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Stressors and Coping Strategies as Perceived among Nursing Students during Related Learning Experience (RLE)

*Geraldine Sabate Ridad orcid scopus  -  College of Nursing, Mindanao State University - Iligan Institute of Technology, Philippines
Haniya Angintaopan  -  College of Nursing, Mindanao State University - Iligan Institute of Technology, Philippines
Princess Haniefa Mae Ayunan  -  College of Nursing, Mindanao State University - Iligan Institute of Technology, Philippines
Saipoden Manalocon  -  College of Nursing, Mindanao State University - Iligan Institute of Technology, Philippines
Open Access Copyright (c) 2024 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Stress in relation to academic studies is identified to be one of the reasons behind suicide cases in higher education institutions around the world. Locally, there is none to less studies that explored this area among nursing students. As stress is inevitable in nursing students’ Related Learning Experience (RLE), recognizing the stressors that affect their quality of RLE is necessary.

Purpose: This study aimed to investigate the stressors and coping strategies that nursing students commonly use in managing stress during their RLE and their relationship to each other.

Methods: A descriptive correlational research design with total enumeration sampling was employed. A pilot-tested questionnaire was used to gather data from 191 junior and senior nursing students from two nursing schools in Iligan City. Weighted mean, standard deviation, percentages, and Spearman rho were used to analyze the data.

Results: The findings show that the "Clinical Instructor" (Mean=3.01) is perceived to cause higher stress among all the intrapersonal and interpersonal stressors identified. Students highly utilize both intrapersonal (Self-Concept Mean=3.75) and interpersonal strategies (Role Function Mean=4.13, Interdependence Mean=3.46) to cope with stress. When students’ clinical “skill confusion” increases, they tend to work less with others (r=-0.259, p=0.000). When “staff nurses” cause them less stress, their use of positive “self-concept” decreases as well (r=0.152, p=0.035). Furthermore, when students are stressed with their “Duty-mates,” they rely more on “physiological” coping mechanisms (r=0.160, p=0.027). When their “clinical instructor” causes them stress, they cope less with “physiological” (r=-0.237, p=0.001) and “interdependence” strategies (r=-0.317, p=0.000).

Conclusion:Among all the stressors, clinical instructor causes more stress to the students. The students’ perceived stressors affect their effective use of intra and interpersonal coping strategies. Nurse educators, nursing schools and regulating bodies can consider these results in designing a holistic curriculum and helping students manage stress healthily.

 

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Keywords: Curriculum; nurses; nursing students; psychological adaptation

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  1. Ab Latif, R., & Nor, M. Z. M. (2019). Stressors and coping strategies during clinical practice among diploma nursing students. The Malaysian Journal of Medical Sciences, 26(2), 88. https://doi.org/10.21315%2Fmjms2019.26.2.10
  2. Admi, H., Moshe-Eilon, Y., Sharon, D., & Mann, M. (2018). Nursing students’ stress and satisfaction in clinical practice along different stages: A cross-sectional study. Nurse Education Today, 68, 86-92. https://doi.org/10.1016/j.nedt.2018.05.027
  3. Aedh, A. I., Elfaki, N. K., & Mohamed, I. A. (2015). Factors associated with stress among nursing students (Najran University-Saudi Arabia). IOSR Journal of Nursing and health Science, 4(6), 33-38. https://www.iosrjournals.org/iosr-jnhs/papers/vol4-issue6/Version-6/E04663338.pdf
  4. Al-Qerem, W., Hammad, A., Amawi, H. A., Jarab, A. S., & Ling, J. (2021). Anxiety and depression among pharmacy students before and during COVID-19 pandemic. Tropical Journal of Pharmaceutical Research, 20(5), 1039-1047. https://doi.org/10.4314/tjpr.v20i5.22
  5. Al‐Gamal, E., Alhosain, A., & Alsunaye, K. (2018). Stress and coping strategies among Saudi nursing students during clinical education. Perspectives in Psychiatric Care, 54(2), 198-205. https://doi.org/10.1111/ppc.12223
  6. Al‐Zayyat, A. S., & Al‐Gamal, E. (2014). Perceived stress and coping strategies among Jordanian nursing students during clinical practice in psychiatric/mental health courses. International Journal of Mental Health Nursing, 23(4), 326-335. https://doi.org/10.1111/inm.12054
  7. Alghamdi, S., Aljabri, S., Jafari, G., Alzebali, R., Alkunaidiri, N., & Kalantan, N. (2019). Sources of stress among undergraduate nursing students. Global Journal of Health Science, 11(9), 116. https://doi.org/10.5539/GJHS.V11N9P116
  8. Aljohani, W., Banakhar, M., Sharif, L., Alsaggaf, F., Felemban, O., & Wright, R. (2021). Sources of stress among Saudi Arabian nursing students: A cross-sectional study. International Journal of Environmental Research and Public Health, 18(22), 11958. https://doi.org/10.3390%2Fijerph182211958
  9. Alvarez, H. A. O., Provencio-Vasquez, E., Slavich, G. M., Laurent, J. G. C., Browning, M., McKee-Lopez, G., Robbins, L., & Spengler, J. D. (2019). Stress and health in nursing students: The nurse engagement and wellness study. Nursing Research, 68(6), 453-463. https://doi.org/10.1097%2FNNR.0000000000000383
  10. Baluwa, M. A., Lazaro, M., Mhango, L., & Msiska, G. (2021). Stress and coping strategies among Malawian undergraduate nursing students. Advances in Medical Education and Practice, 12, 47-556. https://doi.org/10.2147/AMEP.S300457
  11. Bam, V. B., Oppong, G. A., & Ibitoye, M. B. (2014). Stress and coping mechanisms of nursing students during clinical practice in Ghana. Journal of Science and Technology (Ghana), 34(2), 50-59. https://doi.org/10.4314/just.v34i2.6
  12. Bodys-Cupak, I., Majda, A., Zalewska-Puchała, J., & Kamińska, A. (2016). The impact of a sense of self-efficacy on the level of stress and the ways of coping with difficult situations in Polish nursing students. Nurse Education Today, 45, 102-107. https://doi.org/10.1016/j.nedt.2016.07.004
  13. Chaabane, S., Chaabna, K., Bhagat, S., Abraham, A., Doraiswamy, S., Mamtani, R., & Cheema, S. (2021). Perceived stress, stressors, and coping strategies among nursing students in the Middle East and North Africa: An overview of systematic reviews. Systematic Reviews, 10(1), 136. https://doi.org/10.1186/s13643-021-01691-9
  14. Cheng, W. L. S., Chow, P. P. K., & Wong, F. M. F. (2023). Associations among stressors, perceived stress, and psychological distress in nursing students: a mixed methods longitudinal study of a Hong Kong sample. Frontiers in Psychology, 14, 1234354. https://doi.org/10.3389/fpsyg.2023.1234354
  15. Ching, S. S. Y., Cheung, K., Hegney, D., & Rees, C. S. (2020). Stressors and coping of nursing students in clinical placement: A qualitative study contextualizing their resilience and burnout. Nurse Education in Practice, 42, 102690. https://doi.org/10.1016/j.nepr.2019.102690
  16. Commission on Higher Education. (2009). CHED Memorandum Order (CMO) No. 14, Series of 2019: Policies and standards for Bachelor of Science in Nursing (BSN) program. https://ched.gov.ph/wp-content/uploads/2017/10/CMO-No.14-s2009.pdf
  17. Delawala, F. (2020). The relationship between stress and teamwork during interprofessional collaboration: An integrative literature review [Doctoral dissertation, North-West University]. Boloka Institutional Repository. https://repository.nwu.ac.za/handle/10394/34988
  18. Duraku, Z. H., & Hoxha, L. (2018). Self-esteem, study skills, self-concept, social support, psychological distress, and coping mechanism effects on test anxiety and academic performance. Health Psychology Open, 5(2), 2055102918799963. https://doi.org/10.1177/2055102918799963
  19. Durgun Ozan, Y., Duman, M., Çiçek, Ö., & Baksi, A. (2020). The effects of clinical education program based on Watson's theory of human caring on coping and anxiety levels of nursing students: A randomized control trial. Perspectives in Psychiatric Care, 56(3). https://doi.org/10.1111/ppc.12477
  20. El Ansari, W., Adetunji, H., & Oskrochi, R. (2014). Food and mental health: Relationship between food and perceived stress and depressive symptoms among university students in the United Kingdom. Central European Journal of Public Health, 22(2), 90-97. https://doi.org/10.21101/cejph.a3941
  21. Fink, G. (2016). Stress, definitions, mechanisms, and effects outlined: Lessons from anxiety. In G. Fink (Ed.), Stress: Concepts, cognition, emotion, and behavior (pp. 3–11). Academic Press. https://doi.org/10.1016/B978-0-12-800951-2.00001-7
  22. Gorton, K. L., & Foss, K. (2017). Partnerships with clinical settings: Roles and responsibilities of nurse educators. In M. H. Oermann, J. C. De Gagne, & B. C. Phillips (2nd Ed.), Teaching in Nursing and Role of the Educator: The Complete Guide to Best Practice in Teaching, Evaluation, and Curriculum Development (pp. 203-230). Springer Publishing Company
  23. Grobecker, P. A. (2016). A sense of belonging and perceived stress among baccalaureate nursing students in clinical placements. Nurse Education Today, 36, 178-183. https://doi.org/10.1016/j.nedt.2015.09.015
  24. Guro, N. M., & Buenavidez, E. B. (2023). Sleep deprivation, clinical exposure anxiety, and psycho-emotional state of nursing students. International Journal of Social Science and Human Research, 6(11), 7052-7060. http://dx.doi.org/10.47191/ijsshr/v6-i11-66
  25. Hershner, S. D., & Chervin, R. D. (2014). Causes and consequences of sleepiness among college students. Nature and Science of Sleep, 6, 73-84. https://doi.org/10.2147/NSS.S62907
  26. Hindustan Times. (2023, March 16). Academic stress among causes of suicides at top institutes like IIT: Centre. Hindustan Times. https://www.hindustantimes.com/india-news/dwarka-expressway-pm-modi-inaugurates-haryana-stretch-how-will-it-help-101710132848972.html
  27. Hirsch, C. D., Barlem, E. L. D., Almeida, L. K. D., Tomaschewski-Barlem, J. G., Lunardi, V. L., & Ramos, A. M. (2018). Stress triggers in the educational environment from the perspective of nursing students. Texto & Contexto-Enfermagem, 27, e0370014. https://doi.org/10.1590/0104-07072018000370014
  28. Hutmacher, F. (2021). Putting stress in historical context: Why it is important that being stressed out was not a way to be a person 2,000 years ago. Frontiers in Psychology, 12, 539799. https://doi.org/10.3389/fpsyg.2021.539799
  29. Ismaile, S. (2017). Perceived clinical stressors among Saudi nursing students. Open Journal of Nursing, 7(4), 463. https://doi.org/10.4236/ojn.2017.74036
  30. Khan, N., & Alam, B. (2015). Views of nursing students about clinical instructor behaviours that affect the development of self-confidence, peshawar, KP, Pakistan. International Journal of Innovative Research and Development, 4(4), 10-20. https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=4cf33a21db522c71839bc534b3ca55f0f1d3006c
  31. Labrague, L. J. (2021). Resilience as a mediator in the relationship between stress-associated with the Covid-19 pandemic, life satisfaction, and psychological well-being in student nurses: A cross-sectional study. Nurse Education in Practice, 56, 103182. https://doi.org/10.1016/j.nepr.2021.103182
  32. Labrague, L. J. (2022). Specific coping styles and its relationship with psychological distress, anxiety, mental health, and psychological well‐being among student nurses during the second wave of the COVID‐19 pandemic. Perspectives in Psychiatric Care, 58(4), 2707-2714. https://doi.org/10.1111/ppc.13111
  33. Labrague, L. J., McEnroe-Petitte, D. M., Gloe, D., Thomas, L., Papathanasiou, I. V., & Tsaras, K. (2017). A literature review on stress and coping strategies in nursing students. Journal of Mental Health, 26(5), 471-480. https://doi.org/10.1080/09638237.2016.1244721
  34. Labrague, L. J., McEnroe-Petitte, D. M., Papathanasiou, I. V., Edet, O. B., Tsaras, K., Leocadio, M. C., Colet, P., Kleisiaris, C. F., Fradelos, E. C., Rosales, R. A., Santos-Lucas, K. V., & Velacaria, P. I. T. (2018). Stress and coping strategies among nursing students: An international study. Journal of Mental Health, 27(5), 402-408. https://doi.org/10.1080/09638237.2017.1417552
  35. Lavoie-Tremblay, M., Sanzone, L., Aubé, T., & Paquet, M. (2022). Sources of stress and coping strategies among undergraduate nursing students across all years. Canadian Journal of Nursing Research, 54(3), 261-271. https://doi.org/10.1177%2F08445621211028076
  36. Mahomed, N. J. B., Johari, K. S. K., & Mahmud, M. I. (2019). Coping strategies and psychological well-being of guidance and counselling teachers in schools. Creative Education, 10(12), 3028. http://www.scirp.org/journal/Paperabs.aspx?PaperID=96791
  37. McCarthy, B., Trace, A., O’Donovan, M., Brady-Nevin, C., Murphy, M., O'Shea, M., & O'Regan, P. (2018). Nursing and midwifery students' stress and coping during their undergraduate education programmes: An integrative review. Nurse Education Today, 61, 197-209. https://doi.org/10.1016/j.nedt.2017.11.029
  38. McCloughen, A., Levy, D., Johnson, A., Nguyen, H., & McKenzie, H. (2020). Nursing students’ socialisation to emotion management during early clinical placement experiences: A qualitative study. Journal of Clinical Nursing, 29(13-14), 2508-2520. https://doi.org/10.1111/jocn.15270
  39. McEwen, M., & Wills, E. (2019). Theoretical Basis for Nursing (5th ed.). Lippincott Williams & Wilkins
  40. Milton-Wildey, K., Kenny, P., Parmenter, G., & Hall, J. (2014). Educational preparation for clinical nursing: The satisfaction of students and new graduates from two Australian universities. Nurse Education Today, 34(4), 648-654. https://doi.org/10.1016/j.nedt.2013.07.004
  41. Mindanao State University-Iligan Institute of Technology Clinic. (2018). First Semester of Academic Year 2018-2019 Report
  42. Monteiro, N. M., Balogun, S. K., & Oratile, K. N. (2014). Managing stress: the influence of gender, age and emotion regulation on coping among university students in Botswana. International Journal of Adolescence and Youth, 19(2), 153-173. https://doi.org/10.1080/02673843.2014.908784
  43. Msiska, G., Kamanga, M., Chilemba, E., Msosa, A., & Munkhondya, T. E. (2019). Sources of stress among undergraduate nursing students during clinical practice: A Malawian perspective. Open Journal of Nursing, 9(01), 1. https://doi.org/10.4236/ojn.2019.91001
  44. Munawar, S., Hussain, M., Afzal, M., & Gilani, S. A. (2019). Nursing students’ perceptions of clinical instructor behaviors that affect the development of self-confidence. European Academic Research, 7(3), 1817-1832. https://euacademic.org/UploadArticle/4026.pdf
  45. Nebhinani, M., Kumar, A., Parihar, A., & Rani, R. (2020). Stress and coping strategies among undergraduate nursing students: A descriptive assessment from Western Rajasthan. Indian Journal of Community Medicine, 45(2), 172-175. https://doi.org/10.4103%2Fijcm.IJCM_231_19
  46. O’Connor, D. B., Gartland, N., & O’Connor, R. C. (2020). Stress, cortisol and suicide risk. International Review of Neurobiology, 152, 101-130. https://doi.org/10.1016/bs.irn.2019.11.006
  47. Polit, D., & Beck, C. (2022). Essentials of Nursing Research (10th ed.). Lippincott Williams & Wilkins
  48. Quah, S. (2014). Caring for persons with schizophrenia at home: Examining the link between family caregivers' role distress and quality of life. Sociology of Health & Illness, 36(4), 596-612. https://doi.org/10.1111/1467-9566.12091
  49. Rafati, F., Nouhi, E., Sabzevari, S., & Dehghan-Nayeri, N. (2017). Coping strategies of nursing students for dealing with stress in clinical setting: A qualitative study. Electronic Physician, 9(12), 6120. https://doi.org/10.19082%2F6120
  50. Rayan, A. (2019). Mindfulness, self-efficacy, and stress among final-year nursing students. Journal of Psychosocial Nursing and Mental Health Services, 57(4), 49-55. https://doi.org/10.3928/02793695-20181031-01
  51. Ribeiro, Í. J., Pereira, R., Freire, I. V., de Oliveira, B. G., Casotti, C. A., & Boery, E. N. (2018). Stress and quality of life among university students: A systematic literature review. Health Professions Education, 4(2), 70-77. https://doi.org/10.1016/j.hpe.2017.03.002
  52. Roy, C. (2009). The Roy adaptation model. (3rd ed.). Upper Saddle River New Jersey, Pearson Education
  53. Shdaifat, E., Jamama, A., & AlAmer, M. (2018). Stress and coping strategies among nursing students. Global Journal of Health Science, 10(5), 33-41. https://doi.org/10.5539/gjhs.v10n5p33
  54. Stewart, J. G., Shields, G. S., Esposito, E. C., Cosby, E. A., Allen, N. B., Slavich, G. M., & Auerbach, R. P. (2019). Life stress and suicide in adolescents. Journal of Abnormal Child Psychology, 47, 1707-1722. https://doi.org/10.1007/s10802-019-00534-5
  55. Tharani, A., Husain, Y., & Warwick, I. (2017). Learning environment and emotional well-being: A qualitative study of undergraduate nursing students. Nurse Education Today, 59, 82-87. https://doi.org/10.1016/j.nedt.2017.09.008
  56. Thomas, C. M., McIntosh, C. E., Lamar, R. A., & Allen, R. L. (2017). Sleep deprivation in nursing students: The negative impact for quality and safety. Journal of Nursing Education and Practice, 7(5), 87. http://dx.doi.org/10.5430/jnep.v7n5p87
  57. Toqan, D., Ayed, A., Malak, M. Z., Hammad, B. M., ALBashtawy, M., Hayek, M., & Thultheen, I. (2023). Sources of stress and coping behaviors among nursing students throughout their first clinical training. SAGE Open Nursing, 9, 23779608231207274. https://doi.org/10.1177/23779608231207274
  58. World Health Organization. (2023, August 28). Suicide. https://www.who.int/news-room/fact-sheets/detail/suicide

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