A Study to Assess the Academic Stress and Coping Strategies used among the undergraduate nursing students from selected colleges of Pune City

 

Mr. Amol Bhagwat Kanade¹*, Ms. Shubhangi Sarwan², Ms. Pradnya Said², Ms. Suvarna Kadam², Mr. Gokul Dhakne², Mr. Pramod Gore²

 

ABSTRACT:

Background: Stress in nursing education is acknowledged as one of the most important issue in the modern world. During nursing education and training, nursing student are frequently exposed to various stressors which are directly or indirectly impaired their learning and performance. A large number of studies on the problem point out the existence of academic stress in the nursing students and reported higher academic and external stress than students in physical therapy, pharmacy, dentistry and medicine. Objectives: 1) To assess the stress level among the undergraduate students, 2) To identify the causative factors for stress among undergraduate students, 3) To associate the findings with selected demographic variables. Material and material: A Non-Experimental Exploratory study was carried out to assess the academic stress and coping strategies used among the undergraduate nursing students from selected colleges of Pune city. Data was collected from 60 undergraduate nursing students by Non-Probability purposive Sampling technique by using Academic Stress Scale. The descriptive and inferential statistics was used for data analysis. Result: The result of the study revealed that majority of 53.33% of students had moderate stress (99-147), 31.67% of them had slight stress (50-98) and 15% of them had high stress (148-196). Majority of 66.66% of students try to find meaning in the situation. Maximum of 65% of students pray and trust in god. Conclusion: The present study indicates that the majority of 53.33% of students had moderate level of stress and majority of the students follows coping strategies such as try to find meaning in the situation, pray and trust in god, seek help from family or friends. The findings emphasize a need for planned health teaching to improve knowledge and practice of Undergraduate nursing students. Further research is needed to identify and compare what interventions are effective in supporting students to cope with stress during their undergraduate education.

 

 

 

INTRODUCTION:

The first definition for stress was created in 1936 by Hans Selye. He stated that stress is “the non-specific response of the body to any demand for change”¹.

 

In medical terms stress is described as, "a physical or psychological stimulus that can produce mental tension or physiological reactions that may lead to illness." When you are under stress, your adrenal gland releases corticosteroids, which are converted to cortisol in the blood stream. Cortisol’s have an immune suppressive effect in your body. According to Richard S Lazarus, stress is a feeling experienced when a person thinks that "the demands exceed the personal and social resources the individual is able to mobilize. “Ann felt that stress ensures when situations are ‘bad’ from a personal point of view and it is essentially in the eye of the beholder. Whiten defines stress as any circumstances that threaten or perceived to be threaten a well-being and thereby tax our adaptive capacities. In general, it is the term applied to the pressures people feel in life. It results from an imbalance between environmental demands and personal adequacies to meet these demands. For some individuals ‘stress’ refers only to a crises or calamity while others perceive the day-to-day life problems and mild irritations as ‘stress’².

 

The situations and pressures that cause stress are known as stressors. We usually think of stressors as being negative, such as an exhausting work schedule or a rocky relationship. However, anything that puts high demands on you can be stressful. This includes positive events such as getting married, buying a house, going to college, or receiving a promotion. of course, not all stress is caused by external factors. Stress can also be internal or self-generated, when you worry excessively about something that may or may not happen, or have irrational, pessimistic thoughts about life. Finally, what causes stress depends, at least in part, on your perception of it. Something that's stressful to you may not faze someone else; they may even enjoy it. For example, your morning commute may make you anxious and tense because you worry that traffic will make you late. Others, however, may find the trip relaxing because they allow more than enough time and enjoy listening to music while they drive^3.

 

Academic stress is inevitable in any educational institution. In optimal limits it mobilizes the potentialities of the students to perform more effectively. However, increasing amounts of academic stress for prolonged periods may create over-whelming frustration and anxiety in the students which may in turn adversely affect their morale, academic achievement, mental health, study habits and adjustment styles. A large number of studies on the problem point out the existence of academic stress in the students. The source of academic stress may vary from institution to institution and individual to individual. Excessive academic stress may lead to a burnout, which is characterized by emotional exhaustion, feeling of low accomplishment and depersonalization of students. Stress in nursing education is acknowledged as one of the most important issue in the modern world. During nursing education and training, nursing student are frequently exposed to various stressors which are directly or indirectly impaired their learning and performance.

The nature of clinical education presents challenges that may cause students to experience stress. Moreover, the practical components of the program which is important in preparing students to develop into professional nurse role by its nature have made the program even more stressful than other programs. Studies indicated that nursing students perceived high level of stress and are prone to stress than other students. This phenomenon is true regardless their academic level. Stecker found that nursing students reported higher academic and external stress than students in physical therapy, pharmacy, dentistry and medicine⁴.

 

STATEMENT OF PROBLEM:

“A study to assess the academic stress and coping strategies used among the undergraduate nursing students from selected colleges of Pune city.”

 

OBJECTIVES:

1.   To assess the stress level among the undergraduate students

2.   To identify the causative factors for stress among undergraduate students

3.   To associate the findings with selected demographic variables

 

MATERIAL AND METHODS:

A Non-Experimental Exploratory study was carried out to assess the academic stress and coping strategies used among the undergraduate nursing students from selected colleges of Pune city. Data was collected from 60 undergraduate nursing students by Non-Probability purposive Sampling technique by using Academic Stress Scale. The descriptive and inferential statistics was used for data analysis.

 

STATISTICAL ANALYSIS:

The data were computerized and verified using the SPSS (statistical package for social science) version 16.0 to perform tabulation and statistical analysis. Qualitative variables were described in frequency and percentages, while quantitative variables were described by mean and standard deviation.

 

RESULTS:

The result of the data was presented under the following headings:

 

SECTION I

This section deals with the data pertaining to the demographic characteristics of the students with respect to Age, gender, educational status, parents’ educational status and family income (in rupees).

 

Table (1): Socio-demographic characteristics of the studied group

Variables	No. (n=60)	%
Age (years): 17-18 18-19 19-20 20-21	02 14 21 23	3.34 23.33 35 38.33
Gender Male Female Transgender	24 36 00	40 60 00
Educational Status Second Year Third Year Final Year	30 24 06	50 40 10
Parents educational status Illiterate Primary Secondary Graduate and above	09 15 15 21	15 25 25 35
Family income (in rupees) 10,000 to 50,000 60,000 to 1Lakh 2Lakhs and Above	25 20 15	41.67 33.33 25

 

SECTION II

It deals with the analysis of data related to identify the causative factors for stress the level of stress among the among undergraduate students

 

Table No 2: Level of stress among the students (N= 60)

S. N	Stress Level	F	%
1	No stress (Score 0 -49)	00	00
2	Slight stress (Score 50-98)	19	31.67
3	Moderate stress (Score 99 - 147)	32	53.33
4	High stress (Score 148 - 196)	09	15
5	Extreme stress (Score 197 -245)	00	00
Total		60	100

 

The above table shows that majority of 53.33% of students had moderate stress (99-147), 31.67% of them had slight stress (50-98) and 15% of them had high stress (148-196).

·       Item 1 indicates that maximum 68.33% students frequently get headaches.

·       Item 2 indicates that maximum 73.33% students get nervous easily.

·       Item 3 indicates that maximum 43.33% students have loss of appetite.

·       Item 4 indicates that maximum 61.66% students have lack of sleep

·       Item 5 indicates that a maximum 45% student complains inadequate space for learning (in hostel or home) and 55% of the students didn’t have complains inadequate space for learning (in hostel or home).

·       Item 6 indicates that a maximum 63.33% student complains lengthy classroom teachings responsible for causing stress.

·       Item 7 indicates that a maximum 38.33% students complains lack of recreational activities for causing stress.

 

Table No 3: Level of stress among the students (N= 60)

PHYSICAL INDICATOR	YES		NO
	F	%	F	%
1) Getting frequent headaches.	41	68.33	19	31.66
2) Getting nervous easily.	44	73.33	16	26.66
3) Has loss of appetite.	26	43.33	34	56.66
4) Has lack of sleep.	37	61.66	23	38.33
5) Inadequate space for learning (in hostel or home).	27	45	33	55
6) Lengthy classroom teachings.	38	63.33	22	36.66
7) Lack of recreational activities.	37	61.66	23	38.33

 

SECTION III

Table No.4: It deals with the analysis of data related to coping mechanism adapted by students to overcome stress.

COPING MECHANISM	Never		Very rarely		Sometimes		Very often		Always
	F	%	F	%	F	%	F	%	F	%
1. Hope that things will get better.	15	25	04	6.67	14	23.33	08	13.33	19	31.67
2. Finds out more about the situation so that it can be handled better.	06	10	09	15	16	26.67	12	20	17	28.33
3. Break the problem down into small pieces.	14	23.33	11	18.33	09	15	06	10	20	33.33
4. Think about different ways to handle the situation.	07	11.67	10	16.67	12	20	05	8.33	26	43.33
5. Looks at the problem objectively.	08	13.33	12	20	15	25	05	8.33	20	33.33
6. Eat, smoke, and chew gum.	42	70	07	11.67	04	6.67	00	0	07	11.67
7. Try out different ways of solving the problem to see which works the best.	06	10	09	15	17	28.33	06	10	22	36.67
8. Draw on past experience to help, you handle the situation.	09	15	07	11.67	13	21.67	07	11.67	24	40
9. Try to find meaning in the situation.	04	6.67	08	13.33	11	18.33	14	23.33	23	38.33
10. Pray, trust in god.	06	10	07	11.67	08	13.33	01	1.67	38	63.33
11. Get nervous.	15	25	05	8.33	15	25	04	6.67	19	31.67
12. Worry.	11	18.33	08	13.33	15	25	05	8.33	21	35
13. Seek comfort or help from family or friends.	09	15	09	15	08	13.33	09	15	25	41.67
14. Set specific goals to help solve the problem.	06	10	06	10	16	26.67	07	11.67	25	41.67
15. Accept the situation as it is.	05	8.33	13	21.67	10	16.67	11	18.33	21	35
16. Wants to be alone in the given situation/condition.	10	16.67	09	15	12	20	09	15	20	33.33
17. Laugh it off, figuring that things would be worst.	19	31.67	11	18.33	13	21.67	08	13.33	09	15
18. Try to put the problem out of your mind.	15	25	14	23.33	09	15	07	11.67	15	25
19. Get prepared to expect the worst.	13	21.67	13	21.67	15	25	03	5	16	26.67
20. Talk the problem over someone who has been in the same type of situation.	11	18.33	18	30	07	11.67	08	13.33	16	26.67
21. Get mad, curse, swear.	24	40	10	16.67	12	20	03	5	11	18.33
22. Cry, get depressed.	20	33.33	07	11.67	13	21.67	06	10	14	23.33
23. Go to sleep, figuring things will be better in the morning.	18	30	08	13.33	06	10	09	15	19	31.67
24. Don’t worry about it; everything will probably work out fine.	12	20	08	13.33	16	26.67	10	16.67	14	23.33
25. Withdraw from the situation.	22	36.67	11	18.33	14	23.33	05	8.33	08	13.33
26. Work off tension with physical activity.	13	21.67	18	30	11	18.33	08	13.33	10	16.67
27. Settle for next best thing.	05	8.33	10	16.67	14	23.33	14	23.33	17	28.33
28. Take out your tension on someone or something else.	29	48.33	11	18.33	09	15	06	10	05	8.33
29. Drink alcoholic beverages.	45	75	04	6.67	08	13.33	01	1.67	02	3.33
30. Do nothing in the hope that the problem will take care of itself.	28	46.67	06	10	11	18.33	08	13.33	07	11.67
31. Blame someone else for your problem.	36	60	9	15	6	10	4	6.67	5	8.33
32. Meditation, yoga, biofeedback.	23	38.33	10	16.67	9	15	6	10	6	10
33. Let someone else solve the problem.	27	45	11	18.33	9	15	6	10	6	10
34. Take drugs.	52	86.67	4	6.67	2	3.33	0	0	2	3.33

 

·       Item 1 indicates that maximum 45% (13.33+ 31.67) students believe that things will get better.

·       Item 2 indicates that maximum 40.33 % (28.33 + 12) students find out more about the situation so that it can be handled better to overcome stress.

·       Item 3 indicates that maximum 39.33% (33.33+6) students break the problem down into small pieces to overcome stress.

·       Item 4 indicates that maximum 51.66% (43.33+8.33) students think about different ways to handle the situation to overcome stress.

·       Item 5 indicates that maximum 41.66% (33.33+08.33) student looks at the problem objectively to overcome stress.

·       Item 6 indicates that maximum 11.67% students responded that they eat, smoke, and chew gum to overcome stress.

·       Item 7 indicates that maximum 46.67% (10+46.67) students uses different ways of solving the problem.

·       Items 8 indicates that maximum 51.67% (40+11.67) students draw on past experience to handle the situation.

·       Item 9 indicates that maximum 66.66% (38.33+28.33) students Try to find meaning in the situation.

·       Item 10 indicates that maximum 65% (1.67+63.33) students pray and trust in god.

·       Item 11 indicates that maximum 38.34% (6.67+31.67) students gets nervous.

·       Item 12 indicates that maximum 42.33% (8.33+34) students gets worry.

·       Item 13 indicates that maximum 56.67% (15+41.67) students seek help from family or friends.

·       Item 14 indicates that maximum 53.34% (11.67+41.67) students set specific goals to solve the problem.

·       Item 15 indicates that maximum 53.33% (18.33+35) students accept the situation as it is.

·       Item 16 indicates that maximum 48.33% (15+33.33) students wants to be alone in the given situation/condition.

·       Item 17 indicates that maximum 28.33% (13.33+15) students thinks that things can’t be better.

·       Item 18 indicates that maximum 36.67% (11.67+25) students tries to put the problem out of their mind.

·       Item 19 indicates that maximum 31.67% (5+26.67) students prepare themselves to expect the worst.

·       Item 20 indicates that maximum 40% (13.33+26.67) students discuss the problem with someone who has been in the same type of situation.

·       Item 21 indicates that maximum 23.33% (5+18.33) students gets mad, curse, swear.

·       Item 22 indicates that maximum 33.33% (10+23.33) students cries, get depressed.

·       Item 23 indicates that maximum 46.67% (15+31.67) students goes to sleep thinking that things will get better in the morning.

·       Item 24 indicates that maximum 40% (16.67+23.33) students think that everything will be fine.

·       Item 25 indicates that maximum 21.66% (8.33+13.33) students withdraw from the situation.

·       Item 26 indicates that maximum 30% (13.33+16.67) students work off tension with physical activity.

·       Item 27 indicates that maximum 51.66% (23.33+28.33) students settle themselves for next best thing.

·       Item 28 indicates that maximum 18.33% (10+8.33) students take out their tension on someone or something else.

·       Item 29 indicates that maximum 5% (1.67+3.33) students drinks alcoholic beverages to overcome stress.

·       Item 30 indicates that maximum 25% (13.33+11.67) students don’t do anything thinking that the problem will take care of itself.

·       Item 31 indicates that maximum 15% (6.67+8.33) students blame others for their problem.

·       Item 32 indicates that maximum 20% (10+10) students uses meditation, yoga, biofeedback for stress management.

·       Item 33 indicates that maximum 20% (10+10) students thinks that let someone else solve the problem.

·       Item 34 indicates that maximum 3.33% students take drugs to overcome stress.

 

CONCLUSION:

The major conclusion drawn from the study is that majority of 53.33% of students had moderate stress, 31.67% of them had slight stress and 15% of them had high stress

 

Majority of the students follows coping strategies such as try to find meaning in the situation, pray and trust in god, seek help from family or friends, set specific goals to solve the problem, accept the situation as it is, draw on past experience to handle the situation, think about different ways to handle the situation to overcome stress and also settle themselves for next best thing.

 

IMPLICATION:

Nursing Education:

Nursing education is developing rapidly in India and Nurses from our country can be found all over the world providing nursing care and education.

 

The education curriculum must include imparting knowledge about academic stress and different coping strategies that can be used to overcome them.

 

As the need of the society are continuously changing newer components must be incorporated in the nursing curriculum like conducting workshops at college level to prevent the consequences faced due to academic stress.

 

Nursing Administration:

The nurse administrator can utilize the type of planned health teaching for the knowledge of undergraduate students regarding academic stress and to increase the awareness of the different coping strategies used to overcome them. Nursing administrator can encourage undergraduate students for various workshops, conferences and special course to make them aware of the present problem related to academic stress and different coping strategies used to overcome them.

 

Nursing Research:

Nursing research is an essential aspect of nursing as it appraises the standards of the profession and develops new nursing norms and body of knowledge.

 

The findings of the present study serve as the basis for professionals and the students to conduct the studies.

 

There is need for extended and intensive nursing research in an area of academic stress and different coping strategies used to overcome them. Articles in newspapers, magazine, television advertisement have made academic stress very popular. Many researchers should look into these issues and conduct researches.

 

RECOMMENDATIONS:

1.     A comparative study can be done between undergraduate nursing students and non-nursing students.

2.     Similar study can be conducted on larger subject to generalize the result.

3.     A planned health teaching can be done to improve coping strategies used by the Undergraduate nursing students.

4.     The same study can be conducted for a longer period to get more reliable result.

5.     The study can be done on various factors such as anxiety, depression, and distress etc.

6.     A study can be conducted to compare the effectiveness of information booklet with other teaching strategies.

7.     Similar kind of studies can be taken under different settings and different target population.

 

ACKNOWLEDGEMENT:

The authors are thankful to Principal Mrs. P.U. Mary, D.E. Society’s Smt. Subhadra K. Jindal College of Nursing for her kind and constant support and timely encouragement and grateful to the study participants for providing the necessary information which was required to fulfil the objective.

 

CONFLICT OF INTEREST:

None.

 

REFERENCES:

1.     Jacob Anthikad, Psychology for graduate nurses, Jaypee Brother’s medical publication, 3rd edition 2004, p.92-97

2.     Vani. R. Ballal, Basic Psychology, EMMESS Medical Publishers, 3rd edition 2009, p.218-231

3.     R. Sreevani, Psychology for Nurses, Jaypee Brothers, Medical Publishers, 1st edition 2009, p.129-127

4.     Dr. S. Kmangal, Psychology for Nurses, Avichal Publishing Company, 1st edition 2012, p.268-270

5.     T Morgan, King, Weisz, Schotler, Introduction to Psychology, Tata Mc grow Hill Publishing Company Ltd, 7th edition, p.326-329

6.     Rajesh.G. Konnur, Psychology for Graduate Nurses, Jaypee Brothers, Medical Publication, 1st Edition 2013, p.165-170

7.     Amanpreetkaur, A Textbook of Psychology, S Vikas and Company (Medical Publishers) India, 1st Edition 2013, p.170-183

8.     Clifford T. Morgan, Introduction to Psychology, 7th edition , Tata-Mc Grawhill Publishing Company, New Delhi, p. 399-404

9.     Kaplan and Sadock’s, Concise Textbook of Clinical Psychiatry, 3rd Edition, Lippincot Williams and Wilkins publication, p. 393-400

10.  Indian Journal of Psychiatry, Volume 57, Number 3, July September 2015, p.367- 373.

11.  Indian Journal of Psychiatry, January- March 2013, p. 63-65 Indian Journal of Continuing Nursing Education Volume 15, Number 1 , January-June 2014, p. 81-8

12.  Indian Journal of Continuing Nursing Education Volume 16 , Number 2 , July- December 2015, p. 86-90

13.  Mohsin Shah Email, Shahid Hasan, Samina Malik, et al. Perceived Stress, Sources and Severity of Stress among medical undergraduates inPakistani Medical School BMC Medical Education. 2010; 10:2

14.  Abhishek Singh, Mukul Chopra, Siddiqui Adiba, et al. A descriptive study of perceived stress among the North Indian nursing undergraduate students Iran J Nurse Midwifery Research. 2013 Jul-Aug; 18(4): 340–342

 

 

 

Received on 11.09.2020          Modified on 21.10.2020

Accepted on 27.11.2020  ©AandV Publications All right reserved