Level of stress and anxiety regarding Covid-19 among nursing students
Dominica Limugha1, Kipgen Lhingpineng1, Leshiiro Kaihe1, Nianlalkim N1, Toppo Mirita1,
Touthang Lilly1, Katasi Cecilia2
12nd Year Post Basic Nursing Students, CON, Christian Institute of Health Sciences and Research: CIHSR, Dimapur, Nagaland.
2Associate Professor, CON, Christian Institute of Health Sciences and Research: CIHSR, Dimapur, Nagaland.
*Corresponding Author Email:
ABSTRACT:
INTRODUCTION: COVID-19 pandemic has caused disasters and disorders all over the world. India is also going through a challenging situation as the number of infected/positive cases is increasing day by day. Due to the crisis of COVID-19 education system has come to a halt as schools and colleges are closed to slow down and prevent the spread of infection. Nursing institution also closed down and online mode of teaching was done. Hands on training is required to relate theory in to practice which was thwarted due to the pandemic COVID-19. Nursing students were panic and apprehensive about the situation even though they were asked to stay in the hostel. OBJECTIVE: To assess the level of stress and anxiety among the nursing students and to associate the level of stress and anxiety with selected demographic variables. METHODS: The study design was descriptive cross-sectional. The study was conducted in College of Nursing CIHSR among the 3rd Year GNM, 3rd Year and 4th Year B. Sc. Nursing Students. Total enumerative sampling method was used and sample size was 95. Standardized instrument on Perceived stress scale for assessing stress and Corona anxiety scale for assessing anxiety regarding COVID – 19 were used for the study. The study was approved by nursing research committee and informed consent was taken. Data was analysed using descriptive and inferential statistics. RESULTS: The study found that 80(84.2%) had moderate stress out of 95 respondents, 8 (8.4%) had high perceived stress, and 7(7.4%) had low level of stress. In the Coronavirus anxiety scale majority of the respondents, 91(95.8%) have little to no dysfunctional anxiety out of 95 respondents, 2 (2.1%) had possible dysfunctional anxiety and 2 (2.1%) had probable dysfunctional anxiety. There were no significant association between level of stress, anxiety and demographic variables. CONCLUSION: Study reveals that majority of the students had moderate level of stress and little to no dysfunctional anxiety regarding COVID - 19. Thus leaflet regarding cause, spread, prevention and management of COVID-19 given to each student to reduce their stress and anxiety.
KEYWORDS: Stress, anxiety and COVID-19.
BACKGROUND:
COVID-19 pandemic has caused chaos and brought catastrophe all over the world. It was started as an epidemic mainly limited to China and was declared as a pandemic on 11th March, 2020 by the WHO1. India is also going through a challenging situation as the number of infected/positive cases is increasing day by day. As the rate of spread is increasing day by day, the government of India has imposed lockdown as it is the only option available to slow down the rate of spreading the infection. On 24th March, 2020, Prime Minister Narendra Modi announced the nationwide lockdown for the first time and now we are on the 5th phase of lockdown. With strict preventive measures and restrictions by the Indian Government in the form of the nationwide lockdown, the citizens are going through a range of psychological and emotional reactions, fear, and uncertainty is one of them2. In Nagaland the number of COVID-19 cases rising in the month of September, 2020 (Nagaland Post)3. Due to its considerable transmissible ability and implementation of lockdown, it has instilled a substantial degree of fear, anxiety, worry, and stress among the population4.
Due to the crisis of COVID-19 education system has come to a halt as schools and colleges are closed to slow down and prevent the spread of infection. For nursing students, hands on training is required in a clinical field to acquire skills. They need to relate theory with practice. But because of the pandemic COVID-19 learning process has changed to online learning and no more exposure to clinical area to learn their skill. Anxiety has a negative effect on the quality of student’s life, their education and clinical practice (Sanad, 2019)5. During an epidemic/pandemic, nursing students are exposed to additional stressful factors. In a study conducted by Wong6 in Hongkong to investigate perceived stress and psychological responses to the SARS outbreak among healthcare students showed that nursing students were significantly more stressed, possibly reflecting a perceived higher risk of infection due to more prolonged contact with patients.
Though the college was closed and the students were kept in the hostel following the WHO guidelines, the students were stressed out. The investigators realised the panic among the students and wanted to help the students to improve their quality of life, this study was conducted to assess the stress and anxiety regarding COVID-19 among nursing students in the College of Nursing, CIHSR. This study will help and provide beneficial information and takes measures to safeguard the mental wellbeing of nursing students.
OBJECTIVES OF STUDY:
1. To assess the level of stress among the nursing students by using the Perceived Stress Scale (PSS).
2. To assess the level of anxiety among the nursing students by using the Coronavirus Anxiety Scale (CAS).
3. To associate the level of stress and anxiety with selected demographic variables.
HYPOTHESIS:
H1-There will be a significant association between selected demographic variables and stress regarding COVID-19.
H2-There will be a significant association between demographic variables and anxiety regarding COVID- 19.
METHODOLOGY:
A descriptive cross-sectional design was used in the study. The study was conducted in College of Nursing, CIHSR, Dimapur, Nagaland. The study was conducted among 3rd year GNM, 3rd year and 4th year B. Sc. (N) students, CIHSR, Dimapur. Conceptual model used for this study is based on Lazarus Transactional Model. Total enumerative sampling method was used and total sample size was 95. The tools have 3 sections.
Part- I: Demographic Variable consists of Age, sex, course and class, religion and state.
Part-II: Section A: Perceived Stress Scale: Perceived stress scale developed by Sheldon Cohen7 is used for this study. It is a free scale. It comprises of 10 items. Reliability of the score on the PSS -10 demonstrated adequate internal consistency reliability (α = 0.78). Moderate concurrent criterion validity with the amount of stress experienced during an average week (r = 0.39, p<0.001) and the frequency of stressful life events within the past year (r = - 0.22, p<0.001); and adequate convergent validity as evidenced by expected negative associations with perceived health status (r = - 0.22, p<0.001) and positive association with psychosomatic symptoms (rs =0.28 to 0.34, p < 0.001) and health services utilization (r = 0.22, p < 0.001). since then, others studies have similarly reported that the PSS -10 has good internal consistency reliability and adequate convergent validity based on associations with measures of physical and health.
Part-II: Section B: Coronavirus Anxiety Scale: Coronavirus anxiety scale was created by Sherman. A. Lee PhD. It is a free scale. It comprises of 5 item mental health screener designed to efficiently and effectively aid health care professionals and researchers identify probable cases of dysfunctional anxiety associated with COVID-19 crisis. Reliability of a confirmatory factor analysis demonstrated that the CAS measures reliable (α=0.92). Construct validity was demonstrated with correlation with CAS scores and demographic, corona virus diagnosis, history of anxiety, corona virus fear, functional impairment, Alcohol/ bar drug coping, religious coping, hopelessness, suicidal ideation, as well as social attitudes. The CAS demonstrated solid discrimination for ability for functional impairment (AUC=0.88) each item of the CAS taps a distinct physiologically based fear or anxiety reaction to Coronavirus related thoughts or information8.
Permission was taken from the College authorities. The study was approved by nursing research committee. Total enumerative sampling method for sample selection. The study was conducted between 22.06.2020 to 12.07.2020. The respondents were approached and after explanation of the procedure written consent was obtained. Data was collected using standardized self- administered structured questionnaires. Total time taken was 15 minutes for each respondent. Descriptive and inferential statistics was used to analyse the data.