Perceived Stress among Al-Muthanna Nursing Students
Diaa F. Jrood1 , Assist. Prof. Dr.Kareem R. Sachit2
1M.Sc. psychiatric & Mental health Nursing, Ministry of Higher Education and Scientific Research, University of Muthanna [email protected]
2 Assist. Professor PhD, University of Baghdad, Collage of Nursing ,Department of Psych.
Nursing, Baghdad City, Iraq. gafar [email protected]
ABSTRACT Objectives to:
1assess level of stress experienced related to academic environment by nursing students.
3- Identify the relationship between Stress for nurses with their demographic characteristic that include:(gender, age, marital status, level of education, monthly income).
Methodology: A descriptive cross-sectional study was carried out to determine the type of stress among nursing students. The level of stress was evaluated through Perceived Stress Scale (PSS) . Results: Shows the majority of the study sample a moderate level of perceived stress.
Conclusions: A moderate level of stress among students illustrates the need for stress management programs and the provision of suitable support.
Recommendations: Providing educational programs for students to learn about stress. Reducing the stress on students, by reducing the duties imposed on them, and using new methods of less stress in teaching and evaluating students.
Keywords: Perceived Stress, Student, Nursing. INTRODUCTION
Stress is a permanent condition that a person experiences during his daily life, especially its connection to the profession of nursing and the work of the primary nurse in providing care and caring to the patient. There are several factors that cause tension, including providing care, giving treatments, pain, exposure to disease risks in the environment in which it exercises its primary role, unknown or unexpected events, internal conflicts, external conflicts and countless matters, and most of the events may be unknown, cultural matters and environmental conditions. The totality of these causes, events and circumstances may have a fundamental impact on the life and psychological state of the nurse who works in hospitals and the student of the College of Nursing (Labrague, McEnroe-Petitte, Gloe, Thomas, Papathanasiou, & Tsaras, 2017).
All students who complete their studies from the early stages to the advanced stages are exposed to stress. This tension results mainly from the academic environment. The higher the level
of stress, this mainly affects the psychological health of students and their academic functions.
These are represented by study and theoretical and practical duties, and from the negative effects of stress on students' psychological health (insomnia, anxiety, loneliness and nervousness) (Seyedfatemi, Tafreshi, & Hagani, 2007; Hamaideh, Al-Omari, & Al-Modallal, 2017).
Psychological stress is defined as a relationship that connects a person with his inner and outer surroundings, and thus the person's condition may be evaluated for himself. If the stress becomes beyond his psychological control, then it will cause psychological stress and disruptions in jobs, especially academic jobs. Stress has two ways. Either a positive path is in the form of a stimulant or a negative way, which is a psychological problem for a person. The most important factor that affects students of the College of Nursing during their academic studies is psychological stress, and it may result from several factors, including clinical work inside the hospital, how to provide care to patients, give treatment, relationships with the nurses in the hospital, and many of the difficulties that the student faces during the student during clinical academic work (Al-Zayyat
& Al-Gamal,2013).
Therefore, the most important classification of stress is the source of personal stress, the other is the source of academic or clinical stress, and the last is the source of social tension. That is why stress is a common term used in daily life, so it is an important resource for medical specialties, including nursing ( Algaralleh, Altwalbeh, & Alzayyat, 2019; Rabin, Feldman, & Kaplan, 1999;
Selye 1956; Pederse, 2005; APA, 2019).
SUBJECTS AND METHODS
A descriptive, Cross-sectional analytic study design was carried out at Al-Muthanna University among nursing students to assess Academic-Related Stress. Started from (January 3 to January 28, 2021).probability, stratified random, systematic random. After obtaining the official approvals for the research study. The Perceived Stress Scale (PSS) Questionnaire was used to collect data for the purpose of the study (S Sheu et al., 1997). The questionnaire required students to record their impression about stress level. It included students from first to fourth year. English version and Arabic translation was used in this study, and back-translation was used to translate the English version of the questionnaire into Arabic language. The study sample was (162) students from the total number of students of the College of Nursing (278). It took the necessary time to fill out the search form.
RESULTS & DISCUSSION:
Discussion the findings of socio-demographic characteristics of study: (Table :1)
1.Gender of Students : Through an overview of the study results, the demographic characteristic of the samples indicated that the majority gender of students were females (75.9%). The study (Algaralleh et al., 2019) assessing the level of stress among students of the Faculty of Nursing, Jordan. The study showed that the percentage of females is the most (85.0%), and this percentage is consistent with the results of the research. Ahmed & Mohammed (2019). Their study of nursing students’ stress and coping strategies during clinical training in KSA. Results of their participants (52% female) from the nursing department at Albaha University. This result is consistent with the results of the research. The researcher realizes that the results were that the percentage of females is the highest. This is due to the admission instructions in the Ministry of Higher Education, provided that the percentage of female admission to the College of Nursing is (80%). As for the admission rate for males in the College of Nursing, it is (20%).
2. Ages of students :The results of the study are in Table (4-1) within the results of demographic information about (72.8%) were between (18-21) years old. The study (Algaralleh et al., 2019) assessing the level of stress among students of the Faculty of Nursing, Jordan. The study showed that the ages of the sample ranged from 20-25 years. This result has a big difference from the results of the study and is not compatible with it. The study (Latif & Nor, 2019) that aimed to survey the type of stressors and identify coping strategies used by the Diploma of Nursing. During Clinical Practices, Malaysia, Kubang Kerian. The results of the study showed that the majority of students are 18-21 years old, and this result is identical to the results of the research. Researcher's belief majority of nursing students are between the ages of 18-21 years. This is due to the large percentage of students admitted in the first phase, where the number of students in the first phase is 139 students. In addition, the majority of the study sample is first stage students.
3. Residence :In table (1) detection Residual about (95.7%) lived with family. Study results agree with the results of the study (Shdaifat, et al., 2018), Saudi Arabia, which showed majority of results for Residence with Family 80.4%. Also the results are consistent with the ratio found in the study (Hamaideh, et al., 2017). Saudi Arabia, Where the highest percentage of living with a family was 82%. The researcher believes that the vast majority of students live with their families. The reason for this is because students at the beginning of their lives must be responsible for arranging and organizing the lives of their children, in addition to the responsibility related to the financial aspect.
In addition to that, students are basically dependent on their families for housing and other life matters.
4. Marital status of students :Table (1): The highest percentage of marital status in the study results is (85.8%) of them were single status, which is included in the demographic information.
The study (Algaralleh et al., 2019), Jordan. The results of marital status showed that the majority of students are single, whose percentage is in the study (86.25%). This result is agreement with the results of the study. The researcher’s opinion, the reason is that the students are at the beginning of their youthful life, and they do not have enough financial income to get married, because marriage requires great financial costs. In addition to their great dependence on the family. Interest in studying.
5. Stage of study: Table (4-1): The results of the study do not correspond with the results of the study (Algaralleh et al., 2019), Jordan, as the majority of the study sample was from the third stage of study (68.13%). Likewise, the results of ( Ahmed & Mohammed 2019), KSA, are inconsistent with the results. The majority of the study sample is from the second stage, at a rate of (32%) of the total study sample. In addition, there is no agreement with the result of (Alsaqri, 2017), Saudi Arabia, as the majority of the study sample is from third stage students (62%). Also, the results do not match the study (Latif & Nor, 2019), Malaysia, Kubang Kerian. The percentage of students participating in the study from the first stage, and the reason depends on the method of sample collection. The majority of the participants were from the first stage. In addition to admission to the College of Nursing, the number of students in the first stage is much higher than in the rest of the other stages.
6. Smoking: Table (1): Concerned to smoking revealed that (95.1%) of them not smoker.
Research (Shdaifat, et al., 2018), Saudi Arabia on students of the College of Nursing. The results showed that the majority of the study sample was a non-smoker, 82.6%. This result is approval with the search results. For the researcher opinion, students of the College of Nursing have a health awareness of the negative effects on their health. Smoking is an unhealthy behavior and style that greatly affects the health of the body, in addition to being a major cause of cancer and respiratory system diseases. So students mainly do not smoke.
7. Family size: Table (4-1): Regarding family size about half of sample the size of family between (3-5) person. The researcher's belief that the number of family members is from 3-5, the reason for this is that the majority of families live independently of the mother's family. So that the young family can build a new and sober foundations. In addition, it has good control and control over matters relating to family and children planning.
8. Housing ownership: Table (4-1):demographic data clarify the majority of responders (90.7%) were the house belongs to the family. According to the researcher, the majority of the families of the students participating in the study, that the family homes are the property of the family and not
rented housing. This is due to the independence of the family, and its dependence on itself in organizing its affairs properly.
9. Family income: Table (4-1): Concerning , family income about(47.5%) of sample were a Fair enough income. The monthly income of the family is a fair enough income, the reason is according to the researcher's belief, the majority of student families do not have enough jobs to help them in financial matters. High unemployment in the Muthanna province. The poverty rate in the governorate is 51%.
10. Father's education level & Mother's education level: Demonstrates table (1) equal result (26%) of sample the fathers were an elementary graduate however, the mother education about (33.1%) were an elementary graduate in level education. The researcher think, the level of education of the father and mother of the sample participating in the research study, mainly elementary graduate in level education. The reason for this is that the parents in the previous period of time they lived did not have the ability to complete his studies due to the strict economic and political conditions. Therefore, the majority of students' parents did not complete their studies, or progressed in studying and obtaining other study certificates.
11. Father's job: Table (1): Finally, concerning the job of father about(34.6)% were a government employee. The researcher think, the majority of students ’parents are government employees. The reason for this is due to the opportunities for recruitment in the previous period, which included opening the positions of appointment in all ministries, to reduce unemployment rates in Iraq and Muthanna Governorate in particular. So it showed that the majority of fathers are government employees.
12.Mother's job: Table (1): while the mother job about 88.3 were a unemployed. The researcher think, the majority of the mothers of the students participating as a sample in the research study are housewives (unemployed) because the mothers in the previous period of time did not have the ability to continue education and obtain advanced studies certificates. Because Iraq was suffering from several economic and political conditions, so these mainly affected education for girls.
Therefore, most of the students' mothers were housewives and non-employees.
Discussion the findings of Table (2):
clarify of sample‘s subdomains concerning perceive stress
The results showed in Table (2) that students of the College of Nursing are exposed to a high percentage of stress from assignments and workload. The results of the study are consistent with the results of the study (Shdaifat, et al., 2018), Saudi Arabia, which confirmed that the
majority of the study sample complained of stress from assignments and workload. Labrague, et al., (2018) , the study aims to conduct to determine the level of stress, its sources and coping strategies among nursing studies. The results of the study showed according to the mentioned countries.
Where the results were consistent with the results of the country of Greece, nursing students complained of a high rate of stress from assignments and workload, in addition to the results of the country of Philippines, also the nursing students participating as a sample in the research study complained of Stress from assignments and workload. The results of the study are consistent with the results of the third country (Nigeria), where the majority of the study sample complained also from stress from assignments and workloads.
Discussion the findings of the levels of Perceived Stress among samples table :(3)
The results of the study showed in table (3) a mean of the perceived stress level was (47.041), the majority of the study sample (69.1%) a moderate level of perceived stress. The study results are consistent with the results of the study (Ahmed & Mohammed, 2019), KSA. where the stress level of the study sample (students of the College of Nursing) at Albaha University had moderate stress levels. According to The results of the study (Shdaifat, et al., 2018), Saudi Arabia.
showed that the majority of the nursing student sample participating in the study had moderate stress. Therefore, there is a match with the results of the study.
Discussion the findings of Relationship between Relationship between perceive stress and students demographic data: table (4)
The results showed that there is a statistically significant relationship between stress, age, and the education level of the father and mother at a significant level (P-value = 0.01) at the (p ≤ 0.05). The results of the study (Shdaifat, et al., 2018), showed that there is no statistically significant relationship between research variables and demographic information (age). This indicates a lack of agreement with the results of the study. Statistical analysis in the study (Labrague, et al., 2018) showed that there is no statistical relationship between the variable of stress and age of nursing students. This does not have a statistical agreement with the results of the study. The statistical results of (Al-Gamal, et al., 2018) showed that there is a statistical significant between the variable of stress and age. This is consistent with the results of the study. The researcher believes that the results showed a statistical significance between stress and the age of the student. The reason is due to the effect of stress in this age group, due to the direct economic, social and academic conditions they are exposed to. The researcher's opinion that the level of education of the father and mother has an effect on the stress that affects students. The more parents educate, it increases people's
understanding of life matters and circumstances better and increases their understanding and culture. The results of the research showed that there was no statistically significant relationship between stress and demographic information that included (Gender, Marital status, Family income) at a significant level (P-value = 0.01) at the (p ≤ 0.05). Results of (Ahmed, et al., 2019).
Demonstrate that there was no significant relationship between demographic information and Stress levels among nursing students at Albaha University. These results are consistent with the results of the study in Demographic Information (Gender, Marital status). The results of the study (Shdaifat, et al., 2018), showed that there is no statistically significant relationship between research variables and demographic information (gender, marital status, family income). This indicates a consensus with the results of the study. The statistical analysis in the study (Labrague, et al., 2018) showed that there is no statistical relationship between the stress variable, gender, and family income of nursing students.
This there is a statistical agreement with the results of the study. In addition to the statistical results of (Al-Gamal, et al., 2018), it was revealed that there is a statistical significant between the stress variable and family income. This does not agree with the results of the study.
The researcher believes that there is no statistical significance with gender . This is due to the students ’response to the questionnaire form and the statistical analysis of the results, and that stress does not affect the person according to his gender, but rather it is a general effect on everyone.
Everyone is under stress. The researcher believes that the effect of marital status and its relationship with stress is not of great importance or a Statistical significance. Because a young man or woman who gets married is more responsible and more organized in their lives, in addition to that marriage increases a person’s understanding of life and reduces hormonal fluctuations.
Table (1): Distribution of the samples according to their demographical characteristics (N
=162):
Demographic data Ranking And Intervals F %
Gender
Male 39 24.1
Female 123 75.9
Age/ year
18-21 118 72.8
22-25 42 25.9
26-29 1 0.6
38-41 1 0.6
Residence With family 155 95.7
With relative 2 1.2
Indoor department 5 3.1
Marital status
Single 139 85.8
Married 22 13.6
Separated 1 0.6
Stage of study First stage 81 50.0
Second stage 36 22.2
Third stage 22 13.6
Fourth stage 23 14.2
Smoking
Yes 8 4.9
No 154 95.1
Family size 3-5 87 53.7
6-8 75 46.3
Housing ownership
The house belongs to the family 147 90.7
Rent 15 9.3
Family income Enough 76 46.9
Fair enough 77 47.5
Not enough 9 5.6
Father's education
level
not read and he does not write 21 12.9
Elementary graduate 43 26.4
A middle school graduated 28 17.2
High school graduate 19 11.7
Institute 21 12.9
Collage 30 19
Mother's education
level
not read and he does not write 50 30.7
Elementary graduate 54 33.1
A middle school graduated 28 17.2
High school graduate 13 8.0
Institute 5 3.1
Collage 12 8.0
Father's job Government employee 56 34.6
Free business 43 26.5
Unemployed 30 18.5
Retired 33 20.4
Mother's job Government employee 13 8.0
Free business 6 3.7
Unemployed 143 88.3
Retired 0 0
F: Frequency ,%:percentage
Table (2): Distribution of sample‘s subdomains concerning perceive stress (N=162):
No. Items M S.D
1. Stress from taking care of patients. 1.365 0.717
2. Stress from assignments and workload. 1.795 0.81
3. Stress from lack of professional knowledge and skills. 1.714 0.864
4. Stress from area of practice. 1.741 0.884
5. Stress from peers and daily life. 1.705 0.77
6. Stress from teachers and nursing staff. 1.648 0.703
M: mean, S.D: stander deviation
Table (3): Distribution the levels of Perceived Stress among samples (N =162):
Low stress:(0-38.7), Moderate stress:(38.8-77,4), High stress:(77.5-116)
Perceived Stress levels Frequency Percent Mean Stander deviation
Low stress 47 29
47.041 17.002
Moderate stress 112 69.1
High stress 3 1.9
Table 4: Relationship between perceive stress and their demographic data(N =162):
Ranking& intervals Perceive Stress
Chi-Square Tests
Age\ year L.S F M.S
F
H.S F
X2 D.F P value Sig
18-21 69 48 1
246.1 180 .001 S
22-25 13 29 0
26-29 1 0 0
38-41 0 1 0
Total 83 78 1 162
Gender L.S F M.S
F
H.S F
X2 D.F P value Sig
Male 20 19 0
66.77 60 0.26 N.S
Female 63 59 1
Total 83 78 1 162
Marital status L.S F M.S F
H.S F
X2 D.F P value Sig
Single 71 67 1
121.11 120 0.46 N.S
Married 12 10 0
Widow 0 1 0
Total 83 78 1 162
Family income L.S F M.S F
H.S F
X2 D.F P
value Sig
Enough 41 35 0
118.364a 120 0.53 N.S
Fair enough 39 37 1
Not enough 3 6 0
Total 83 78 1 162
L.SF: low frequency ,M.SF: moderate frequency, H.SF: high frequency,:x2: Chi-Square, D.F: degree of freedom, sig: significant
CONCLUSION:
The majority of nursing college students have a high level of stress from assignments and workload. The level of stress is a moderate level. The results showed a statistically significant relationship between perceive stress and the demographic information of students, which includes (Age, Father education, Mother education). There is no statistically significant relationship between the perceive stress and the demographic information for students, which includes (Gender, Marital status, Family income).
RECOMMENDATIONS:
Providing educational programs for students to learn about stress. Reducing the stress on students, by reducing the duties imposed on them, and using new methods of less stress in teaching and evaluating students.
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