Assessment of Nursing Students’ Stress Levels and Coping Strategies During Their First Clinical Experience

Objective: This study was performed in order to examine the clinical stress levels of nursing students during their first clinical practice and their stress coping styles. Methods: This descriptive study was performed with 91 freshmen in the nursing department of Namık Kemal University who experienced clinical practice for the first time. Data was collected using a student identification form, the clinical stress questionnaire and the stress-coping patterns scale. Results: The students’ mean age was 19.94±2.91. The mean stress score of the students during their first clinical experience was found to be 29.16±7.92. When the stress coping styles of the students were examined, their mean self-confidence approach score was 2.93±0.54, their seeking social support score was 2.73±0.48, their optimistic approach score was 2.68±0.61, their helpless/self-accusatory approach score was 2.17±0.50, and their submissive approach score was 1.84±0.44. Conclusion: The clinical stress levels of the students were found to be low and the students were found to use the confident approach most in coping with stress.

PDF

___

[1] Khater W, Akhu-Zaheya L, Shaban I. Sources of stress and coping behaviours in clinical practice among baccalaureate nursing students. Int. J. Human. Soc. Sci. Res. 2014; 4(6): 194-202.
[2] Asadizaker M, Abedi ZH, Alijanirenani H, Moradi M, Jahani S. Improvement of the first training for baccalaureate nursing students –a mutual approach. Glob. J. Health Sci 2015; 7(7): 79–92.
[3] Shaban IA, Khater WA, Akhu-Zaheya LM. Undergraduate nursing students’ stress sources and coping behaviours during their initial period of clinical training: A Jordanian perspective. Nurse Educ. Pract. 2012; 12(4): 204-209.
[4] Karabacak Ü, Uslusoy E, Şenturan L, Alpar ŞE, Yavuz D. First day in clinical practice: evaluating stress of nursing students and their ways to cope with it. HealthMED 2012; 6(2): 596-602.
[5] Levett-Jones T, Pitt V, Courtney-Pratt H, Harbrow G, Rossiter R. What are the primary concerns of nursing students as they prepare for and contemplate their first clinical placement experience?. Nurse Educ. Pract. 2015; 15(4); 304-309.
[6] O’Mara L, McDonald J, Gillespie M, Brown H, Miles L. Challenging clinical learning environments: Experiences of undergraduate nursing students. Nurse Educ. Pract. 2014; 14(2): 208-213.
[7] Cooper J, Courtney-Pratt H, Fitzgerald M. Key influences identified by first year undergraduate nursing students as impacting on the quality of clinical placement: A qualitative study. Nurse Educ. Today 2015; 35(9): 1004-1008.
[8] Tasdelen S, Zaybak A. The determination the level of stress of nursing students during their first clinical experience. Florence Nightingale J Nurs 2013; 21(2): 101-106.
[9] Al-Gamal E, Alhosain A, Alsunaye K. Stress and coping strategies among Saudi nursing students during clinical education. Perspect Psychiatr Care 2018; 54:198–205.
[10] Al‐Zayyat AS, Al‐Gamal E. Perceived stress and coping strategies among Jordanian nursing students during clinical practice in psychiatric/mental health courses. Int J Ment Health Nurs 2014; 23(4): 326-335.
[11] Chan CKL, So WKW, Fong DYT. Honk Kong baccalaureate nursing students’ stress and their coping strategies in clinical practice. J Prof Nurs 2009; 25: 307-313.
[12] Lee MH, Holzemer WL, Faucett J. Psychometric evaluation of the Nursing Stress Scale (NSS) among Chinese nurses in Taiwan. J. Nurs. Meas. 2007; 15(2): 133.
[13] Pulıdo-Martos M, Augusto-Landa JM. Lopez-Zafra E. Sources of stress in nursing students: a systematic review of quantitative studies. Int Nurs Rev 2012; 59: 15–25.
[14] Findik ÜY, Ozbas A, Cavdar İ, Topcu SY, Onler E. Assessment of nursing students’ stres levels and coping strategies in operating room practice. Nurse Educ. Pract. 2015; 15: 192-195.
[15] Blomberg K, Bisholt B, Kullén Engström A, Ohlsson U, Sundler Johansson A, Gustafsson M. Swedish nursing students’ experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education. J. Clin. Nurs. 2014; 23(15-16): 2264-2271.
[16] Acıksoz S, Uzun Ş, Arslan F. Assessment of relationship between nursing students’ self-efficacy and levels of their anxiety and stress about clinical practice. Gulhane Med J 2016; 58: 129-135.
[17] Potur DC, Bilgin NÇ, Komurcu N. Evaluating nursing students clinic stress, and coping with stress during the clinic first day of the woman health and diseases nursing clinical course. International Journal of Human Sciences 2015; 12(1):1169-1181.
[18] Atay S, Yılmaz F. The First stress levels of the students of vocational higher school of healt. Journal of Anatolia Nursing and Health Sciences 2011; 14 (4): 32-37.
[19] Temel E, Bahar A, Cuhadar D. Determination of coping attitude with stress and depression level of nursing students. Journal of Fırat Health Services 2007; 2: 108-118.
[20] Sendir M, Acaroglu, R. Reliability and validity of Turkish version of clinical stress questionnaire. Nurse Educ. Today 2008; 28: 737-743.
[21] Hampel P, Petermann F. Perceived stress, coping, and adjustment in adolescents. J. Adolesc. Health 2006; 38(4): 409-415.
[22] Turkum AS. The Development of coping with stress scale: validity and reliabilty studies. Turkish Psychological Counseling and Guidance Journal 2016; 2(18): 25-34.
[23] Nelwati D, McKenna L, Plummer V. Indonesian student nurses’ perceptions of stress in clinical learning: A phenomenological study. J Nurs Educ Pract. 2012; 3(5): 56-65.
[24] Sheu S, Lin HS, Hwang SL. Perceived stress and physio-psychosocial status of nursing students during their initial period of clinical practice: the effect of coping behaviors. Int. J. Nurs. Stud. 2002; 39(2): 165-175.
[25] Melincavage SM. Student nurses’ experiences of anxiety in the clinical setting. Nurse Educ. Today 2011; 31(8): 785-789.
[26] Karagözoğlu Ş, Özden D, Tok Yıldız F. Clinical stress levels of nursing students participating ın an ıntegrated program and the factors affecting the levels. Journal of Anatolia Nursing and Health Sciences 2013; 16(2): 89-95.
[27] Tambağ H. Examination of nursing students’ anxiety levels related to clinical practice with respect to peer support. Perspect Psychiatr Care. 2020. DOI: 10.1111/ppc.12664
[28] Tosunöz İK, Güngör S, Öztunç G. The anxıety before fırst clınıcal experıence: the case of nursıng students. YOBU Faculty of Health Sciences Journal. 2021; 2 (1): 54-61
[29] Zhao FF, Lei XL, He W, Gu YH, Li DW. The study of perceived stress, coping strategy and self-efficacy of Chinese undergraduate nursing students in clinical practice. Int. J. Nurs. Pract. 2015; 21. 401–409.
[30] Tully A. Stress, sources of stress andways of coping among psychiatric nursing students. J. Psychiatr. Ment. Health Nurs. 2004; 11: 43-47.
[31] Karaca A, Yıldırım N, Ankaralı H, Açıkgöz F, Akkuş D. Nursing students’ perceived levels of clinical stress, stress responses and coping behaviors. J. Psychiatr. Nurs. 2017; 8(1): 32-39.
[32] Özdemir H, Khorshıd L, Zaybak A. Determination of nursing students’ stress level toward nursing education. Turkish Journal of Science and Health. 2020; 1(2): 20-28.
[33] Ergin E, Çevik K, Pakiş Çetin S. An ınvestigation of nursing students’ perceptions and coping behaviors of educationrelated stress. Journal of Educatıon and Research in Nursıng. 2018; 15(1): 16-22.
[34] Büyükbayram Z, Ayık DB. Determination of nursing students’ stress levels related to nursing education. Journal of Adnan Menderes University Health Sciences Faculty. 2020; 4(2): 90-99.
[35] Üstündağ H, Bostancı Z, Aydoğan B. Relationship between coping style with stress and the levels of perceived social support among nursing students. Journal of Health Sciences and Professions. 2019; 6(1): 74-83.
[36] Yamac Ö. The relationship between perceived social support and stress coping styles of university students. Doctoral dissertation, Selcuk University Institute of Social Sciences, 2009. Konya.
[37] Yılmaz M, Yaman Z, Erdoğan S. Stressful situation in nursing students and the methods of coping with stress. Mersin University Journal of Health Sciences. 2017; 10(2): 88-99.
[38] Okuyan CB, Deveci E. The methods for coping with stress and stress situations of nursing students in health school. Journal of Anatolia Nursing and Health Sciences. 2020; 23(2): 205-211.
[39] Durmuş ÖGM, Gerçek ÖGA. A research on assessıng the factors affectıng perceıved stress sıtuatıons, bıo-psychologıcal socıal sıtuatıons and copıng behavıors of stress ın unıversıty students’. The Journal of Academic and Social Science. 2017; 5(53);616-633.
[40] Topal Hançer A, Güler N, Süha BK. Nursing senior students’ perceived stress and stress coping behaviors. J Nurs Sci. 2019; 11(4): 347-356
[41] Evgin D, Çalışkan ZI, Caner N. Anxıety levels and strategıes for copıng wıth stress of nursıng students at health college bef1ore clınıcal practıce. SDÜ Journal of Health Sciences. 2017; 8(3): 22-28.