A Study to Assess the Academic Stress among Nursing Students at Selected Nursing College.
Ms. Sunandha1, Dr. G. Neelakshi2, Mrs. G. J. Sarasapharina3
1PG Student, 2 Professor, 3 Lecturer
1,2,3
Department of psychiatric nursing, Sri Ramachandra faculty of Nursing, Sri Ramachandra Institute of higher education and research (DU), Porur, Chennai
Corresponding Author:
Dr.G.Neelakshi
Professor, Sri Ramachandra Faculty of Nursing
Sri Ramachandra Institute of higher education and research (DU), Porur, Chennai-600116, India
Email: [email protected]
ABSTRACT
Background: The present study assesses the academic stress among nursing students
Methods: The research design adopted for this study was non-experimental descriptive study was conducted in Sri Ramachandra Institute of higher education and research (DU).
Results: majority 64 (85.3%) were in the age group of 18 – 20 years, female students 56(74.7%), in hostel 52(69.3%). among 75 students, majority 58 (77.3%) had severe level of academic stress, and 17 (22.7%) of them had moderate level of stress in relation to personal inadequacy; regarding fear of failure, majority 64 (85.3%) of them had moderate level of stress and 10 (13.3%) of them had severe stress and only one (1.03%) person had mild level of stress.
Conclusion: The present study concludes that majority of the students studying 3rd year had moderate level of academic stress.
Keywords:
stress, Academic stress, nursing students
1.Introduction
Stress is a normal part of everyday life and occurs whenever out bodies and mind are faced with demands which tax or exceed out capacity to respond. The nursing profession is generally considered as a noble profession with a lot of expectations from the nurses. These expectations arising from the various sources lead to the component of academic stress among the nursing students.
Nursing students need to cope up with the demands of the parents and the society. Coping is considered as an important resource that can help the students to maintain psychological adaptation during a stressful episode. The nursing students must be taught to put their adaptive capabilities to test so as to ward off the negative impact of academic stress. Successful coping of the academic stress not only depends on the personality characteristics of the nursing students but also on the realistic appraisal of the situation. Thus, a healthy sense of optimum, tempered with same degree of realism appears to be helpful both in warding off the impact of academic stress and in preventing the insidious effect of adjustment styles in understanding health.
In today's highly competitive world, students face various academic problems including exam stress, disinterest in attending classes and inability to understand the subject. Academic stress is the feeling of anxiety or apprehension over one's performance in the academic activities. It can lead to students being unable to perform to the best of their abilities in examinations.
At college there is a range of academic pressure feel, derived from a need for perfection, worry over grades, parental pressure, competition, sports, or a tough class load. The nervous
breakdowns, panic attacks, burnouts, and depression are also apparent in many younger students.
The same situation is not always stressful for all students, and all students do not undergo the same feelings or thoughts when stressed.
Students were considered to be the future pillars who take the responsibilities to take our country to the next phase they should be in better way. To know this, the investigator decided to analysis the academic stress among the college students. The present study aims at investigating how the academic stress experiencing by the nursing students are related to certain factors.
2. Method and Material
Study Design: The research design adopted for this study wasnon-experimental descriptive study was conducted in Sri Ramachandra Institute of higher education and research(DU). The Sister Callista Roy’s adaptation model was adopted for this study. The Academic stress scale was used to collect the data from 75 students in SRMC&RI (DU). The samples were selected through Purposive sampling technique. The data were analyzed using descriptive and inferential statistics.
The setting of the study was in faculty of nursing, SRMC & RI (DU), Porur, Chennai. SRMC &
RI (DU) has nine constituent colleges. Faculty of nursing is one among the oldest college established in the year 1993. Faculty of nursing is three story building runs three programs namely, B.Sc. Nursing (Basic) 4 year course, B.Sc. Nursing (Post Basic) 2 years course and M.Sc. Nursing with five specialties, which is for 2 years. The student of B.Sc. Nursing (Basic) 4 year course is running in the ground floor of the faculty of nursing.
Study Population: All the students undergoing III year B.Sc. Nursing (Basic) program who were available during the study period in the faculty of nursing. All students undergoing III year B.Sc.
Nursing (Basic) program available during the data collection period in the faculty of nursing.
A purposive sampling technique was used in this study and selected 75 students for this study.
Inclusion criteria: Students who were studying III year B.Sc. Nursing (Basic) and available during data collection period.
Exclusion criteria: Students who were not willing to participate in this study
Description of the instrument: The tool of the study has two parts: PART A: Demographic variables . it consist of section 1- Personal data -It includes age sex diagnosed with known illness, substance abuse, parents live together, financial problems, love affairs friendship, leisure time activities, time speed sleeping at night, time spending with friends; section 2- Academic Data- It includes academic year, interest in nursing, mode of entry to nursing program, clinical practice schedule, time bound in completion of requirement, area of current posting. PART B: consists of academic stress scale developed by Kim 1970. Academic stress scale (ASS) comprised of 40 items with five factors: Factor I - Personal Inadequacy – (F1) from item 1-8; Factor II - Fear of Failure - (F2) from item 9-1; Factor III - Interpersonal difficulties with teachers – (F3) from item 17-24;Factor IV - Teacher- pupil relationship/ Teaching methods - (F4) from item 25-
32; Factor V - Inadequate studies facility (F5) from item 33-40. sCORE was interpreted as The total items were 40. Total score ranged from 1-120. Each item is assessed using 3
point Likert scale ranging from 1(do not want to answer) - 3(agree). As per author the total score ranged from120(3x40) is the possible score and the highest score on each factor would be 32 (4 x8). Each factor has equal number of item. The higher the value of the score, the more the academic stress and vice-versa. The level of stress has been classified as Mild level of stress (<25), Moderate level of stress (51-75), and Severe level of stress (>76).
Data collection procedure: researcher obtained permission from principal in-charge, IEC, to conduct the study. The study was conducted in the department of Faculty of nursing. 75 students
were selected by purposive sampling method. The data was collection done among 75 students on 23/3/2018 between 11.00am to 1.00pm by the investigator. The investigator after obtaining written consent from participants of demographic variables and Academic stress scale distributed to each participant and given 20 minutes to complete the questionnaire and clarified their doubts then and there by the investigator. Privacy and confidentiality were taken into consideration.
After the completion of the questionnaire each students was thanked individually
3. Findings:
The findings from the study are tabulated, analyzed and interpreted below.
Major Findings: In relation to Medical Surgical nursing subject among III year B.Sc.
(Basic)year nursing students; among 75 students, majority 58 (77.3%) of them had severe level of academic stress, and 17 (22.7%) of them had moderate level of stress in relation to personal inadequacy; regarding fear of failure, majority 64 (85.3%) of them had moderate level of stress and 10 (13.3%) of them had severe level of stress and only one (1.03%) person had mild level of stress; with regard to interpersonal difficulties with teacher, majority 44(58.7%) of them had moderate level of stress and 31(41.3%) of them had severe level of stress; with regards to teacher pupil relationship/teaching methods, majority 56(74.7%) had moderate level of stress and 19(25.3%) had severe level of stress, whereas in inadequate study facilities, majority 59(78.7%) of them had moderate level of stress and 14(18.7%) of them had severe level of stress and only two (2.7%) of them had mild level of stress. The overall academic stress in medical surgical nursing subject, the students had 68 (90.7%) moderate level of stress and seven (9.3%) of the students had severe level of stress. (Table 3)
In relation to Child Health nursing subject among III year B.Sc. (Basic)nursing students:
Among 75 students, majority, 50 (66.7%) of them had severe level of academic stress, and 25 (33.3%) of them had moderate level of stress in relation to personal inadequacy; regarding fear of failure, majority 56(74.7%) of them had moderate level of stress and 19 (25.3%) of them had severe level of stress; with regard to interpersonal difficulties with teacher, majority 41(54.7%) of them had moderate level of stress and 34(45.3%) of them had severe level of stress, with regards to teacher pupil relationship/teaching methods, majority 62(81.3%) of them had moderate level of stress and 14(18.7%) of them had severe level of stress, whereas in inadequate study facilities, majority 61(81.3%) of them had moderate level of stress and 14(18.7%) of them had severe level of stress. The overall academic stress in Child Health Nursing subject, the students had 68(90.7%) moderate level of stress and seven (9.3%) of the students had severe level of stress.
(Table 4)
In relation to Mental Health nursing subject among III year B.Sc. (Basic)nursing students:
Among 75 students, majority 50 (66.7%) of them had severe level of academic stress, and 25 (33.3%) of them had moderate level of stress in relation to personal inadequacy; regarding fear of failure, majority 53(70.7%) of them had moderate level of stress and 20 (26.7%) of them had severe stress and only one person 2(2.7%) of them had mild level of stress; with regard to interpersonal difficulties with teacher, majority 46(61.3%) of them had moderate level of stress and 29(38.7%) of them had severe level of stress, with regards to teacher pupil relationship/teaching methods, majority 61(81.3%) of them had moderate level of stress and 14(18.7%) of them had severe level of stress, whereas in inadequate study facilities, majority 60(80.0%) of them had moderate level of stress and 15(20.0%) of them had severe level of stress.
The overall academic stress in Mental Health Nursing subject, the students had 69(92.0%) moderate level of stress and six (8.0%) of the students had severe level of stress. (Table 5)
In relation to Nursing Research and Statistics subject among III year B.Sc. (Basic)nursing students: Among 75 students, majority 46 (61.3%) of them had severe level of academic stress, and 29 (38.7%) of them had moderate level of stress in relation to personal inadequacy;
regarding fear of failure, majority 53(70.7%) of them had moderate level of stress and 20 (26.7%) of them had severe stress and only two(2.7%) of them had mild level of stress; with regard to interpersonal difficulties with teacher, majority 46(61.3%) of them had moderate level of stress and 29(38.7%) of them had severe level of stress, with regards to teacher pupil relationship/teaching methods, majority 61(81.3%) of them had moderate level of stress and 14(18.7%) of them had severe level of stress, whereas in inadequate study facilities, majority 60(80.0%) of them had moderate level of stress and 15(20.0%) of them had severe level of stress.
The overall academic stress in Nursing Research subject, the students had 67(89.3%) moderate level of stress and eight (10.7%) of the students had severe level of stress. (Table 6)
Overall academic stress among III year B.Sc. (Basic)nursing students reveals that among 75 students, majority 68 (90.7%) of them had moderate level of academic stress, and 7 (9.3%) of them had severe level of stress in relation to medical surgical nursing subject; regarding Pediatric nursing subject, majority 68(90.7%) of them had moderate level of stress and seven (9.3%) of them had severe level of stress; with regard to mental health nursing subject, majority 69(92.0%) of them had moderate level of stress and 6(8.0%) had severe level of stress, and with regards to nursing research subject, majority 67(89.3%) of them had moderate level of stress and 8(10.7%) of them had severe level of stress, whereas in the overall the mental health nursing subject has the moderate academic stress than the other subjects (Table 7).
The mean and standard deviation of academic stress among III year B.Sc. (Basic)nursing students in subject wise revealed that the mean and standard deviation value of academic stress among 3rd year nursing students were 84.35+- 4.357 in medical surgical nursing subject, 83.52+- 4.551 in pediatric nursing subject, 83.27+- 4.919 in mental health nursing subject, and 83.16+- 5.573 in nursing research subject respectively. It showed that there was no statistical significant difference was identified in terms of their academic stress (Table 8).
Regarding association of the academic stress with selected demographic variables
III year B.Sc. (Basic)nursing students in Medical Surgical nursing subject among Table 9 shows that there was a significant association found between the level of academic stress with interest of nursing at the start of program in medical surgical nursing subject at the level of p<.001.(Table 9).
III year B.Sc. (Basic)nursing students in Child Health nursing subject among Table 10 shows that there was no significant association found between the level of academic stress with any of the background variables in child health nursing subject at the level of p>.05.( Table 10).
III year B.Sc. (Basic)nursing students in Mental Health nursing subject among Table 11 shows that there was no significant association found between the level of academic stress with any of the background variables in mental health nursing subject at the level of p>.05. (Table 11).
III year B.Sc. (Basic)nursing students in Nursing Research and Statistics subject among Table 12 shows that there was no significant association found between the level of academic stress with professional in the family in nursing research and statistics subject at the level of p<.05. (Table 12).
4. Conclusion:
The present study concludes that majority of the students studying 3rd year had moderate level of academic stress in the subjects of medical surgical nursing, pediatric nursing, mental health nursing and nursing research. It indicates that they had discomfort and poor coping in meeting the expected objectives of the third year nursing program. It shows that they were in need of support in meeting the curriculum demands. Intervention to lower the academic stress and increase the self - esteem should be carried out so that the learning of students will be efficient.
Conflict of Interest: Authors do not have anything to disclose and declare not conflict of interest.
Informed Consent: Informed consent was obtained from the participants with the option to withdraw them from the study at any time.
Source of Funding: None References
[1] Abouserie, R(1994) Sources and levels of stress in relation to locus of control and self- esteem in university students. Educational Psychology, 14(3), 323-330.
[2] Atindanbila, S. & Bayem, E., (2011), The types and incidence of stressors among students in the University of Ghana.
[3] Anspaugh, D. J., Hamrick, M. H. & Rosato, F. D., (2003), Wellness. Concepts and applications (5th ed), New York: McGraw-Hill.
[4] Atindanbila, S., Abasimi, E., & Anim, M.T., (2012), A Study of Work Related Depression, Anxiety and Stress of Nurses at Pantang Hospital in Ghana. Research on Humanities and Social Sciences, 2, (9), 1-8.
[5] Altiok, H. O., & Ustun, B., (2013), The Stress Sources of Nursing Students.
Educational Sciences: Theory & Practice, 13(2), 760-766.
[6] Admi, H (1997). Nursing student’s sress during the initial clinical experience: Journals of Nursing education 36(7), 323-327.
[7] Artha, (2017), Understanding Academic Stress among Adolescents Journal of Social Sciences, Vol. 16, No. 1, 39-52.
[8] Arabacı Baysan L, Korhan Akın E, et.al., (2015), Nursing students anxiety and stress level and contrubited factors before-during and after first clinical placement. Journal of Hacettepe University Faculty of Nursing 1–16.
[9] Bernard, J. L., & Bernard, M. L., (1982), Factors related to suicidal behaviour among college students and the impact of institutional responses. Journal of College Student Person, 8, 409-413.
[10] B. Pikó and M. Piczil, , (2012), Study of stress, coping and psychosomatic health among baccalaureate nurses-to-be, ORV. Hetil. 1531225–1233.
[11] Beck, D.L, & Srivastava, R., (1991), Perceived level and sources of stress in baccalaureate nursing students. Journal of Nursing Education, 30(3), 127-133.
[12] Brown, M., & Ralph, S.,( 1999), Using the DYSA program to reduce stress and anxiety
in first-year university students. Pastoral Care, 17(3), 8-13.
[13] Brookes N, Murata L, Tansey M., (2006),Guiding practice development using the Tidal Commitments. Journal of Psychiatric and Mental Health Nursing 13 (4): 460–3.
[14] Cheung, T.; Wong, S.Y.; Wong, K.Y.; et.al.,(2016), Depression, Anxiety and Symptoms of Stress among Baccalaureate Nursing Students in Hong Kong: A Cross- Sectional Study. Int. J. Environ. Res. Public Health 2016, 13, 779.
[15] D. Chrzanowska, L. Wdowiak et.al. (2004), The origin of stress, its causes, symptoms and frequency of appearance among the students of Medical University of Lublin, Ann.
Univ. Mariae Curie Sklodowska Med. 59, 438–443.
[16] Denise E, Judith W, Herrman., (2008) Adolescent stresses through the eyes of high- Risk teens. Paediatric nursing;34(5): 375-380.
[17] Esia-Donkoh, K., (2014), Stress coping strategies of 2012/2013 Final year Sandwich students of the Department of Basic Education, University of Education, Winneba(UEW), Ghana. International Journal of Education learning and Development, 2 (1), 63-76.
[18] Feldman, R. S., (2008), Understanding Psychology (8th ed.). New York: McGraw Hill.
[19] Fiona Timmins, (2002) “Stress in 12 areas among nursing students“. Journal of Nursing Management Volume 13 Issue 6, Pages 477 – 482.
[20] G.C. Chan and D. Kohm, 2007), Understanding the psychosocial and physical work environment in a Singapore medical school, Singapore Med. J. 48, (166–171.
[21] Heron, M., 2013, Death: Leading causes for (2010). National Vital Statistics Reports, 62 (6), 1-88, US Department of Health and Human Services, CDC and Prevention center for Health statistics, 3311 Teledo Road, R5419 Hyattsville MD 20782
[22] Kyreaa, D.A., (2014), Causes of Stress Among Nurses In the Greater Accra Region.
International Journal of Research In Social Sciences, 3, (8), 74-81.
[23] Kumar S, Dagli RJ, Mathur A, Jain M, Prabu D, Kulkarni S., (2009) Perceived sources of stress amongst Indian dental students. Eur J Dent Educ;13:39–45.
[24] Lazarus, R. S., & Folkman, S., (1984), Stress, appraisal and coping. New York:
Springer.
[25] L.N. Dyrbye, M.R. Thomas and T.D. Shanafelt, , (2006), Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students, Acad. Med. 81354–373.
[26] M.J. Hayes, D.R. Smith, and D. Cockrel (2009),, Prevalence and correlates of musculoskeletal disorders among Australian dental hygiene students, Int. J. Dent. Hyg.
7, (176–181.
[27] M.C. Lima, M.S. Domingues and A.T. Cerqueira, (2006), Prevalence and risk factors of common mental disorders among medical students, Rev. Saude Publica, 40, 1035–
1041.
[28] Omura, K ., (2007), Situation-related changes of causal structures and the stress model in Japanese college students. Social Behavior and Personality, 35(1), 943-960.
[29] Pulido-Martos M, Augusto-Landa JM, et.al., (2011;), Sources of stress in nursing students: A systematic review of quantitative studies. Int Nurs Rev 59:15–25.
[30] Ross, S.E, Niebling, B.C & Heckert, T.M., (1999), Sources of stress among college students. College Student Journal, 33(2),312-317.
[31] Robotham, D., (2008), Stress among Higher Education Students: Towards a Research Agenda. Higher Education, 56,(6),735-746.
[32] Seyedfatemi, N., Tafreshi, M. & Hagani, H.,( 2007), Experienced stressors and coping strategies among Iranian nursing students. BMC Nursing, 6, 11.
[33] Sherina MS, Rampal L, Kaneson N., (2004), Psychological Stress Among Undergraduate Medical Students. Med J Malaysia. 59:207–11.
[34] Sheu S, Lin HS, Hwang SL., (2002), Perceived stress and physio-psycho-social status of nursing students during their initial period of clinical practice: the effect of coping behaviors.
[35] Stanley, N., & Manthorpe, J., (2001), Responding to students' mental health needs:
Impermeable systems and diverse users. Journal of Mental Health, 70(1), 41-52.
[36] Towbes, L. C, & Cohen, L. H., (1996), Chronic stress in the lives of college students:
Scale development and prospective prediction of stress. Journal of Youth and Adolescence, 25, 199-217.
[37] W. El Ansari, R. Oskrochi and G. Haghgoo, (2014), , Are students' symptoms and health complaints associated with perceived stress at university? Perspectives from the United Kingdom and Egypt, Int J Environ Res Public Health. 11(10), 9981-10002.
[38] Watson, R., Deary, I., Thompson, D., & Li, G., (2008), A study of stress and burnout in nursing students in Hong Kong: A questionnaire survey. International Journal of Nursing Studies,45,(10),1534-1542.
[39] Vliet, H. V., & Andrews, G. (2009). Internet- based course for the management of stress for junior high schools. Australian and new Zealand Journal of Psychiatry.
43:305-309.
[40] V.E. Bruls, C.H. Bastiaenen, and R.A. de Bie, (2013) Non-traumatic arm, neck and shoulder complaints: Prevalence, course and prognosis in a Dutch university population, BMC Musculoskelet. Disord. 14(8),
[41] Young, (2000), “Reduction of stress among nursing students”, The University of Victoria community newspaper July 14, pp – 55-65.
