relating to stress throughout their course of study.

A descriptive study of Bruneian student nurses’ perceptions of stress

While much has been written about stress in nursing in the 'West', less research has been done on this issue in many 'Eastern' countries. This paper offers the findings of the first study of stress in student nurses in Brunei. The paper describes a study of 20 Brunei nursing students and their views about stress in nursing. A modified grounded theory approach was used in collecting and analysing data (and the 'modifications' are described). Findings were organised around the themes: stressors, moderators and outcomes [Carson, J., and Kuipers, E., 1998. Stress management interventions. In: Hardy, S., Carson, J., Thomas, B. (Eds.), Occupational Stress: Personal and Professional Approaches. Stanley Thornes, Cheltenham. pp. 157-174.]. Students often found their status as students caused them stress in the clinical setting: with other nurses, with doctors and even with patients. Academic related stressors included having to complete assignments and having to study in English. Various ways of moderating stress were reported including talking to 'trusted friends', engaging in sports or simply being quiet. Positive and negative outcomes of stress were identified: stress could lead to mental illness but, also, it could be motivating. This report concludes with a Weberian 'ideal type': a composite word-picture of the findings.

Predicting stress in pre-registration midwifery students attending a university in Northern England

Objective to determine which variables predict stress (psychological distress) in pre-registration midwifery students. Design a cross-sectional survey, using a range of self-report measures bound together in a ‘questionnaire pack’. Setting the study reported here is taken from a wider investigation into stress among nursing and midwifery students, undertaken in the nursing and midwifery department of a large university in Northern England. Participants 120 pre-registration midwifery students pursuing one of three diploma programmes: ‘standard’, ‘enhanced’ and ‘short’. Measurements multivariate logistic regression was used as the analytical technique. The variables used in the analyses undertaken were all derived from formal and study-specific, self-report measures included in the questionnaire pack. ‘Stress’ (whether a participant was psychologically distressed or not) was obtained via the General Health Questionnaire. Potential predictors of stress were collected from two formal measures (the Student Nurse Stress Index and the Coping Inventory for Stressful Situations) and from questions in the questionnaire pack designed to elicit demographic data and data of specific interest to nurse and midwife educators. Findings 102 questionnaire packs (85%) were returned. The prevalence of stress among participants was over 40%. A series of logistic regression analyses resulted in five competing regression models. Through a systematic selection process, two of these models were chosen for discussion. These models suggested that the key predictors of psychological distress in the population studied were self-report of stress levels, the type of midwifery programme being pursued, the use of ‘task-oriented’ coping and, possibly, whether or not a student smokes cigarettes. Key conclusions and implications for practice despite the prevalence rate of 40%, the prevalence of stress among midwifery students is generally no better or worse than that of other students or of qualified health-care professionals. Those involved in midwifery education need to know how to manage student stress effectively. This can be achieved by ensuring that personal teachers (continue to) play a key role in supporting students, especially when students self-report high levels of stress. Incorporating formal stress-management training into pre-registration midwifery programmes may also be useful. Sound knowledge of the issues associated with student stress during curriculum design, however, may ultimately prove to be the most effective way of managing student stress. In a discipline such as midwifery, these issues are as divergent as the politics of midwifery, the processes used in recruitment and selection, the role of women in society, and the nature, quality and quantity of the learning experiences and the assessment strategies used.

A study to ascertain the effect of structured student tutorial support on student stress, self-esteem and coping

The overall aim of this intervention study was to investigate, and measure quantitatively, the psychological effects of structured student tutorial support, on undergraduate students' level of stress, self-esteem and cognitive coping. A quantitative research approach was adopted using a quasi-experimental design (post-test only, non-equivalent control group design) in order to ascertain whether there were any significant differences between the experimental conditions (n=25) and a control group (n=25). The independent variable was structured student tutorial support and the dependent variables were student stress, self-esteem and cognitive coping. A total of 50 subjects were randomly assigned to either the experimental or control group. Quantitative data were collected using: the Student Nurse Stress Index (Jones, M.C., Johnston, D.W., 1997a. The derivation of a 22 item Student Nurse Stress Index, using exploratory, confirmatory and multi-sample confirmatory factor analytic techniques. In: Paper Presented at the Annual Nursing Research Conference, 18-20th April, University of Wales, Swansea; Jones, M. C. Johnston, D.W., 1999. Derivation of a brief Student Nurse Stress Index. Work and Stress 13(2), 162-181), the Self Esteem Scale (Rosenberg, M., 1965. Society and the Adolesent Self Image. Princeton University Press, Princeton, NJ) and a Linear Analogue Coping Scale (Gammon, J., 1998. Analysis of the stressful effects of hospitalisation and source isolation on coping and psychological constructs. International Journal of Nursing Practice 4(2), 84-97). The methods of data analysis were the application of the t-test and descriptive statistics. The results indicated a significantly lower level of stress in the experimental group (t=-3.85, p=0.001) and a significantly higher self esteem (t=4.11, p=0.001). Results also suggested that students who were provided with structured tutorial support perceived they coped more effectively with their studies (t=4.65, p=0.001). The study concluded that structured tutorial support was an influential variable in reducing student stress, promoting self-esteem and facilitating more effective coping, suggests further interventional research is needed to evaluate this further.

Stress, sources of stress and ways of coping among psychiatric nursing students.

This study measured levels of distress, sources of stress and ways of coping of a convenience sample of psychiatric nursing students (n = 35). Instruments used were the 30-item General Health Questionnaire, the Jones and Johnson (1997) Student Nurse Stress Index, Parkes (1985) Ways of Coping Questionnaire and a demographic questionnaire. Findings revealed that all students were significantly distressed, exceeding a conventional cut-off score of 5 on the 30-item General Health Questionnaire. Students were found to have limited coping skills. Preparing to become a nurse in this setting was found to be significantly emotionally stressful and a possible risk to the well-being of students. This study provides a baseline from which to address the problem of stress among diplomate psychiatric nursing students.

Student nurse stress in the preceptorship experience.

Student nurses appear to experience significantly more stress during their academic preparation than they do during the first year of employment. Preceptorship is among the most stressful of student experiences. It is within the context of a challenging and at times daunting work environment that two complete strangers (preceptor and student) strive to accommodate one another within a professional capacity. If the relationship between preceptor and student is less than successful, not only can it be frustrating and disheartening, but it can result in student stress and disillusionment about nursing and an inability to integrate and learn. Using a hypothetical case, the authors discuss the importance of student assessment, close communication between faculty and preceptors, and quick responses to student stress as a means by which to circumvent the serious potential of student burnout in the practice setting.

The derivation of a brief Student Nurse Stress Index

The lack of an adequate measure of perceived sources of stress for student nurses led to the construction of the Student Nurse Stress Index (SNSI). Responses from 235 first-year student nurses to 35 items from the Beck and Srivastava Stress Inventory (Beck, and Srivastava, 1991), and 15 new items, were subjected to exploratory factor analysis using principal components analysis and oblimin rotation. A reliable 22-variable solution with a simple oblique structure including Academic load, Clinical sources, Interface worries, and Personal problems factors was obtained in this initial sample, and confirmed at an exploratory level in a further independent validation sample of 188 first-year students. Confirmatory factor analysis established the four-factor model in the first sample, but required that three variables load onto more than one factor. This more complex four-factor model was confirmed using independent data from the validation sample, and the total invariance of factor loadings and factor covariances of this more complex four-factor model was established in both data sets simultaneously using multi-sample techniques. The SNSI shows cross-sample factor congruence, good internal reliabilities, and concurrent and discriminant validity across a range of reporting conditions.

Stress and distress in nursing students

Stress and distress in nursing students